1st COVID-19/SARS2 Vaccine
November 9, 2020 7:18 AM Subscribe
Pfizer announces it will seek emergency use authorization in UK on the announcement of a 90% effective vaccine tested in 43500 volunteers. This comes as somewhat expected news after Pfizer stated in September it would fight a US FDA EUA after US Administration Officials announced they might seek one before Phase 3 trials were complete before the November 3 US elections. The FDA has stated it would like more 2-month follow-up data on half of volunteers.
Extended discussion:
Emergency use authorisation for COVID-19 vaccines: lessons from Ebola
An ethical framework for global vaccine allocation (and the dangers of vaccine nationalism)
Extended discussion:
Emergency use authorisation for COVID-19 vaccines: lessons from Ebola
An ethical framework for global vaccine allocation (and the dangers of vaccine nationalism)
Just found firechicago posted this news bit at the bottom of the mink thread.
posted by rubatan at 7:27 AM on November 9, 2020 [1 favorite]
posted by rubatan at 7:27 AM on November 9, 2020 [1 favorite]
The really great news is that
posted by Dashy at 7:28 AM on November 9, 2020 [5 favorites]
since all of the vaccines are targeting the same Spike protein, it is highly likely that they are all going to work. There may well be differences between them, in safety, level of efficacy across different patient groups, and duration, but since all of them have shown robust antibody responses in Phase I trials, I think we can now connect those dots and say that we can expect positive data from all of them.(quoted from the Sci Trans Med article that lolochezia linked, emphasis mine)
posted by Dashy at 7:28 AM on November 9, 2020 [5 favorites]
Thanks for that analysis link, lalochezia. Two things from there that I found especially noteworthy:
What does this mean for the pandemic vaccine effort in general? The first big take-away is that coronavirus vaccines can work. I have already said many times (here and in interviews) that I thought that this would be the case, but now we finally have proof. The worst “oh-God-no-vaccine” case is now disposed of. And since all of the vaccines are targeting the same Spike protein, it is highly likely that they are all going to work. There may well be differences between them, in safety, level of efficacy across different patient groups, and duration, but since all of them have shown robust antibody responses in Phase I trials, I think we can now connect those dots and say that we can expect positive data from all of them....
But the other thing to keep in mind is that this candidate has (so it appears) by far the most challenging distribution of all of them. The Pfizer/BioNTech candidate, last we heard, needs -80C storage, and that is not available down at your local pharmacy. Pfizer has been rounding up as many ultracold freezers (and as much dry ice production) as they can, but there seems little doubt that this is going to be a tough one.posted by lazaruslong at 7:30 AM on November 9, 2020 [10 favorites]
Great preliminary news. This is at the upper end of effectiveness for what could be expected for the first generation of vaccines. It's more effective than the commonly used pertussis vaccine, for instance. The company has said it could manufacture enough to vaccinate about 25 million people by year's end, but that figure is global and includes US, Canada, EU, UK, and Japan. The most exciting part of this really is that if this vaccine hits 90%, it's possible and even likely that several others will too as they share a mechanism of action (as others wrote while I was typing ;)
posted by saturday_morning at 7:30 AM on November 9, 2020 [1 favorite]
posted by saturday_morning at 7:30 AM on November 9, 2020 [1 favorite]
Personally I highly doubt that we're going to see any significant fraction of people vaccinated by the end of 2020. Even if this vaccine is rushed enough to start distribution (a BIG if) you still have to wait about a month after the first dose before receiving the second stage.
Much more likely (I think) that safety keeps being evaluated and distribution systems keep getting spun up over the next few months, with first round injections starting (if all goes well) sometime in Q2/Q3 2021.
posted by lazaruslong at 7:34 AM on November 9, 2020 [2 favorites]
Much more likely (I think) that safety keeps being evaluated and distribution systems keep getting spun up over the next few months, with first round injections starting (if all goes well) sometime in Q2/Q3 2021.
posted by lazaruslong at 7:34 AM on November 9, 2020 [2 favorites]
I'm...still cautious. Optimistic, but cautious.
posted by EmpressCallipygos at 7:34 AM on November 9, 2020 [1 favorite]
posted by EmpressCallipygos at 7:34 AM on November 9, 2020 [1 favorite]
This vaccine, like all of the front-runners, targets the spike protein, so there is good reason to think that one or more of the other vaccine candidates will also prove effective. Options are good!
It's also notable that Pfizer pointedly did not take Operation Warp Speed funding directly, instead investing $2 billion of its own money in exchange for a $1.95 billion pre-order from the US government, pending proof of efficacy.
On the one hand, it is pretty amazing what a giant multi-national pharma company can do, and I'm happy this appears to be working out. On the other hand, this seems like proof, if proof were needed, that giant multi-national pharma companies like Pfizer need to be broken up. We should not need corporations to do the work of governments.
This vaccine does require -80ºC storage, which means ultracold freezers or dry ice. That presents a challenging distribution problem for rural areas and developing countries. But it's not much of a problem for urban areas, which is where most people in the world live, particularly in the countries that are the worst off, such as the United States and the countries of Europe. From another perspective, 25 million people is almost enough to vaccinate all of the doctors and nurses in the world (in 2014 there were about 27 million doctors and nurses worldwide).
posted by jedicus at 7:34 AM on November 9, 2020 [16 favorites]
It's also notable that Pfizer pointedly did not take Operation Warp Speed funding directly, instead investing $2 billion of its own money in exchange for a $1.95 billion pre-order from the US government, pending proof of efficacy.
On the one hand, it is pretty amazing what a giant multi-national pharma company can do, and I'm happy this appears to be working out. On the other hand, this seems like proof, if proof were needed, that giant multi-national pharma companies like Pfizer need to be broken up. We should not need corporations to do the work of governments.
This vaccine does require -80ºC storage, which means ultracold freezers or dry ice. That presents a challenging distribution problem for rural areas and developing countries. But it's not much of a problem for urban areas, which is where most people in the world live, particularly in the countries that are the worst off, such as the United States and the countries of Europe. From another perspective, 25 million people is almost enough to vaccinate all of the doctors and nurses in the world (in 2014 there were about 27 million doctors and nurses worldwide).
posted by jedicus at 7:34 AM on November 9, 2020 [16 favorites]
Even if it doesn't get distributed until Spring 2021, I think people will be better able to put up with hardship if there's an end in sight. A bigger issue, at least in the US, is going to be convincing people to get vaccinated. We've got a lot of paranoia and disinformation to overcome.
posted by ArbitraryAndCapricious at 7:38 AM on November 9, 2020 [28 favorites]
posted by ArbitraryAndCapricious at 7:38 AM on November 9, 2020 [28 favorites]
Oh man, you got that right on both counts, but the first especially. Gah. Cautiously optimistic but the realistic prospect of a vaccine is just...oxygen right now. Wonderful.
posted by lazaruslong at 7:41 AM on November 9, 2020 [5 favorites]
posted by lazaruslong at 7:41 AM on November 9, 2020 [5 favorites]
I've had major questions & reservations about vaccines for this virus (still do). We know there are a few second infection events, these skirt the region between "normal variability" (some individuals just have broken immune systems or something just goes wrong) and "maybe we should be concerned" (our tracing and detection isn't actually so good: we now have enough, double traced and genotyped, and we know we don't do this enough, it might be more prevalent than we would like it to be).
I think Derek Lowe's "The worst 'oh-God-no-vaccine' case is now disposed of." We already knew: largely people haven't gotten it again a lot, yet. But we aren't out of the woods yet: 1) There's reason to think anti-body dependent enhancement is of concern and reason to think it is not: jury is out. 2) Duration of sustained immunity is still just totally unknown (suggestive all over the place between SARS/MERS & other hCoVs).
The really great news is the 90% number, if true. Influenza - with its many ciculating strains opposed by a massive global surveilance network and many billions $USD spent annually to produce vaccines - is 10-80% effective each year, median ~ 50%. We didn't dream a first coronavirus vaccine could be 90% effective.
posted by rubatan at 7:42 AM on November 9, 2020 [4 favorites]
I think Derek Lowe's "The worst 'oh-God-no-vaccine' case is now disposed of." We already knew: largely people haven't gotten it again a lot, yet. But we aren't out of the woods yet: 1) There's reason to think anti-body dependent enhancement is of concern and reason to think it is not: jury is out. 2) Duration of sustained immunity is still just totally unknown (suggestive all over the place between SARS/MERS & other hCoVs).
The really great news is the 90% number, if true. Influenza - with its many ciculating strains opposed by a massive global surveilance network and many billions $USD spent annually to produce vaccines - is 10-80% effective each year, median ~ 50%. We didn't dream a first coronavirus vaccine could be 90% effective.
posted by rubatan at 7:42 AM on November 9, 2020 [4 favorites]
Cautiously optimistic but at the end of the day isn't this basically just a press release from a pharma company?
posted by windbox at 7:47 AM on November 9, 2020 [11 favorites]
posted by windbox at 7:47 AM on November 9, 2020 [11 favorites]
I wouldn't be surprised if this were just a puff piece, but this story about the company behind the vaccine is fairly inspiring.
posted by Slothrup at 7:48 AM on November 9, 2020
posted by Slothrup at 7:48 AM on November 9, 2020
Pardon my ignorance, but where does this 90% come from? I understand that a certain portion of a population got the vaccine. Another portion got a placebo. And I assume more placebo getters got the virus than the vaccine getters. But how was exposure to the virus either controlled or managed. How do we know that the vaccine group was equally exposed as the placebo group, or vice versa. This certainty of 90% seems premature to my gut sense. How reliable is it?
posted by njohnson23 at 7:50 AM on November 9, 2020
posted by njohnson23 at 7:50 AM on November 9, 2020
Is there any info about how long it remains protective? I don’t see how there could be yet, becaus ehow could they have data on it; but how long is it expected to remain protective for?
There’s a big difference between distributing a two-dose -80c storage vaccine to everyone once, and doing the same thing once a year.
posted by nat at 7:53 AM on November 9, 2020
There’s a big difference between distributing a two-dose -80c storage vaccine to everyone once, and doing the same thing once a year.
posted by nat at 7:53 AM on November 9, 2020
A primer from Natalie Dean on how efficiency is calculated
posted by Dashy at 7:54 AM on November 9, 2020 [10 favorites]
posted by Dashy at 7:54 AM on November 9, 2020 [10 favorites]
I got a small amount of PFE stock for my 14th birthday. I have never touched it.
It is finally today worth as much as the day it was bought.
posted by phunniemee at 7:54 AM on November 9, 2020 [16 favorites]
It is finally today worth as much as the day it was bought.
posted by phunniemee at 7:54 AM on November 9, 2020 [16 favorites]
And Dow Futures are rocketing!!!!
posted by Chickenring at 7:57 AM on November 9, 2020
posted by Chickenring at 7:57 AM on November 9, 2020
How do we know that the vaccine group was equally exposed as the placebo group, or vice versa.
Math.
Okay, that's a glib answer. But the idea is that you have two groups, one that got the vaccine and one that got the placebo, and the people in the groups don't know which groups they're in. Furthermore, the participants are not deliberately exposed to the vaccine; they're just going about their business. They wait until a certain number of people across both groups get sick before they do the analysis. There were 94 cases and they're claiming 90% efficacy, so it's something like 86 people in the control group and 8 in the vaccine group got coronavirus. Those numbers are pretty small - especially that 8! - so it's totally possible that the "real" efficacy could be 85% or 95%.
(Disclaimer: I am a statistician but I don't know much about clinical trials.)
posted by madcaptenor at 7:59 AM on November 9, 2020 [15 favorites]
Math.
Okay, that's a glib answer. But the idea is that you have two groups, one that got the vaccine and one that got the placebo, and the people in the groups don't know which groups they're in. Furthermore, the participants are not deliberately exposed to the vaccine; they're just going about their business. They wait until a certain number of people across both groups get sick before they do the analysis. There were 94 cases and they're claiming 90% efficacy, so it's something like 86 people in the control group and 8 in the vaccine group got coronavirus. Those numbers are pretty small - especially that 8! - so it's totally possible that the "real" efficacy could be 85% or 95%.
(Disclaimer: I am a statistician but I don't know much about clinical trials.)
posted by madcaptenor at 7:59 AM on November 9, 2020 [15 favorites]
From what I could see, the Pfizer vaccine entered stage 3 testing after both the Oxford/AstraZeneca and the Moderna vaccines. How did it suddenly jump ahead of them?
posted by 1970s Antihero at 8:02 AM on November 9, 2020 [1 favorite]
posted by 1970s Antihero at 8:02 AM on November 9, 2020 [1 favorite]
The Oxford one at least was halted because one of the people in the study became extremely sick (not with Covid, with something they were worried was caused by the vaccine)
posted by mcstayinskool at 8:05 AM on November 9, 2020 [3 favorites]
posted by mcstayinskool at 8:05 AM on November 9, 2020 [3 favorites]
On a more somber note, the heartbreaking reason we have this news today, instead of 6 months from now, is that CV has been allowed to spread so widely that enough people got sick this quickly.
The Sturgis and Mad King rallies, opening schools and colleges, the populist revolts against masks and any other containment measures - we're in uncontrolled exponential spread, and people will die yet. Many people.
There's a lot of success that led to this good news, but a sizeable amount of failure as well.
. for all of them.
posted by Dashy at 8:06 AM on November 9, 2020 [33 favorites]
The Sturgis and Mad King rallies, opening schools and colleges, the populist revolts against masks and any other containment measures - we're in uncontrolled exponential spread, and people will die yet. Many people.
There's a lot of success that led to this good news, but a sizeable amount of failure as well.
. for all of them.
posted by Dashy at 8:06 AM on November 9, 2020 [33 favorites]
madcaptenor' comment correction : participants are not deliberately exposed to the vaccine covid virus
posted by lalochezia at 8:06 AM on November 9, 2020 [2 favorites]
posted by lalochezia at 8:06 AM on November 9, 2020 [2 favorites]
How did it suddenly jump ahead of them?
The Moderna trial, met its 30k enrolled in October. Smaller enrollment with later enrollment means it probably is taking longer to get to case threshold. Depending on how they construct their threshold, if the vaccine was less effective it could actually make it take longer.
posted by rubatan at 8:08 AM on November 9, 2020
The Moderna trial, met its 30k enrolled in October. Smaller enrollment with later enrollment means it probably is taking longer to get to case threshold. Depending on how they construct their threshold, if the vaccine was less effective it could actually make it take longer.
posted by rubatan at 8:08 AM on November 9, 2020
thanks lalochezia! I was up with a baby half the night so I'm barely coherent.
posted by madcaptenor at 8:15 AM on November 9, 2020 [3 favorites]
posted by madcaptenor at 8:15 AM on November 9, 2020 [3 favorites]
On the one hand, it is pretty amazing what a giant multi-national pharma company can do, and I'm happy this appears to be working out. On the other hand, this seems like proof, if proof were needed, that giant multi-national pharma companies like Pfizer need to be broken up. We should not need corporations to do the work of governments.
Maybe I'm just being petty, but the fact that Pfizer did this on its own without Operation Warp Speed funding means that the outgoing Trumpists don't get to take credit, and I'll give Pfizer a mulligan this once.
This certainty of 90% seems premature to my gut sense. How reliable is it?
Really good question. Building on what madcaptenor said, I ran some quick statistics on the numbers in the press release which gave me a relative risk of 0.095 with a 95% confidence interval of 0.046 to 0.197. Translation: given these numbers, there's a 95% chance that the true efficacy is between 80.3% and 95.4%.
posted by saturday_morning at 8:20 AM on November 9, 2020 [18 favorites]
Maybe I'm just being petty, but the fact that Pfizer did this on its own without Operation Warp Speed funding means that the outgoing Trumpists don't get to take credit, and I'll give Pfizer a mulligan this once.
This certainty of 90% seems premature to my gut sense. How reliable is it?
Really good question. Building on what madcaptenor said, I ran some quick statistics on the numbers in the press release which gave me a relative risk of 0.095 with a 95% confidence interval of 0.046 to 0.197. Translation: given these numbers, there's a 95% chance that the true efficacy is between 80.3% and 95.4%.
posted by saturday_morning at 8:20 AM on November 9, 2020 [18 favorites]
From what I could see, the Pfizer vaccine entered stage 3 testing after both the Oxford/AstraZeneca and the Moderna vaccines. How did it suddenly jump ahead of them?
They may have gotten it into more people in areas with a lot of infection earlier. Oxford/AZ started in the UK which had relatively few infections for the first few months after they started the trial, that one has also been paused a few times which means the total number of people x days may well be lower. UK now has substantial infections so would expect a readout from that one pretty soon.
Some other thoughts:
-The low temperature is an issue. It's a good thing that the world's poorest countries seem to be so much better at public health that it's unlikely to lead to a horrifically unjust outcome since it it is primarily the wealthy countries that desperately need a vaccine but I would expect one of the other vaccines to have a much larger global distribution.
-While it will be some time before everyone is vaccinated, vaccinating just the highest risk 10% of the population will remove most of the mortality risk (if indeed it works well in those groups which I did not see in the released material).
-As others have said, the prior probability that other spike protein based vaccines will work has just gone way up. It would now be more surprising than not if we did not have at least a few "acceptable" vaccines being reviewed for approval by the end of the year.
-Pfizer has said that based on the rate of decline of T-cell activity and antibody titres, they expect at least a year of protection but TBH that should be taken with a grain of salt because we don't really have a great correlate of protection for this virus (so we don't know at what
posted by atrazine at 8:24 AM on November 9, 2020 [4 favorites]
They may have gotten it into more people in areas with a lot of infection earlier. Oxford/AZ started in the UK which had relatively few infections for the first few months after they started the trial, that one has also been paused a few times which means the total number of people x days may well be lower. UK now has substantial infections so would expect a readout from that one pretty soon.
Some other thoughts:
-The low temperature is an issue. It's a good thing that the world's poorest countries seem to be so much better at public health that it's unlikely to lead to a horrifically unjust outcome since it it is primarily the wealthy countries that desperately need a vaccine but I would expect one of the other vaccines to have a much larger global distribution.
-While it will be some time before everyone is vaccinated, vaccinating just the highest risk 10% of the population will remove most of the mortality risk (if indeed it works well in those groups which I did not see in the released material).
-As others have said, the prior probability that other spike protein based vaccines will work has just gone way up. It would now be more surprising than not if we did not have at least a few "acceptable" vaccines being reviewed for approval by the end of the year.
-Pfizer has said that based on the rate of decline of T-cell activity and antibody titres, they expect at least a year of protection but TBH that should be taken with a grain of salt because we don't really have a great correlate of protection for this virus (so we don't know at what
posted by atrazine at 8:24 AM on November 9, 2020 [4 favorites]
Translation: given these numbers, there's a 95% chance that the true efficacy is between 80.3% and 95.4%.
Slight correction: There’s a 95% chance that the interval 80.3% - 95.4% contains the true efficacy, which is not quite the same thing. (Sorry, I’m a Bayesian, I have to stickle just a little bit about confidence intervals vs. credible intervals.) Here is a nice visualization of confidence intervals.
In any case, though, this is good news!
posted by snowmentality at 8:39 AM on November 9, 2020 [17 favorites]
Slight correction: There’s a 95% chance that the interval 80.3% - 95.4% contains the true efficacy, which is not quite the same thing. (Sorry, I’m a Bayesian, I have to stickle just a little bit about confidence intervals vs. credible intervals.) Here is a nice visualization of confidence intervals.
In any case, though, this is good news!
posted by snowmentality at 8:39 AM on November 9, 2020 [17 favorites]
I ran some quick statistics on the numbers in the press release which gave me a relative risk of 0.095 with a 95% confidence interval of 0.046 to 0.197. Translation: given these numbers, there's a 95% chance that the true efficacy is between 80.3% and 95.4%.
I ran this too and am curious what numbers I'm missing. The protocol says there's a 50% split between 43538 placebo and vaccine test subjects, and with 86 placebo subjects who were infected and 8 who received the vaccine (94 total infected), I get a Fisher test CI of 0.039 to 0.192:
I ran this too and am curious what numbers I'm missing. The protocol says there's a 50% split between 43538 placebo and vaccine test subjects, and with 86 placebo subjects who were infected and 8 who received the vaccine (94 total infected), I get a Fisher test CI of 0.039 to 0.192:
> d <- rbind(c(21769,21769), c(86,8)) > fisher.test(d) Fisher's Exact Test for Count Data data: test p-value < 2.2e-16 alternative hypothesis: true odds ratio is not equal to 1 95 percent confidence interval: 0.03888864 0.19172814 sample estimates: odds ratio 0.09304754posted by They sucked his brains out! at 8:40 AM on November 9, 2020 [2 favorites]
-While it will be some time before everyone is vaccinated, vaccinating just the highest risk 10% of the population will remove most of the mortality risk (if indeed it works well in those groups which I did not see in the released material).Where I live, I think you could take care of a lot of the mortality if you vaccinated people who come into contact with the highest-risk populations: for instance, people who work in nursing homes and people who provide home-based care for very sick people. This is stuff that public health experts know how to do, and hopefully public health experts will be deciding who gets the vaccine first. (I would feel better about that in the US if the Biden administration were in charge now, not in a few months.)
posted by ArbitraryAndCapricious at 8:46 AM on November 9, 2020 [8 favorites]
Slight correction: There’s a 95% chance that the interval 80.3% - 95.4% contains the true efficacy, which is not quite the same thing.
Slighter correction: There's either a 0% chance or 100% chance that the interval contains the true efficacy; we just don't know which.
Before we start collecting data, there's a 95% chance that our 95% confidence interval will contain the true value of whatever. After we collect the data, there's not any chance left; our statement is either right or wrong. Before I flip a fair coin and hold it where you can't see it, there's a 50/50 chance of heads. Afterwards, you might not know whether it's heads or tails, but it's definitely one or t'other.
posted by GCU Sweet and Full of Grace at 8:51 AM on November 9, 2020 [2 favorites]
Slighter correction: There's either a 0% chance or 100% chance that the interval contains the true efficacy; we just don't know which.
Before we start collecting data, there's a 95% chance that our 95% confidence interval will contain the true value of whatever. After we collect the data, there's not any chance left; our statement is either right or wrong. Before I flip a fair coin and hold it where you can't see it, there's a 50/50 chance of heads. Afterwards, you might not know whether it's heads or tails, but it's definitely one or t'other.
posted by GCU Sweet and Full of Grace at 8:51 AM on November 9, 2020 [2 favorites]
(Hmm, should be rbind(c(21683,21761), c(86,8)), I think, but that doesn't change the result too much.)
posted by They sucked his brains out! at 8:52 AM on November 9, 2020
posted by They sucked his brains out! at 8:52 AM on November 9, 2020
The UK government published (back in September) its priority list for a Covid vaccine.
If you don't want to click:
This interim ranking of priorities is a combination of clinical risk stratification and an age-based approach, which should optimise both targeting and deliverability. A provisional ranking of prioritisation for persons at-risk is set out below:
older adults’ resident in a care home and care home workers
all those 80 years of age and over and health and social care workers
all those 75 years of age and over
all those 70 years of age and over
all those 65 years of age and over
high-risk adults under 65 years of age
moderate-risk adults under 65 years of age
all those 60 years of age and over
all those 55 years of age and over
all those 50 years of age and over
rest of the population (priority to be determined)
Note this is also based on only vaccinating adults. It's provisional, and you can disagree with it, but it's public information. The tricky bit is actually delivering it...
posted by YoungStencil at 8:56 AM on November 9, 2020 [9 favorites]
If you don't want to click:
This interim ranking of priorities is a combination of clinical risk stratification and an age-based approach, which should optimise both targeting and deliverability. A provisional ranking of prioritisation for persons at-risk is set out below:
older adults’ resident in a care home and care home workers
all those 80 years of age and over and health and social care workers
all those 75 years of age and over
all those 70 years of age and over
all those 65 years of age and over
high-risk adults under 65 years of age
moderate-risk adults under 65 years of age
all those 60 years of age and over
all those 55 years of age and over
all those 50 years of age and over
rest of the population (priority to be determined)
Note this is also based on only vaccinating adults. It's provisional, and you can disagree with it, but it's public information. The tricky bit is actually delivering it...
posted by YoungStencil at 8:56 AM on November 9, 2020 [9 favorites]
They sucked his brains out!, efficacy is (1 - risk ratio). You’ve calculated the CI for the odds ratio, which is not quite the same thing as the risk ratio. Risk = infected/(infected + not infected); odds = infected/not infected.
posted by snowmentality at 8:57 AM on November 9, 2020 [2 favorites]
posted by snowmentality at 8:57 AM on November 9, 2020 [2 favorites]
I ran this too and am curious what numbers I'm missing.
Oops, I put 84 cases instead of 86 in the control group. My CI should actually be 0.045 to 0.192. This is why I'm a clinician and not a statistician.
Slight correction: There’s a 95% chance that the interval 80.3% - 95.4% contains the true efficacy, which is not quite the same thing.
Slighter correction: There's either a 0% chance or 100% chance that the interval contains the true efficacy; we just don't know which
This is also why I'm a clinician and not a statistician. ;)
posted by saturday_morning at 8:57 AM on November 9, 2020 [9 favorites]
Oops, I put 84 cases instead of 86 in the control group. My CI should actually be 0.045 to 0.192. This is why I'm a clinician and not a statistician.
Slight correction: There’s a 95% chance that the interval 80.3% - 95.4% contains the true efficacy, which is not quite the same thing.
Slighter correction: There's either a 0% chance or 100% chance that the interval contains the true efficacy; we just don't know which
This is also why I'm a clinician and not a statistician. ;)
posted by saturday_morning at 8:57 AM on November 9, 2020 [9 favorites]
Thanks, snowmentality!
posted by They sucked his brains out! at 9:03 AM on November 9, 2020
posted by They sucked his brains out! at 9:03 AM on November 9, 2020
It's also notable that Pfizer pointedly did not take Operation Warp Speed funding directly, instead investing $2 billion of its own money in exchange for a $1.95 billion pre-order from the US government
Thanks capitalism! Thanks large pharmaceutical company! This is kind of like cheering for the Red Army in 1942; on this rare occasion it's merited.
posted by justsomebodythatyouusedtoknow at 9:10 AM on November 9, 2020 [11 favorites]
Thanks capitalism! Thanks large pharmaceutical company! This is kind of like cheering for the Red Army in 1942; on this rare occasion it's merited.
posted by justsomebodythatyouusedtoknow at 9:10 AM on November 9, 2020 [11 favorites]
Where I live, I think you could take care of a lot of the mortality if you vaccinated people who come into contact with the highest-risk populations: for instance, people who work in nursing homes and people who provide home-based care for very sick people. This is stuff that public health experts know how to do, and hopefully public health experts will be deciding who gets the vaccine first. (I would feel better about that in the US if the Biden administration were in charge now, not in a few months.)
That depends on how well it prevents spread of the disease. The trial is measuring disease so we don't really know if this is preventing transmission at all.
If it did then for sure you'd do the people who work there earlier since they will likely have a more robust immune response to a vaccine and you get more bang for your proverbial buck by vaccinating them.
posted by atrazine at 9:11 AM on November 9, 2020
That depends on how well it prevents spread of the disease. The trial is measuring disease so we don't really know if this is preventing transmission at all.
If it did then for sure you'd do the people who work there earlier since they will likely have a more robust immune response to a vaccine and you get more bang for your proverbial buck by vaccinating them.
posted by atrazine at 9:11 AM on November 9, 2020
Pardon my ignorance, but where does this 90% come from?
~85 people on the placebo got coronavirus, and only ~8 people on the vaccine did.
That's all it means. Under the conditions and behaviors of the people participating in the trial over a few months, you are 90% less likely to get coronavirus if you have the vaccine.
It does not necessarily mean there is a 90% chance you are immune or a 90% you can go to choir practice in the Covid ward of a hospital and be safe or anything like that.
posted by mark k at 9:12 AM on November 9, 2020 [7 favorites]
~85 people on the placebo got coronavirus, and only ~8 people on the vaccine did.
That's all it means. Under the conditions and behaviors of the people participating in the trial over a few months, you are 90% less likely to get coronavirus if you have the vaccine.
It does not necessarily mean there is a 90% chance you are immune or a 90% you can go to choir practice in the Covid ward of a hospital and be safe or anything like that.
posted by mark k at 9:12 AM on November 9, 2020 [7 favorites]
Just curious how this (potentially, acknowledging that there may be other successful candidates) scales to a global population - do Pfizer license this out to other companies or do they do everything in house?
posted by piyushnz at 9:39 AM on November 9, 2020
posted by piyushnz at 9:39 AM on November 9, 2020
Pharmaceutical manufacturing typically involves global supply chains, vendors and manufacturing, given the number of specialized materials and operations you need. You often do this by paying to use other companies' facilities and personnel. So it's not really "in house" but if I had to guess I don't think you'll see them just licensing out German and Swiss rights to Roche, for example.
It's more common to split marketing due to licensing, than to split manufacturing. That is, you make the drug or vaccine and sell or send it to your European partner, who stores, markets and distributes.
There are exceptions--HIV medication is manufactured in India independently by companies there, who distribute in Africa at the lowest possible cost, under patent-pooling agreements with various global pharma companies. You could get this sort of thing given it's a global pandemic, but I don't think it really applies though, because I suspect the global vaccine manufacture capacity is not going to have a lot to spare.
posted by mark k at 9:56 AM on November 9, 2020 [1 favorite]
It's more common to split marketing due to licensing, than to split manufacturing. That is, you make the drug or vaccine and sell or send it to your European partner, who stores, markets and distributes.
There are exceptions--HIV medication is manufactured in India independently by companies there, who distribute in Africa at the lowest possible cost, under patent-pooling agreements with various global pharma companies. You could get this sort of thing given it's a global pandemic, but I don't think it really applies though, because I suspect the global vaccine manufacture capacity is not going to have a lot to spare.
posted by mark k at 9:56 AM on November 9, 2020 [1 favorite]
Behind Pfizer's vaccine, an understated husband-and-wife 'dream team' - "From humble roots as the son of a Turkish immigrant working at a Ford factory in Cologne, BioNTech Chief Executive Ugur Sahin, 55, now figures among the 100 richest Germans, together with his wife and fellow board member Oezlem Tuereci, 53... Tuereci, the daughter of a Turkish physician who had migrated to Germany, said in a media interview that even on the day of their wedding, both made time for lab work."
posted by kliuless at 10:10 AM on November 9, 2020 [20 favorites]
posted by kliuless at 10:10 AM on November 9, 2020 [20 favorites]
A bigger issue, at least in the US, is going to be convincing people to get vaccinated.
Make it free so everyone can afford it. Issue proof of vaccination when people get the shot. Then either require or encourage schools, airlines, restaurants, pubs, etc., to require proof of vaccination.
posted by pracowity at 10:13 AM on November 9, 2020 [9 favorites]
Make it free so everyone can afford it. Issue proof of vaccination when people get the shot. Then either require or encourage schools, airlines, restaurants, pubs, etc., to require proof of vaccination.
posted by pracowity at 10:13 AM on November 9, 2020 [9 favorites]
Pfizer developed the vaccine with BioNTech (a German company), and the outgoing administration tried to take credit and failed:
Pence breaks [post-election] silence to take credit for Pfizer vaccine - and drugs company immediately denies Trump involved (The Independent) "HUGE NEWS: Thanks to the public-private partnership forged by President @realDonaldTrump, @pfizer announced its Coronavirus Vaccine trial is EFFECTIVE, preventing infection in 90% of its volunteers," tweeted Mr Pence.
Nikki Haley, Mr Trump’s former UN ambassador, also claimed that the Pfizer work was down to Mr Trump, saying: “Many thanks”. Seemingly unaware that Pfizer had very publicly rejected federal funds, she said: "This will be one of the most important action items done by the administration in response to this pandemic."
Dr Kathrin Jansen, Pfizer’s head of vaccine development, told the New York Times: “We were never part of the Warp Speed ... We have never taken any money from the US government, or from anyone.” Pfizer later clarified that they were considered “part” of Warp Speed, because the US government had placed an [advanced purchase] order for a potential vaccine. But they received no funding for its development, unlike their rivals.
Back in September, Pfizer's CEO Albert Bourla was asked on Face the Nation why the company refused that type of government funding; he said, “I wanted to liberate our scientists from any bureaucracy. When you get money from someone...that always comes with strings.”
posted by Iris Gambol at 10:30 AM on November 9, 2020 [15 favorites]
Pence breaks [post-election] silence to take credit for Pfizer vaccine - and drugs company immediately denies Trump involved (The Independent) "HUGE NEWS: Thanks to the public-private partnership forged by President @realDonaldTrump, @pfizer announced its Coronavirus Vaccine trial is EFFECTIVE, preventing infection in 90% of its volunteers," tweeted Mr Pence.
Nikki Haley, Mr Trump’s former UN ambassador, also claimed that the Pfizer work was down to Mr Trump, saying: “Many thanks”. Seemingly unaware that Pfizer had very publicly rejected federal funds, she said: "This will be one of the most important action items done by the administration in response to this pandemic."
Dr Kathrin Jansen, Pfizer’s head of vaccine development, told the New York Times: “We were never part of the Warp Speed ... We have never taken any money from the US government, or from anyone.” Pfizer later clarified that they were considered “part” of Warp Speed, because the US government had placed an [advanced purchase] order for a potential vaccine. But they received no funding for its development, unlike their rivals.
Back in September, Pfizer's CEO Albert Bourla was asked on Face the Nation why the company refused that type of government funding; he said, “I wanted to liberate our scientists from any bureaucracy. When you get money from someone...that always comes with strings.”
posted by Iris Gambol at 10:30 AM on November 9, 2020 [15 favorites]
Make it free so everyone can afford it.
On 60 Minutes they were describing it free but you needing to go through your health insurance and they were more vague about how people without health insurance were to get it only if they "couldn't afford it."
As someone who stupidly did not get gap health insurance because of the cost I know that free when in context of someone having to reimburse you is not free. I bet a large majority of uninsured Americans are in a position of probably being able to afford it on paper but it is really difficult to justify paying several hundred a month in health insurance when you're healty and just happy you have money to pay rent.
I would go further and say during this pandemic at this time the people on paper that should be able to afford health insurance is going to be a lot higher. Plus like with unemployment if you put up barriers, you turn people off, just like with voting.
In my mind it isn't free or easily available unless you're pulling up to a CVS, roll up your sleeve and get an injection. There's no reason people would get more than one injection and if a small percent somehow or for some reason choose to abuse it I'm sure that's the same if not lower then any product loss to any scheme as none will be 100% distributed effectively.
I would say even that a marginal $10 cash fee is a lot more obtainable to people then filling out paperwork. Hard to keep up on paperwork if you don't have a computer, a smartphone, etc. Real easy to take $10 down to a pharmacy and get an injection.
posted by geoff. at 10:33 AM on November 9, 2020 [3 favorites]
On 60 Minutes they were describing it free but you needing to go through your health insurance and they were more vague about how people without health insurance were to get it only if they "couldn't afford it."
As someone who stupidly did not get gap health insurance because of the cost I know that free when in context of someone having to reimburse you is not free. I bet a large majority of uninsured Americans are in a position of probably being able to afford it on paper but it is really difficult to justify paying several hundred a month in health insurance when you're healty and just happy you have money to pay rent.
I would go further and say during this pandemic at this time the people on paper that should be able to afford health insurance is going to be a lot higher. Plus like with unemployment if you put up barriers, you turn people off, just like with voting.
In my mind it isn't free or easily available unless you're pulling up to a CVS, roll up your sleeve and get an injection. There's no reason people would get more than one injection and if a small percent somehow or for some reason choose to abuse it I'm sure that's the same if not lower then any product loss to any scheme as none will be 100% distributed effectively.
I would say even that a marginal $10 cash fee is a lot more obtainable to people then filling out paperwork. Hard to keep up on paperwork if you don't have a computer, a smartphone, etc. Real easy to take $10 down to a pharmacy and get an injection.
posted by geoff. at 10:33 AM on November 9, 2020 [3 favorites]
>That depends on how well it prevents spread of the disease. The trial is measuring disease so we don't really know if this is preventing transmission at all.
It's very important to underline this. It is very possible--perhaps even the most likely possibility--that the people who have had the vaccine are far more likely to have an asymptomatic and perhaps shorter-running case of COVID-19. Rather than that it prevents ANY infection--and any chance of retransmission--at all.
Maybe the vaccinated people have the first 2-3 days of pre-symptomatic explosion of viral growth, then their immune system ramps up to shut it down before it gets much beyond that point, in most cases.
That would mean they are still very much capable of spreading the virus during those several days. Recall that the period approx 2 days before through 2 days after onset of symptoms is the point of highest transmissibility of the disease. So it is quite possible for the person to be completely or nearly completely protected from the disease by the vaccine, but that period of highest transmissibility to be affected only slightly or not at all.
This situation would still lead to a negative PCR test unless the test just happened to be given right during that (let's say) 2-5 day window of asymptomatic infection. The person would be asymptomatic or very close to it, so wouldn't have any particular reason to suspect they are ill or seek out a COVID test at this time. A PCR test given later on wouldn't result in a positive, because by that time the virus has been eradicated. Point being: This scenario could still result in a 90% or so reduction in COVID as detected via symptoms or positive PCR tests, while still allowing a several-day window of transmission to occur even in the 90% of people who didn't develop a disease that was noticed or detected.
This is a very, very possible and even likely outcome of current COVID-19 vaccines, based on the behavior of other coronavirus illnesses and immune response. For most other coronaviruses you are unlikely to develop serious illness on second or subsequent exposure, but you can still contract the virus and spread it to others even though the symptoms are minor or non-existent. That is one reason cold coronaviruses, for example, continue to spread around the globe continuously and are so difficult to stamp out.
Source: Pretty much every episode of This Week in Virology over the past few months--just for example, episode 667 starting at 38:41 (see also discussion of previous question starting at 33:47, where they mention some vaccines that work at first but then lead to worse infections 3-12 months down the road. Everyone hopes this won't be the case with the COVID-19 vaccines but we won't know for certain until we get 3-12 months down the road).
Another source: Recent discussion by Anthony Fauci and other leading people supervising the vaccine trials along these lines:
posted by flug at 10:34 AM on November 9, 2020 [14 favorites]
It's very important to underline this. It is very possible--perhaps even the most likely possibility--that the people who have had the vaccine are far more likely to have an asymptomatic and perhaps shorter-running case of COVID-19. Rather than that it prevents ANY infection--and any chance of retransmission--at all.
Maybe the vaccinated people have the first 2-3 days of pre-symptomatic explosion of viral growth, then their immune system ramps up to shut it down before it gets much beyond that point, in most cases.
That would mean they are still very much capable of spreading the virus during those several days. Recall that the period approx 2 days before through 2 days after onset of symptoms is the point of highest transmissibility of the disease. So it is quite possible for the person to be completely or nearly completely protected from the disease by the vaccine, but that period of highest transmissibility to be affected only slightly or not at all.
This situation would still lead to a negative PCR test unless the test just happened to be given right during that (let's say) 2-5 day window of asymptomatic infection. The person would be asymptomatic or very close to it, so wouldn't have any particular reason to suspect they are ill or seek out a COVID test at this time. A PCR test given later on wouldn't result in a positive, because by that time the virus has been eradicated. Point being: This scenario could still result in a 90% or so reduction in COVID as detected via symptoms or positive PCR tests, while still allowing a several-day window of transmission to occur even in the 90% of people who didn't develop a disease that was noticed or detected.
This is a very, very possible and even likely outcome of current COVID-19 vaccines, based on the behavior of other coronavirus illnesses and immune response. For most other coronaviruses you are unlikely to develop serious illness on second or subsequent exposure, but you can still contract the virus and spread it to others even though the symptoms are minor or non-existent. That is one reason cold coronaviruses, for example, continue to spread around the globe continuously and are so difficult to stamp out.
Source: Pretty much every episode of This Week in Virology over the past few months--just for example, episode 667 starting at 38:41 (see also discussion of previous question starting at 33:47, where they mention some vaccines that work at first but then lead to worse infections 3-12 months down the road. Everyone hopes this won't be the case with the COVID-19 vaccines but we won't know for certain until we get 3-12 months down the road).
Another source: Recent discussion by Anthony Fauci and other leading people supervising the vaccine trials along these lines:
A key point to note, however, is that the vaccine isn’t an end-all solution to the pandemic. That’s in large part because any inoculations developed now are focused on simply preventing symptoms from arising, rather than blocking out the virus altogether.So this is good news--very good news--but don't throw away your masks and social distancing just yet. And don't plan on it automatically even if the vaccine is completely successful and after it has been pretty widely disseminated. Maybe, maybe not, even at that point.
posted by flug at 10:34 AM on November 9, 2020 [14 favorites]
A bigger issue, at least in the US, is going to be convincing people to get vaccinated.
I'm sure someone will know an issue why, but can't we have a one-off meaningful tax credit for getting the vaccine given the significant economic benefit to widespread vaccination (I seem to remember a thread with mention of a tax for not getting the vaccine - but I prefer the incentive here rather than a penalty and a penalty seems more likely to be challenged).
posted by inflatablekiwi at 10:37 AM on November 9, 2020 [1 favorite]
I'm sure someone will know an issue why, but can't we have a one-off meaningful tax credit for getting the vaccine given the significant economic benefit to widespread vaccination (I seem to remember a thread with mention of a tax for not getting the vaccine - but I prefer the incentive here rather than a penalty and a penalty seems more likely to be challenged).
posted by inflatablekiwi at 10:37 AM on November 9, 2020 [1 favorite]
geoff., ten is a lot of dollars to a lot of people. Why put up any barrier to access at all?
posted by aniola at 10:48 AM on November 9, 2020 [3 favorites]
posted by aniola at 10:48 AM on November 9, 2020 [3 favorites]
-- Thanks capitalism! Thanks large pharmaceutical company! This is kind of like cheering for the Red Army in 1942; on this rare occasion it's merited.
Beyond the promising news itself, we owe thank-you notes for this decision:
In their announcement of the results, Pfizer and BioNTech revealed a surprise. The companies said they had decided not to conduct the 32-case analysis “after a discussion with the FDA.” Instead, they planned to conduct the analysis after 62 cases. But by the time the plan had been formalized, there had been 94 cases of Covid-19 in the study. It’s not known how many were in the vaccine arm, but it would have to be nine or fewer. This means that the statistical strength of the result is likely far stronger than was initially expected. It also means that if Pfizer had held to the original plan, the data would likely have been available in October, as its CEO, Albert Bourla, had initially predicted.
Pfizer and BioNTech could've really Comey-ed up the US election, and didn't, despite the Admin's attempts at interference. Last month Politico had info from an internal Pfizer memo, about Bourla's refusal to capitulate to political pressure.
posted by Iris Gambol at 10:52 AM on November 9, 2020 [19 favorites]
Beyond the promising news itself, we owe thank-you notes for this decision:
In their announcement of the results, Pfizer and BioNTech revealed a surprise. The companies said they had decided not to conduct the 32-case analysis “after a discussion with the FDA.” Instead, they planned to conduct the analysis after 62 cases. But by the time the plan had been formalized, there had been 94 cases of Covid-19 in the study. It’s not known how many were in the vaccine arm, but it would have to be nine or fewer. This means that the statistical strength of the result is likely far stronger than was initially expected. It also means that if Pfizer had held to the original plan, the data would likely have been available in October, as its CEO, Albert Bourla, had initially predicted.
Pfizer and BioNTech could've really Comey-ed up the US election, and didn't, despite the Admin's attempts at interference. Last month Politico had info from an internal Pfizer memo, about Bourla's refusal to capitulate to political pressure.
posted by Iris Gambol at 10:52 AM on November 9, 2020 [19 favorites]
I'm sure someone will know an issue why, but can't we have a one-off meaningful tax credit for getting the vaccine given the significant economic benefit to widespread vaccination
Because lots of people have legitimate medical reasons that prevent them from getting vaccines. "In that case, why don't we just separate the charlatans from the real medical doctors who get to decide who what 'legitimate' means?" I hear you ask. Well, now you've added actual monetary benefits to a holy war that had been raging for years upon years before anyone had even heard of COVID-19.
posted by sideshow at 10:58 AM on November 9, 2020 [1 favorite]
Because lots of people have legitimate medical reasons that prevent them from getting vaccines. "In that case, why don't we just separate the charlatans from the real medical doctors who get to decide who what 'legitimate' means?" I hear you ask. Well, now you've added actual monetary benefits to a holy war that had been raging for years upon years before anyone had even heard of COVID-19.
posted by sideshow at 10:58 AM on November 9, 2020 [1 favorite]
This interim ranking of priorities is a combination of clinical risk stratification and an age-based approach, which should optimise both targeting and deliverability. A provisional ranking of prioritisation for persons at-risk is set out below:
older adults’ resident in a care home and care home workers
all those 80 years of age and over and health and social care workers
Just out of my own sense of curiosity, I looked at what this could mean in Canada to get a sense of scale (the numbers are in thousands and the percent is the share of the total population).
Residents in collective care facilities, age 75+: 375K, 1.1%
Residents in collective care facilities, under 75: 134K, 0.4%
Nursing/residential care workers: 382K, 1.1%
---
Key health and social care workers*: 1,209K, 3.4%
Remaining adults 85+: 530K, 1.3%
Remaining adults 80-84: 664K, 1.9%
Remaining adults 75-79: 973K, 2.8%
---
Remaining adults 70-74: 1,390K, 4.0%
Remaining adults 65-69: 1,950K, 5.5%
Remaining health care and social assistance workers: 603K, 1.7%
That first tranche of care home workers and residents are 2.5% of the population, the second tranche including key health care workers and adults 75+ is an additional 9.6% of the population, and the third tranche down to 65+ and the entire health/social care worker group is around 10.9% of the population (it adds up to 11.2%, but there are 99K health/social care workers over 65, 0.3% of the population, and they'd be double counted; most of these workers are going to be 65-74, although my dear aunt in Saskatoon who still picks up a few shifts in the nursing home down the street is over that.)
All told, that's 23.1% of the population before including anyone who is under 65 but high risk. Which is a fair bit.
* Key health and social care workers: I used this table which goes down to the four digit NAICS breakdown of workers; nursing and residential care workers are category 6230. I included as key workers 6211, physician's offices; 6214, out-patient care; 6216, home health care; 6220, hospitals; and 6241, individual and family social assistance services.
The remaining health and social care workers outside my definition of "key workers" are 38% day care workers, 19% dental office workers, and 26% workers in the offices of other health care practitioners (which is primarily chiropractors, optometrists, physical/occupational/speech therapists, and mental health care workers). Not that these aren't important, but they are generally at least one of: not urgent, not involving the elderly or high risk, able to be done remotely.
posted by Superilla at 10:59 AM on November 9, 2020 [6 favorites]
older adults’ resident in a care home and care home workers
all those 80 years of age and over and health and social care workers
Just out of my own sense of curiosity, I looked at what this could mean in Canada to get a sense of scale (the numbers are in thousands and the percent is the share of the total population).
Residents in collective care facilities, age 75+: 375K, 1.1%
Residents in collective care facilities, under 75: 134K, 0.4%
Nursing/residential care workers: 382K, 1.1%
---
Key health and social care workers*: 1,209K, 3.4%
Remaining adults 85+: 530K, 1.3%
Remaining adults 80-84: 664K, 1.9%
Remaining adults 75-79: 973K, 2.8%
---
Remaining adults 70-74: 1,390K, 4.0%
Remaining adults 65-69: 1,950K, 5.5%
Remaining health care and social assistance workers: 603K, 1.7%
That first tranche of care home workers and residents are 2.5% of the population, the second tranche including key health care workers and adults 75+ is an additional 9.6% of the population, and the third tranche down to 65+ and the entire health/social care worker group is around 10.9% of the population (it adds up to 11.2%, but there are 99K health/social care workers over 65, 0.3% of the population, and they'd be double counted; most of these workers are going to be 65-74, although my dear aunt in Saskatoon who still picks up a few shifts in the nursing home down the street is over that.)
All told, that's 23.1% of the population before including anyone who is under 65 but high risk. Which is a fair bit.
* Key health and social care workers: I used this table which goes down to the four digit NAICS breakdown of workers; nursing and residential care workers are category 6230. I included as key workers 6211, physician's offices; 6214, out-patient care; 6216, home health care; 6220, hospitals; and 6241, individual and family social assistance services.
The remaining health and social care workers outside my definition of "key workers" are 38% day care workers, 19% dental office workers, and 26% workers in the offices of other health care practitioners (which is primarily chiropractors, optometrists, physical/occupational/speech therapists, and mental health care workers). Not that these aren't important, but they are generally at least one of: not urgent, not involving the elderly or high risk, able to be done remotely.
posted by Superilla at 10:59 AM on November 9, 2020 [6 favorites]
Pfizer is the big distributor. The company that developed this is BioNTech:
BioNTech's Covid vaccine: a shot in the arm for Germany's Turkish community
Couple who set up and run firm are children of long-maligned ‘guest workers’ from Turkey
posted by vacapinta at 11:05 AM on November 9, 2020 [13 favorites]
BioNTech's Covid vaccine: a shot in the arm for Germany's Turkish community
Couple who set up and run firm are children of long-maligned ‘guest workers’ from Turkey
posted by vacapinta at 11:05 AM on November 9, 2020 [13 favorites]
Not getting as much attention is that this is an mRNA based vaccine. I'm guessing it shares or resembles some molecular delivery technology used for gene therapy because naked mRNA has as much a chance of living in (or on) a human (go go nucleases) as humans do in a vat of acid. IIRC from a decade ago when I last took a course in this.
The tech works BUT every crank who hooted about vaccines invading their genome is going to out in force with "proof". I would't be surprised to see "the vaccine is going to inject 5G polyribo trackers into your genome!!!1!" this week if they haven't appeared already.
Between the scare tactics mobilizing everyone within an easy walk of vaccine skepticism, partisan obstruction, and all the usual logistics/financial issues I'm not confident in this (or any) vaccine being super useful.
posted by Slackermagee at 11:17 AM on November 9, 2020
The tech works BUT every crank who hooted about vaccines invading their genome is going to out in force with "proof". I would't be surprised to see "the vaccine is going to inject 5G polyribo trackers into your genome!!!1!" this week if they haven't appeared already.
Between the scare tactics mobilizing everyone within an easy walk of vaccine skepticism, partisan obstruction, and all the usual logistics/financial issues I'm not confident in this (or any) vaccine being super useful.
posted by Slackermagee at 11:17 AM on November 9, 2020
On 60 Minutes they were describing it free... etc. etc.
Can't something just be free free in America? It's costing trillions of dollars so far. Offer everyone in the United States, citizen or not, a no-strings-attached free vaccination and give them proof of that vaccination. Then open up everything to people who get the vaccination. Fill the concert venues and theaters and cinemas and restaurants and pubs to capacity. Tell everyone in the world that they are welcome to visit as long as they have proof of vaccination.
Because lots of people have legitimate medical reasons that prevent them from getting vaccines.
Let them get proof of not being able to be vaccinated, but only from an approved doctor. No proof by divination or whatever.
posted by pracowity at 11:23 AM on November 9, 2020 [9 favorites]
Can't something just be free free in America? It's costing trillions of dollars so far. Offer everyone in the United States, citizen or not, a no-strings-attached free vaccination and give them proof of that vaccination. Then open up everything to people who get the vaccination. Fill the concert venues and theaters and cinemas and restaurants and pubs to capacity. Tell everyone in the world that they are welcome to visit as long as they have proof of vaccination.
Because lots of people have legitimate medical reasons that prevent them from getting vaccines.
Let them get proof of not being able to be vaccinated, but only from an approved doctor. No proof by divination or whatever.
posted by pracowity at 11:23 AM on November 9, 2020 [9 favorites]
The Pfizer/BioNTech candidate, last we heard, needs -80C storage, and that is not available down at your local pharmacy. Pfizer has been rounding up as many ultracold freezers (and as much dry ice production) as they can, but there seems little doubt that this is going to be a tough one.
Yeah, RNA is just intrinsically not that stable compared to DNA. Saw some discussion on Twitter this morning that this may be OK to sit at refrigerator temp for 2-5 days at the point of use. That feels right to me as an RNA biologist who cares a lot about not having my RNA degrade, but a) given the choice I'd prefer a -20ºC freezer to a fridge, b) freeze/thaws are bad, so your standard frost-free freezer is not a good idea and c) I'm only used to working with pure RNA in water or a buffer, whereas this is undoubtedly in a different solution that may increase or decrease stability.
posted by deludingmyself at 11:23 AM on November 9, 2020 [3 favorites]
Yeah, RNA is just intrinsically not that stable compared to DNA. Saw some discussion on Twitter this morning that this may be OK to sit at refrigerator temp for 2-5 days at the point of use. That feels right to me as an RNA biologist who cares a lot about not having my RNA degrade, but a) given the choice I'd prefer a -20ºC freezer to a fridge, b) freeze/thaws are bad, so your standard frost-free freezer is not a good idea and c) I'm only used to working with pure RNA in water or a buffer, whereas this is undoubtedly in a different solution that may increase or decrease stability.
posted by deludingmyself at 11:23 AM on November 9, 2020 [3 favorites]
The -80 temperature is... just below the sublimation temperature of dry ice, which is ... not so great because something much more expensive must be used to keep it cold?
posted by runcifex at 11:24 AM on November 9, 2020
posted by runcifex at 11:24 AM on November 9, 2020
go go nucleases
Please do not cheer on the nucleases, they are the bane of my existence.
posted by deludingmyself at 11:25 AM on November 9, 2020 [17 favorites]
Please do not cheer on the nucleases, they are the bane of my existence.
posted by deludingmyself at 11:25 AM on November 9, 2020 [17 favorites]
Pfizer is the big distributor. The company that developed this is BioNTech:
As someone in the industry I wouldn't phrase it this way. Developing a drug or vaccine is complicated and has many parts. Pfizer partnered w/ BioNTech and co-developed the vaccine, both contributing technical and scientific expertise. (In a situation like this I wouldn't even like the phrasing "BioNTech invented, then with Pfizer developed . . . " but that's a more reasonable assertion.)
The codevelopment is even how it's phrased in the Guardian link you put it by BioNTech itself. They assert they could have done all the development themselves but didn't. Which makes complete sense for a young company in a global health crisis trying to do things as quickly as possible.
posted by mark k at 11:32 AM on November 9, 2020 [9 favorites]
As someone in the industry I wouldn't phrase it this way. Developing a drug or vaccine is complicated and has many parts. Pfizer partnered w/ BioNTech and co-developed the vaccine, both contributing technical and scientific expertise. (In a situation like this I wouldn't even like the phrasing "BioNTech invented, then with Pfizer developed . . . " but that's a more reasonable assertion.)
The codevelopment is even how it's phrased in the Guardian link you put it by BioNTech itself. They assert they could have done all the development themselves but didn't. Which makes complete sense for a young company in a global health crisis trying to do things as quickly as possible.
posted by mark k at 11:32 AM on November 9, 2020 [9 favorites]
The -80 temperature is... just below the sublimation temperature of dry ice, which is ... not so great because something much more expensive must be used to keep it cold?
It's stored at -70 to -80ºC, or standard deep freeze. The reason for the range is likely that there's been a recent push for labs to stop setting ultralow freezers at -80ºC and raise the temperature to -70ºC, which produces significant energy savings with basically no impact on sample stability. But uptake has been slow and "the -80 freezer" is still the default for cold storage that doesn't require liquid nitrogen temps.
posted by deludingmyself at 11:32 AM on November 9, 2020 [12 favorites]
It's stored at -70 to -80ºC, or standard deep freeze. The reason for the range is likely that there's been a recent push for labs to stop setting ultralow freezers at -80ºC and raise the temperature to -70ºC, which produces significant energy savings with basically no impact on sample stability. But uptake has been slow and "the -80 freezer" is still the default for cold storage that doesn't require liquid nitrogen temps.
posted by deludingmyself at 11:32 AM on November 9, 2020 [12 favorites]
Let them get proof of not being able to be vaccinated, but only from an approved doctor. No proof by divination or whatever.
Sure. Some doctor in a MAGA hat will say they have bone spurs, and therefor can't be vaccinated.
Unfortunately, Trump has forever poisoned the whole well regarding COVID in the US. He's pushed a narrative that it's not a big deal, just the flu, a liberal hoax to undermine him, 5G, or something else that "Not getting the [liberal] vaccine" will become the new "not wearing a [liberal] mask."
Unfortunately, they will feel vindicated, because, as more and more people do get vaccinated, true herd immunity* will develop, and everyone becomes less and less likely to catch/transmit the disease. And COVID will look more and more like Y2K.
*As opposed to the "herd immunity" proposed by Trump: let everyone catch COVID, and those who survive will be immune. All the dead bodies? ...nothing to see here.
posted by MrGuilt at 11:34 AM on November 9, 2020 [3 favorites]
Sure. Some doctor in a MAGA hat will say they have bone spurs, and therefor can't be vaccinated.
Unfortunately, Trump has forever poisoned the whole well regarding COVID in the US. He's pushed a narrative that it's not a big deal, just the flu, a liberal hoax to undermine him, 5G, or something else that "Not getting the [liberal] vaccine" will become the new "not wearing a [liberal] mask."
Unfortunately, they will feel vindicated, because, as more and more people do get vaccinated, true herd immunity* will develop, and everyone becomes less and less likely to catch/transmit the disease. And COVID will look more and more like Y2K.
*As opposed to the "herd immunity" proposed by Trump: let everyone catch COVID, and those who survive will be immune. All the dead bodies? ...nothing to see here.
posted by MrGuilt at 11:34 AM on November 9, 2020 [3 favorites]
That depends on how well it prevents spread of the disease. The trial is measuring disease so we don't really know if this is preventing transmission at all.
The reason we don't know is because the trial is not testing for infection or transmission. They are simply waiting for some subset of the population to show clinical symptoms.
To test for prevention of infection or transmission would mean doing a PCR test on each participant once a week or so. They aren't doing this because of cost. It might cost a few million more in a billion dollar project.
This is a false economy because they are waiting to get a certain number of subjects with clinical symptoms and that can take months. If they were also measuring asymptomatic infections using PCR, some estimates are 10 times as frequent, they might get quicker and more accurate results.
posted by JackFlash at 11:35 AM on November 9, 2020 [3 favorites]
The reason we don't know is because the trial is not testing for infection or transmission. They are simply waiting for some subset of the population to show clinical symptoms.
To test for prevention of infection or transmission would mean doing a PCR test on each participant once a week or so. They aren't doing this because of cost. It might cost a few million more in a billion dollar project.
This is a false economy because they are waiting to get a certain number of subjects with clinical symptoms and that can take months. If they were also measuring asymptomatic infections using PCR, some estimates are 10 times as frequent, they might get quicker and more accurate results.
posted by JackFlash at 11:35 AM on November 9, 2020 [3 favorites]
...as long as they have proof of vaccination.
While that doesn't sound unreasonable to normal people, one of the big problems in the US is that the antivax/antimask crowd already is objecting strenuously to the idea of some mandatory proof of vaccination in order to go out and do things. In their minds it is all about the government controlling you. Of course, there is a lot of overlap between these people and those who think that there should be mandatory proof of citizenship in order to vote, but consistency has never been the conspiracy theorist's strong suit. People's behavior (in the US at least) may well be the biggest obstacle to controlling this disease.
posted by TedW at 11:35 AM on November 9, 2020 [6 favorites]
While that doesn't sound unreasonable to normal people, one of the big problems in the US is that the antivax/antimask crowd already is objecting strenuously to the idea of some mandatory proof of vaccination in order to go out and do things. In their minds it is all about the government controlling you. Of course, there is a lot of overlap between these people and those who think that there should be mandatory proof of citizenship in order to vote, but consistency has never been the conspiracy theorist's strong suit. People's behavior (in the US at least) may well be the biggest obstacle to controlling this disease.
posted by TedW at 11:35 AM on November 9, 2020 [6 favorites]
I'm so sorry that you have to work with PCR DeludingMyself.
Just saw your post, I jumped to conclusions!
posted by Slackermagee at 11:36 AM on November 9, 2020
Just saw your post, I jumped to conclusions!
posted by Slackermagee at 11:36 AM on November 9, 2020
Thanks, @deludingmyself! That's good news and interesting to know.
posted by runcifex at 11:37 AM on November 9, 2020
posted by runcifex at 11:37 AM on November 9, 2020
Even through the amount that it really matters drastically pales in comparison to how much people are going to argue about it Online: The Feds agreeing up front to buy million of doses from Pfizer whether or not it proved effective was part of Operation Warp Speed, and it definitely contributed to how many resources Pfizer put into developing it. Without the Feds, the usual thing would likely happened, which is Pfizer would have waited for results like today before they started pumping out doses, instead of doing it even before the testing proved the vaccine was good for anything.
In other words, both sides of the "You can thank the Trump Administration for the good news!" are both wrong and correct. Well, much iof one side wants you to believe "Mr." Trump was personally responsible, so they are more wrong so fuck them.
posted by sideshow at 11:38 AM on November 9, 2020 [3 favorites]
In other words, both sides of the "You can thank the Trump Administration for the good news!" are both wrong and correct. Well, much iof one side wants you to believe "Mr." Trump was personally responsible, so they are more wrong so fuck them.
posted by sideshow at 11:38 AM on November 9, 2020 [3 favorites]
I'm so sorry that you have to work with PCR
No apologies required! My work is a blast. I get to pick off problems no one knows the answers to and design experiments to find those answers, all while focused on RNA, the world's coolest biopolymer! I love it. Although it's been hard to focus on it the past week or two in the midst of... uh, everything.
posted by deludingmyself at 11:49 AM on November 9, 2020 [13 favorites]
No apologies required! My work is a blast. I get to pick off problems no one knows the answers to and design experiments to find those answers, all while focused on RNA, the world's coolest biopolymer! I love it. Although it's been hard to focus on it the past week or two in the midst of... uh, everything.
posted by deludingmyself at 11:49 AM on November 9, 2020 [13 favorites]
In their announcement of the results, Pfizer and BioNTech revealed a surprise. The companies said they had decided not to conduct the 32-case analysis “after a discussion with the FDA.” Instead, they planned to conduct the analysis after 62 cases. But by the time the plan had been formalized, there had been 94 cases of Covid-19 in the study. It’s not known how many were in the vaccine arm, but it would have to be nine or fewer. This means that the statistical strength of the result is likely far stronger than was initially expected. It also means that if Pfizer had held to the original plan, the data would likely have been available in October, as its CEO, Albert Bourla, had initially predicted.
Pfizer and BioNTech could've really Comey-ed up the US election, and didn't, despite the Admin's attempts at interference. Last month Politico had info from an internal Pfizer memo, about Bourla's refusal to capitulate to political pressure.
I mean, you've got to think that a company full of scientists isn't going to want to throw a Hail Mary to an anti-science zealot who accelerated a pandemic through his incompetence.
posted by leotrotsky at 11:55 AM on November 9, 2020 [5 favorites]
Pfizer and BioNTech could've really Comey-ed up the US election, and didn't, despite the Admin's attempts at interference. Last month Politico had info from an internal Pfizer memo, about Bourla's refusal to capitulate to political pressure.
I mean, you've got to think that a company full of scientists isn't going to want to throw a Hail Mary to an anti-science zealot who accelerated a pandemic through his incompetence.
posted by leotrotsky at 11:55 AM on November 9, 2020 [5 favorites]
The Feds agreeing up front to buy million of doses from Pfizer whether or not it proved effective was part of Operation Warp Speed, and it definitely contributed to how many resources Pfizer put into developing it.
That is not true. Pfizer's deal with the government was specifically contingent on the vaccine being effective.
posted by jedicus at 12:22 PM on November 9, 2020 [12 favorites]
That is not true. Pfizer's deal with the government was specifically contingent on the vaccine being effective.
posted by jedicus at 12:22 PM on November 9, 2020 [12 favorites]
this seems like proof, if proof were needed, that giant multi-national pharma companies like Pfizer need to be broken up. We should not need corporations to do the work of governments.
Frankly, I don't see how you could look at the last four fucking years of the US government and think 'Yea, I want to put all of my eggs in that basket' when we have a demonstrably functional system working on over a hundred vaccines from just as many independently managed facilities. Remind me -- did Jonas Salk have to deal with President Eisenhower saying the polio vaccine would be ready by November?
It may be that the government lab's job is to call balls and strikes (still an important role!) while universities and companies handle the logistics of creation, manufacture, and distribution.
posted by pwnguin at 12:32 PM on November 9, 2020 [5 favorites]
Frankly, I don't see how you could look at the last four fucking years of the US government and think 'Yea, I want to put all of my eggs in that basket' when we have a demonstrably functional system working on over a hundred vaccines from just as many independently managed facilities. Remind me -- did Jonas Salk have to deal with President Eisenhower saying the polio vaccine would be ready by November?
It may be that the government lab's job is to call balls and strikes (still an important role!) while universities and companies handle the logistics of creation, manufacture, and distribution.
posted by pwnguin at 12:32 PM on November 9, 2020 [5 favorites]
Fact Sheet: Explaining Operation Warp Speed, with timeline, at the U.S. Department of Health & Human Services; HHS press release on Pfizer agreement from July:
The U.S. Department of Health and Human Services and the Department of Defense (DoD) today announced an agreement with U.S.-based Pfizer Inc. for large-scale production and nationwide delivery of 100 million doses of a COVID-19 vaccine in the United States following the vaccine’s successful manufacture and approval. The agreement also allows the U.S. government to acquire an additional 500 million doses. [...] Pfizer is collaborating with BioNTech, a German biotechnology company, to develop COVID-19 investigational vaccines without U.S. government financial support.posted by Iris Gambol at 12:34 PM on November 9, 2020 [4 favorites]
I work in the administrative office of the research service at a large midwestern VA hospital. A few weeks back the central office put out a call for -70°C freezers - how many extra did each facility research line have available? We were told the vaccines in development needed to be stored at very low temperatures and we were expected to pitch in to help the facility find space. We quickly freed up 4 or 5 for our pharmacy. Scuttlebutt is that a delivery of Pfizer vaccine is expected in the near future. Our site will be a distribution center for other facilities in the area. Odds are that employees at the VA will be among the first to get vaccinated.
We'll see. Some clinical staff approached me for info on how to do surveys in the facility, trying to get a handle on how people feel about being vaccinated. I can tell you from experience that getting employees to get the flu vaccine is a fight every year, and that one is common enough for it to seem like no big deal... a brand new vaccine though? Yikes. Not looking forward to the paperwork on employee vaccination compliance.
posted by caution live frogs at 12:34 PM on November 9, 2020 [14 favorites]
We'll see. Some clinical staff approached me for info on how to do surveys in the facility, trying to get a handle on how people feel about being vaccinated. I can tell you from experience that getting employees to get the flu vaccine is a fight every year, and that one is common enough for it to seem like no big deal... a brand new vaccine though? Yikes. Not looking forward to the paperwork on employee vaccination compliance.
posted by caution live frogs at 12:34 PM on November 9, 2020 [14 favorites]
Frankly, I don't see how you could look at the last four fucking years of the US government and think 'Yea, I want to put all of my eggs in that basket'
It's not about wanting the government to handle the entire process, but rather that—just as I don't want there to be any human billionaires—I think it's dangerous to have multi-national corporations that are so large that they can drop $2 billion on a single project without blinking.
I'm totally fine with companies and universities doing the work, but that can be done without enormous concentration of wealth in the hands of fundamentally selfish entities whose primary reason for existence is the avoidance of liability and accountability.
posted by jedicus at 12:39 PM on November 9, 2020 [7 favorites]
It's not about wanting the government to handle the entire process, but rather that—just as I don't want there to be any human billionaires—I think it's dangerous to have multi-national corporations that are so large that they can drop $2 billion on a single project without blinking.
I'm totally fine with companies and universities doing the work, but that can be done without enormous concentration of wealth in the hands of fundamentally selfish entities whose primary reason for existence is the avoidance of liability and accountability.
posted by jedicus at 12:39 PM on November 9, 2020 [7 favorites]
Over here, in the UK, I understand we've bought 40m doses (10m in the first batch). I'm confident that our taxes will pay for them, and I'm pretty sure they'll be distributed through GPs and pharmacies. Encouraging the vaccine avoidant and vaccine resistant is still going to be a big problem, but it's one that good people are working on. I'm hoping one of the other vaccines works and is a 1-dose thing as it's harder to get people to come back in a second time though.
posted by plonkee at 12:41 PM on November 9, 2020 [1 favorite]
posted by plonkee at 12:41 PM on November 9, 2020 [1 favorite]
Actual wording in the press release is "more than 90% effective".
I wonder how likely it is that their internal estimate is say, 90-95% and they went with the lower bound to avoid later disappointment. Not that I'm getting my hopes. 90% would be great.
posted by joeyh at 12:53 PM on November 9, 2020
I wonder how likely it is that their internal estimate is say, 90-95% and they went with the lower bound to avoid later disappointment. Not that I'm getting my hopes. 90% would be great.
posted by joeyh at 12:53 PM on November 9, 2020
Real easy to take $10 down to a pharmacy and get an injection.
Pretty much anyone can afford $10 for a vaccine shot.
Not anyone can afford $10 each for themselves, a spouse, four children, and a live-in adult sibling.
And families like that will skip the vaccine entirely instead of doing the ghoulish math of "who's most vulnerable and therefore should get the one shot we can afford this month."
posted by ErisLordFreedom at 12:56 PM on November 9, 2020 [4 favorites]
Pretty much anyone can afford $10 for a vaccine shot.
Not anyone can afford $10 each for themselves, a spouse, four children, and a live-in adult sibling.
And families like that will skip the vaccine entirely instead of doing the ghoulish math of "who's most vulnerable and therefore should get the one shot we can afford this month."
posted by ErisLordFreedom at 12:56 PM on November 9, 2020 [4 favorites]
geoff., ten is a lot of dollars to a lot of people. Why put up any barrier to access at all
I get that but if someone is going to make a big stink about using paperwork to get a free vaccine I'm saying it is a lot easier to seek a donation for $10 then to fill out something that says you can't afford $10. The paperwork assumes people have access to the resources they need to fill out the paperwork. $10 is a lot but a recurring $70/mo phone bill is a lot more. Lot easier to get around the $10 then filling out a form, with address with phone number, etc. I'm just saying if there needs to b a barrier to entry (there shouldn't be) cold hard cash is a lot easier then things we take for granted like stability in housing, etc.
A few weeks back the central office put out a call for -70°C freezers - how many extra did each facility research line have available
Pretty sure I heard that dry ice and anything that could deep freeze was being bought out months ago. I don't think it was a secret that at least one vaccine would've required it and people were preparing for it before they even knew it was viable.
posted by geoff. at 1:11 PM on November 9, 2020 [1 favorite]
I get that but if someone is going to make a big stink about using paperwork to get a free vaccine I'm saying it is a lot easier to seek a donation for $10 then to fill out something that says you can't afford $10. The paperwork assumes people have access to the resources they need to fill out the paperwork. $10 is a lot but a recurring $70/mo phone bill is a lot more. Lot easier to get around the $10 then filling out a form, with address with phone number, etc. I'm just saying if there needs to b a barrier to entry (there shouldn't be) cold hard cash is a lot easier then things we take for granted like stability in housing, etc.
A few weeks back the central office put out a call for -70°C freezers - how many extra did each facility research line have available
Pretty sure I heard that dry ice and anything that could deep freeze was being bought out months ago. I don't think it was a secret that at least one vaccine would've required it and people were preparing for it before they even knew it was viable.
posted by geoff. at 1:11 PM on November 9, 2020 [1 favorite]
And COVID will look more and more like Y2K.
Not after the end of this year it won't. We've still got spread from the elections, Thanksgiving, and Christmas to amplify the current wave in places where people are being encouraged to ignore the virus (most states led by a Trumpist governor). The current covid wave is going to translate to significant mortality in a lot of states. Hospitals digging up adjacent parks to bury bodies is hard to forget.
posted by benzenedream at 1:12 PM on November 9, 2020 [1 favorite]
Not after the end of this year it won't. We've still got spread from the elections, Thanksgiving, and Christmas to amplify the current wave in places where people are being encouraged to ignore the virus (most states led by a Trumpist governor). The current covid wave is going to translate to significant mortality in a lot of states. Hospitals digging up adjacent parks to bury bodies is hard to forget.
posted by benzenedream at 1:12 PM on November 9, 2020 [1 favorite]
We've still got spread from the elections, Thanksgiving, and Christmas
I hear so many people talk about these as if they're just like exceptions? Even sane friends. I understand the need and want to see family but the virus doesn't go, okay you've been good -- we'll let you see family on Thanksgiving.
posted by geoff. at 1:15 PM on November 9, 2020 [10 favorites]
I hear so many people talk about these as if they're just like exceptions? Even sane friends. I understand the need and want to see family but the virus doesn't go, okay you've been good -- we'll let you see family on Thanksgiving.
posted by geoff. at 1:15 PM on November 9, 2020 [10 favorites]
I'm becoming increasingly disturbed by the number of people who lose their shit over the prospect of being sad for a little while. I realize I'm weird, but it occasionally happens that I have to miss holidays with the family. It even makes me sad. That's why I treat myself to something nice and then look forward to next year.
Not killing one's parents by giving them COVID seems like a much easier thing to take than being stuck at home alone for Christmas (which for me invariably means being alone on my birthday, too) because you can't find anyone to take care of the pets or can't afford enough plane tickets for both people to travel.
The thing that really gets me angry about it is that the same people who insist on putting everyone else at risks because of their feelings are the same assholes who whine about "snowflakes" and say, completely seriously, that feelings don't matter.
It's getting to the point that I think there is a good chance that some environmental factor has caused a large fraction of the population to develop some mental disorder, much in the way lead was once causing population-wide problems before regulation reduced the amount of lead in the environment.
posted by wierdo at 1:53 PM on November 9, 2020 [31 favorites]
Not killing one's parents by giving them COVID seems like a much easier thing to take than being stuck at home alone for Christmas (which for me invariably means being alone on my birthday, too) because you can't find anyone to take care of the pets or can't afford enough plane tickets for both people to travel.
The thing that really gets me angry about it is that the same people who insist on putting everyone else at risks because of their feelings are the same assholes who whine about "snowflakes" and say, completely seriously, that feelings don't matter.
It's getting to the point that I think there is a good chance that some environmental factor has caused a large fraction of the population to develop some mental disorder, much in the way lead was once causing population-wide problems before regulation reduced the amount of lead in the environment.
posted by wierdo at 1:53 PM on November 9, 2020 [31 favorites]
some environmental factor has caused a large fraction of the population to develop some mental disorder
Facebook
Twitter
FoxNews
posted by mcstayinskool at 2:16 PM on November 9, 2020 [11 favorites]
FoxNews
posted by mcstayinskool at 2:16 PM on November 9, 2020 [11 favorites]
The future is already here – it's just not evenly distributed. - William Gibson
How long will we be saying that I wonder.
posted by fraxil at 2:19 PM on November 9, 2020 [6 favorites]
How long will we be saying that I wonder.
posted by fraxil at 2:19 PM on November 9, 2020 [6 favorites]
It's getting to the point that I think there is a good chance that some environmental factor has caused a large fraction of the population to develop some mental disorder, much in the way lead was once causing population-wide problems before regulation reduced the amount of lead in the environment.
Late-stage imperialist, hetero-patriarchal, white supermacist capitalism, perhaps, too, and I wouldn't at all be surprised if there were an environmental factor like a toxic chemical we haven't realized. Though that'd be likely a consequence of the former. We're not healthy. It takes way too much work these days to be and feel healthy. And by healthy, I mean free enough from external (physical and psychological) toxicity to live and make autonomous choices despite this toxicity surrounding us.
posted by ipsative at 2:26 PM on November 9, 2020 [8 favorites]
Late-stage imperialist, hetero-patriarchal, white supermacist capitalism, perhaps, too, and I wouldn't at all be surprised if there were an environmental factor like a toxic chemical we haven't realized. Though that'd be likely a consequence of the former. We're not healthy. It takes way too much work these days to be and feel healthy. And by healthy, I mean free enough from external (physical and psychological) toxicity to live and make autonomous choices despite this toxicity surrounding us.
posted by ipsative at 2:26 PM on November 9, 2020 [8 favorites]
(your periodic reminder that people with mental illnesses already exist and some of them are right here in this room writing this comment, we are barely, barely hanging on and we are not all MAGAs.)
posted by We put our faith in Blast Hardcheese at 2:34 PM on November 9, 2020 [44 favorites]
posted by We put our faith in Blast Hardcheese at 2:34 PM on November 9, 2020 [44 favorites]
Yeah, I've taken it quite seriously but "a little sad" seems to be underselling it. I haven't seen any friends or family in a year [I am lucky in that at least I have my wife, but she's the only person I've seen other than cashiers at the grocery store and doctors], I've had multiple surgeries that became more complicated thanks to hospitals being crazy now, etc.
And it's not getting better anytime soon. A vaccine is great, but by the time it gets distributed enough (assuming results hold up!) its still going to be another year or two of isolation. [And of course this was completely unnecessary as countries that had their shit together didn't have all this, like my wife's country...]. So I doubt next year will be normal holidays/etc either.
posted by thefoxgod at 2:39 PM on November 9, 2020 [11 favorites]
And it's not getting better anytime soon. A vaccine is great, but by the time it gets distributed enough (assuming results hold up!) its still going to be another year or two of isolation. [And of course this was completely unnecessary as countries that had their shit together didn't have all this, like my wife's country...]. So I doubt next year will be normal holidays/etc either.
posted by thefoxgod at 2:39 PM on November 9, 2020 [11 favorites]
Plus there's a significant difference between "one person visiting a low-risk parent, traveling by car with no stops, after a hard quar, so that neither of them sits alone in a dark apartment eating frozen pizza on Thanksgiving" and "40 people who've regularly been going to bars getting together for a 6-hour indoor food marathon and coughing on grandma."
When you hear second- or third-hand that someone is "doing thanksgiving" be sure you know which version of "doing" they're talking about before you decide they're a deranged monster.
posted by We put our faith in Blast Hardcheese at 2:53 PM on November 9, 2020 [28 favorites]
When you hear second- or third-hand that someone is "doing thanksgiving" be sure you know which version of "doing" they're talking about before you decide they're a deranged monster.
posted by We put our faith in Blast Hardcheese at 2:53 PM on November 9, 2020 [28 favorites]
I'm driving to my father's house the weekend before Thanksgiving and staying there until the first week of January. It's not ideal (in several ways, because spending a month-and-a-half cooped up with my father is not exactly my idea of living my best life), but my father was widowed this summer after 55 years of marriage to my mom, and I'm not leaving him alone for the holidays. I'm quarantining here for two weeks before I leave, and I think I can avoid having contact with other people while I'm on the road. And I realize that there are a lot of people who will judge me for traveling for the holidays, and they can fuck themselves. Seriously. I am trying so hard to be responsible in such a multilayered and complex shit-show of a situation, and it's hard enough without all the moralizing.
posted by ArbitraryAndCapricious at 2:56 PM on November 9, 2020 [41 favorites]
posted by ArbitraryAndCapricious at 2:56 PM on November 9, 2020 [41 favorites]
it's hard enough without all the moralizing.
Just got into a friendly argument with my roofer about whether I am an idiot for not having seen my boyfriend (in another state) except for masked-on hikes since March. Roofer was wearing a mask, but hates, it, hates the whole thing, etc etc. Do not blame him. Told him that I was a rule-follower (and Vermont says no) but I understood what he was saying. He kept tossing scenarios at me "But what if you got hit by a bus tomorrow!?" and I just said I was lucky enough that I had formed pathways to having real interactions with the people in my life even remotely, so while this would not all be my choice, it was largely acceptable. He had a hard time with this, but hey, I didn't have to convince him. I think eating pizza alone on Thanksgiving sounds like it might actually be kind of great. I'm just hoping a legit vaccine on the horizon can keep people being as safe as they are able to be for a bit longer.
posted by jessamyn at 3:09 PM on November 9, 2020 [8 favorites]
Just got into a friendly argument with my roofer about whether I am an idiot for not having seen my boyfriend (in another state) except for masked-on hikes since March. Roofer was wearing a mask, but hates, it, hates the whole thing, etc etc. Do not blame him. Told him that I was a rule-follower (and Vermont says no) but I understood what he was saying. He kept tossing scenarios at me "But what if you got hit by a bus tomorrow!?" and I just said I was lucky enough that I had formed pathways to having real interactions with the people in my life even remotely, so while this would not all be my choice, it was largely acceptable. He had a hard time with this, but hey, I didn't have to convince him. I think eating pizza alone on Thanksgiving sounds like it might actually be kind of great. I'm just hoping a legit vaccine on the horizon can keep people being as safe as they are able to be for a bit longer.
posted by jessamyn at 3:09 PM on November 9, 2020 [8 favorites]
Sounds like we agree that it should be free, no strings attached.
I still would like to note the following, which maybe you already know but it isn't clear to me: $70/month for a phone bill?! I spit out my figurative beverage. Also like 10-20% of people in the US are housing insecure. Not everyone with housing takes it for granted.
posted by aniola at 3:13 PM on November 9, 2020 [2 favorites]
I still would like to note the following, which maybe you already know but it isn't clear to me: $70/month for a phone bill?! I spit out my figurative beverage. Also like 10-20% of people in the US are housing insecure. Not everyone with housing takes it for granted.
posted by aniola at 3:13 PM on November 9, 2020 [2 favorites]
Does this mean it's possible to vaccinate against the common cold?
posted by chmmr at 3:58 PM on November 9, 2020
posted by chmmr at 3:58 PM on November 9, 2020
I think eating pizza alone on Thanksgiving sounds like it might actually be kind of great.
I am very very glad that there are people for whom this situation is "largely acceptable." For my part, almost everything that gave my life shape or meaning is impossible or at any rate deeply irresponsible now, and I do not think that "a little sad" begins to cover it. I have been drowning for months on end (I am just now pulling, slowly, out of a suicidal tailspin, and definitely not out of the woods although out of the hospital) and agree with the poster above who called this news oxygen.
I'm sorry, I know the world before was a terrible world and I was a monster to have loved it. But this [gestures at everything] can't be the extent of the new world, either.
posted by We put our faith in Blast Hardcheese at 4:06 PM on November 9, 2020 [10 favorites]
I am very very glad that there are people for whom this situation is "largely acceptable." For my part, almost everything that gave my life shape or meaning is impossible or at any rate deeply irresponsible now, and I do not think that "a little sad" begins to cover it. I have been drowning for months on end (I am just now pulling, slowly, out of a suicidal tailspin, and definitely not out of the woods although out of the hospital) and agree with the poster above who called this news oxygen.
I'm sorry, I know the world before was a terrible world and I was a monster to have loved it. But this [gestures at everything] can't be the extent of the new world, either.
posted by We put our faith in Blast Hardcheese at 4:06 PM on November 9, 2020 [10 favorites]
There are a few coronaviruses which cause cold-like symptoms. There are unfortunately ~220 strains of viruses which cause "colds". You would have to vaccinate against all of them to have a chance of reducing incidence.
posted by benzenedream at 4:10 PM on November 9, 2020
posted by benzenedream at 4:10 PM on November 9, 2020
geoff. says:
There's no reason people would get more than one injection
Not true, actually; this vaccine requires more than one dose, spaced by a few weeks. Most of the other candidates do as well.
posted by eirias at 4:10 PM on November 9, 2020 [3 favorites]
There's no reason people would get more than one injection
Not true, actually; this vaccine requires more than one dose, spaced by a few weeks. Most of the other candidates do as well.
posted by eirias at 4:10 PM on November 9, 2020 [3 favorites]
I'm actually somewhat alarmed that this whole "You're Thanksgiving-ing WRONG" thing seems to have crept into this thread.
There is no one single answer for how to square that circle - everyone's interfamily relationships are different, everyone has different resources, everyone has different needs, everyone has different health risks, etc. And making a decision about What Is Best is going to be a complicated and nuanced decision for EVERYONE, and there is no one-size-fits-all answer, and that means that whatever decision someone makes, if it's different from yours well then that just means that there are probably different circumstances that you may not know about and are probably none of your business anyway, so all we can do is trust each other to make their own best choice that suits their own unique circumstance best.
And that's all separate from the vaccine anyway. I'm more surprised that there isn't this massive free "vaccinate everyone" program being rolled out like what they did with the polio vaccine in the 50s when THAT first happened. True, today there are people who would prefer the right to not be vaccinated, but that's just making me wonder if anyone in the 50s refused the polio vaccine on moral/religious/whatever grounds. Anyone know of a book I could read up on that? It's suddenly got me real curious.
posted by EmpressCallipygos at 4:21 PM on November 9, 2020 [7 favorites]
There is no one single answer for how to square that circle - everyone's interfamily relationships are different, everyone has different resources, everyone has different needs, everyone has different health risks, etc. And making a decision about What Is Best is going to be a complicated and nuanced decision for EVERYONE, and there is no one-size-fits-all answer, and that means that whatever decision someone makes, if it's different from yours well then that just means that there are probably different circumstances that you may not know about and are probably none of your business anyway, so all we can do is trust each other to make their own best choice that suits their own unique circumstance best.
And that's all separate from the vaccine anyway. I'm more surprised that there isn't this massive free "vaccinate everyone" program being rolled out like what they did with the polio vaccine in the 50s when THAT first happened. True, today there are people who would prefer the right to not be vaccinated, but that's just making me wonder if anyone in the 50s refused the polio vaccine on moral/religious/whatever grounds. Anyone know of a book I could read up on that? It's suddenly got me real curious.
posted by EmpressCallipygos at 4:21 PM on November 9, 2020 [7 favorites]
I'm pretty sure the amish have long resisted the polio vaccine. I remember outbreaks in lancaster county Pa and in minnesota in our lifetime.
posted by OHenryPacey at 4:27 PM on November 9, 2020
posted by OHenryPacey at 4:27 PM on November 9, 2020
I agree with the idea, but, not travelling to be with family, not being in large gatherings, seems to me to be a "one-size-fits-all (with exceptions)" approach answer.
It's so hard. But, the case numbers are already going through the roof. These vaccine announcements will also probably lead to less caution. Even though, that's not how vaccines work...
posted by Windopaene at 4:32 PM on November 9, 2020 [1 favorite]
It's so hard. But, the case numbers are already going through the roof. These vaccine announcements will also probably lead to less caution. Even though, that's not how vaccines work...
posted by Windopaene at 4:32 PM on November 9, 2020 [1 favorite]
apologies for contributing to the holiday derail; it looked like the thread was veering perilously close to a really unhelpful conflation of struggling with isolation/actual brain damage?!?/support of Trumpism and meant only to cut that off at the pass.
posted by We put our faith in Blast Hardcheese at 4:34 PM on November 9, 2020 [5 favorites]
posted by We put our faith in Blast Hardcheese at 4:34 PM on November 9, 2020 [5 favorites]
I agree with the idea, but, not travelling to be with family, not being in large gatherings, seems to me to be a "one-size-fits-all (with exceptions)" approach answer.
My roommate's parents have an apartment in the basement of their house, and their house is a very short walk from NJ Transit. He had been planning to get a test and if he tested negative, then travel there himself there in the first week of December, and self-isolate in the basement apartment for two weeks. Then, and only then, would he go upstairs to see his parents, both of which are getting on in years and he wants to see before they die.
...It is possible to travel safely, and it is also possible for people to be responsible enough to do the legwork to figure out how to do that.
posted by EmpressCallipygos at 4:38 PM on November 9, 2020 [9 favorites]
My roommate's parents have an apartment in the basement of their house, and their house is a very short walk from NJ Transit. He had been planning to get a test and if he tested negative, then travel there himself there in the first week of December, and self-isolate in the basement apartment for two weeks. Then, and only then, would he go upstairs to see his parents, both of which are getting on in years and he wants to see before they die.
...It is possible to travel safely, and it is also possible for people to be responsible enough to do the legwork to figure out how to do that.
posted by EmpressCallipygos at 4:38 PM on November 9, 2020 [9 favorites]
Yeah, I've taken it quite seriously but "a little sad" seems to be underselling it. I haven't seen any friends or family in a year [I am lucky in that at least I have my wife, but she's the only person I've seen other than cashiers at the grocery store and doctors], I've had multiple surgeries that became more complicated thanks to hospitals being crazy now, etc.
The people getting bent out of shape aren't like you, they're the ones who have been railing against lockdowns and refusing to abide by any restrictions on large group gatherings. I'm talking about the people who have been carrying on as if COVID doesn't exist, not people who have a very real reason to feel isolated and even depressed due to a lack of social contact.
If you've been seeing people as normal all year, it's not unreasonable to characterize missing holidays as a reason for to feel sad and observe that sometimes being a responsible adult means doing things that are distressing and hard. It's much worse for those who have actually been making a sacrifice for the greater good. I feel sympathy for people in that situation, not for those who are being narcissistic pricks who don't care one iota about how other people are affected by their actions. The world would be a much better place if we could all get the help and support we need, especially in times like this.
Also, I'm sorry if I caused anyone suffering from mental illness any kind of distress. I'm pretty shitty at phrasing. I hoped that I had been clear about who my comment was directed toward, but clearly should have done a better job.
posted by wierdo at 5:06 PM on November 9, 2020 [3 favorites]
The people getting bent out of shape aren't like you, they're the ones who have been railing against lockdowns and refusing to abide by any restrictions on large group gatherings. I'm talking about the people who have been carrying on as if COVID doesn't exist, not people who have a very real reason to feel isolated and even depressed due to a lack of social contact.
If you've been seeing people as normal all year, it's not unreasonable to characterize missing holidays as a reason for to feel sad and observe that sometimes being a responsible adult means doing things that are distressing and hard. It's much worse for those who have actually been making a sacrifice for the greater good. I feel sympathy for people in that situation, not for those who are being narcissistic pricks who don't care one iota about how other people are affected by their actions. The world would be a much better place if we could all get the help and support we need, especially in times like this.
Also, I'm sorry if I caused anyone suffering from mental illness any kind of distress. I'm pretty shitty at phrasing. I hoped that I had been clear about who my comment was directed toward, but clearly should have done a better job.
posted by wierdo at 5:06 PM on November 9, 2020 [3 favorites]
...It is possible to travel safely, and it is also possible for people to be responsible enough to do the legwork to figure out how to do that.
My dad was recently hospitalized for brain cancer, and is just recently an out patient, and I have had to make the super shitty choice of staying put and not traveling, especially since I live in a relatively safe, low activity bubble of very low infection rates where people started masking up long before there were orders.
Plus, because of our low rates - businesses like restaurants were allowed to re-open with limited capacity and we're already understaffed, and it's pretty important I keep my job right now and don't leave my coworkers in a bind.
And travel is already super difficult for me right now in general even without a pandemic.
It helps that my dad is kind of a workaholic and agrees with me, but it sucks that there's a non-zero chance I might not get to see him again.
On the other hand, there was already that non zero chance of that because I haven't been able to travel to see him in almost 10 years anyway, so... cool, cool. Keep being awesome at sucking, 2020.
On the other-other hand I know he's a fighter and he's kind of already been through a bunch of stuff that should have killed him already, and I take after him in that one of our superhero powers is boredom. Put me in an ICU and I'll get so bored that I start healing nearly as fast a Deadpool just because I want to get the fuck out of there that much.
posted by loquacious at 5:25 PM on November 9, 2020 [5 favorites]
My dad was recently hospitalized for brain cancer, and is just recently an out patient, and I have had to make the super shitty choice of staying put and not traveling, especially since I live in a relatively safe, low activity bubble of very low infection rates where people started masking up long before there were orders.
Plus, because of our low rates - businesses like restaurants were allowed to re-open with limited capacity and we're already understaffed, and it's pretty important I keep my job right now and don't leave my coworkers in a bind.
And travel is already super difficult for me right now in general even without a pandemic.
It helps that my dad is kind of a workaholic and agrees with me, but it sucks that there's a non-zero chance I might not get to see him again.
On the other hand, there was already that non zero chance of that because I haven't been able to travel to see him in almost 10 years anyway, so... cool, cool. Keep being awesome at sucking, 2020.
On the other-other hand I know he's a fighter and he's kind of already been through a bunch of stuff that should have killed him already, and I take after him in that one of our superhero powers is boredom. Put me in an ICU and I'll get so bored that I start healing nearly as fast a Deadpool just because I want to get the fuck out of there that much.
posted by loquacious at 5:25 PM on November 9, 2020 [5 favorites]
Loquacious - the fact that my roommate is able to travel isn't meant to be an invective against your NOT being able to, and I apologize if it read as such.
My point is that we should all each trust each other to make the choice that is uniquely best for them, based on each person's unique set of circumstances. And - that instead of anyone giving people like my roommate a side-eye for "what are you doing traveling, we shouldn't be doing that" when you don't know the steps they're taking, we should be sympathizing with people like you who have made that tough call because "holy crap I understand why you made that choice but DAMN that must have been a tough one, that sucks".
More trust and more empathy, y'all.
posted by EmpressCallipygos at 6:52 PM on November 9, 2020 [3 favorites]
My point is that we should all each trust each other to make the choice that is uniquely best for them, based on each person's unique set of circumstances. And - that instead of anyone giving people like my roommate a side-eye for "what are you doing traveling, we shouldn't be doing that" when you don't know the steps they're taking, we should be sympathizing with people like you who have made that tough call because "holy crap I understand why you made that choice but DAMN that must have been a tough one, that sucks".
More trust and more empathy, y'all.
posted by EmpressCallipygos at 6:52 PM on November 9, 2020 [3 favorites]
But how was exposure to the virus either controlled or managed.
Oh! I think I can answer this one. I volunteered for the Astra Zeneca trial because I heard that they needed more Hispanic people and I figured I would add my .5 Hispanic self to see if I could help.
I got the call this morning for my initial screening. The first thing they did was a risk assessment. They asked me a few questions about my potential covid exposure. I'm working from home, kid is schooling from home, spouse works in an office with no visitors and wears a mask. I'm in a small bubble with one healthcare worker who wears a mask and is tested regularly. I always wear a mask in the store. I fell really easily in one of the lowest categories for exposure, so I was rejected as a test subject.
They're looking for people regularly exposed to the general public, and who have a better chance of putting the vaccine to use. It's such an important part of the screening that they do it first. I, ultimately, don't leave my house often enough or see enough people to be a good candidate.
posted by Alison at 6:53 PM on November 9, 2020 [16 favorites]
Oh! I think I can answer this one. I volunteered for the Astra Zeneca trial because I heard that they needed more Hispanic people and I figured I would add my .5 Hispanic self to see if I could help.
I got the call this morning for my initial screening. The first thing they did was a risk assessment. They asked me a few questions about my potential covid exposure. I'm working from home, kid is schooling from home, spouse works in an office with no visitors and wears a mask. I'm in a small bubble with one healthcare worker who wears a mask and is tested regularly. I always wear a mask in the store. I fell really easily in one of the lowest categories for exposure, so I was rejected as a test subject.
They're looking for people regularly exposed to the general public, and who have a better chance of putting the vaccine to use. It's such an important part of the screening that they do it first. I, ultimately, don't leave my house often enough or see enough people to be a good candidate.
posted by Alison at 6:53 PM on November 9, 2020 [16 favorites]
Then either require or encourage schools, airlines, restaurants, pubs, etc., to require proof of vaccination.
This shouldn't be considered until there is vaccine in excess of demand.
I'm sure someone will know an issue why, but can't we have a one-off meaningful tax credit for getting the vaccine given the significant economic benefit to widespread vaccination
Because for a poor person a promise of $50 a year from now doesn't let one magically come up with $40 today.
It's stored at -70 to -80ºC, or standard deep freeze.
I'm assuming this was meaning standard medical deep freezers. Standard food freezers don't get anywhere near that cold.
Not true, actually; this vaccine requires more than one dose, spaced by a few weeks. Most of the other candidates do as well.
But there won't be anyone just cruising from pharmacy to pharmacy getting injections Pierce Style even if it is free. Or at least not so much as to be a significant drawback. This is how mass vaccinations work here in Canada. They keep track of who got it but there is no screening/look up before you get it. It would be possible to visit multiple vaccination sites but no one does.
Even if that was a real risk you could mark injection sites with an indelible ink (like how they handle multiple voter fraud in some countries).
posted by Mitheral at 7:07 PM on November 9, 2020 [1 favorite]
This shouldn't be considered until there is vaccine in excess of demand.
I'm sure someone will know an issue why, but can't we have a one-off meaningful tax credit for getting the vaccine given the significant economic benefit to widespread vaccination
Because for a poor person a promise of $50 a year from now doesn't let one magically come up with $40 today.
It's stored at -70 to -80ºC, or standard deep freeze.
I'm assuming this was meaning standard medical deep freezers. Standard food freezers don't get anywhere near that cold.
Not true, actually; this vaccine requires more than one dose, spaced by a few weeks. Most of the other candidates do as well.
But there won't be anyone just cruising from pharmacy to pharmacy getting injections Pierce Style even if it is free. Or at least not so much as to be a significant drawback. This is how mass vaccinations work here in Canada. They keep track of who got it but there is no screening/look up before you get it. It would be possible to visit multiple vaccination sites but no one does.
Even if that was a real risk you could mark injection sites with an indelible ink (like how they handle multiple voter fraud in some countries).
posted by Mitheral at 7:07 PM on November 9, 2020 [1 favorite]
The problem with multi dose treatments isn’t that people get too many, it’s that they don’t make it back to finish the series, AIUI.
posted by clew at 7:20 PM on November 9, 2020 [2 favorites]
posted by clew at 7:20 PM on November 9, 2020 [2 favorites]
With the promise of a vaccine on the horizon, all the more reason to comply with lockdown and mask mandates.
As John Kerry said almost half a century ago: "How do you ask a man to be the last man to die in Vietnam? How do you ask a man to be the last man to die for a mistake?"
Who wants to be the last person to die from Covid?
posted by JackFlash at 7:37 PM on November 9, 2020 [7 favorites]
As John Kerry said almost half a century ago: "How do you ask a man to be the last man to die in Vietnam? How do you ask a man to be the last man to die for a mistake?"
Who wants to be the last person to die from Covid?
posted by JackFlash at 7:37 PM on November 9, 2020 [7 favorites]
My point is that we should all each trust each other to make the choice that is uniquely best for them, based on each person's unique set of circumstances.
It’s not like there aren’t people out there who are going to do something stupid but in general I agree. Also, given the apparent dynamics of spread, if somebody who usually has a mass gathering decides to visit their nuclear family instead that’s probably significant harm reduction.
posted by atoxyl at 8:15 PM on November 9, 2020 [3 favorites]
It’s not like there aren’t people out there who are going to do something stupid but in general I agree. Also, given the apparent dynamics of spread, if somebody who usually has a mass gathering decides to visit their nuclear family instead that’s probably significant harm reduction.
posted by atoxyl at 8:15 PM on November 9, 2020 [3 favorites]
It's not about wanting the government to handle the entire process, but rather that—just as I don't want there to be any human billionaires—I think it's dangerous to have multi-national corporations that are so large that they can drop $2 billion on a single project without blinking.
I'm confused -- do you think Pfizer is somehow unqualified to invent vaccines? Wouldn't they be among the most prepared to invest 2 billion? It's not like Tim Cook or Elon Musk got on stage and announced they were going to be investing 2 billion developing their own vaccine, or that Pfizer hasn't thought it through or doesn't have a buyer on hand. Is now not precisely the scenario in which we should be trading money to save lives sooner?
Like, if you want to grouse about market inefficiencies in pharmaceuticals, I recommend starting a thread about the antibiotic pipeline. That's where the human health incentives are most misaligned with profit motives -- if you invent a new and effective antibiotic, medically the worst thing you can do is provide it to every human on earth. Your drug gets put aside as a last line of defense, for only the sickest patients with drug-resistant infections. It should go without saying that charging thousands of dollars per dose to make up for the lost sales isn't a very gratifying way to make your investment back. As a result, we have far fewer antibiotics under investigation than coronoavirus vaccines, and only 1 of the top 50 pharmas has a drug in that pipeline. This is an area where I think non-profits and governments can step in and actually buy up patents or something to further stockpile against the future where penicillin-resistant strains are normal.
posted by pwnguin at 8:22 PM on November 9, 2020 [7 favorites]
I'm confused -- do you think Pfizer is somehow unqualified to invent vaccines? Wouldn't they be among the most prepared to invest 2 billion? It's not like Tim Cook or Elon Musk got on stage and announced they were going to be investing 2 billion developing their own vaccine, or that Pfizer hasn't thought it through or doesn't have a buyer on hand. Is now not precisely the scenario in which we should be trading money to save lives sooner?
Like, if you want to grouse about market inefficiencies in pharmaceuticals, I recommend starting a thread about the antibiotic pipeline. That's where the human health incentives are most misaligned with profit motives -- if you invent a new and effective antibiotic, medically the worst thing you can do is provide it to every human on earth. Your drug gets put aside as a last line of defense, for only the sickest patients with drug-resistant infections. It should go without saying that charging thousands of dollars per dose to make up for the lost sales isn't a very gratifying way to make your investment back. As a result, we have far fewer antibiotics under investigation than coronoavirus vaccines, and only 1 of the top 50 pharmas has a drug in that pipeline. This is an area where I think non-profits and governments can step in and actually buy up patents or something to further stockpile against the future where penicillin-resistant strains are normal.
posted by pwnguin at 8:22 PM on November 9, 2020 [7 favorites]
"I mean, it’s one banana vaccine, Michael. What could it cost, ten dollars? "
posted by zymil at 8:51 PM on November 9, 2020 [3 favorites]
posted by zymil at 8:51 PM on November 9, 2020 [3 favorites]
By noting the repeat dose I certainly wasn’t suggesting that people were going to binge on a Covid vaccine — rather that the need for multiple doses complicates the “walk in at CVS” version of the roll out that geoff seemed to be suggesting. This is well outside my expertise and I don’t know how that circle will be squared if we even get that far; but I do know that there was a lot of excitement when J&J announced their phase III study precisely because their candidate is a single dose. I don’t care how we pay for it but I do think any plan that results in a lot of half vaccinated people is probably a bad one.
posted by eirias at 8:59 PM on November 9, 2020 [1 favorite]
posted by eirias at 8:59 PM on November 9, 2020 [1 favorite]
I'm assuming this was meaning standard medical deep freezers. Standard food freezers don't get anywhere near that cold.
Neither do the freezers in most pharmacies or doctor's offices. Actual biolabs have this sort of deep freeze capability but not many other places do.
posted by Justinian at 9:00 PM on November 9, 2020 [1 favorite]
Neither do the freezers in most pharmacies or doctor's offices. Actual biolabs have this sort of deep freeze capability but not many other places do.
posted by Justinian at 9:00 PM on November 9, 2020 [1 favorite]
(This is relevant because cities etc will have plenty such spaces, but rural areas will not.)
posted by Justinian at 9:16 PM on November 9, 2020 [1 favorite]
posted by Justinian at 9:16 PM on November 9, 2020 [1 favorite]
By noting the repeat dose I certainly wasn’t suggesting that people were going to binge on a Covid vaccine — rather that the need for multiple doses complicates the “walk in at CVS” version of the roll out that geoff seemed to be suggesting.
All states are required by the CDC to maintain an Immunization Information System which is a lifetime database of every vaccination you have ever had. So you could walk into a CVS for your first shot and three weeks later walk into a Walgreens and they could instantly look up your previous information and see that you were due for your second shot (or had already had your second shot). Some states may be better than others in the completeness of their data coverage.
posted by JackFlash at 9:21 PM on November 9, 2020 [2 favorites]
All states are required by the CDC to maintain an Immunization Information System which is a lifetime database of every vaccination you have ever had. So you could walk into a CVS for your first shot and three weeks later walk into a Walgreens and they could instantly look up your previous information and see that you were due for your second shot (or had already had your second shot). Some states may be better than others in the completeness of their data coverage.
posted by JackFlash at 9:21 PM on November 9, 2020 [2 favorites]
I'm happy Pfizer's is over 90% accurate, but needing two super frozen shots months apart makes the whole situation even more complicated. I was hoping one of the ones with only one shot and not needing super fridges would be the top winner.
Also, how the hell are we going to revaccinate the entire world over and over again every year, if that's what's needed? Twice apiece every year?
But that said, between this and the election, that's the only hope I have of the nightmare ending, so....
posted by jenfullmoon at 9:22 PM on November 9, 2020
Also, how the hell are we going to revaccinate the entire world over and over again every year, if that's what's needed? Twice apiece every year?
But that said, between this and the election, that's the only hope I have of the nightmare ending, so....
posted by jenfullmoon at 9:22 PM on November 9, 2020
I don’t think the two shots or super-deep freeze requirements are problems. Rather, since the first shots are going to medically fragile individuals and health care workers, they’re most able to deal with the inconvenience and hassle. Which is fine, because it’s vital that we get as many people vaccinated as soon as possible. Since John Q. Public has to wait anyways due to our lower risk profile, we can wait to get the single-shot vaccine when/if it’s confirmed and on the market.
posted by Big Al 8000 at 9:41 PM on November 9, 2020
posted by Big Al 8000 at 9:41 PM on November 9, 2020
The common cold is not a single virus but a layman term for basically any mild respiratory infection.
Echoing this...
Just this weekend while we were driving to the hiking trail, we happened to listen to an epidsode of The Curious Cases of Rutherford & Fry (one of my daughter's favorite things, of late), that addressed this. They said there are about 200 types of virus known to cause "a cold", including influenza, when you happen to have a mild case.
Weirdly, the epidsode seems to have been made in February, and so it mentions COVID-19 but comes before we knew what havoc it would cause.
posted by polecat at 11:08 PM on November 9, 2020 [1 favorite]
Echoing this...
Just this weekend while we were driving to the hiking trail, we happened to listen to an epidsode of The Curious Cases of Rutherford & Fry (one of my daughter's favorite things, of late), that addressed this. They said there are about 200 types of virus known to cause "a cold", including influenza, when you happen to have a mild case.
Weirdly, the epidsode seems to have been made in February, and so it mentions COVID-19 but comes before we knew what havoc it would cause.
posted by polecat at 11:08 PM on November 9, 2020 [1 favorite]
As someone in the industry I wouldn't phrase it this way.
It's funny that – here in Germany it's all BioNTech BioNTech BioNTech (with help from Pfizer) and in US media it's all Pfizer Pfizer Pfizer (and by the way BioNTech also).
Seems everyone including the US administration wants a piece of this.
posted by romanb at 12:17 AM on November 10, 2020 [1 favorite]
It's funny that – here in Germany it's all BioNTech BioNTech BioNTech (with help from Pfizer) and in US media it's all Pfizer Pfizer Pfizer (and by the way BioNTech also).
Seems everyone including the US administration wants a piece of this.
posted by romanb at 12:17 AM on November 10, 2020 [1 favorite]
How do you even “pause” a clinical trial that involves vaccinating people and waiting until they get sick? Does that mean just not vaccinating any more people?
posted by bashing rocks together at 2:01 AM on November 10, 2020 [1 favorite]
posted by bashing rocks together at 2:01 AM on November 10, 2020 [1 favorite]
The people getting bent out of shape aren't like you, they're the ones who have been railing against lockdowns and refusing to abide by any restrictions on large group gatherings
In my experience, that certainly isn’t true - I’ve never heard one of those types even question travel plans. I do hear a lot of people who have been staying locked down and are concerned that holiday travel will cause a dangerous spike in cases.
I also hear a bizarre number of older people blithely making plans to travel to/host a younger generation that is trying to explain that this years Thanksgiving is cancelled, which I guess shouldn’t surprise me but does.
On another note, I would say that anyone strictly isolating themselves alone since March should make significant efforts to find a few or at least one other person they can spend time with, or even move in with*. As we have been discussing in this thread, this isn’t going to be gone in January and spending a year locked alone in your own house while three other individuals do the same thing nearby seems like a painful missed opportunity.
*Obviously if you’re not worried by lack of social contact this isn’t an issue.
posted by bashing rocks together at 2:18 AM on November 10, 2020
In my experience, that certainly isn’t true - I’ve never heard one of those types even question travel plans. I do hear a lot of people who have been staying locked down and are concerned that holiday travel will cause a dangerous spike in cases.
I also hear a bizarre number of older people blithely making plans to travel to/host a younger generation that is trying to explain that this years Thanksgiving is cancelled, which I guess shouldn’t surprise me but does.
On another note, I would say that anyone strictly isolating themselves alone since March should make significant efforts to find a few or at least one other person they can spend time with, or even move in with*. As we have been discussing in this thread, this isn’t going to be gone in January and spending a year locked alone in your own house while three other individuals do the same thing nearby seems like a painful missed opportunity.
*Obviously if you’re not worried by lack of social contact this isn’t an issue.
posted by bashing rocks together at 2:18 AM on November 10, 2020
I see a good bit of blame in this thread being leveled at the people who are shut in their homes who have not had any human contact since March. I'm not isolated for lack of trying; I'm isolated because our government completely failed us and now a quarter of a million people are dead here. I'm disabled. Getting this virus would likely kill me. I would love to see another person, but I don't know anyone who acts remotely safely enough for that to be an option. That is not my fault, and it's really demoralizing to hear, over and over, that people think that I should just make more effort, or that I am being over cautious, or that I just don't understand or trust other people's decision making enough. Anything to blame me for my situation. I'm not the one who needs to try harder in this scenario. If I sound too bent out of shape about this, maybe that is cause for introspection. Being erased in the way that disabled people have been erased during this pandemic is definitely just cause to be a bit bent out of shape. Thank god a vaccine is on the horizon. It means I and others like me might be able to see other human beings again sometime in the next few years.
posted by k8lin at 5:34 AM on November 10, 2020 [34 favorites]
posted by k8lin at 5:34 AM on November 10, 2020 [34 favorites]
Unless test subjects start dropping dead in the meantime, I'm going to get inoculated as soon as I can. (Though I suspect I had the damned thing already back in late February.)
posted by pracowity at 6:23 AM on November 10, 2020
posted by pracowity at 6:23 AM on November 10, 2020
Yes, "pausing" a trial means just not doing more vaccinations, but they're still doing all the other work. It's not like the scientists are going on vacation. A lot of these vaccines are seeing a couple of adverse reactions, usually around week 8 after injection, when antibodies peak. It's like an auto-immune reaction to the antibodies and it happens with a lot of vaccines. They're just making sure that the side effects aren't deadly, determining if it even is a side effect of the vaccine, and heavily monitoring everyone else who had the vaccine at the same time.
posted by sexyrobot at 6:55 AM on November 10, 2020 [2 favorites]
posted by sexyrobot at 6:55 AM on November 10, 2020 [2 favorites]
Unfortunately looking at current rates of spread in the United States we are going to be in the unlucky group of countries for whom this vaccine has only a marginal impact on total deaths and long term health consequences. 4 million active cases, over a hundred thousand new cases -- over double what is was 30 days ago. The rate of growth is accelerating; even with all the new therapies the case fatality rate remains above 2%. Biden won't be in office for 72 days and absent some change of heart by Trump, or major coordinated action at the state level it seems to me that the numbers look extremely grim for Americans. 3-7 million cases just between now and December 15th. 15-20 million more cases December to January 20th. The final nut shots to USA will be that with hospitals overwhelmed by Covid normally treatable but deadly problems are likely to kill more people than usual and with all these new cases there will be a greater chance of a mutation that reduces the efficacy of the vaccine.
posted by interogative mood at 7:50 AM on November 10, 2020 [1 favorite]
posted by interogative mood at 7:50 AM on November 10, 2020 [1 favorite]
Yeah, I don't know anyone I trust that much to "pod up" with and/or also wants to pod, and podding doesn't somehow seem to work as a single person, somehow.
posted by jenfullmoon at 7:56 AM on November 10, 2020
posted by jenfullmoon at 7:56 AM on November 10, 2020
There are a lot of vaccine trials where I live, so my family and I have signed up for various ones. I worry that we’re making it more likely for one of us to have a bad reaction to a vaccine, but it seemed less dangerous than getting sick from the virus. My husband and I got the Pfizer one, my two adult kids and sister got the moderna one and my mom is going to do the Johnson and Johnson one soon. For the Pfizer one, we barely had any symptoms - he had a slightly sore arm and I had a REALLY sore arm/shoulder after each shot. For Moderna, all three who got it had flu like symptoms for about 24 hours. (Of course we don’t really know who had a real shot but the Moderna one had very obvious side effects.)
posted by artychoke at 8:18 AM on November 10, 2020 [6 favorites]
posted by artychoke at 8:18 AM on November 10, 2020 [6 favorites]
As societies, we just simply need to prioritize distribution and although I realize there's nothing simple about the actual distribution -- we provide a lot of infrastructure that we take for granted like air traffic control, cars, policing, schools, etc. We can figure this out as long as we have the will for it, and it's not like vaccination is that new.
I have some faith, even if I'm sitting in Ontario where I'm grateful I got the flu vaccine because our idiot gov't didn't order enough despite knowing this would be a massive year for it.
My hope is that we are also learning how important health including mental health, health care, inclusive design, and inclusivity is. I was perplexed by a few decisions our local health authorities made (and to be clear, Ontario is messing things up badly right now) until I spoke with a friend that works in the field that pointed out they are looking at way more data than just Covid - suicides, opiate deaths, overdoses, etc. Another friend of mine works in the ER for a children's hospital and she said it got so bad over lockdown nurses were rotating out of the ER more frequently because there were so many crisis situations involving suicides and violence. :(
I am a big believer in social distancing, cancelling non-essential gatherings, masks, etc. If people are dead or can't breathe or function that is a huge deal. I also believe it's my responsibility to hold my elected officials to account for their policies, which need to be focused on a) supporting people right now and b) taking the steps back to a society where someone who's got a lung condition can still have an engaged life, i.e. move towards getting this pandemic under control and prepare for the next one.
But I have learned since the spring that health and wellness, and equity, are complex issues, and it's really, really not up to me as an individual to manage other people's responses...it's up to me to manage my own, speak my truth, let people I know are being cavalier -- and by that I mean people I really do know are QAnon followers or whatever -- that I disagree in order to apply a small amount of social pressure, and be there for others.
It's not up to me to legislate whether someone absolutely has to get out of the house and see a person or two in order to stay sane. I do personally believe that large family gatherings are pretty risky and maybe should be managed either through quarantining or smaller groups but I recognize that this is me speaking from a culture that is geared towards the 2.2 child nuclear family unit and if I had 10 siblings I might feel differently.
I also want to share...my family has prioritized my job, which requires some contact with basically the public, and school. As a result we haven't done any other social things since September. We're healthy and okay, but it is a grind at this point because...we basically limited seeing the people we care about most to do economic (or educational) productivity. (At least my kids each have at least one friend in their classes, but the way things shook out it's nothing like it was before.) I totally get why someone who works at say, Home Depot, who is essentially forced to be around idiot public people all day, starts to get lax.
Their work messaging is to be there for everyone who comes in (hopefully with proper PPE and distancing) and then on weekends...stay home because you're a carrier. I mean, this is true, and it's due to a virus, not to someone being mean. But I get how that feels and I think it explains why contacts grew so much once there was any opening up beyond essential services at all. And it's why the government needs to pick up the bill for vaccines, so that all of that normalizes and we're not penalizing the people who are least able to afford things and probably most at risk.
That is something I can put my name behind and lobby for.
posted by warriorqueen at 8:20 AM on November 10, 2020 [8 favorites]
I have some faith, even if I'm sitting in Ontario where I'm grateful I got the flu vaccine because our idiot gov't didn't order enough despite knowing this would be a massive year for it.
My hope is that we are also learning how important health including mental health, health care, inclusive design, and inclusivity is. I was perplexed by a few decisions our local health authorities made (and to be clear, Ontario is messing things up badly right now) until I spoke with a friend that works in the field that pointed out they are looking at way more data than just Covid - suicides, opiate deaths, overdoses, etc. Another friend of mine works in the ER for a children's hospital and she said it got so bad over lockdown nurses were rotating out of the ER more frequently because there were so many crisis situations involving suicides and violence. :(
I am a big believer in social distancing, cancelling non-essential gatherings, masks, etc. If people are dead or can't breathe or function that is a huge deal. I also believe it's my responsibility to hold my elected officials to account for their policies, which need to be focused on a) supporting people right now and b) taking the steps back to a society where someone who's got a lung condition can still have an engaged life, i.e. move towards getting this pandemic under control and prepare for the next one.
But I have learned since the spring that health and wellness, and equity, are complex issues, and it's really, really not up to me as an individual to manage other people's responses...it's up to me to manage my own, speak my truth, let people I know are being cavalier -- and by that I mean people I really do know are QAnon followers or whatever -- that I disagree in order to apply a small amount of social pressure, and be there for others.
It's not up to me to legislate whether someone absolutely has to get out of the house and see a person or two in order to stay sane. I do personally believe that large family gatherings are pretty risky and maybe should be managed either through quarantining or smaller groups but I recognize that this is me speaking from a culture that is geared towards the 2.2 child nuclear family unit and if I had 10 siblings I might feel differently.
I also want to share...my family has prioritized my job, which requires some contact with basically the public, and school. As a result we haven't done any other social things since September. We're healthy and okay, but it is a grind at this point because...we basically limited seeing the people we care about most to do economic (or educational) productivity. (At least my kids each have at least one friend in their classes, but the way things shook out it's nothing like it was before.) I totally get why someone who works at say, Home Depot, who is essentially forced to be around idiot public people all day, starts to get lax.
Their work messaging is to be there for everyone who comes in (hopefully with proper PPE and distancing) and then on weekends...stay home because you're a carrier. I mean, this is true, and it's due to a virus, not to someone being mean. But I get how that feels and I think it explains why contacts grew so much once there was any opening up beyond essential services at all. And it's why the government needs to pick up the bill for vaccines, so that all of that normalizes and we're not penalizing the people who are least able to afford things and probably most at risk.
That is something I can put my name behind and lobby for.
posted by warriorqueen at 8:20 AM on November 10, 2020 [8 favorites]
This (in North Dakota) seems homicidal:
In an attempt to alleviate some of the staffing concerns, Burgum announced that the state health officer has amended an order that will allow health care workers with asymptomatic cases of COVID-19 to continue working in hospitals' COVID-19 units. The Republican governor said hospital administrators asked the state to take the extraordinary step.posted by Dashy at 10:33 AM on November 10, 2020 [3 favorites]
can't we have a one-off meaningful tax credit for getting the vaccine given the significant economic benefit to widespread vaccination
Just pay people. Get vaccinated? Get $20 cash on your way out the door. A tax credit received six months later is a weak incentive for people on the margins. The cost to society of letting a person go unvaccinated (even the financial cost alone) is much higher than that.
posted by justsomebodythatyouusedtoknow at 11:38 AM on November 10, 2020 [10 favorites]
Just pay people. Get vaccinated? Get $20 cash on your way out the door. A tax credit received six months later is a weak incentive for people on the margins. The cost to society of letting a person go unvaccinated (even the financial cost alone) is much higher than that.
posted by justsomebodythatyouusedtoknow at 11:38 AM on November 10, 2020 [10 favorites]
"I totally get why someone who works at say, Home Depot, who is essentially forced to be around idiot public people all day, starts to get lax."
Yeah, if you're literally in danger all day, every day, I can see why those people think differently about it than I do as a shut-in. Like if you still have a day off, why bother to keep yourself unexposed for a day when you're just gonna be in danger again tomorrow?
posted by jenfullmoon at 12:05 PM on November 10, 2020 [2 favorites]
Yeah, if you're literally in danger all day, every day, I can see why those people think differently about it than I do as a shut-in. Like if you still have a day off, why bother to keep yourself unexposed for a day when you're just gonna be in danger again tomorrow?
posted by jenfullmoon at 12:05 PM on November 10, 2020 [2 favorites]
Apparently AZ/Oxford trial on course to read-out next week.
posted by atrazine at 12:13 PM on November 10, 2020 [5 favorites]
posted by atrazine at 12:13 PM on November 10, 2020 [5 favorites]
That's the spine melter, right?
posted by Justinian at 12:35 PM on November 10, 2020 [1 favorite]
posted by Justinian at 12:35 PM on November 10, 2020 [1 favorite]
I would love to see another person, but I don't know anyone who acts remotely safely enough for that to be an option.
I am suggesting looking for strangers with the same constraints, but I don’t intend to blame you. It’s a suggestion that people in my acquaintance have usually not considered.
posted by bashing rocks together at 1:00 PM on November 10, 2020 [1 favorite]
I am suggesting looking for strangers with the same constraints, but I don’t intend to blame you. It’s a suggestion that people in my acquaintance have usually not considered.
posted by bashing rocks together at 1:00 PM on November 10, 2020 [1 favorite]
I totally get why someone who works at say, Home Depot, who is essentially forced to be around idiot public people all day, starts to get lax.
Yeah I think a lot of people who can’t work from home are pretty fatalistic about this. And meanwhile a lot of us who can are very cautious. By medical logic this doesn’t really make sense but by most people’s intuitive personal risk management logic it does.
posted by atoxyl at 1:12 PM on November 10, 2020 [3 favorites]
Yeah I think a lot of people who can’t work from home are pretty fatalistic about this. And meanwhile a lot of us who can are very cautious. By medical logic this doesn’t really make sense but by most people’s intuitive personal risk management logic it does.
posted by atoxyl at 1:12 PM on November 10, 2020 [3 favorites]
Just pay people. Get vaccinated? Get $20 cash on your way out the door.
So I haven't done the math, but I bet that number could be a lot higher. If we're willing as a country to give $1200 to everybody in "stimulus" (and surely it should have been more!), why not pay people $1200 to get the vaccine and end this thing?
(Disclaimer: I am not an economist.)
posted by madcaptenor at 1:57 PM on November 10, 2020 [3 favorites]
So I haven't done the math, but I bet that number could be a lot higher. If we're willing as a country to give $1200 to everybody in "stimulus" (and surely it should have been more!), why not pay people $1200 to get the vaccine and end this thing?
(Disclaimer: I am not an economist.)
posted by madcaptenor at 1:57 PM on November 10, 2020 [3 favorites]
Yeah I think a lot of people who can’t work from home are pretty fatalistic about this. And meanwhile a lot of us who can are very cautious. By medical logic this doesn’t really make sense but by most people’s intuitive personal risk management logic it does.
If you're pretty sure you're going to either die or suffer permanent health issues within the next year, because the nation is actively trying to kill you and everyone you care about, who could blame you for going out and eating a good meal, or attending a fun barbecue?
I mean, I'm sure someone can, but it sure as fuck isn't gonna be me.
posted by We put our faith in Blast Hardcheese at 3:04 PM on November 10, 2020 [5 favorites]
If you're pretty sure you're going to either die or suffer permanent health issues within the next year, because the nation is actively trying to kill you and everyone you care about, who could blame you for going out and eating a good meal, or attending a fun barbecue?
I mean, I'm sure someone can, but it sure as fuck isn't gonna be me.
posted by We put our faith in Blast Hardcheese at 3:04 PM on November 10, 2020 [5 favorites]
I can't work from home, and yeah, it's partly that I'm fatalistic about the disease. It's partly that I am extremely resentful about having reduced the scope of my life so sharply--except in one specific area of my life, the "going to work so that other people can profit off my labor" area of my life. It makes me feel like a shell of a person who only exists for Job. I don't get to quarantine and see my family. I am working harder and longer than I normally would because so many of my coworkers have had to quarantine.
I am not therefore taking risks I shouldn't be taking. I am keeping my department open through the sheer power of how deeply socially isolated I am. But I think I would risk a lot to do something for my own happiness, instead of for my employer's bottom line.
posted by Jeanne at 3:55 PM on November 10, 2020 [23 favorites]
I am not therefore taking risks I shouldn't be taking. I am keeping my department open through the sheer power of how deeply socially isolated I am. But I think I would risk a lot to do something for my own happiness, instead of for my employer's bottom line.
posted by Jeanne at 3:55 PM on November 10, 2020 [23 favorites]
It's partly that I am extremely resentful about having reduced the scope of my life so sharply--except in one specific area of my life, the "going to work so that other people can profit off my labor" area of my life.
Much more acutely put than I could do.
(Anecdotally, this is a sentiment shared among many people I know who DO work remotely. The people I know who are faring best, mentally, are actually the folks who lost their jobs. They have the stress of dealing with the UI system and worry, in a long-term sense, about getting new jobs and making enough money. But day-to-day, they have built fairly pleasant lives in quarantine.)
posted by We put our faith in Blast Hardcheese at 5:20 PM on November 10, 2020 [2 favorites]
Much more acutely put than I could do.
(Anecdotally, this is a sentiment shared among many people I know who DO work remotely. The people I know who are faring best, mentally, are actually the folks who lost their jobs. They have the stress of dealing with the UI system and worry, in a long-term sense, about getting new jobs and making enough money. But day-to-day, they have built fairly pleasant lives in quarantine.)
posted by We put our faith in Blast Hardcheese at 5:20 PM on November 10, 2020 [2 favorites]
It's very important to underline this. It is very possible--perhaps even the most likely possibility--that the people who have had the vaccine are far more likely to have an asymptomatic and perhaps shorter-running case of COVID-19. Rather than that it prevents ANY infection--and any chance of retransmission--at all.
Maybe the vaccinated people have the first 2-3 days of pre-symptomatic explosion of viral growth, then their immune system ramps up to shut it down before it gets much beyond that point, in most cases .....
Source: Pretty much every episode of This Week in Virology over the past few months--just for example, episode 667 starting at 38:41 (see also discussion of previous question starting at 33:47, where they mention some vaccines that work at first but then lead to worse infections 3-12 months down the road. Everyone hopes this won't be the case with the COVID-19 vaccines but we won't know for certain until we get 3-12 months down the road).
Another source: Recent discussion by Anthony Fauci and other leading people supervising the vaccine trials along these lines:
A key point to note, however, is that the vaccine isn’t an end-all solution to the pandemic. That’s in large part because any inoculations developed now are focused on simply preventing symptoms from arising, rather than blocking out the virus altogether.
So this is good news--very good news--but don't throw away your masks and social distancing just yet. And don't plan on it automatically even if the vaccine is completely successful and after it has been pretty widely disseminated. Maybe, maybe not, even at that point.
I listen to TWIV as well, and I also keep up some of the studies being published about the immunological response to COVID. The press release actually states that its "more than 90% effective". It's frustrating that its so vague, but it at least indicates that the other vaccines should work. The Phase 1 and Phase 2 trials certainly were promising in that they showed the vaccines elicited similar and robust immune responses, even in elderly people. We just need the phase 3 for confirmation, but this is the very promising.
Although it would nice to know if the participants in the experimental group who were symptomatic for COVID had severe or mild disease, if its true that the vaccine is preventing symptomatic disease that isn't picked up by the study, then it's likely the vaccine is lessening the severity in patients who do become symptomatic. That's the case with the influenza vaccine, which incidentally is much less efficacious. That's also the case of for natural immunity to most circulating respiratory viruses. According to the the press release the study will evaluate the impact of the vaccine on disease severity, but that will take much more time.
Really, above 90% efficacy is fantastic for a vaccine. The yahoo article quoting Fauci was written before this news. If Fauci had further information regarding the efficacy of the vaccines under trial and their impact on disease severity and sterilizing immunity, which isn't being testing due to resource and time constraints, he would have been seriously in breach of ethical and experimental protocols to disclose such information. He also would be possessed with prophetic vision, in which case I want to ask him about upcoming lottery numbers. These studies are supposed to be blinded. The circumstances and individuals to which these blinds are lifted are carefully controlled. Interviews to yahoo finance are not one of them, needless to say.
In addition, the impact of symptomaticity on disease transmissibility is murky. For example, we know children who are asymptomatic contain just as much, if not more, virus, than adults. Yet there are hints from studies that they don't transmit the disease as well. Why this might be is unknown. Also, there are hints from modeling that asymptomatic individuals don't transmit as well as symptomatic individuals. Really, the known difficulty about preventing spread of SARS-COV 2 is that we know transmissibility peaks just before symptom onset. As a result, a person can transmit to others before they know they are sick. By the time they are tested it is too late.
Last, there was fairly extensive discussion of ADE early in the pandemic. From what I can tell people who study the possibility closely consider the risk minimal. If it were a seriously concern, I doubt public health officials would be advocating distribution of this vaccine to billions of people.
The actual press release: Release
posted by eagles123 at 8:56 PM on November 10, 2020 [1 favorite]
Maybe the vaccinated people have the first 2-3 days of pre-symptomatic explosion of viral growth, then their immune system ramps up to shut it down before it gets much beyond that point, in most cases .....
Source: Pretty much every episode of This Week in Virology over the past few months--just for example, episode 667 starting at 38:41 (see also discussion of previous question starting at 33:47, where they mention some vaccines that work at first but then lead to worse infections 3-12 months down the road. Everyone hopes this won't be the case with the COVID-19 vaccines but we won't know for certain until we get 3-12 months down the road).
Another source: Recent discussion by Anthony Fauci and other leading people supervising the vaccine trials along these lines:
A key point to note, however, is that the vaccine isn’t an end-all solution to the pandemic. That’s in large part because any inoculations developed now are focused on simply preventing symptoms from arising, rather than blocking out the virus altogether.
So this is good news--very good news--but don't throw away your masks and social distancing just yet. And don't plan on it automatically even if the vaccine is completely successful and after it has been pretty widely disseminated. Maybe, maybe not, even at that point.
I listen to TWIV as well, and I also keep up some of the studies being published about the immunological response to COVID. The press release actually states that its "more than 90% effective". It's frustrating that its so vague, but it at least indicates that the other vaccines should work. The Phase 1 and Phase 2 trials certainly were promising in that they showed the vaccines elicited similar and robust immune responses, even in elderly people. We just need the phase 3 for confirmation, but this is the very promising.
Although it would nice to know if the participants in the experimental group who were symptomatic for COVID had severe or mild disease, if its true that the vaccine is preventing symptomatic disease that isn't picked up by the study, then it's likely the vaccine is lessening the severity in patients who do become symptomatic. That's the case with the influenza vaccine, which incidentally is much less efficacious. That's also the case of for natural immunity to most circulating respiratory viruses. According to the the press release the study will evaluate the impact of the vaccine on disease severity, but that will take much more time.
Really, above 90% efficacy is fantastic for a vaccine. The yahoo article quoting Fauci was written before this news. If Fauci had further information regarding the efficacy of the vaccines under trial and their impact on disease severity and sterilizing immunity, which isn't being testing due to resource and time constraints, he would have been seriously in breach of ethical and experimental protocols to disclose such information. He also would be possessed with prophetic vision, in which case I want to ask him about upcoming lottery numbers. These studies are supposed to be blinded. The circumstances and individuals to which these blinds are lifted are carefully controlled. Interviews to yahoo finance are not one of them, needless to say.
In addition, the impact of symptomaticity on disease transmissibility is murky. For example, we know children who are asymptomatic contain just as much, if not more, virus, than adults. Yet there are hints from studies that they don't transmit the disease as well. Why this might be is unknown. Also, there are hints from modeling that asymptomatic individuals don't transmit as well as symptomatic individuals. Really, the known difficulty about preventing spread of SARS-COV 2 is that we know transmissibility peaks just before symptom onset. As a result, a person can transmit to others before they know they are sick. By the time they are tested it is too late.
Last, there was fairly extensive discussion of ADE early in the pandemic. From what I can tell people who study the possibility closely consider the risk minimal. If it were a seriously concern, I doubt public health officials would be advocating distribution of this vaccine to billions of people.
The actual press release: Release
posted by eagles123 at 8:56 PM on November 10, 2020 [1 favorite]
About the problem of vaccinated people who get asymptomatic covid-19, and may still infect others, the study does have followup visits and blood draws at 1 month and 6 months after vaccinaton (and 12 and 24). Antibody tests won't tell if a vaccinated person caught covid (because the vaccine should produce antibodies as well), but it should tell how many people in the control group had covid, and those were asymptomatic cases.
Maybe that can factor that data into the efficiency numbers. I don't know if they will. The protocol is more pages than I am likely to make sense of. Probably the answer is in there somewhere.
posted by joeyh at 8:14 AM on November 11, 2020
Maybe that can factor that data into the efficiency numbers. I don't know if they will. The protocol is more pages than I am likely to make sense of. Probably the answer is in there somewhere.
posted by joeyh at 8:14 AM on November 11, 2020
It's partly that I am extremely resentful about having reduced the scope of my life so sharply--except in one specific area of my life, the "going to work so that other people can profit off my labor" area of my life.
Fundamentally that's much deeper than covid restrictions and more about general alienation of labour who owns output. On the one hand, it's the most logical thing in the world that the one activity that continues is the one that produces useful outputs for our society. Doctors and farmers are not wondering why that is the one thing they keep doing, it's obvious. On the other hand, if your job doesn't feel like it's really adding any value to society then it will feel profound ridiculous that the only thing allowed to keep going is trading your time in order to make shareholders rich.
posted by atrazine at 10:00 AM on November 11, 2020 [4 favorites]
Fundamentally that's much deeper than covid restrictions and more about general alienation of labour who owns output. On the one hand, it's the most logical thing in the world that the one activity that continues is the one that produces useful outputs for our society. Doctors and farmers are not wondering why that is the one thing they keep doing, it's obvious. On the other hand, if your job doesn't feel like it's really adding any value to society then it will feel profound ridiculous that the only thing allowed to keep going is trading your time in order to make shareholders rich.
posted by atrazine at 10:00 AM on November 11, 2020 [4 favorites]
Speaking of shareholders and riches: Pfizer CEO sold $5.6 million in stock the day of breakthrough vaccine news (WaPo, Nov. 11) CEO Albert Bourla’s transaction was planned ahead of time as part of a financial schedule that allows executives to periodically sell shares of their company. On Monday, Bourla sold 132,508 shares of Pfizer at a price of $41.94, which adds up to just under $5.6 million, according to filings with the Securities and Exchange Commission. [...] Bourla still owns more than 80,000 Pfizer shares.
posted by Iris Gambol at 11:36 AM on November 11, 2020
posted by Iris Gambol at 11:36 AM on November 11, 2020
> Last, there was fairly extensive discussion of ADE early in the pandemic. From what I can tell people who study the possibility closely consider the risk minimal.
For the benefit of everyone else, ADE is Antibody Dependent Enhancement and means, in short, that for certain viruses if you are exposed once or receive a vaccination, then catch the virus later (usually not immediately later but say after 6 months or a year) then you can have a MUCH WORSE case of the illness than if you hadn't been previously exposed/vaccinated.
This has actually happened during the initial vaccine for respiratory syncytial virus and dengue virus. That is the main reason the vaccine trails for these viruses failed.
So as you say, people think this probably won't be the case for Sars-CoV-2 and also, there are some known techniques to reduce the chances of it happening. Here is one study summarizing and discussing the issue.
However, my point--which still stands--is that no one knows this for certain until clinical trails have run their course. And the "run their course" means, among other things, allowing sufficient time for the trial to run, to discover such possible effects.
The protocol for vaccine trials has been developed and refined over the years as various low-probability events actually occurred as vaccines were tested (not as rigorously as now) and then rolled out, only for surprises to develop.
> I doubt public health officials would be advocating distribution of this vaccine to billions of people.
It's more likely to be a risk/benefit analysis. We have a known large risk of very large global harm with no vaccine. If the vaccines are rolled out early and fast, there is a small risk (though with potentially large harm, as well) of something such as ADE developing that we haven't discovered yet because the longest trials have run only a few months.
It's a risk I would probably take as well.
But if some previously unseen problems do develop as these vaccines roll out to hundreds of millions and billions of people--and undoubtedly we will see something, such as side effects that occur only 1/100,000 or 1/1,000,000, ie, the things the Phase 3 trials didn't have the statistical power to detect--potentially the worst downside will be sowing further distrust in vaccinations and stoking anti-vaxxer fears and numbers. This won't be fun to deal with if there is even a moderate downside that shows up only 6-12-18-24 months down the line.
Point is not to say that we shouldn't roll out these vaccines, but it makes sense to communicate that--like all vaccines--they have a hugely positive reward/risk ratio. But they do in fact have some risk, particularly in the earlier days.
posted by flug at 12:18 PM on November 11, 2020 [6 favorites]
For the benefit of everyone else, ADE is Antibody Dependent Enhancement and means, in short, that for certain viruses if you are exposed once or receive a vaccination, then catch the virus later (usually not immediately later but say after 6 months or a year) then you can have a MUCH WORSE case of the illness than if you hadn't been previously exposed/vaccinated.
This has actually happened during the initial vaccine for respiratory syncytial virus and dengue virus. That is the main reason the vaccine trails for these viruses failed.
So as you say, people think this probably won't be the case for Sars-CoV-2 and also, there are some known techniques to reduce the chances of it happening. Here is one study summarizing and discussing the issue.
However, my point--which still stands--is that no one knows this for certain until clinical trails have run their course. And the "run their course" means, among other things, allowing sufficient time for the trial to run, to discover such possible effects.
The protocol for vaccine trials has been developed and refined over the years as various low-probability events actually occurred as vaccines were tested (not as rigorously as now) and then rolled out, only for surprises to develop.
> I doubt public health officials would be advocating distribution of this vaccine to billions of people.
It's more likely to be a risk/benefit analysis. We have a known large risk of very large global harm with no vaccine. If the vaccines are rolled out early and fast, there is a small risk (though with potentially large harm, as well) of something such as ADE developing that we haven't discovered yet because the longest trials have run only a few months.
It's a risk I would probably take as well.
But if some previously unseen problems do develop as these vaccines roll out to hundreds of millions and billions of people--and undoubtedly we will see something, such as side effects that occur only 1/100,000 or 1/1,000,000, ie, the things the Phase 3 trials didn't have the statistical power to detect--potentially the worst downside will be sowing further distrust in vaccinations and stoking anti-vaxxer fears and numbers. This won't be fun to deal with if there is even a moderate downside that shows up only 6-12-18-24 months down the line.
Point is not to say that we shouldn't roll out these vaccines, but it makes sense to communicate that--like all vaccines--they have a hugely positive reward/risk ratio. But they do in fact have some risk, particularly in the earlier days.
posted by flug at 12:18 PM on November 11, 2020 [6 favorites]
>Really, above 90% efficacy is fantastic for a vaccine. The yahoo article quoting Fauci was written before this news.
The question, though, is which of these options is true:
#1. The vaccine greatly reduces the number of active disease cases and, generally, the severity of the disease, but still allows mild/asymptomatic cases that can still result in disease transmission
OR
#2. Whether it prevents any disease at all (include mild or asymptomatic cases) and also, whether it prevents vaccinated individuals from acting as vectors to transmit the virus to others.
#1 is the type of immunity we would expect with typical coronaviruses; #2 is so-called "sterilizing immunity".
I just read through the protocol; it is not even designed to detect asymptomatic cases. It is also not designed to determine whether or not the vaccine reduces transmission of the disease.
At all.
The protocol detects incidences of COVID-19 by whether the participants note symptoms and then went to the doctor and had a positive test result. And when cases do happen, the severity of the disease will be tracked.
But there is literally nothing there that addresses transmissibility or asymptomatic cases.
With coronaviruses, it is the NORM that immunity is "sloppy". That is to say, even after the initial infection which which confers a degree of immunity, people can still contract the disease and can still transmit it to others. Often they have mild symptoms or no symptoms at all. But they still have a viral infection active enough to allow transmission of the virus to others.
So this would be the expectation for any coronavirus after any vaccine, in the absence of definite evidence to the contrary: Sloppy and fairly short-lived immunity, not sterilizing immunity.
And in fact there is absolutely no evidence at all in support of sterilizing immunity for this vaccine, so our default position must be that people who are vaccinated will still be able to have mild or asymptomatic infections and that they will still be able to transmit the disease to others during this period.
The hope would be that there will be some reduction in the amount of transmission for people who are vaccinated--even just a 10-20% reduction in transmissibility would be hugely helpful.
But even a 50% reduction in transmissibility from vaccination would be far, far short of the 99-100% reduction we see, for example from the measles vaccine.
> The yahoo article quoting Fauci was written before this news.
Er, Fauci has been following the vaccine protocols and trails in detail from day 1. He knows exactly what they are planned, designed, and capable of doing, and what they're not. He knows they are not even looking at reduction in disease transmission at this point.
The only bit of information added by "this news" is the exact percentage of reduction in cases the vaccine has produced. Fauci, and everyone else who has been paying attention, already knew that vaccine producers were shooting for/hoping for/planning for an 80% or better effectiveness of vaccines.
In short, the news release tell use that this vaccine is meeting or exceeding expectations. Hooray!
But the press release didn't give Fauci any new information at all about the issue of whether or not people who are vaccinated will still be susceptible to asymptomatic or mild cases of the disease, and whether vaccination will reduce transmission of the disease.
He already knew that the vaccine studies were not even planning to measure those aspects of the vaccine, and that any results from the trials will shed no light whatsoever on them.
The problem we will have is we're likely to go through a lengthy period where a large percentage of the population is vaccinated by a large percentage isn't. As long as the unvaccinated percentage is even 15-20% then the potential for pretty large outbreaks is still there.
And if the vaccinated portion of the population can still catch and transmit the disease--even with mild or no symptoms and even at a somewhat reduced rate of transmission--we are still very much in a danger zone as long as there is large un-vaccinated group out there.
Because people who are vaccinated are going to be prone to "resume life as usual" and that increase in Covid transmission thanks to the removal of social distancing, masks, etc etc etc is quite likely to overwhelm any reduction in transmission due to vaccination.
People who have been vaccinated will be "safe"--well, at least 90% safe--but the 10-20-30-40-50-60% of the world population not yet vaccinated will be just as vulnerable as ever.
Perhaps even more so if the vaccinated group resumes life as usual, because "we're safe," yet are still able to act as vectors for the disease.
TLDR: However you dice it, this is not going to be "take a couple of shots and things thing is OVER". It's more likely to be a fairly long and very gradual wind-down period. Even at best. Set your expectations accordingly--and perhaps we'll manage to exceed them.
posted by flug at 1:04 PM on November 11, 2020 [5 favorites]
The question, though, is which of these options is true:
#1. The vaccine greatly reduces the number of active disease cases and, generally, the severity of the disease, but still allows mild/asymptomatic cases that can still result in disease transmission
OR
#2. Whether it prevents any disease at all (include mild or asymptomatic cases) and also, whether it prevents vaccinated individuals from acting as vectors to transmit the virus to others.
#1 is the type of immunity we would expect with typical coronaviruses; #2 is so-called "sterilizing immunity".
I just read through the protocol; it is not even designed to detect asymptomatic cases. It is also not designed to determine whether or not the vaccine reduces transmission of the disease.
At all.
The protocol detects incidences of COVID-19 by whether the participants note symptoms and then went to the doctor and had a positive test result. And when cases do happen, the severity of the disease will be tracked.
But there is literally nothing there that addresses transmissibility or asymptomatic cases.
With coronaviruses, it is the NORM that immunity is "sloppy". That is to say, even after the initial infection which which confers a degree of immunity, people can still contract the disease and can still transmit it to others. Often they have mild symptoms or no symptoms at all. But they still have a viral infection active enough to allow transmission of the virus to others.
So this would be the expectation for any coronavirus after any vaccine, in the absence of definite evidence to the contrary: Sloppy and fairly short-lived immunity, not sterilizing immunity.
And in fact there is absolutely no evidence at all in support of sterilizing immunity for this vaccine, so our default position must be that people who are vaccinated will still be able to have mild or asymptomatic infections and that they will still be able to transmit the disease to others during this period.
The hope would be that there will be some reduction in the amount of transmission for people who are vaccinated--even just a 10-20% reduction in transmissibility would be hugely helpful.
But even a 50% reduction in transmissibility from vaccination would be far, far short of the 99-100% reduction we see, for example from the measles vaccine.
> The yahoo article quoting Fauci was written before this news.
Er, Fauci has been following the vaccine protocols and trails in detail from day 1. He knows exactly what they are planned, designed, and capable of doing, and what they're not. He knows they are not even looking at reduction in disease transmission at this point.
The only bit of information added by "this news" is the exact percentage of reduction in cases the vaccine has produced. Fauci, and everyone else who has been paying attention, already knew that vaccine producers were shooting for/hoping for/planning for an 80% or better effectiveness of vaccines.
In short, the news release tell use that this vaccine is meeting or exceeding expectations. Hooray!
But the press release didn't give Fauci any new information at all about the issue of whether or not people who are vaccinated will still be susceptible to asymptomatic or mild cases of the disease, and whether vaccination will reduce transmission of the disease.
He already knew that the vaccine studies were not even planning to measure those aspects of the vaccine, and that any results from the trials will shed no light whatsoever on them.
The problem we will have is we're likely to go through a lengthy period where a large percentage of the population is vaccinated by a large percentage isn't. As long as the unvaccinated percentage is even 15-20% then the potential for pretty large outbreaks is still there.
And if the vaccinated portion of the population can still catch and transmit the disease--even with mild or no symptoms and even at a somewhat reduced rate of transmission--we are still very much in a danger zone as long as there is large un-vaccinated group out there.
Because people who are vaccinated are going to be prone to "resume life as usual" and that increase in Covid transmission thanks to the removal of social distancing, masks, etc etc etc is quite likely to overwhelm any reduction in transmission due to vaccination.
People who have been vaccinated will be "safe"--well, at least 90% safe--but the 10-20-30-40-50-60% of the world population not yet vaccinated will be just as vulnerable as ever.
Perhaps even more so if the vaccinated group resumes life as usual, because "we're safe," yet are still able to act as vectors for the disease.
TLDR: However you dice it, this is not going to be "take a couple of shots and things thing is OVER". It's more likely to be a fairly long and very gradual wind-down period. Even at best. Set your expectations accordingly--and perhaps we'll manage to exceed them.
posted by flug at 1:04 PM on November 11, 2020 [5 favorites]
I'll feel better when the results are actually published and peer-reviewed.
posted by Iris Gambol at 2:51 PM on November 11, 2020
posted by Iris Gambol at 2:51 PM on November 11, 2020
I ran some numbers just so you can appreciate the difficulty of getting good phase 3 results.
A typical phase 3 involves around 40,000 people. Half are placebo and half are given the vaccine.
In order to show good statistical results, according to the CDC, you need to have at least 164 people to get the disease. Hopefully most of these are in the placebo group. So assuming a 90% effectiveness you need around 150 people in the placebo group to get the disease.
That's 150 people infected out of a placebo group of just 20,000 people. But in the entire 9 months of the pandemic so far, only 640 people per 20,000 have gotten the disease, about 70 per month. So you could expect to have to run your experiment, after the second shot, for more than two months to get the desired response.
On the bright side, the recent spike in covid infections may speed up the results by getting more placebo people infected quickly. That's a bad joke, but it shows why China is doing their trials in Brazil instead of China. The infection rate in China is so low they could wait forever to get good statistical results, but in Brazil the infection rate is so high that they can get valid results quickly.
posted by JackFlash at 5:57 PM on November 11, 2020 [4 favorites]
A typical phase 3 involves around 40,000 people. Half are placebo and half are given the vaccine.
In order to show good statistical results, according to the CDC, you need to have at least 164 people to get the disease. Hopefully most of these are in the placebo group. So assuming a 90% effectiveness you need around 150 people in the placebo group to get the disease.
That's 150 people infected out of a placebo group of just 20,000 people. But in the entire 9 months of the pandemic so far, only 640 people per 20,000 have gotten the disease, about 70 per month. So you could expect to have to run your experiment, after the second shot, for more than two months to get the desired response.
On the bright side, the recent spike in covid infections may speed up the results by getting more placebo people infected quickly. That's a bad joke, but it shows why China is doing their trials in Brazil instead of China. The infection rate in China is so low they could wait forever to get good statistical results, but in Brazil the infection rate is so high that they can get valid results quickly.
posted by JackFlash at 5:57 PM on November 11, 2020 [4 favorites]
Moderna says their COVID-19 vaccine is 94.5 percent effective in early analysis
posted by 1970s Antihero at 7:00 AM on November 16, 2020 [6 favorites]
posted by 1970s Antihero at 7:00 AM on November 16, 2020 [6 favorites]
Better news: "A key advantage of Moderna’s vaccine is that it does not need ultra-cold storage like Pfizer’s, making it easier to distribute. Moderna expects it to be stable at normal fridge temperatures of 2 to 8 degrees Celsius (36 to 48°F) for 30 days and it can be stored for up to 6 months at -20C."
posted by Mitheral at 7:20 AM on November 16, 2020 [5 favorites]
posted by Mitheral at 7:20 AM on November 16, 2020 [5 favorites]
-20C (-4F for people used to freedom units) degrees is obtainable with normal consumer grade deep freezers.
posted by Mitheral at 7:22 AM on November 16, 2020 [2 favorites]
posted by Mitheral at 7:22 AM on November 16, 2020 [2 favorites]
... consumer grade deep freezers.
Standard kitchen freezers, even. Very good news.
posted by mr_roboto at 8:47 AM on November 16, 2020 [4 favorites]
Standard kitchen freezers, even. Very good news.
posted by mr_roboto at 8:47 AM on November 16, 2020 [4 favorites]
Freezers that are part of a frost free refrigerator cycle the temperature too much to be reliable for this sort of storage. At least at the six month range. They'd be fine for the 30 day end.
posted by Mitheral at 10:04 AM on November 16, 2020 [3 favorites]
posted by Mitheral at 10:04 AM on November 16, 2020 [3 favorites]
Note that these freezers used for storage have to have logs which guarantee that the temperature never rose over the stability threshold for the duration of storage. Not sure if they will require stability tracking to the point of injection but it would be a massive fail if the effectiveness drops to 50% because of bad supply chain management (e.g. a few defrost cycles).
posted by benzenedream at 8:40 AM on November 17, 2020
posted by benzenedream at 8:40 AM on November 17, 2020
Oxford/AstraZeneca Vaccine Is Shown to Be Effective — and It’s Cheap
It will be cheaper and far easier to store. AstraZeneca’s doses come in at about $2.50 a shot, and require only fridgelike temperatures to remain safe.posted by 1970s Antihero at 8:07 AM on November 23, 2020 [4 favorites]
When study subjects in Brazil and the U.K. — both of which have seen high levels of COVID in recent months — were given two spaced-out doses, Astra Zeneca’s doses were shown to be 62 percent effective. When given a half-dose followed by a full one, the vaccine was 90 percent effective. Overall, the rate was 70 percent.
And IIUC the 70% rate for the AstraZeneca vaccine is based on actual viral load tests, so is not necessarily worse than the 95% rate for Pfizer or Moderna (who only looked at symptoms.)
posted by mark k at 8:34 AM on November 23, 2020
posted by mark k at 8:34 AM on November 23, 2020
Unsanitized: We’ve Given Almost Nothing to States and Cities for Vaccine Distribution
So how much money has been allocated for this, the largest logistical project in the history of mankind? $200 million. That’s all the jurisdictions have received thus far. Biden has promised $25 billion for vaccine distribution, but that’s tied up in the moribund stimulus talks. There may be some smart person devising some way to unlock emergency funding along the lines of what Trump did on the border wall, but at the moment, you need Congress to issue some dollars. “[W]e absolutely do not have enough to pull this off successfully,” said the state health officer of Mississippi to the New York Times.posted by tonycpsu at 12:51 PM on November 23, 2020 [3 favorites]
This is absolute madness. The economic and public health effects of efficient delivery of a vaccine are almost incalculable. It will unleash pent-up demand across the country and return the country to something resembling normalcy. This multi-trillion-dollar, multi-tens-of-thousand-life action is resting on a couple hundred million distributed across the country? What? [...]
As Olivia Webb reports, with states largely unable to act, HHS is going through CVS and Walgreens to deliver to long-term care facilities. Other large chain pharmacy partnerships are being put in motion. Distribution, in other words, is being privatized. “There are huge potential failure points,” Webb notes, common to the idea that scale can magnify disruptions. If one of the thousands of little nodes in the jurisdictions have a refrigeration problem, that can be managed with some other part of the network. If CVS fails, that could affect a much larger population.
Bunch of folks are starting to look askance at the AZ vaccine. Here's one writeup out of Wired, and another slightly different one from the NYT.
posted by Justinian at 2:34 PM on November 25, 2020 [1 favorite]
posted by Justinian at 2:34 PM on November 25, 2020 [1 favorite]
My local one-person-I-interact-with-outside-my-household friend who I go masked dog walking with is an essential worker at a hospital (but does not work directly with COVID patients, I'm not even sure we've had any COVID patients here) and we were talking about what their plan is. It's a tiny community hospital so a lot of the planning is more widely shared with staff. They're planning to build a testing/vaccination kiosk out in the parking lot (the current testing at the hospital is drive-up but takes place by one of the entrances and is suboptimal because of that - testing in Vermont overall is pretty good) and all the chatter seems to indicate that if things go the way they're supposed to, they'll be vaccinating essential workers in early January and they're looking at getting the Pfizer vaccine. It's still a ways off, and a longer way off for me who is not essential, not elderly, etc etc, but just seeing a plan start to coalesce (and a future non-Trump administration) has been heartening.
posted by jessamyn at 5:21 PM on November 25, 2020 [2 favorites]
posted by jessamyn at 5:21 PM on November 25, 2020 [2 favorites]
I think we might be headed for a bad time when the vaccine starts to get wide distribution. We have no proof that the two leading vaccines lead to the type of immunity that contributes to herd immunity. We don’t know if someone who has received the vaccine can still spread the virus. Now throw that fact in with anti-science rhetoric, toss in some “I don’t have to wear a mask because I’ve been vaccinated” refusal to follow public health recommendations and you might have the virus spreading even faster than it is today. In that case the only reasonable response is for individuals to scramble to get vaccinated as soon as possible.
posted by rdr at 10:26 PM on December 6, 2020 [1 favorite]
posted by rdr at 10:26 PM on December 6, 2020 [1 favorite]
If we even just prevent medical personnel from contracting the virus by January that will be a huge help. I'm not holding out hope for the general public doing the right thing based on the last year.
posted by benzenedream at 10:33 PM on December 6, 2020 [1 favorite]
posted by benzenedream at 10:33 PM on December 6, 2020 [1 favorite]
toss in some “I don’t have to wear a mask because I’ve been vaccinated” refusal to follow public health recommendations and you might have the virus spreading even faster than it is today
It's a good slatepitch, but even with the worst case scenario of the vaccine not reducing spread at all (which is exceedingly unlikely) the people you describe will be limited to the people already proudly not wearing a mask.
Realistically some places should be essential business and masks-for-everyone (grocery stores, for example) but others will end up places only vaccinated people go (gyms, bars). But regardless I just selfishly want to get the vaccine so I can go to the gym, get a haircut, and have friends over for a dinner where we can all shout things.
posted by mark k at 11:29 PM on December 6, 2020 [1 favorite]
It's a good slatepitch, but even with the worst case scenario of the vaccine not reducing spread at all (which is exceedingly unlikely) the people you describe will be limited to the people already proudly not wearing a mask.
Realistically some places should be essential business and masks-for-everyone (grocery stores, for example) but others will end up places only vaccinated people go (gyms, bars). But regardless I just selfishly want to get the vaccine so I can go to the gym, get a haircut, and have friends over for a dinner where we can all shout things.
posted by mark k at 11:29 PM on December 6, 2020 [1 favorite]
But if the vaccine doesn’t prevent transmission that can still make more people sick, mark k. Masks and distance are probabilistic defenses, and the more asymptomatic carriers there are the higher the probability masks have to "roll against" in the groceries, etc. It’s basically the problem we seem to be having with college students now, AIUI - they feel fine and spread everywhere, even in regions with high levels of mask wearing.
What I’ve read about the vaccines describes them as probabilistic protection too, though that’s partly the newness and the kind of data one gets to start.
posted by clew at 11:44 AM on December 7, 2020
What I’ve read about the vaccines describes them as probabilistic protection too, though that’s partly the newness and the kind of data one gets to start.
posted by clew at 11:44 AM on December 7, 2020
Whitehouse.gov transcript quoting Trump: Plus, you do have an immunity. You develop immunity over a period of time, and I hear we’re close to 15 percent. I’m hearing that, and that is terrific. That’s a very powerful vaccine in itself. And just tremendous progress has been made.
posted by rdr at 6:25 PM on December 8, 2020
posted by rdr at 6:25 PM on December 8, 2020
The executive order he signed at the 'vaccine summit' is Executive Order on Ensuring Access to United States Government COVID-19 Vaccines; "The White House event was predicated as a signing ceremony for an executive order designed to pressure vaccine manufacturers to prioritize shipments within the U.S. over other countries — although the order didn’t appear to have any legal teeth." (Politico). Vaccine manufacturers declined to attend. The WH "launched the event with a video misleadingly portraying people such as Anthony Fauci, the government’s top infectious disease expert, as naysayers about Trump's vaccine timeline.[...] Meanwhile, in Delaware, Fauci appeared via video at the Biden event, which also featured the president-elect’s top incoming health staffers."
The U.S. has hit 15 million confirmed cases of COVID-19, with one million of those confirmations occurring in the past week, and we're closing in on 300,000 deaths attributed to the virus. Global cases: 68,252,608 / Global deaths: 1,557,343.
Canada, Brazil, Germany, United States and Indonesia prepare to follow UK in rolling out COVID-19 vaccines:
Canada will receive its first doses of the Pfizer vaccine before the end of the month, with millions more to follow early in the new year. Canadian officials had initially expected to get a total of 6 million doses of vaccines [enough to vaccinate 3 million people] from Pfizer and Moderna by the end of March. [...] Since the pandemic began, Canada has reported a total of 415,182 cases of COVID-19 and 12,665 deaths. Ontario and Quebec, the two most populous provinces, account for 67 per cent of the total cases and 87 per cent of the deaths.
Germany expects to begin coronavirus vaccinations "in the very first days" of 2021, according to Chancellor Angela Merkel's chief of staff. Infection figures in Germany have more or less stabilised at a high level since a partial shutdown started on November 2, but have not gone down. On Monday, the national disease control centre reported 12,332 new cases over the past 24 hours, compared with 11,168 a week ago, and 147 new deaths.
Brazil's most populous state, São Paulo, plans to start vaccinations on January 25. [...] Brazil has the world's third highest coronavirus case count, at more than 6.6 million, and the second heaviest death toll, more than 177,000.
Russia's new Sputnik V vaccine is being transported across the country after the start of a mass vaccination effort in Moscow this weekend. Soldiers in Russia's Far East region of Zabaykalsky Krai were given the vaccine on Monday. One thousand doses of the vaccine have also been transported to a warehouse in the Chelyabinsk region, to be given to medical workers and teachers. Sputnik V needs to be stored at minus 18 degrees Celsius and is being transported in refrigerated minivans. [This vaccine is touted as being over 95 per cent effective; it did not finish a third clinical trial.]
Provincial governments across China are placing orders for experimental, domestically made coronavirus vaccines, though health officials have yet to say how well they work or how they may reach the country's 1.4 billion people. [...] Even without final approval, more than 1 million healthcare workers and others who are deemed at high risk of infection have already received experimental vaccines from Sinovac and Sinopharm, under emergency use permissions. Developers have yet to disclose how effective their vaccines are, and have not given any details about possible side effects. But China is also testing its vaccines overseas. The country's pharmaceutical industry has at least five vaccines from four producers being tested in more than a dozen countries, including Russia, Egypt and Mexico.
Indonesia received 1.2 million doses of the Chinese Sinovac vaccine on Sunday, according to President Joko Widodo. The Indonesian Government is also expecting another 1.8 million doses and raw materials — which could produce about 45 million doses — to come next year. The vaccine, known as CoronaVac, still needs approval from regulators. Indonesia's highest Islamic clerical body is also working to issue a halal certification for the vaccine.
posted by Iris Gambol at 1:00 AM on December 9, 2020
The U.S. has hit 15 million confirmed cases of COVID-19, with one million of those confirmations occurring in the past week, and we're closing in on 300,000 deaths attributed to the virus. Global cases: 68,252,608 / Global deaths: 1,557,343.
Canada, Brazil, Germany, United States and Indonesia prepare to follow UK in rolling out COVID-19 vaccines:
Canada will receive its first doses of the Pfizer vaccine before the end of the month, with millions more to follow early in the new year. Canadian officials had initially expected to get a total of 6 million doses of vaccines [enough to vaccinate 3 million people] from Pfizer and Moderna by the end of March. [...] Since the pandemic began, Canada has reported a total of 415,182 cases of COVID-19 and 12,665 deaths. Ontario and Quebec, the two most populous provinces, account for 67 per cent of the total cases and 87 per cent of the deaths.
Germany expects to begin coronavirus vaccinations "in the very first days" of 2021, according to Chancellor Angela Merkel's chief of staff. Infection figures in Germany have more or less stabilised at a high level since a partial shutdown started on November 2, but have not gone down. On Monday, the national disease control centre reported 12,332 new cases over the past 24 hours, compared with 11,168 a week ago, and 147 new deaths.
Brazil's most populous state, São Paulo, plans to start vaccinations on January 25. [...] Brazil has the world's third highest coronavirus case count, at more than 6.6 million, and the second heaviest death toll, more than 177,000.
Russia's new Sputnik V vaccine is being transported across the country after the start of a mass vaccination effort in Moscow this weekend. Soldiers in Russia's Far East region of Zabaykalsky Krai were given the vaccine on Monday. One thousand doses of the vaccine have also been transported to a warehouse in the Chelyabinsk region, to be given to medical workers and teachers. Sputnik V needs to be stored at minus 18 degrees Celsius and is being transported in refrigerated minivans. [This vaccine is touted as being over 95 per cent effective; it did not finish a third clinical trial.]
Provincial governments across China are placing orders for experimental, domestically made coronavirus vaccines, though health officials have yet to say how well they work or how they may reach the country's 1.4 billion people. [...] Even without final approval, more than 1 million healthcare workers and others who are deemed at high risk of infection have already received experimental vaccines from Sinovac and Sinopharm, under emergency use permissions. Developers have yet to disclose how effective their vaccines are, and have not given any details about possible side effects. But China is also testing its vaccines overseas. The country's pharmaceutical industry has at least five vaccines from four producers being tested in more than a dozen countries, including Russia, Egypt and Mexico.
Indonesia received 1.2 million doses of the Chinese Sinovac vaccine on Sunday, according to President Joko Widodo. The Indonesian Government is also expecting another 1.8 million doses and raw materials — which could produce about 45 million doses — to come next year. The vaccine, known as CoronaVac, still needs approval from regulators. Indonesia's highest Islamic clerical body is also working to issue a halal certification for the vaccine.
posted by Iris Gambol at 1:00 AM on December 9, 2020
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posted by lalochezia at 7:25 AM on November 9, 2020 [2 favorites]