The key takeaway here is that this one, unlike Pfizer's, appears to be easier to store as it remains stable at minus 20C for up to six months and can be kept in a standard fridge for up to a month.
Agreed, but the Pfizer vaccine isn't as bad as most people think: you get 5 days are normal freezer temperatures. That is more than enough time to drive from their manufacturing location in Wisconsin (this might be a cold storage faultily and manufacturing elsewhere - I'm not sure) to anywhere in North America - so long as wherever you drive to already has people lined up to get the vaccine.
The above won't be hard to do for the first 3 months at least: just give the shot to health care workers as they come in for their scheduled shift. What gets hard is when you want to do a walk-in clinic: you need to figure out how much to order without knowing how many people will show up.
Note, don't take the above as a statement that Pfizer will (or should) ship at higher temperatures. While it works out on paper that they can, they have been putting effort into arranging really cold shipment for a reason: it is best to give the entire time stored at higher temperatures to the end clinic. Human logistics are the hardest part of this and this and really cold shipment gives more flexibility to the hardest part.
In any case: with both vaccines the hard part is ensuring people get their second dose on time after starting the shots! This is by far the most difficult logistical issue with either vaccine.
I would expect vaccination to be fully booked for a while, since it's going to be the most important thing in life to do for anyone not suffering from other serious issues and without anti-vaccination beliefs.
I presume that like most vaccines, there is a gap between you receiving it and developing immunity?
I hope everyplace offering vaccinations will have something in place to prevent anyone who comes in who is already infected but asymptomatic from infecting others there.
Given some states' track records on how they handled other things that attracted a lot of people, such as in-person voting, I'm not at all confident that we won't have some states that manage to turn vaccination clinics into super spreader events, which should be deeply embarrassing.
A good way to handle it is the way Kaiser handled flu vaccinations this year in western Washington. They had 10 minute windows available. You reserved online your spot in one of those windows. When you arrived a person at the door asked your name, checked you off the list, and gave you a pre-printed label with your information, and sent you in.
There were two or three people administering the vaccine, so two or three people for each 10 minute window. You went an stood in line with the others who shared your window, with the line very spread out.
When it was your turn you went in to get the vaccination, gave the person their your label, got vaccinated, and were sent out a side or back door so you would not cross paths with the people waiting or arriving.
> I hope everyplace offering vaccinations will have something in place to prevent anyone who comes in who is already infected but asymptomatic from infecting others there.
I remember getting the vaccine and it was offered outdoors, with a line in a parking lot and a nurse having a tent or a table or something. So that was good (although we weren't wearing masks -- the level of concern and associated precautions with H1N1 felt high at the time but now seems pretty trivial compared to COVID-19).
I recently went to my doctor's office for a seasonal flu shot and the office had separated spaces in the waiting room, lots of air filters going, and all patients and workers wearing face masks. And I think they wouldn't allow more than 4 or 5 patients in the office at a time. So those same precautions would feel pretty decent to me for COVID vaccination.
Edit: I guess I'm reflexively thinking of San Francisco in imagining this -- the outdoor line-up seems perfectly fine here, but it might be pretty unpleasant in January in New York or St. Petersburg or Edmonton...
Several food trucks have sprung up in my neighborhood that seem to have an even better impromptu system. You walk up to the window, they hand you a small device and send you back to your car. When your device lights up, you go to the pickup window. There is no line at all.
I don't know how many hundred dollars it cost them to buy a couple dozen devices or how much it costs to wipe each one down and put it back under the infrared/anti-cootie lamp each use. But there are orders going out the window about every 2 minutes and no customers within 50 feet of each other.
that's why we need to stop treating phone numbers as personal identifiers... nobody in the world would dream of using IPv6 addresses as personal identifiers
to this point you (everybody, really) should have a burner phone number
FWIW, I found Kaiser's flu shot system to be a nightmare to navigate for my family. There were different appointment times for kids and adults, so it was going to involve multiple trips on multiple days.
We ended up just going to Target, which was much more risky, but actually something we could accomplish.
He points out that the standard being adopted by these studies for the point efficacy is 14 days after the second dose. That's honestly not too bad. It's no magic bullet, but it's survivable.
During covid time local clinic did drive through flu vaccination. It's as distanced as you can realistically expect. And with prebooking you're not overwhelmed.
> other serious issues and without anti-vaccination beliefs
This was redundant. Anti-vaccination “belief“ is a serious, mental, issue.
Against HN rules, but it’s time to stop being so easy on people who try to distort science and reality and call them for what it is. You cannot have a eye to eye conversation with anti-vacciners, flat-earthers, climate-change deniers, election-fraud believers and Trump supporters.
The more leeway we give the more they try to win public opinion and damage our world.
Well, tolerance has got us non-solutions like vaccine waivers for schools, and legislation that makes it easier for people who choose not to vaccinate their kids to spread easily preventable diseases. It also got us sick and dead kids.
Yes, it's a belief/acceptance/trust/whatever you want to call it. I believe demonstrated science is fact, but that's still a belief about the world. My parents are in scientific fields, I received a science and engineering based education, and generally have faith in the scientific method as performed by most scientists.
But we DO have to convince people, we have to convince people by showing them how it works, and letting them decide that that makes sense, you can't just mandate belief as a science authoritarian.
And science is still performed by humans, and we're fallible, and our incentives aren't always good, and every time there's a public failure of the process, and every time a scientist goes on record to shill for a company's chosen viewpoint, it dings the general public's faith in science and scientific experts in general.
You arguments here are the problem. I know that you mean well and in a perfect world what you say would make sense, but when you say “science is still performed by humans” is an opportunity for the school dropout to say, “see even between them they have doubts, the earth is flat”.
What’s the better alternative? If you don’t explain how we know the earth is roughly spherical, that’s the opportunity for that person to conclude “see, they can’t even refute it; look for yourself, sheeple...”
Your understanding of science is pretty bad if you seriously believe there are no rational objections (re: long-term effects) to consuming a drug that didn't even exist a year ago.
Done right, being less tolerant of speech/behavior that can be detrimental to the common good does change minds for the better. Any "code of conduct" is precisely this: directly calling out detrimental behavior as vile with no tolerance for it. The fact that nearly half of voters in the United States support Trump does not change this.
So you're saying that authoritarian measures are the way? Codes of conduct change minds if people are receptive, or they play along so that they don't get abused, and it looks like it's changed their mind.
From where I'm sitting, perceived authoritarian tendencies on the democratic side is a large part of what really motivates Trump voters. That's certainly a lot of the narrative, if you ever visit that side of the media landscape.
> That’s what censorship is. A small group of people will decide what is considered misinformation and will censor everything that goes against that
This is not censorship. Censorship is stopping you from expressing your thoughts. Not publishing your thoughts is not. You can say whatever you want but no newspaper is in any obligation to publish it.
Similar with social media, you can write whatever you want on your personal "page", but they are under no obligation to make sure it reaches other people's feed.
Is censorship really the greatest crime? Is there no intelligent way to facilitate the search for truth that doesn’t require us to get bogged down in accepting every possibility as equally plausible? Of course there is. One thing is certain. Crying “that’s censorship!” will not get us to that place.
There is a time in not that long ago recorded history where this would have risked settling on the conclusion that the Earth was the center of the universe (and it was flat), leeches and blood-letting were a treatment for diseases, and heavier than air flying machines were impossible.
If you’ll permit a scientifically inaccurate analogy here: sunlight is the best disinfectant.
So is fighting misinformation a lost cause, or can we come up with some plan that doesn't involve a small group of people censoring it? Would some kind of distributed rating system like upvotes/downvotes be acceptable, or is the better course of action to be okay with letting all information -- even if specifically designed to trick people, not only the most gullible, but even the most discerning skeptics -- circulate?
I believe the government should not have a say in whether or not all information circulates, but ordinary people who build information sharing systems (and I don't just mean electronic ones) have an opportunity to figure this out. Should they not?
I don't think authoritarian measures are an appropriate way for a government to operate, but in the context of whether something is "against HN rules" I think making it known that an idea is harmful is a good thing.
It all comes down to whether or not the community in question is one in which members can readily leave without cost. I don't agree with making anti-vaxxers change their ways by government force, but I'm into being intolerant of them in other ways to the point that they'll come around and obviate any need for governmental force in the first place.
How can you be sure that the censors will always be on the side of the angels?
Follow-up question: how can you be sure that you, personally, are on the side of the angels? Especially if you have never been allowed to hear the opposing point of view?
Seriously, the growing support for censorship in the previously libertarianish Tech community has been the worst development of the last decade.
Actually, I don't care for censorship. I'd rather let the idea be presented and let the intolerance for it drown it out by way of copious rebuttals, not removal. I won't know if I'm on the side of the angels, but I'll know I'm in good company and I'll have heard both sides at levels roughly proportionate to the size of the population interested in defending each side.
In hindsight, I see how citing codes of conduct implies support for censorship, when my actual intent was simply to demonstrate another example of "intolerance" having noble goals.
These are fine questions, and their answers should sit uncomfortably in all humans. But unless we are content to let human knowledge dissolve into meaninglessness, we must look to something external to our own reasoning to help decide what to believe. For me, I have drawn that line at Scientific Consensus because it has proved the most robust tool humanity has ever found for determining what is actually true. Is it perfect? No. Is it better than everything else? Undoubtedly yes. I think it must be the starting point and possibly the ending point for all discussions of this nature. To use another tool you must first convince me it is better than Scientific Consensus.
"ut unless we are content to let human knowledge dissolve into meaninglessness, we must look to something external to our own reasoning to help decide what to believe. For me, I have drawn that line at Scientific Consensus because it has proved the most robust tool humanity has ever found for determining what is actually true"
Well, I agree with the scientific consensus on a general base. But since science was not always right, I don't see a valid argument from there to censorship.
You want to censor ideas not covered by scientific consensus?
"and their answers should sit uncomfortably in all humans"
Because, also no. I do not feel uncomfortable. I am strongly against censorship. Open, unrestricted exchange of ideas. If the scientific way is the best (which I believe), then the crackpot approaches will fail naturally. But if you censor those other approaches, you might actually strenghten them.
Your plan is reasonable if human minds were genuinely and effectively open to letting the best ideas win. But they are not. Human minds care more about reputation than veracity and this has important ramifications for plans like yours: namely that they don’t work. Confirmation bias is real and pervasive and as completely in control of my mind as it is of yours. I encourage you to read Haidt’s The Righteous Mind and see if what you purpose still makes sense.
And this is the root of the divide, as far as I can tell. It's quite literally nerds and bullies all over again. Those who see the light and those who think you're a tool for doing so.
Netiquette 101: Don't feed the trolls. (But here we are.)
Every single human being can be assumed to think they fall in the reasonable bunch. This is a combination of hardwired bootstrapping (seems unavoidable), self-serving biases, and the fact that most mistakes won’t be recognized even in hindsight (so much for saying hindsight is 20/20).
Let's also accept that many judgements on outcome are not only subjective but culturally biased. Assuming we both agreed on values and we were analyzing identical scenarios then you could argue that a difference in choice would boil down to differences in the effective use of reasoning
Most people disagreeing on most subjects have probably barely applied any sort of reasoning to get there.
Most pro-vaxxers have simply picked up the dominant opinion from the surrounding society -- not a bad heuristic in practice. Most anti-vaxxers have picked up an opinion from a persuasive single source and then read some other sources that back it up.
I admit I'm in the first category, I certainly vaccinate my own children, but I can't really claim that I've come to this decision after a thorough understanding of immunology, I have simply followed the path of least resistance.
You don't need a degree in immunology to be very skeptical of anti-vaxxers' claims. Reading a bit of history is enough to know what happens when vaccines don't exist.
The steelman version of antivaxxism isn't "vaccines shouldn't exist", it's "on an individual basis, the risk-reward ratio of certain vaccines is not worth it. I should personally not vaccinate myself or anyone I care about, and be a free rider on societal herd immunity"
That particular version of antivaxxism is the one I would have the most trouble refuting. It's especially troubling since if it were true then the powers that be would have every incentive to try to keep it quiet and attack anyone who suggests it.
I mean, I make the same judgement call every year for flu shots. Is it at least plausible that I would be better off overall making the same call for some other disease?
> (...) I should personally not vaccinate myself or anyone I care about, and be a free rider on societal herd immunity"
> That particular version of antivaxxism is the one I would have the most trouble refuting.
What's hard to refute? I mean, the exceptionalism argument only sticks with sociopaths who believe society exists only to serve their personal interests without having to contribute anything in return.
> it's "on an individual basis, the risk-reward ratio of certain vaccines is not worth it."
That's not really true though. The risks involved in getting a vaccine are much, much smaller than the risks involved in not getting the vaccine, especially with diseases like Covid.
2. That same source lays out why worrying about this risk is not rational (in this case)
3. No-one is seriously calling for forced vaccination for corona
4. (my opinion) by over-emphasizing the "personal choice" angle we are letting anti-vaxxination pseudo science and conspiracy beliefs spread without being challenged. Some things are more wrong than others and the science for the harm of vaccines has oveerwhelmingly failed to arrive. So using the term "without anti-vaccination beliefs" is fair in this case, since I will argue the only reason why you'd reject a vaccine that is recommended by a physician is an irrational belief not grounded in evidence
> No-one is seriously calling for forced vaccination for corona
There will be de facto mandatory vaccination, to a degree. This is a Canadian news source but read about the companies involved with creating this program (by the way—-it’s not Ticketmaster). It is definitely coming to America and already underway.
No coronavirus vaccine, no entry? Experts say it’s possible in pandemic’s next stage
In Europe, mandatory vaccinations do exist in some countries, for both children and adults. Also, in Croatia (which is part of the European Union), if you refuse to have your child vaccinated, it is legally considered to be child abuse. In Croatia, they have school doctors that literally come to the schools with nurses that not only ensure the health of all of the kids, but also have them vaccinated there. Homeschooling is also illegal in Croatia.
>>The New York State Bar Association (NYSBA) is recommending that the state consider mandating a COVID-19 vaccine once a scientific consensus emerges that it is safe, effective and necessary.
It is also not definitive that the 532 cases of Guillan-Barré were actually caused by the vaccine. In any large scale vaccination effort people die/get sick just because that is what happens in any large population.
> No-one is seriously calling for forced vaccination for corona
Define forced. I'm not in favor of pinning people down and forcibly injecting them with something, but I am all for some kind of vaccination "passport", where if you don't have proof of vaccination you stop enjoying the benefits of society. No public schools or services, right for businesses to refuse service, etc. Or at the very least, a heavy tax fine or something a long those lines.
If people choose to not get a vaccine, that's fine. But its time we align incentives to eliminate these externalities being born from societal free-loaders who believe in quack-science.
In response to 3, many rational people are. And I agree with them. We have mandatory vaccinations for MMR and for dTAP. Have you ever heard of anyone catching diphtheria? A reasonable risk profile puts COVID-19 at higher risk than whooping cough, as the chances of getting it are so much higher, even if the fatality rate is lower.
"Mandatory" vaccination for children in the USA usually aren't: all states allow exemption for true medical reason, and [edit: --some--] almost all allow exemption on religious grounds. Sixteen allow exemption for parental objection.
> We have mandatory vaccinations for MMR and for dTAP. Have you ever heard of anyone catching diphtheria?
Not specifically, but DTaP vaccinates against pertussis which has seen epidemic-level outbreaks in the past decade in multiple states.
I'd expect any SARS-CoV-2 vaccinations to be targeted at adults for the foreseeable future, but who knows.
> I did find a a source of 532 developing Guillan-Barré
You should have mentioned that the 532 cases of Guillan-Barré were found within the 48 million people receiving the swine flu vaccine.
Accordig to Wikipedia, the incidence of Guillam-Barré is about 2 per 100,000 people per year.
Statistically speaking, your example suggests that taking the swine flu vaccine is linked with a lower incidence of Guillam-Barre syndrome, nearly lowering it to about 60% of the baseline.
If we're allowed to play fast and loose with back-of-the-napkin statistics, your example contradicts your original claims, and indeed makes a strong case in favour of vaccination.
Physicians recommend many drugs that end up proving to have dangerous side effects. The anti-inflamatory Vioxx is just one that comes to mind without doing any research.
That's like saying that there have been unsafe cars in history without understand which cars and why and why they're unsafe.
There's a lot of unsafe stuff, but this example is so absurdly generalized that it seems either malicious or just so ignorant that it's not even a worthy position to take.
I've had lots of vaccines in my life, the thing is, all those were for diseases that had a high risk of crippling or killing me.
Why would I want a vaccine that is actually less effective than my chances of surviving?
If I get the vaccine, there's a 95% chance it'll work, if I get covid, there's a 97% chance i'll live.
All I know is, if you told someone they had a 97% chance of winning at a casino, they'd be down there in a flash.
Why would I choose to have some barely tested vaccine with not fully studied long term side effects made by companies who have extremely poor track records with medication in general?
Pfizer is bascially responsible for the oxycontin epidemic. Their reps bribe doctors into pushing their drugs.
Moderna's some secretive biotech company that just appeared out of nowhere with this whole covid thing.
What reason do I have to trust any of these companies over the 97% survival rate I can expect from getting covid?
It's the other way around - for any given chance of you getting COVID, there's a (to use your number) 3% mortality rate - if you take the vaccine - that outcome changes because you now have much smaller risk of infection, to 0.15% chance.
Your choice is between 3% and 0.15% - not 95% and 97%.
I don't think this individualistic way of looking at things is sound, though. First 3% mortality sounds way high - even given health system collapse (basically turning every ventilator survivor into a dead patient).
And on the other hand, mostly the old and those with pre-conditions will die - we alltake the vaccine to protect everyone. That way we might avoid a population wide 0.5% (or thereabouts) mortality rate.
That would still 1 in 200 - most people would likely know a handful of people dying from the disease if there's no mitigation.
> Your choice is between 3% and 0.15% - not 95% and 97%.
I would put it differently: if we become covid carriers, we become spreaders. Those 3% are, thus, applied to a large population comprised of everyone we interact ina daily basis.
Thus even if at most the likelihood that we die of covid is only 3% tops, the likelihood that at least one person that catches covid from us does is proportional to the number of people we infect.
With a 3% fatality rate, the likelihood that at least one person we infect will die can reach 80% if we spread it to over 50 people.
If we infect someone over 60, the likelihood that they will die from covid grows from that 3% to about 20%.
So unless you are infected while living in a bubble, the real risk is far higher.
I live in a US state with essentially no lock down measures in place. Companies around me are going out of business by the dozen. These companies are not going out of business due to any government mandate they are going out of business because of economic uncertainty and people not spending as they dont want to go to places and potentially get sick. I used to spend ~$500 a month on eating out, I spend almost zero now as I dont want to take the risk. This has nothing to do with government choices and fully to do with mine. Now multiply this by tens of thousands of other people making the same choice and you will understand why an effective widely used vaccine is important for an economic recovery. Until the virus is under control I and many others will severely curtail our spending and there will be only a limited economic recovery.
In addition I dont go out as I have elderly relatives who I dont want to sicken, they dont expect it, its my choice. So blaming others for being selfish is really missing the point and is an illustration of not really understanding the current economic situation.
Your point is perfectly true, but there is also one more thing to consider. It is possible for the health care system to get overworked like they did in NYC and North Italy. There are signs it could happens in other places in the US now like Wisconsin.
At that point everything else suddenly becomes critical, because there is no ICU left.
Also, at least in CA, doctors/hospitals/dentists etc are only doing what is critical right now to avoid the whole hospital going into lockdown. That has large consequences for health outcomes and for the economy of those practises.
To add some data to that: there is a correlation between disease spread and GDP reduction, and it's the one that consistent with your anecdote: The economic impact is greater where the disease is left unchecked :
(unfortunately, the graph doesn't include countries like china, vietnam, and many other asian countries, because that would make the trend even clearer.)
average of 17 pedestrians are killed by cars in the US every day (data from 2018). Over 1,000 people per day are dying from covid in the US. So your odds of dying crossing the road on any given day are actually far, far less than your odds of dying from covid...
I think it's easy to look at a mortality rate of half a percent, and think "no big deal" - but it really is. One in every 200 people dying would mean most of us have a close connection to a couple of victims.
And there's already more dead from covid-19 in the US than casualties during the Vietnam War. Granted, more elderly people than young, but it's still a bit difficult to accept that it's insignificant.
Add to this what could happen with an exponential surge, with icus being over-run - and a) you'd end up being more likely to die from other causes, like a traffic accident - and b) many of the current covid-19 survivors would end up as casualties.
You sound like a child. No one is panicking, the problem is it's killing people and hospitalizing even more people to the point of overrunning hospitals.
Very very few hospitals have actually been overrun. Many were and still are empty (or flooding in with people who couldn't get treatment for other things during the lockdowns). The cases in NYC, Michigan and Kirkland (Seattle) were all due to orders that packed elderly care facilities with sick. Governors Whitmer and Cuomo made huge mistakes with their orders and neither is owing up to it.
The problem is that with the infection spreading exponentially you might have hospitals half empty one day and at 200% a week later.
Here in Czech Republic it looks like we managed to avoid running out of capacity during the ongoing second wave, but just. The measures taken included canceling any elective and non-life-threatening surgeries, drafting medical school students, many foreign doctors that came to help and moving covid patients in critical state from overloaded hospitals hospitals.
We even built two full field hospitals which we will thankfully not need as it looks like. BTW, building one of them took about a week - which you migh not have, once you hit exponential growth. Not to mention having spare medical personnel to run it.
> Why would I want a vaccine that is actually less effective than my chances of surviving?
Well, the vaccine hopefully doesn't kill you if it's ineffective, so the numbers aren't exactly comparable.
The reasoning in this comment is wild. Let's take it back to the math a moment:
Let's take your 3% chance of death (actually the population survival rate is significantly higher IIRC, but OTOH there's long haul COVID to consider too). If the vaccine is 95% effective, all else being equal you have a 3% chance of death without the vaccine, and a 0.15% chance of death with the vaccine. So the question becomes: is there a greater than 2.85% chance of the vaccine killing you or doing you crippling injury? If not, you're probably better off taking the vaccine.
Numbers depend on the age. Bulk of deaths are concentrated in older populations. CDC recently updated estimated infection fatality rates for COVID. Here are the updated survival rates by age group:
The CDC updated their pandemic planning scenarios[0] based on earlier studies in Europe plus some educated guesswork using data collected from the US through August 8. The numbers which you represent as the CDC’s sole official estimate of true IFR are only one of three possible sets of parameters that they provide for scenario modelling. Furthermore, the footnote on these estimates states “The estimates for persons ≥70 years old presented here do not include persons ≥80 years old”, since the underlying study they base the model on assumed that CFR = IFR for people ≥80 years old. Why they label this 70+ instead of 70–79 is beyond me, and I have no idea how sound the methodology is that they used to derive these estimates.
I would also mention that there are studies in peer review on patient populations in the United States which suggest IFRs closer to CDC planning scenario 4/5 than 3—for example, this one from Connecticut[1]:
We all hope for the best—that the lower bounds are true—but I think we should also be prepared for the reality that the upper bounds might be the correct ones, and act conservatively.
Also, you know, all IFR estimates assume that patients will actually be able to access care. Without hospitals, IFR approaches IHR, and the hospitalisation rates from the Connecticut study are grim: 0.8%, 2.68%, 3.09%, 12.43%, and 79.89%.
" if you told someone they had a 97% chance of winning at a casino, they'd be down there in a flash"
this is a bad analogy, what if you also told them that if they lost they were taken out back and shot? I bet a lot fewer people would show up. In this particular case, winning just means not dying, if I could increase my odds of not dying I would probably do so.
Also there is no proof that getting covid grants lifetime immunity, so lets assume immunity lasts a year, every year you now have a 3% chance of dying from covid using your numbers. 3% is not that low, there is a ~3% chance of rolling double sixes with 2 dice, and that happens all the time.
Your IJME link does not support in any way your assertion about the "danger" of the HPV vaccine. From the link, 30,000 were vaccinated. Three girls died for reasons that are never stated. The article provides that "there is no conclusive evidence of a causal link between the vaccine and the deaths."
I take the general gist of some of your points, but it might be worth reframing some of your logic. To take just one point, let's go to the casino: you have a 97% chance of winning...pretty great! The downside is that if you lose, we take you out back and shoot you. Do you still want to go?
Looking at your individual risk profile is a good way to decide who ought to get vaccinated first its a poor way to decide who gets vaccinated at all. There are some parties including those who are too young to vaccinate or who have poor immune systems whom are only protected by the surrounding population not passing around virii like baseball cards.
Having a large enough host population to sustain an outbreak means those vulnerable parties are fucked and the rest of the population even those for whom the vaccine is 90% effective are at still at some risk. Worse the selection pressure among millions of vectors to develop a strain that can infect the previously safe population is high and the possibility is real.
This is to say that the proper assessment of safety is the likely net effect on the entire population of an increasingly large portion of society not vaccinating.
Existing precedent would seem to suggest that its impossible to force you to vaccinate but possible to prevent you from participating in society if you do not. For example the state can put you in jail for not putting your kid in school but not let you do so unless you vaccinate your kid.
I would not be terribly surprised if people, especially vulnerable people argued that a work allowing anti vaxxers to work alongside them violated their right to a safe workplace.
Imagine one lawsuit from someones family that lost a baby or a family member resulting in an 7-8 figure settlement. There wont have to be a law. The lawsuits will be from anti vaxxers alleging that this violates their rights and will take place over the following 2 years after every major workplace in America adopts such rules giving American workers the choice between employment and remaining an antivaxxer.
I'm not anti-vax by any means, but I would rather have 3 months of outcomes from widespread deployment prior to being vaccinated or having my low-risk family members be vaccinated.
That this vaccine is mRNA-based makes it likely safer than some other lightly-tested vaccines, but if you're young, healthy, and at low-risk of serious COVID infection, I'm not sure it's wise to be among the first in line for this vaccine.
Yes, of course it is, provided that the vaccine that I take would otherwise go un-given in that 3 month period. That seems unlikely to me as we are likely to be vaccinating as many people as we can manufacture doses during that period and the difference is "which" rather than "how many".
I leave my house about once a week, wearing a mask, to spend 20 minutes grocery shopping. My risk of contracting, contracting and dying from, or contracting and spreading the disease is extremely low and quite possibly lower than leaving that dose for someone else who is leaving their house and being around people more than 4 hours in those 3 months. Bonus is that someone at higher risk gets "my" dose and I get 3 additional months of population-wide study of safety, side-effects, and efficacy.
You're fine then, because the young, healthy and low-risk won't be able to access any vaccine for months after higher-risk people. It's probably closer to a year before the really low-risk people get any.
A little, but when you are talking about my baby that is going to the part with older kids. A lot of kids do look at my baby first learning to crawl and run up to get a close look.
Agreed. I think vaccines are generally a good idea, but that there are risks involved in beta testing them.
Also, there are some interesting treatments targeting the ACE2 receptors that SARS-CoV-2 binds to which looks like they are reducing mortality rates, and perhaps long-term scarring in the lungs. Among these are Vitamin-D (which people are probably nutritionally-deficient anyways), and human recombinant soluable ACE2 (basically, injecting a form of ACE2 into the body so that the virus binds to that, instead of to cells with a lot of ACE2 receptors, thus short-circuiting the replication pathway). I would be interested to see if nutritionally-sufficient vitamin-d is better at preventing severe cases of covid-19 than masking or social distancing.
My own opinion is that it is foolish to pin all the hopes on a single strategy (prevention, via vaccination), which is not guaranteed to work or guaranteed to be safe. To add forced vaccination is folly. I think it is better to see a depth of prevention and treatment options (including vaccination).
The study described findings of antibody-dependent enhancement with the original SARS. I am no expert, but my understanding is that when test subjects were given the vaccine, and then later 'challenged' by the SARS virus, they developed a pathological response. In other words, taking the vaccine had a potential to make their response to SARS and potentially other coronaviruses worse.
The study I linked therefore recommended caution in giving the vaccine to humans.
Obviously this is something that vaccine researchers are aware of (see https://www.nature.com/articles/s41564-020-00789-5), but I think it's something that is perfectly rational to be concerned about given the time and money pressures available with SARS-CoV-2 vaccination.
There won’t be enough vaccines to go around, so no one will be forced to take anything for at least a year. By then we might be at 60-70% of the population vaccinated, at which point the R0 of the virus would be much lower.
Don’t worry about it for now, the rest of us will take the risk so you don’t have to.
I feel like we are about to enter the variation on the prisoner's dilemma where we all get a massive benefit if at least 70% of us get the vaccine, but getting the vaccine has a cost (please roll a D20 to select your random side effect) so everyone has an incentive to be one of the shirkers.
I foresee things getting ugly as we collectively all get together to shame, bully and trick the shirkers into compliance.
The immunocompromised and the economy get a benefit if we get to 70% vaccinated; I get a benefit for myself just by getting the vaccine.
I’ll allow that there is seemingly a significant portion of the population who believes they don’t personally benefit from a vaccine, but your comment said -everyone- is incentivized to shirk: that’s just not true.
That is fair. But I think that the fraction of people who individually benefit from getting the vaccine is less than the 70% who need to get it, do there's going to be a gap that will need to be filled with lies, bullying and shaming.
Of course this depends on the unknown factor of how bad the side effects are, if they are nonexistent then it's a different story, but if they are on average as bad as a flu shot then it becomes tricky.
I suppose I'm really thinking in the context of countries like Australia which have essentially eradicated the virus. My risk of getting the virus right now is practically zero, so my only incentive to get vaccinated is that we can eventually reopen our borders once enough people are vaccinated. And personally I'm in no hurry to get flooded by foreign tourists anyway.
This is not how the Prisoner's dilemma works since not getting the vaccine is not a purely dominant strategy. You are neglecting to adjust the vaccination scenario payout to account for the fact that you personally are much less likely to get Covid-19 if exposed to someone infected. This benefit largely exceeds any cost of receiving the vaccine based on current data.
This is not a prisoner's dilemma. The expected payoff if you get vaccinated is still far higher than the cost, whatever the rest of the population does, so you can ignore the cost in your calculation. It's like if the situation for the prisoner was that if you stay silent you go free, but if you both stay silent you both go free and the rest of your gang gets a reduced sentence too. Why would you ever defect?
The alternative is a high chance of becoming ill with COVID, which according to the data available so far is much riskier than the vaccine (1-2% hospitalization risk even for healthy young adults, evidence of long term issues at least in some people).
Unless of course your alternative plan is full isolation for years, in which case not taking the vaccine is the correct choice, but such isolation is only reasonable if you don't care about going outside anyway at all.
There looks like treatments developing that can reduce the mortality or severity of COVID after contracting it, including possibly reducing long-term scarring from it. These treatments are coming out of better modeling and understanding on how COVID spreads in the body and kills people.
It isn't so binary or black and white -- vaccinate or risk dying. We're starting to get other options.
I’m not scared of a vaccine. I am not sure what words I used to give you that impression.
I do see a lot of people fixating on vaccines as if it will make everything better. Vaccines will help, but better if there are other treatments as well. I think that if mortality rates and long-term scarring decreases, then people won’t feel like their survival depends upon other people’s cooperation.
Presumably because any side-effects of new COVID treatments would only affected those who get a serious form of COVID while any side-effects of a vaccine would be applied to the entire population.
Some of those options, like monoclonal antibodies, are extremely expensive and hard to produce and distribute at scale, plus they only work early in the course of the disease. I'm not aware of any small-molecule drugs that have hopes of great efficacy on the horizon. You're not going to pump out 150K/day doses of MABs.
It really is vaccinate or risk dying. The other options are too expensive, too timing-dependent or too ineffective.
Vaccines are the only way we can end the pandemic though. However great a treatment is, it won't stop anyone catching it or spreading it. If we're to be able to go back to anything resembling normal, we need to stop widespread transmission in the population, and the only way to do that without these restrictions is for an effective sterilising vaccine.
The strong asymptomatic spread of this virus, however, makes these decisions more complicated and less individualistic than “what happens to me if I catch it”.
There's a recent quasi-exprimental study on that, showing that vitamin-d is likely one of the central factors in better outcomes for severe cases of covid-19:
According to this study, vitamin-d gives better outcome than the other treatments, including hospitalization:
"Regarding care dedicated to COVID-19, only the proportion of patients who received a bolus of vitamin D3 during or just before COVID-19 differed between deceased participants and survivors, with a higher prevalence in survivors (respectively 92.2 % versus 66.7 %, P = 0.023). In contrast, there was no between-group difference in the proportion of patients treated with corticosteroids, hydroxychloroquine or dedicated antibiotics, or hospitalized for COVID-19."
And this has to do with Vitamin-D's role with the ACE2 receptor. SARS-CoV-2 has a binding affinity to ACE2, aggressively invading cells with proportionally higher ACE2 receptors (including the lungs).
In fact, someone had tried injecting hrsACE2 into someone as a treatment -- that is, letting the virus bind to hrsACE2 instead of the ACE2 receptors in the cells.
A treatment with hrsACE2 isn't generally-available, and needs a lot more study. The logsitics in producing them at scale would need to be solved, if this is a viable treatment. But this looks promising to me.
The logistic problem will be a major blocker in most of the other parts of the world, for e.g. anywhere in developing world. Even though it might work for US, rest of the world will still have the logistic problem due to the temperature restrictions.
IDK, put that shit in a properly insulated box stuffed with dry ice pellets, you'll maintain ultra-cold for three days easy with no electricity. So if you're loading a plane in Europe that spends 24 hours flying to $remote_destination, it still leaves you with 48 hours to do distribution by road, then you have another 5 days at normal freezer temperatures that is available for actually giving people the vaccine.
Flight from Wisconsin to any airport in the world in 24 hours. Plenty of time to distribute from then - especially as it’s cities (near airports) that are the main targets
The bigger takeaway is that Moderna's vaccine doesn't produce CD8+ (T-Cell) responses. Pfizer's T-Cell responses are off-the-charts good. This could affect your immune system's memory ability and could offer longer protection. Both the Moderna and Pfizer vaccine offers CD4 T-Cell responses. CD8+ is a nice-to-have, so the Pfizer vaccine would be an A+ grade, and this Moderna one is a solid "A".
The 2nd key takeaway here is that while 5 patients in the vaccination group tested positive for coronavirus, none of them had severe disease. Which means to me that while this vaccine isn't a magic shield, if you do get it, it will keep you out of the hospital and probably make it a very mild experience.
> Which means to me that while this vaccine isn't a magic shield, if you do get it, it will keep you out of the hospital and probably make it a very mild experience.
Is that conclusion warranted given the small number of people who got it? Perhaps in another population one of those 5 will indeed have severe, hospital-needed symptoms?
If the immune reaction in the vaccinated was good enough to avoid symptoms but a few still tested positive then those five are surely not the only ones. What are the chances that a random person without symptoms would be getting tested exactly those days that a very mild infection lasts? Those studies don't observe the subjects with daily PCR or something like that (impossible for ten thousands) and most mild infections remain undiscovered. And mild, hard to discover infections aren't exceptionally rare even without a vaccine, as antibody testing studies have shown again and again.
The pressing follow-up question is this: how many of the control group were discovered with (and despite of) equally weak symptoms? The answer could be anything between many more and many less. If it's more (more discovered very mild cases amongst the placebo group) then the vaccine apparently prevents most infections from happening at all, but if it's less then the vaccine doesn't really reduce the number of infected (and infective), it only prevents bad outcomes (which usually remain undiscovered, even in a phase III trial group).
A vaccine that only prevents bad outcomes would still be very valuable, but only to the vaccinated themselves because it would not create a herd immunity effect. This virus is very good at spreading from a mild case, so if the vaccinated still get unnoticeable mild cases they would still serve the virus as stopovers.
Contract tracing is more likely to identify sources of infection when the people remember being in the same room with someone who had symptoms. This is also why public transport is virtually absent as a infection source in contact tracing data, but private parties are very prominent.
From what I've heard, virus concentration in the upper respiratory tract (i.e. where the aerosols come from) peaks two or three days before symptoms start.
Here in Germany there's the statistic of "75% of infection sources are not found by tracing" circulating hard through public discussions. I doubt that many of those untraceable infections could be coming from symptomatic carriers, given the level of awareness. Coughing people basically do not exist in the 2020 public. And tracing should still be good enough to recognize most cases when the source became symptomatic after the contact (which would very likely be before the receiver became aware of the infection, triggering tracing). I consider this a pretty strong indication of asymptomatic spread, or very weakly symptomatic (thresholds are very subjective).
I would be surprised if they didn't specifically test all participants in the trial for covid antibodies, symptoms or not. Does anybody know what validation was done?
Depends a lot on the question of whether the antibody test can distinguish the immune system's reaction to the virus from the immune system's reaction to the vaccine (or in this case: to the proteins built from mRNA blueprints in the vaccine). If they can't, and this is quite likely given that they all target the same spike protein, the outcome would hopefully be positive for all of the vaccinated.
In the Pfizer trial, all the subjects in the interim evaluation had symptomatic infection confirmed by PCR test. I'm not sure about Moderna, but it's likely to use the same or similar methods.
> Which means to me that while this vaccine isn't a magic shield, if you do get it, it will keep you out of the hospital and probably make it a very mild experience.
With an n of 5, isn't this a premature conclusion?
If you compare the endpoint "severe illness"... 11 out of ~15000 ended up with severe illness on placebo, and 0 out of ~15000 ended up with severe illness in the treated group.
This corresponds to binomial 95% confidence intervals of (0.0004, 0.0013) and (0.0000, 0.0002). So it seems to prevent severe illness.
Whether it reduces the odds of severe illness IF YOU ARE INFECTED or purely reduces the odds of severe illness by preventing infection--- you're right, there's not nearly enough n to know.
> so the Pfizer vaccine would be an A+ grade, and this Moderna one is a solid "A".
Right now, ease of rolling out a vaccine is more important than its effectiveness, within reason. As long as the vaccine is effective enough to slow the spread of the virus it will save lives -- the more people we vaccinate, the fewer potential spreaders there will be, and that should help us protect people who have not been vaccinated yet.
Today, we would probably be better off with an A grade vaccine that is easier to store and ship across the country than we would be with an A+ vaccine that is more picky about storage temperature.
Of course, we can probably have both vaccines at the same time once the manufacturing capacity spins up.
The immune system is extremely complicated, but very broadly: CD8+ T-cells (also known as killer T-cells) kill infected cells directly, whereas CD4+ T-cells (also known as helper T-cells) release signals that guide many aspects of immune response, including activating CD8+ cells
The immune system at its core is basically rolling dice like crazy for new random RNA source code that is compiled into molecule hardware that will hopefully work against the invasor somehow. It even has a mechanism to deposit samples of the invasor were the freshly rolled candidates are let loose. Apparently it's buying into the TDD paradigm. The dice are probably not rolled to try completely random RNA sequences with a D4 for each base, more like mashups of the existing library from previous infections. Different immune systems can come up with different solutions to the same virus and even the same solution can be stumbled upon very early or reached very late, only hours before EOL. The content of the existing library likely plays a decisive role and even more does the general bandwidth of mashup attempts. This apparently shrinks drastically from children to elderly. Maybe an evolutionary tradeoff to compensate for the weak library children have, maybe a side effect of the existing library.
(source: mostly stuff I read linked from the hn page, hopefully without excessive misreading)
Totally anecdotally, the 4 people in my family who got it are all 65+ with multiple underlying issues. It was a bad head cold for a week and half, all recovered. I know, sadly, that isn't the case for so many. I just don't know what to think.
Even in the 80+ population most people are okay. A sample of four is not big enough to see the catastrophic effects even fairly small hospitalization numbers have when millions get infected.
This is exactly my point, and yet my comment gets downvoted.
People seem content with vaccines, meanwhile I want to understand WHY some people fair better than others. There's a far better solution than vaccines to be found, if people are willing to ask the question, and look for it.
Not to downplay Pfizer's role in logistics here, but they didn't really develop the vaccine. They're the logistics+manufacturing branch of the joint Biontech-Pfizer venture in this, while Biontech did the RND.
I am assuming they are also responsible for the clinical trials, but I'm not sure about that. It would make sense, though, because navigating the approval processes of the different agencies requires very specialized experience and domain knowledge.
Yes, Biontech appears to be more of a long shot project aiming for a future where you can manipulate your immune system into fighting your cancer with a personalized vaccine. That's why they were in the unique position of having the skills for putting together an mRNA vaccine targeting the SARS-COV2 spike on very short notice without having established organizational knowledge of running those approval trials.
Moderna has the same setup. They just happened to be able and willing to raise huge amounts of money (and play ball with the .gov) to produce it themselves. It's also why Pfizer is claiming they can produce a billion vaccines over the next year while Moderna is only saying they can do 100 million.
From the linked article: "Moderna said it could potentially manufacture 1bn doses by the end of 2021, adding to a further 1.3bn from Pfizer/BioNTech in the same timeframe."
Given the timelines and uncertainty, I don't think 1B and 1.3B are materially different. Both require 2 doses per vaccination.
Oh great, capitalism at it's best: there's an acute crisis, we might have the solution, but if we don't solve it vertically integrated we would have to share the spoils with a cooperation partner. This can't happen, quick! Bring in the investors!
Take a step back. Why did Moderna founders invest in research and technology? Are they selfless idealists? Probably not, at least that is not the only driving motivator. And even if they are, they still want the company to earn money in order to invest it into more research.
Bottom line is they want the company to be successful, so their long-term plan is to profit from making drugs. If they lived in a socialist economy where no such profit was possible, they would not have bothered, and then there would be no cure. If that is the world you prefer to live in, you have options (North Korea, Cuba and Venezuela currently, the rest having collapsed or transitioned to free market some time ago).
Isn't the difference more due to tests levels and announcement precautions ? Pfizer's announced temperature looks like the one for very long term ARN storage while standard fridge for a month doesn't look like it should alter ARN much.
I read in the New York Times article that Moderna and Pfizer use different (proprietary) lipid solutions in the vaccines. It's possible that Pfizer is just being overly cautious and they don't need the ultra cold storage, but it's also possible that Moderna has a fundamentally better solution.
Who knows. Almost all therapeutic rnas have unnatural RNA bases or base linkages that are, for example, resistant to internal phosphatases/autohydrolysis to improve half life; half life can also depend on secondary structure, and of course as a sibling comment mentioned, it can depend on the stability of the lipid nanoparticles.
I’m curious - why is there such a difference between them? What is it specifically about the pfizer one that requires a lower temp? Does anyone know what the other potential vaccines (Oxford in particular) will require?
RNA is fragile. DNA is pretty stable. Proteins are somewhere in between but can be engineered to be very stable.
Most vaccines are a protein (originally a fragment from the (inactivated) virus, now more often a synthetically manufactured fragment of the virus).
These vaccines (Moderna & Pfizer) are delivered as the RNA that encodes a fragment of the virus (that your own body then uses to produce a fragment of the virus). The delivery mechanism is very different, but the viral fragment that your body sees is the same as it would if the protein was delivered directly, as is traditional.
RNA can't reliably survive on a surface for more than a few minutes (which is somewhat good news since coronovirus itself is an RNA virus), or more than a few days unrefrigerated, and is very sensitive to any contamination by bacteria or other organisms.
Traditional proteins are generally much less fragile both chemically and as food for other organisms. And sometimes a protein (vaccine) can be specifically engineered to be even more stable in room-temperature, dry, or other unforgiving conditions.
And none of this takes into account specific formulations, or other chemicals that are used to aide the delivery process. Much of this has to be measured empirically. It's not clear to me if there is some chemical difference between the Pfizer & Moderna vaccines, or if the different temps are just what they use as their protocol filed with the FDA.
Further, see /u/dnautics below, often RNA therapeutics aren't completely true RNA (they can have chemical features to enhance stability).
A biologists might be able to provide more detail but some big molecules are just inherently more stable than others, it can be incredibly tricky to predict this up front since it depends on complex interactions within the molecule itself. These are the kind of problems that projects like Folding@Home try to solve with lots of computing power (though I think they focus more on proteins, not sure if they also do RNA).
Pfizer release their data ahead of Moderna. How is Moderna "ahead"?
And no, stability testing happens pretty early on. Pfizer would have definitely collected enough data at this point to say whether or not their vaccine is stable at higher temperatures.
Pfizer released a press release, but as far as I can tell that isn't as much data. Given the time I'd guess that the mathematicians at Moderna worked all weekend crunching numbers and writing a paper (which is what I'd do if I was a statistician there).
Pfizer is big enough to have/let a PR department do a press release during business hours. Of course given that Pfizer did a press release first Moderna for PR reasons needed to release more data to make a bigger splash.
No matter how you look at it, there is important data that will be in the FDA (and equivalent in other countries) submission that we don't have. There could be a "thats funny" thing burred, though odds are against it.
They are not identical, unless (unknown to me, but possible) Pfizer has released more since the initial press release. Pfizer (again at least in the initial release) said a number of infections, and "at least 90% effective". Moderna released a number of infections and the number in that who got the placebo vs vaccine.
The difference is not very big, but to those who like numbers it is big enough.
Incidentally, mumps is something that is decreasing in prevalence because of coronavirus precautions. In normal times, 88% isn't quite enough for herd immunity to mumps and there are sporadic outbreaks. I (M35) got it last year even though I was vaccinated along with almost everyone from my age cohort and younger, and everyone significantly older is immune because they contracted it in childhood. But that outbreak which began in late 2018 went away very quickly in April-May 2020 [0]
Yes but those are near lifetime immunities. Not said (that I'm aware of) with these two covid vaccines is how long they protect for. If it is less than a year it will be very hard to get and keep people taking it.
The cost of getting a booster every year is minuscule compared to the number of lives lost, not to mention the hit to the world economy.
A working vaccine is a huge W. If immunity only lasts 12 months instead of 10 years that just decreases the font size down to 64 point from 72 point. I'll take it.
That may be but they must have some indication of how strong a response those who got the vaccine are generating vs the time they entered the trial. Is there fall off? More or less than expected? How confident are they that immunity will last at least a year?
They don't really have an indication of that. The way these trials work is just that they send everyone out to live their lives and check infection rates in the experimental group against the control group, so there's no effective way to dig in deeper to the biomechanics of it. A standardized measurement of immune response could only be done through what's known as a "challenge trial", where participants are deliberately infected with a predetermined dose; some of these are in the works, but none have yet been approved or performed.
Lifetime immunity doesn't make much economic sense. If you have a vaccine with people and governments from all over the world begging for you to sell it to them, vaccine as a service seems like a more efficient model than a one-time purchase.
Not for the market leader, and maybe not for number two. But if you're at the end of the pack, nobody buys from you and you look at the 10 billion people market you could get with a lifetime vaccine...
Which is why monopolies are bad. You don't have a pack anymore, and the leader(s) don't have incentive to do much disruption.
I just got a SHRINGRX vaccine which is rated 97% effective. The second dose provoked a much stronger reaction, perhaps because I had some antibodies from the first.
> In Moderna's trial, 15,000 study participants were given a placebo, which is a shot of saline that has no effect. Over several months, 90 of them developed Covid-19, with 11 developing severe forms of the disease.
> Another 15,000 participants were given the vaccine, and only five of them developed Covid-19. None of the five became severely ill.
I was thinking about this since I read the article. The number you state seems to be 0.5% of total subjects. To my understanding, this is not how "p < 0.005" is employed.
If we take the control group, we have P(Corona)=90/15000.
The likelyhood of getting as an extreme result in the vaccine group is then P(0 cases) + ... + P(5 cases) = [math and statistics] = the actual p-value.
How did you determine the statistical significance in your post?
What seems to be vague... They didn't contract Covid, but we're they exposed to it in a lab environment, or just set off on their way to be evaluated x months later?
It is fine for it to be vague. It is implied because medical ethics and international humanitarian law preclude exposing subjects to a deadly virus, let alone for testing purposes, let alone in a blind study.
Additionally, you can apply common sense that if 15,000 people were exposed to the virus with no protection, more than 90 of them would become infected.
>They didn't contract Covid, but we're they exposed to it in a lab environment, or just set off on their way to be evaluated x months later?
This is what is referred to as a 'challenge trial'[0]. It is something the UK is apparently working on but afaik, neither of the current vaccine candidates have used any form of challenge trial. This is one of the difficulties with vaccine testing...if I were to vaccinate everyone in the world against small pox, how do I prove it's effectiveness?
Edit: for some fun, I figured I should link to the 'COVID challenge trial volunteers advocacy organization'. Yes, an advocacy group for people who want to be infected with COVID. https://1daysooner.org/
Challenge trials also don't provide as much useful information.
Nobody is getting covid on purpose, in a lab. Being protective or unprotective against a lab dose isn't the same as being protective or unprotective against a real-world dose.
I don't think anyone has really proposed this. Challenge trials are much more about getting quick answers to efficacy of treatment -- ethically, it's at least somewhat defensible to expose a volunteer if you also have medicine/vaccine for them, even if you're not sure how well it will work. It would be wildly unethical to give the virus to folks just to see how much virus it takes to get sick.
You might also get useful information about how people's immune systems react, when you give them too little of the virus to get infected. It's not only about figuring out the dose for the main trial. It also could have been done 6 months ago...
"It would be wildly unethical to give the virus to folks just to see how much virus it takes to get sick."
Depends. If there are volunteers for it, (which I can imagine to be the case) - and the volunteers are fully aware of the risk - then it might be ethical to let them proceed and save millions of other people.
1. You have to have a control group, so half of test subjects would be exposed to the virus without having received the vaccine.
2. The highest-priority recipients for a vaccine are members of high-risk groups; it'd be pointless to run a challenge trial full of low-risk individuals.
So a challenge trial wouldn't just mean giving the virus to a few thousand vaccinated macho 20-year-olds. It'd mean giving the virus to unvaccinated 80-year-old care home residents.
> it'd be pointless to run a challenge trial full of low-risk individuals.
This is binary all-or-nothing thinking. It considers 90% the same as 0%, since both are not 100%.
Testing on healthy young people you learn how a normal immune system reacts to a vaccine candidate. High risk groups mostly have similar immune systems.
Even if somehow you could only vaccinate everyone under 60, that would do enormous good stopping the spread.
Another way of making the point: we did COVID challenge trials on monkeys first, because their immune systems are a decent model for that 80-year-old human's. Well, a 30-year-old human is an even better model of an 80-year-old human. A challenge trial on young people wouldn't prove everything, but it would give a high-information signal quickly.
> This is binary all-or-nothing thinking. It considers 90% the same as 0%, since both are not 100%.
Thinking is not just "binary or not"; there are degrees. If exposing that group of people would be 90% pointless, it's not much less out of the question than if it were 100% pointless.
In all phase3 trials large groups of people, as similar to each other in all variables as possible, will be either given a placebo or the actual vaccine and then go back to their normal lives.
The trials have a set "Covid-19 cases" mark where the stop to evaluate. The Pfizer vaccine has 164 contractions of Covid-19 as their mark to conclude the research. This research seems to aim for 151.
The Moderna vaccine, which is based on similar mRNA technology as BioNTech’s, is expected to be assessed by the FDA on a final analysis of 151 Covid cases among trial participants who will be followed on average for more than two months.
If both groups are similar enough you can then say how effective the vaccine is in preventing it.
This, by the way, is why most phase 3 trials take place in the US and/or Brazil (among other places): the more Covid-19 is around the faster you can get to the set number of contractions and conclude the phase 3.
I don't think they have started yet, but such trials are planned in the UK.
There's no easy blanket "unethical" ruling from on high. Obviously this isn't a risk-free thing to volunteer for, but it isn't risk free for nurses to go to work either, and thankfully, they still do.
Also, you'd possibly be giving an unrealistic dose in the lab. If you give someone 1000x the viral load they'd ever get in the real world, the vaccine might not work. Or might work but send the immune system into a crazy overdrive cytokine storm.
Well, given that 90/15000 = 0.6% in the control group developed the disease, you can consider the vaccine group as a Bernouili trial of n = 15000 with probability p = 0.6%. Then the probability of observing 5 or fewer cases is 3.4*10^-32, from the tail probability of the binomial distribution.
Of course, that's assuming that five guys from the vaccine group didn't get infected at the same after-ski party, or any funny business that violates statistical independence ...
Naive question: If the null hypothesis is that there is no difference, wouldn't that imply 95/30,000, p = 0.0031, putting the probability of observing less than 5 cases at a much more reasonable 1*10^(-14).
I think Fisher's exact test [1] is most commonly used in these types of trials. But the P-value roland (parent comment) provided also make sense to me. For the Fisher's test R says...
Covid NoCovid
_____ _______
Vaccine 5 1495
NoVaccine 90 1410
9.0e-22 one tailed
4.5e-22 two tailed
No, I think you must estimate p only using the cohort where people were not treated, otherwise you will underestimate the population fraction. In order to test if the null hypothesis is true, we can't assume that's its true when constructing the test.
Sure, but there's other cheaper/simpler methods of vaccinating against Covid-19. Moderna has the inside track with $2.5Bn of government funding and a wealthy country able to afford their more complex vaccine. We'll probably find that the Russian, Chinese and Indian vaccines all work in the next few months so the mRNA aspect is not essential.
Vaccine development has progressed far faster than I would have ever guessed. This might be a dumb question but what has enabled a COVID-19 vaccine to be developed in such short time? I was under the impression that developing a vaccine took on the order of 10s of years while this has been put together in 10s of months. I was also under the impression that this was because making vaccines for viruses was much harder than other treatments because interrupting the viruses reproduction chain is essentially requiring you to interrupt your cell's reproduction chain.
Is there some tool that has been used here that hasn't been available in the past? I know the FDA said they would allow skipping some preliminary testing to fast track a drug. Was that a huge help?
SARS-CoV2 is quite similar to the previous SARS virus, so the development for vaccines against that one could be reused. In this case the target was already known, every vaccine is targeting the Spike surface protein. So the existing knowledge allowed them to mostly skip the very first phase of development.
The mRNA platform the BioNTech/Pfizer and the Moderna vaccine use is new, and that is generally something that can lead to shorter development.
As far as I understand, the biggest difference here is simply doing more things in parallel that you usually would do sequentially. This adds more risk because you already waste money in later expensive steps that are unnecessary because a previous step turns out to already fail the vaccine candidate. The easiest example here is producing the vaccine before phase III trials are completed, that is pure risk (in part assumed by governments in this case). This is really a case of "money is no object", a vaccine is useful enough in this case that you can take a lot of financial risk and pour lots of resources into development compared to a less critical vaccine.
The other thing that the more pessimistic timelines assume is that not everything will work out. Any problem can delay a vaccine or kill a candidate entirely.
I know nothing about vaccine development, but I'd guess part of the answer is "It mattered."
People try way harder when the stakes are high, and everyone involved is at least a little terrified of being "the one who delayed it." That does wonders for cutting through pointless red tape and bureaucratic delays.
A minor example:
About ten years ago, a flash flood completely destroyed about thirty linear feet of the main road connecting the tourist district of Hershey, Pennsylvania to the rest of the town.
I assumed it would take weeks or months to repair, based on how long road work has usually taken in the area. It would have been a disaster for a lot of the local restaurants, economically.
IIRC, two days after the flood the road was back in order. It certainly didn't take more than a week.
Obviously, inventing a new vaccine is orders of magnitude more complex than fixing a road, but I think this aspect of human nature still applies.
This was the main interstate connecting the suburbs to the business districts in Atlanta. The traffic on alternate routes after the collapse was apocalyptical. However, the new replacement was built in record time (1 month). The teams were given cash bonuses and other incentives to finish ahead of schedule. Basically, when "it matters", things get done quicker.
The difference is we know how to make the bridge, and knew where to place it. A lot of the effort in a new bridge is work that didn't have to be done for that bridge because it was already done. No need to figure out what to do with traffic (which means no phases that must complete first). No need to dig new footings, just use the old ones. No need to do a new design - the old one was good enough.
The bridge collapsed because of a fire and there seems to be no reason to redesign bridges to resist a fire like that so a lot of effort was saved. If we decided fires were too common we wouldn't be able to replace bridges as quickly because we need to do engineering work first on a new one.
We know a lot about making viral vaccines too so we have a lot of companies so a couple different methods get used and at least a few of them pan out. It's like if we could have 20 companies try to build the same bridge without interfering with each other and whichever worked became real.
They talk about this being entirely self-funded.
I wonder about the lack of a cold vaccine - presumably the value would be enormous in terms of avoiding lost productivity. I’ve always been under the impression that a vaccine for the “common cold” is very difficult because of its rapid mutations, mRNA or not. I’m curious why COVID is going to be much different.
Early on I remember an epidemiologist/virologist interviewed on JRE saying that building a point-in-time vaccine isn’t difficult, building a human-safe vaccine with long term efficacy is what’s difficult.
There is a good reason to develop at least one rhinovirus vaccine, though: so we have the expertise to deal with a bad rhinovirus strain if one should arise later. The coronavirus experience - SARS, MERS, and now COVID-19 - seems to suggest that such groundwork on common virus types would be a good idea.
> Then, my administration cut through every piece of red tape to achieve the fastest-ever, by far, launch of a vaccine trial for this new virus, this very vicious virus. And I want to thank all of the doctors and scientists and researchers involved because they’ve never moved like this, or never even close.
> The NIH and HHS have also been working constantly with private industry to evaluate more than 100 potential treatments.
> The Food and Drug Administration has swiftly approved more than 130 therapies for active trials; that’s what we have right now, 130. And another 450 are in the planning stages. And tremendous potential awaits. I think we’re going to have some very interesting things to report in the not-too-distant future. And thank you very much to Dr. Hahn.
> Through a historic series of funding bills, my administration is providing roughly $10 billion to support a medical research effort without parallel. I especially want to thank Senator Steve Daines of Montana for his incredible work. He has worked so hard to secure additional funding for vaccine development. He has been right at the forefront.
He also goes on to discuss Operation Warp Speed [2] which, as far as I understand it, creates trials and determines a distribution plan.
You have a lot of downvotes but no responses. Seems like the government actually supported this vaccine effort pretty well, I don't understand the problem.
I don't think people were downvoting because the government didn't provide support for the development of this vaccine, but because OP was quoting an extremely unreliable source on this topic.
Also a source that's trying to claim personal responsibility for the successes of others, where none is deserved. A government that had the capacity to develop treatments but choose not to would have been in dereliction of their duty; if there's ever been a clear, classic case for communal response, this is it. Claiming as success a response that only partially obstructed dealing with the virus is obscene; and even the parts that appear to be well-executed were clearly not due to exceptional executive action; many parts of government were involved, not least of which the bureaucrats (aka the deep state, those horrible people that actually keep things running).
Exceptional leadership would have been taking action December 2019 or early January - and as many south-east Asian countries show: even clear guidance and simple public health measure matter hugely; but people need to understand and support the measures, because it all hinges on real people changing their behavior; and creating controversy and abusing possible future treatments as distractions from actions that needed to be taken many months ago - and still do - undermines that.
And to cap it all off, the president is not working towards delivering those treatments and vaccines, because he's actively undermining the normal transition of power. Even if the election outcome were uncertain, gambling with people's lives like that shows a careless disregard for actually serving country - because an ethical person would at least work to protect others when it's not only their job, but easy, and conventional to do so.
Coming up with multiple vaccine candidates was fast (it took days to weeks in this case). That's partly because some approaches are straightforward (like growing virus and then inactivating it), partly because there are ready-to-go platforms for vaccine development (e.g., adenovirus-vector and mRNA platforms), and partly because there's been work on closely-related coronaviruses (SARS-CoV-1 and MERS, from which people already knew how to genetically modify the spike protein to remain in its pre-fusion state).
In short, there were several vaccine candidates within days to weeks of the genome being decoded.
What takes time is testing the vaccine candidates for safety and effectiveness. Companies normally go step-by-step. They run a phase-I trial, then evaluate the results and decide whether to go on to a phase-II trial. If they run a phase-II trial, they again wait until the results are in and have been evaluated before moving on to a phase-III trial. That reduces financial risk. In this case, companies began preparing phase-III trials before the phase-II trials were even completed. You can begin enrolling people into the trials and producing the necessary doses before you even know whether the phase-II results are any good. One of the reasons they could do that was because the government was taking on the financial risk.
Technically, Moderna's phase-I trial is not even complete yet: [1]. It runs until November 2021. But Moderna moved forward onto the next phase as soon as it had enough data from the phase-I trial to justify doing so (I assume this meant some combination of safety and efficacy data).
This is already a $10+ trillion pandemic in terms of economic destruction (we'll see economic damage spread out for more than a decade, so the final tally will be even higher). The vaccines are a couple billion dollars each, including manufacturing at scale. A lot of drugs now cost that to bring to market and don't have a small fraction of the positive impact on humanity.
If all that existed were market forces, Moderna and Pfizer could charge ten times what they are. They obviously knew the extreme blowback they'd suffer if they did that (including likely nationalization of their vaccines).
$20-$30 per dose in affluent nations is absurdly cheap to end this nightmare. That's a couple order-out pizzas.
Some, like the AstraZeneca virus, are old vaccines that they never finished developing, taken off the shelf and dusted down. That particular one is a modified SARS vaccine that never made it out of phase two trials, because the market for it disappeared. So by starting from here, they were able to save years of work.
These both use mRNA technology which is new but has heavily been invested in for years. SARS classic, MERS, and Ebola had all spurred development of tools for rapid vaccine development and that meant that a lot of the technical hurdles were accomplished before the crisis started, so the remaining work was still massive but within the range of possibility:
One of the biggest part of the slowdown is communication between private companies which want to bring vaccines to the market and public agencies which want to make sure that it is safe.
To make sure that this is done most effectively, the US government announced "Operation Warp Speed" back in May which has helped private and public organizations work very effectively.
The biggest factor is almost certainly laws in many countries including the US which shield anyone and everyone involved in the making and distribution of a vaccine for COVID (or other pandemics) from any liability whatsoever for any and all consequences of the vaccine. Even if, to take it to the extreme, it kills people and they knew it would kill people and still sold it, they still can't be found liable in any way.
Other comments are correctly pointing out some corollaries of this, such as trials proceeding very quickly and trial phases being run almost in parallel; but the root cause all of this can happen is the legal immunity for the consequences.
The large number of infections is a major factor as well as what everyone else said. If you have a new vaccine for something rare it would be years before you can enough data to say if your vaccine works.
Vaccine technology has been developing rapidly for a couple of decades. Biologists could leverage developments earlier conrona viruses like SARS-1 and MERS. Those were controlled before vaccines were deployed.
The tough nut are retroviruses like HIV. 40 years without a HIV vaccines. Though the related feline virus has a vaccine.
The big question for me is: what's the difference in the RNA fragment targeted by the Moderna vs. the RNA targeted by the Pfizer one? is there any overlap? mostly overlap?
What I'm really asking of course is are they complementary? or essentially the same thing? will it make sense having both? how fast will the virus mutate once these vaccines are ubiquitous?
It's not so much that - I guess what I'm trying to get at is a couple of things:
-whether applying some combination vaccines to a population will reduce the R value more than just one
-whether applying some combination vaccines to a population will provide more resistance to virus mutation
I guess it depends on whether they target different portions of the spike protein, the same portion, or the whole thing - if you're going after a small portion you essentially get to wildcard the rest of the protein, if you're doing the whole thing it's very specific and simple mutations will defeat it
I would guess we'll never find out the answer to that one, as it's unlikely to be studied in any rigorous way. But my guess is that it would reduce the R value a bit, but maybe not very much, since the immune system is likely to say "oh, that again, well we already know how to fight that", rather than generating a new type of antibody. But that opinion is worth everything you paid for it. : )
It's important information for the people planning epidemic responses, especially on behalf of governments (assuming you have a government that cares about responding to the epidemic).
Getting you R down as fast as possible is the thing that's going to really stop the epidemic in the large (rather than just in your body) and that's what this sort of information is useful for
... assuming the get into your cell and attach to a ribosome and manufacture a sufficient number of covid spike proteins to before they are denatured ...
What we still don't know for both Pfizer/BioNTech and Moderna vaccines:
"A vaccine that prevents infection entirely provides indirect protection to others. If I can't get infected, I can't infect you. But it is possible to have a vaccine that prevents disease but individuals can still be infectious." (1)
In that case, those at risk are only protected when they receive a vaccine, but still aren't when just those who they are in contact with received it.
"Most Phase 3 trials are measuring efficacy to prevent disease as the primary analysis" (2)
Not infection.
The whole thread with more details, already written in September, before both announcements:
by: "Natalie E. Dean, PhD, Assistant Professor of Biostatistics at @UF
specializing in emerging infectious diseases and vaccine study design. @HarvardBiostats
PhD." (3)
It would seem at least reasonable to hope that one follows from the other. If our bodies fight the virus effectively, the viral loads we would shed ought to be lower. The period where high virus loads are found in our bodies will be shorter, requiring less hospitalisations, and thus chances to give it to other vulnerable people.
There are of course lots of hypotheticals here, and things to be concerned about, but a priori surely we should be hopeful it reduces infections too?
> The period where high virus loads are found in our bodies will be shorter
is precisely what can't be assumed in advance but must be measured, as there are known examples where the assumption doesn't hold at all (and that includes the flu vaccines).
(Not to mention that just "shorter" is by definition not "sterilizing", the transmission is then obviously still possible.)
If the virus is transmitted via the upper respiratory tract, and it is, it's less probable that the immune cells in blood can prevent the infection and viral shedding of the mucosa. The cells have to be first attacked and infected before the immune reaction can kick in. Even now, it is known that the highest infectiousness of SARS-CoV-2 is often before the symptoms are observable, i.e. before the immune reaction starts. That would also explain the existence of asymptotic carriers: their immune system already protects them, but they are still able to infect others.
Does this mean that if a lot of people refuse to take the vaccine then we could still be dealing with masks, social distancing and lockdowns to protect those that refuse the vaccine?
Maybe, but at some point it is their own stupid fault.
The real question is the 5-10% that the vaccines don't work for - are they completely unprotected and we should wear a mask to protect them, or does enough protection exist such that they only get mildly sick vs die. There isn't enough evidence yet, but what we have suggests the former.
That's an additional problem, also known from the flu vaccines: some of those vaccinated just can't develop enough immunity to be protected, and unfortunately there are more of such among the older population. We also don't know the numbers for that population for these vaccines.
I worry also for the times during which there are not enough vaccines for everybody who is willing to get one. And also for the times when the immunity by those vaccinated vanes -- in other vaccines that also happens faster among those who are older. These numbers we can't have now anyway, that will by definition take much more time to be known.
These interim results are about as promising as you could expect, which is frankly amazing given it was developed in a matter of months (depending how you count, Moderna says "2 months"). Ultimately, its effectiveness depends on if and how quickly SARS-CoV-19 and its spike protein evolve resistance. That won't really be known until after widespread deployment and depends both on different factors inherent the virus' replication, its spike protein, host factors and how effectively the vaccine is rolled out.
Not that I am antivax or anything, but I think this is a good time to remind the great Fred Brooks quote about software development in particular, and product development in general.
"while it takes one woman nine months to make one baby, nine women can't make a baby in one month". [1]
Are we missing something in this fast-paced vaccine development ? Are we taking more risks ? Nobody seems to be talking about this and less so now that we have entered into the "mine is better" PR war.
One factor speeding up the phase 3 trials is the high rate of infections. Since the evaluation is done at a set number of confirmed cases among the test subjects, this happens much sooner for covid than it would be for just about anything else at this time.
Another factor is money. The covid vaccine trials have done some testing steps in parallel that would normally be done sequentially to avoid wasting money should it fail along the way. So yes, more risks are being taken, but they are financial, not clinical.
> So yes, more risks are being taken, but they are financial, not clinical.
While most vaccines produced so far have been quite safe, there are three known cases I'm aware of that weren't, (Early 1950s attenuated Polio vaccine that caused polio, H1N1 Pandemrix vaccine making narcolepsy 6-fold more prevalent in sweden in 2009, swine flu vaccine increasing risk for guillan-barre in 1976).
Of these, the 1st and the 3rd were rushed out. So I wouldn't say "no clinical risks". There's some info here[0], though it's not complete
In all three cases I mentioned, as far as I know there was either immediate indication or suspicion raised within the 1st year, but took several years to reach conclusions.
The polio case was very clear very quickly, the others not so much.
There's quite a bit about long term autoimmune response that we don't understand. I'm not up-to-date on everything, but from what I remember, strep-A infection is associated with increased likelihood of RA decades later; Epstein Barr exposure (causing Giullan Barre in children and Mono in adults) is associated with higher probability for MS, and there are a few other such suspected causalities - autoimmune diseases are no joke, and it seems like they can be triggered by either a pathogen (virus, bacteria) or a vaccine (which is designed to provoke the same kind of immune reaction without letting the pathogen do harm).
On average to society, it is almost sure that if nothing becomes suspicious within a year, it is a net gain.
To individuals, the question is much more complicated - autoimmune diseases often appear in clusters; I think it is prudent for people with a history (or even family history) of autoimmune disease to hold off as much as they can - as it may take years or decades to figure out how it effects the unlucky ones (of which they are much more likely to be).
Nature published a relatively easy-to-consume article about mRNA vaccine technology in 2018, which is perhaps good reading as we try to interpret the meaning of these recent announcements: https://www.nature.com/articles/nrd.2017.243
> [With] these early efficacy results, we may be measuring the effects of an impressive front line army that spins up in response to the vaccine - but then we should be careful not to assume the same efficacy persists to hold that line after most of the troops disappear! [...] Only time and careful follow up will tell how much the >90% efficacy of the two vaccines holds after the early vaccine responses fade away.
I'm getting tired of all the anti-vaccine pessimism.
Don't listen to the fearmongering. There may have been a handful of outliers in the world who got reinfected, but there's data showing that immunity seems to last for over six months in 100 out of 100 people tested[1]. There have also been multiple studies showing that some people exposed to the original SARS virus in ~2003 have cross-immunity to COVID. There's also evidence of pre-existing immunity from other coronaviruses[2].
When the vaccine becomes available to you, get vaccinated. In the meantime, wear a mask and keep being careful, but we have legitimate reasons to be hopeful. We have two vaccines showing efficacy, more to come in the following months. There's also a synthetic antibody therapy that just got FDA emergency approval[3]. This is going to save a lot of lives. All of the serious data points to the fact that this is going to make a huge dent in the number of new cases and fatalities.
No one benefits from painting vaccines as invincible magic. We don't want to give the actual crazies any more fuel then we have to. Realism is important for restoring the "credibility of science" after the flailing contradictory guidance we got from official sources early in the pandemic.
95% success is not invincible magic. The 85% success rate for MMR cited downthread is definitely not invincible magic. "Close" is highly debatable. They're still a good idea, but let's use honest arguments.
95% means that if most of the population is vaccinated, the virus will probably disappear. The magic works not by not getting infected, but by not infecting other people.
> 95% means that if most of the population is vaccinated, the virus will probably disappear.
"Most" (>50%) is likely not enough.
Based on estimates of R0 for SARS-CoV-2, if its 95% effective lifelong immunity, then about 63%-75% need to be vaccinated for herd immunity; that number goes up if the protection is shorter-lived:
> 95% means that if most of the population is vaccinated, the virus will probably disappear. The magic works not by not getting infected, but by not infecting other people.
This is a good time to note that AFAIK the Pfizer vaccine will not do a whole lot for preventing spread, so much as preventing an infection from breaking out into the disease (i.e. not all people infected with COV-19 wind up with COVID)
Once your immune system is trained to attack the known pathogen, it should be doing that before the virus is ever able to gain a foothold in your body and spread from you to someone else. People who have been vaccinated will not spread the virus.
Yeah, these claims are FUD. Yes, there are theoretical concerns; as with all new things, there is no complete certainty. But we should be absolutely clear that immunity usually reduces transmission. That that's at least very common is trivially observable in the real world too; no need for fancy statistics: just note that anything we have effective vaccines for has dramatically reduces spread in societies using those vaccines broadly.
Additionally, vaccine transmission reduction worries can be conflated with direct vaccine risk worries. There are risks to untested vaccine candidates, and some can even cause more severe illness. That's why we test, surely? And though I can't find the citation off the top of my head, there are even cases where a vaccine might enhance spread in extremely peculiar circumstances; I found a paper documenting such effect when vaccinating animals vs. an otherwise generally fatal disease; the vaccine simply delayed the inevitable and that delay caused a measurable increase in spread - but that's not at all like covid 19, which is not usually fatal. These theoretical concerns do not appear likely to be a factor this time, and most remaining doubt will clear up once phase 3 trials are complete: in particular, you'll know before you're vaccinated.
Whether the vaccines will reduce spread is obviously we don't know for absolutely sure; but reduced transmission does appear to be the most likely outcome. We should definitely act and plan as if it will (while measuring and hedging to detect if we're wrong). If new data appears that undermines this assumption, then we should adapt - but that's not likely. Much more likely is that the exact details of how much spread is reduced is unknown (so a 90% effective vaccine might reduce spread by less than 90%; or even by more; and we don't know those numbers).
So for example, when a paper like this https://www.thelancet.com/journals/lancet/article/PIIS0140-6... points out the limitations of currently knowledge, you should interpret that as just that - a limitation of current knowledge, not that it's very likely that a vaccine will leave spread mostly unaffected.
The final nail in the coffin for this FUD is that it's not actionable. Attempts to vaccinate - with the hope of reducing transmission - won't be ill-advised in retrospect in the unlikely event it turns out not to; it still reduces severity safely. So in terms of policy after phase 3 trials are complete and before mass-rollout: who cares? At worst vaccines will reduce disease impact with a good chance to reduce spread too. But if people start thinking the vaccine is likely useless, uptake could drop, which is throwing away such a great chance. This is classic FUD: doubt that's simply undermining rational action, without cause.
this is a really important subject that isn't getting enough air time.
The difference between a vaccine that stops the infection and a vaccine that stops the disease.
The later is definitely not as useful in the early days. because you end up with lots of people operating on a "pre-covid" normal behavior basis when they could be infecting lots of people that are unable to get vaccinated.
The Former is a much better solution. Stop people getting infected, then they can't wander around shedding and spreading.
Wow, that's a huge difference that people talk about, I didn't know that the 2 mRNA vaccines are so different. Actually it means that the title is wrong!
Somebody asked what happens if somebody uses both vaccines, it's a really interesting question, but I think we won't have enough data.
But oh, what a big if! There are still a lot of details and failure modes that need to work out to get the happy ending. That's why we need to set realistic expectations.
I don't think anyone with any amount of scientific background thinks that these first-generation vaccines will eradicate COVID, but IMO the actual data says immunity is likely to be very good and last for 6+ months, probably more. Then, in 2022, we'll get new vaccines that account for new COVID mutations, and we'll make another big dent in the number of cases again.
"Eradicate" is a very strong word. We haven't eradicated measles or diphtheria, either. I think everyone would be pretty happy to get covid-19 down to the same incidence as measles.
I hope we have a better chance of eradicating covid, than we do measles. A first factor making measles harder to eradicate is that it can strikes fairly early in life, and covid appears to affect young children much less and not to be as transmissable either (studies show schools are a source of transmission, but that's largely 15+ yro teenages AFAICT). Transmission in necessarily vaccinated very young children won't be as much of an issue. Secondly, measles is much more infectious. People that come in close contact with contagious measles cases almost always get infected (90%), whereas with covid there are clearly many cases in which people get lucky. Over the course of the cov19 disease it may be likely you'll infect people, but each short exposure by itself is a fairly low risk; unlike with measles. And that helps, because it means that with measles you'd expect to need a much higher degree of vaccination to achieve herd immunity that with a less contagious virus like cov19. Intuitively: when a case does slip through it's much more likely to explode and infect many others when the virus is measles, than when it's cov-19.
Of course, just because it's an easier problem - hopefully - than measles eradication doesn't mean it's achievable. But at least it's plausibly achievable.
(There are warning signs too; like animal reservoirs which are a factor for cov-19 but not measles, so it's not all roses.)
Many topics shouldn’t be political issues, and a vaccine is one of them. Some people have very little information and take absolute positions on things and try to spread their faith, but discussion here isn’t that.
I posted the parent comment and I agree with almost all of what you say here. If you read the thread I linked to, it's overwhelmingly positive ("exceedingly encouraging") and in no way can be characterized as "anti-vax" or fearmongeriing. It makes a specific point about the length of efficacy being unknown with mRNA vaccines, which are a new approach. I think this is worth acknowledging. It's certainly not a reason not to take the vaccine, nor does the thread imply that it is. In the worst case, the vaccine should still have a tremendous positive impact.
Even assuming the estimate of risk given there is correct, and even ignoring the evidence for persistent damage not infrequently arising from non-lethal cases, it’s really odd to me how cavalier people are about that 0.5% risk of death. That’s 1 in 200, so it’s not huge, sure- but if you gave me the choice between running that risk or taking a shot, I know which I would go for. It would even be too high a price for a night out with my friends.
Like, a 1-in-200 chance of losing all the hopes you had for your life and instead dying an agonizing death in some overcrowded ICU, doesn’t sound like it should be treated lightly.
Other than herd immunity (from vaccination or natural incidence) what do you expect will durably protect you from infection? The positivity rate a year ago was zero, in a year's time it's most unlikely to still be 5%.
Some people can't get vaccinated due to health reasons or they don't mount a proper immune response. They need you to do your part to establish herd immunity.
I'm in neither of those populations but I really don't see why any healthy 18-25 year old would want to life a single finger for a 60-80 year old, after the latter left the former with a broken economy, overpriced education system and an unaffordable housing market. I mean, it shouldn't be on the younger (inherently politically weaker) generation to re-establish inter-generational solidarity... (You can see the effects of this even pre-vaccine - youngsters partying while oldsters arguing for lock-downs.)
That confuses generalities with specifics. The 60-80 year old that you infect might be someone who agrees with you and worked very hard to oppose those things.
I suspect the number one reason is that most 18-25 year olds actually love their parents and grandparents, and don't want to see them dying an agonizing death from covid.
Clearly this doesn't apply to everyone, but I reckon it applies to most.
Think about the people who are old, immune compromised, sensitive to something in the vaccine, etc.: vaccines protect them when enough people in the community are vaccinated that the virus cannot spread. You personally may not be at high risk but it’s still non-zero and your decision to get vaccinated will help people who for whatever reason cannot.
I'll be at home in bed, infecting nobody. And yes, I do wear a mask in public. I doubt their efficacy, but's not such an imposition that I will give it the benefit of the doubt. Injecting something of unproven safety into my body is an entirely different matter.
If that were possible, the flu would be eradicated already. You only develop symptoms for most transmissible respiratory infections after you've already been contagious for a day or so.
Maybe, if you're unlucky. In all likelihood, you'll be asymptomatic and spreading it to a bunch of other people without realizing it (which is most of the reason we're in this mess). Then those people do the same, get sick, and/or die.
You'd have probably infected people, including high-risk people, before you experienced symptoms. If you're vaccinated, you ~won't be infecting people.
A source for one of the claims from Moderna's press release: "By the end of 2020, the Company expects to have approximately 20 million doses of mRNA-1273 ready to ship in the U.S."
20 million doses are for 10 million people. Everyone needs two shots.
Also, having the doses is one thing. Distributing and administering them is another. At least 30% of people will certainly refuse to get vaccinated as well, further complicating things.
I welcome the vaccine (am a pro-vaxxer), but have no plans to be part of the first wave of recipients. Am fine beta testing games, but not eager to beta test a vaccine.
I think this perspective gets lost amongst concerns about anti-vaxxers - I don’t think 30% of the US is anti-vaccine, but >1 are skeptical about being a lab rat for something with a fast-tracked testing phase.
Except your not beta testing. We had pre-alpha testing (phase I), alpha testing (phase II), and beta testing (phase III) already.
We (the US) should've had coordinated national messaging and education of vaccine mechanisms and safety starting the middle of last summer, but that would've required actual national leadership.
Unless you are a front line worker or are high-risk, you won't be part of the first wave of vaccinations. By the time someone offers you a shot, it will have been give to tens of millions of people over several months (and well over 6 months for the Phase 3 participants).
At some point, you have to take a leap of faith. For all you know, it could take 10 years for negative effects to appear. Not being the first in line will tell you nothing that the trial didn’t already tell us, and waiting a year will tell you nothing about side effects in 2, 5, 10 or 20 years.
I choose to trust the scientists who understand the science of how these vaccines interact with the body. I would prefer to take a bet on them and be part of the solution rather than believing in some self-formulated risk analysis and remaining part of the problem.
The kind of people swayed by "national messaging" (e.g. "Your government assures you this fast-tracked vaccine is safe enough for you") are probably not the problem here.
It's the people that have heard enough "national messaging" in their lifetime to regard everything skeptically (see [0]-[5] for some context).
More "national messaging" isn't what fixes healthy skepticism of the same.
This pretty much. I think people get a little too into dunking on general anti-vaxxers, and want to extend it to ridiculing any skepticism at all. I don't really want to be first in line for something rushed through full-scale trials to fight a disease with a >99% survival rate.
Fortunately, it seems unlikely this will be an issue. It'll take a while to ramp up production and distribution, and the first doses will likely go to some combination of those most vulnerable to the disease, and those most worried about it. I think we'll be able to be a lot more confident about it by the time there are even doses available for those who are reluctant, much less before anyone starts thinking about the more coercive methods being floated.
The first few tens of millions of people vaccinated will be people who are at high risk and would be turbo-fucked if they got Covid-19. That changes the risk calculus a lot.
I think you'll essentially get your wish regardless. Assuming you're just a regular Joe citizen (not a healthcare worker, not someone high risk) you're highly unlikely to get access to the first run regardless. So, if phase 3 was a beta test, phase 4 will be millions of doses going to people as a sort of invite only full-release. So, as long as you're fine taking it 3-6 months or more after that, if no ill effects have befallen the millions of early adopters, then you're gold.
I have always been fully vaccinated. My children have been fully vaccinated. But I have to admit some trepidation about a fast-tracked vaccine. Governments need a silver bullet to end Covid-19 quickly, which means that the risk of corners being cut is non-zero. I'll probably take the shot, but vigilance is in order.
The first wave of vaccines are destined for frontline and high-risk individuals. They may have a different perspective on the vaccine than your Average Joe, and I doubt uptake will be a big concern. I don't think distributing and administering will be difficult since it will be on a limited scale. The later rollout to the general public is where most of the problems may be.
To some extent we are guessing because nothing is approved. Maybe something "funny" we be found in the data and nothing get approved and we never get a vaccine. Maybe everything goes perfect and we have both vaccines approved by December 1st, with the other following (which currently don't have enough data to apply for approval) in a few days.
There isn’t enough manufacturing capacity for vaccinate the entire US unless the companies decide to ignore the rest of the world.
Pfizer is slated for around 1B doses (500M people treated) next year, or about 10% of the global population.
I would estimate all high risk groups (elderly, front line workers) vaccinated by Q2'21. Then a phased roll out based on risk. If you're a healthy young 25 year old, you'll likely be one of the last to be vaccinated.
Depends on what else gets approved. Best case is both of these are approved this year, with a couple others by the end of January. If that best case happens we could see countries opening up starting in March, with full opening up this summer.
Given the amount of research happening around Corona-viruses, will we see a vaccine for the Common Cold? Will the vaccination of the Common Cold eventually "pay-back" the money spent on dealing with COVID-19 as fewer people will take time off work to recover from the Cold?
> Well over 200 virus strains are implicated in causing the common cold, with rhinoviruses being the most common.
> Vaccination has proven difficult as there are many viruses involved and they mutate rapidly. Creation of a broadly effective vaccine is, therefore, highly improbable.
IIRC the virus in the rhinoviruses family mutates more rapidly than the virus in the coronavirus family.
> IIRC the virus in the rhinoviruses family mutates more rapidly than the virus in the coronavirus family.
This may be true, I don't know. I do know that my experience with coronavirus colds is that they hit much harder and have more severe symptoms compared to rhinovirus colds. So well worth taking out just the CV segment.
It's a conclusion from symptoms. Complete lack of upper respiratory involvement, heavy lung involvement, very hard immune response symptoms for 5 days(CV) vs copious runny nose, sneezing, stuffy head for 3 days (RV).
It seems that we will, the success of the current vaccine trials are derisking mRNA vaccines generally, which will make it cheaper to develop modern vaccines.
Yes I agree - but I read this [1] today, which talks about "universal" vaccines.
"RNA and DNA vaccines are so far experimental, but trials have been promising and many scientists believe it could be one of those two types that will be the model that goes into mass production to protect against COVID-19.
The attraction, say experts, is that they will potentially offer a step towards something that has been the holy grail of vaccine design – the universal vaccine.
The vaccines being trialed by the team from Pfizer, which tests show provides protection in 90% of cases, and from Moderna, which shows efficacy of 94.5%, are RNA vaccines. If either proves to be the winner in the race for a COVID vaccine, it will represent a seismic shift in vaccine technology."
Interesting. The next paragraph explains more what they mean by that:
"Jeffrey Almond, a visiting professor of microbiology at William Dunn School of Pathology, University of Oxford, told Sky News: 'All the current vaccines we have: diptheria, whooping cough, polio, measles, papillomavirus, you name it; all of them are very different. You don't have a generic process to make them. You have a dedicated factory, a dedicated process, very different technologies.
"'What RNA and DNA offer is an escape from that. We can make the RNA by a single process in a single factory. All we have to do is change the sequence of the RNA or DNA.'"
Very cool, but not necessarily "universal" in the sense you'd need to target all the different rapidly-mutating cold viruses.
> "We can make the RNA by a single process in a single factory. All we have to do is change the sequence of the RNA or DNA."
That's really interesting! Imagine RNA vaccine creation "as a service." Researchers order fully-formed injectable vaccines for animal trials just by submitting a sequence. It would be like AWS for vaccines.
No, the hope is even greater: your doctor orders a fully formed injectable vaccine for the specific cancer that is currently growing in your body. Nobody else has exactly that same mutation, so there is no point in animal trails as the vaccine will only be helpful to you.
This vaccine is a great help to the above: it proves conclusively that the idea is sound. Probably future mRNA vaccines can skip all the phase 1-2 trials and go directly to 3. And for rare diesease they can even skip phase 3.
Yes if mRNA works well, we will probably get 95% effective vaccines within the next decade or two targeting diseases such as HIV, influenza, almost any virus basically.
That's not the issue with HIV. The issue with HIV is that it's a retrovirus. It uses both reverse transcription and inscription enzymes to change your DNA.
A vaccine works to stimulate your immune system's "memory" that's evolved for treating infections. (That can be anti-bodies, but it's more complex .. also involves memory T-cells, the complement system, etc.)
When the same virus comes it, it will infect cells, but your body is much more prepared to handle it. The trouble with HIV is that it's the initial infection that can slowly inactivate an immune system over 2~5 years (not everyone though. Some people have HIV and never develop AIDS; known as Long Term Non-Progressives).
A vaccine wouldn't help at all with HIV. Keep in mind, the HIV rapid test checks for the presence of antibodies.
HIV vaccines face tremendous challenges - almost 100% mortality rate if untreated, the fact that immune system activation helps the virus, very frequent mutations, lack of good targets for antibodies, etc. So don't hold your breath, mRNA is unlikely to help much in that case.
Are you speaking from advanced knowledge? My understanding is that you still have to find a relatively stable binding site that doesn't have a high degree of similarity to human cell markers. So the mRNA technique is a great path from the identification of a binding site to a vaccine, with the difficulty of that identification not being particularly predictable.
And when exactly will it become an actual problem in the sense that it actually affects anyone's life? 1000 years? 10000 years? Like global warming is going to suddenly show its teeth on some random day and we'll all be sorry. You sound like someone preaching the coming rapture, thinking people are crazy for rolling their eyes and continuing on with their lives.
Literally right now there's a bunch of island nations that will probably not exist in 30 years. Many coastal cities are getting worse floods every year, having to invest billions in measures to protect themselves.
Every drought means conflict, they mean war, refugees and instability. Sure, the first world will be shielded from the worst for some time, but this isn't a Hollywood movie, the pressure will keep increasing every year exposing every flaw in the system.
Corona has shown that our world does not deal well with pressure and you can't make a vaccine for food insecurity.
So if it's not your problem it's not a problem at all?
Nth order effects will make it your problem pretty quickly.
Many are blind to exponentially growing phenomena.
One good example is that a several degree increase can melt the Siberian ice and release methane stores equivalent to 100 years of maximal human CO2 footprint. That's already a massive nth order effect.
Like I said, I just don't really care and it's not going to affect my life. I'm all for improving technology and efficiency and believe that it will never truly be a life threatening issue and it's foolish to sit around and be afraid of it. You say it's going to be my problem but how? What would that look like exactly? Maybe in 1000 years it would literally be a problem but by then through the natural course of technological evolution it will just not be a problem. If freeman dyson, a man who solved some of the hardest problems of the 20th century, can say that there is little scientific rogor in our models, estimation and understanding of our affect on climate change, why should I pretend like you know what you're talking about?
But do you understand his argument? I’m pretty sure he would not disagree with projected temperature increase or wet bulb temperature estimates. They are already being measured and confirmed.
I’m pretty sure he would also agree with the estimate for Siberian methane stores. He would just be careful with predicting what happens when they get released.
The average temperature increase can have different effects and that is one of the lines of his argument.
If you do not care about the issue and don’t want to hear opposing opinion then do not leave a comment.
Given the projected temperature increase the wet bulb temperature will make vast areas around the equator deadly for humans. Millions will be affected in our lifetime or will be confined to spaces isolating from the harsh conditions.
Although the temp increase might happen during the colder times of the day so the wet bulb might never reach the deadly quantities.
We had devastating fires over Christmas in Australia, directly linked to global warming. https://www.bbc.com/news/science-environment-51742646 . (In fact we just went from one disaster to another here, the second being C19).
This is just the beginning. It will get far worse and then worse again, thanks to people denying it and saying we might think about maybe reducing our emissions gradually next decade sometime..
In South Australia they're talking about taxing EVs because they don't get to tax their owners by way of the fuel excise. There's zero regard for pollution, it doesn't even have a monetary value - high polluters aren't taxed at all, so they're taxing the solution not the pollution instead. (Contrast Norway).
This is why I said it's going to get far far worse. There's so many thick skins to get through, blocking and impeding what needed to be immediate action decades ago and still isn't.
I've been on here for 10 years. When did hacker news loose all resemblance to hacker culture? And i'm not a truther (thanks for making me use a word like that btw), maybe a rationalist is a better word. Let's all wake up an be afraid of asteroids too.
The actual words you used in your reply to my post (akin to "we may see someone affected by global warming in 10,000 years maybe and besides that I don't care") was just pure denialism.
Observing science has been part of the HN culture as long as I've been here.
Several Pacific Islands, and some in the Indian ocean have already lost significant parts of their land. Just because something doesn't personally affect you does not make it a hoax.
I'm a huge believer in alternative energy, but it's just nonsense to blame natural disasters across-the-board on climate change. It almost implies that the climate would be docile without human-introduced CO2. Plenty of bad weather events happened before climate change. The most deadly Atlantic Ocean hurricane on record was in 1780. The Dust Bowl droughts were the worst in American History.
I'm not sure the dust bowl draughts are a great example - they weren't product of global climate change - but I think they were very much the result of large scale "terra forming" - changing prairie to farm land?
At any rate, the question isn't so much - were extreme bad weather events bad before as well, more - are they getting worse and/or more frequent?
While you're being downvoted, I agree with you. The artificially low interest rates are a huge burden to society, so while I'm optimistic about the vaccine, I believe that getting back to a society based on savings instead of debt will be extremely painful.
I'm talking about the next 10 years, people are so focused on 2020 that they don't see the big picture, that the economy is getting worse every year, and it effects everybody, even people who have wealth...we're all connected.
And even on the healthcare side, we will have to deal with the consequences of the lockdown. Massive backlog in hospitals, cancer screening and vaccination campaigns not happening, obesity up, psychological consequences, and also the knockdown effect of disruptions and economic crisis on treatment and vaccination campaigns in developing countries.
The government orders are a huge part of it! Case in point, look at the employment numbers and other economic indicators from early April vs today. It was so, so much worse in April, yet the pandemic is mostly the same. But today we don’t have nearly as strict lockdowns.
These are only results of the US-specific lack of welfare protection mechanisms, not a lockdown per se - especially unememployment and to a lesser degree also the negative growth are significantly less accentuated in the other OECD countries.
The high unemployment was because of how the US structured the spring legislative response. Businesses were ordered to close, and that made employees eligible to collect unemployment insurance. A federal program paid those unemployed people $2400 a month (in addition to their unemployment insurance).
The US poverty rate went down during the period. So it wasn't a lack of welfare protection, it was just a (likely bad) implementation choice, paying individuals instead of paying businesses to keep them on payroll.
The lack of response since that expired in July fits your description though.
I know, I'm not from the US but I tried to follow the US development closely. Many other countries have furlough-like systems where workers get money in cases of force majeure like floods or a factory burning down, without losing employment. One usually gets payout as a percentage of regular wage (depends on the countries, I'd say it usually lies between 60 and 90% of net income). These institutions were already in place, and when lockdowns were ordered the government just had to inject more money into them. All the red tape and all logistics were already in place. Most countries also allow soft fade-outs (I'm lacking the proper word here, sorry), i.e. 80% furlough and 20% regular work in month 1, 50/50 in month 2 etc.
The big advantage of this approach (in addition to the obvious advantages for the workers) is that companies don't lose the organizational knowledge held by the workers: With whom to speak in case machine X fails, whom to approach in customer company Y for a new deal etc.).
The government orders have been overwhelmingly the largest piece of it! I wrote this a few months back; the secondary effects from government intervention, and they fear they've brought with them, have been far reaching and disastrous:
The citation for gunshot wound victims being counted as Covid deaths says it was 5 deaths, and it was only on the publicly-available dashboard to track deaths. Not being used for official reporting purposes. In my opinion it's kind of dishonest how you present that.
I'll admit it made me lose interest in reading much further because I don't trust you to have used the other 42 citations in good faith.
Anyway, that was just meant as constructive criticism. Just something to keep in mind in your writing in the future.
It was one account, but during that time period, there were tons of reports, every single week, from miscounted deaths. The No Agenda Podcast guys covered it pretty well.
If it's just a couple here or there, there are miscounts for sure. But with news report after news report from local stations, I think the issue might be enough to be statically significant, or at least warrant investigation and not outright dismissal.
Furthermore, Sweeden seems to be doing alright as far as fatality numbers across their population for the year, even though their covid orders were much more limited:
> because I don't trust you to have used the other 42 citations in good faith.
We're getting into this really interesting era where we're attacking people's views for their sources .. even though there has been obvious bias in all mainstream reporting for over a decade. If you're not willing to entertain viewpoints you don't agree with, that's on you, not on me.
Entirely reasonable of OP to posit bad faith on your part, especially given how you've reacted and the way you constructed a strawman to get upset about.
The secondary effects from a pandemic rampaging through society unchecked by government orders would be very bad as well. At some point people just stop showing up for their jobs and then you might even end up with a barter based anarchy were big cities would simply starve in absence of the required logistics.
Seriously? In my big city, people are generally behaving as if the disease doesn't exist, at least on weekends. Restaurants are pretty full, stores are busy. The only time it feels different is during weekdays, when the city is empty from forced WFH. When people are given the choice, they are choosing to go out in the world, risks and all.
I think a majority of people stopped giving a shit in June[1]. The government's continued lockdown policies are 100% at fault for continued economic distress.
Hmm, "counting the number of requests made to Apple Maps for directions" is different than people actually going places, though. If you look at the Google location data reports, the retail and recreation category was down 16% when the Apple graph was at its peak: https://www.gstatic.com/covid19/mobility/2020-08-14_US_Mobil...
> When people are given the choice, they are choosing to go out in the world, risks and all.
That could change pretty fast when hospitals have to start sending seriously ill home to die. That would still only directly affect a small minority, but the same people who feel safer than they should now would then start feeling more in danger than they should. There's a certain irony in how a lot of people think that the rules are unnecessary exactly because they do work.
In general, the further back you go, the less practical it would be for most people to avoid going into an office if they wanted to remain employed and to avoid doing most of their shopping in-person.
Travel was also significantly less than what it is now. 20 years ago it would have been a local epidemic with limited spread. 10 years ago would have been a pandemic but still limited in terms of spread.
It would have slowed the initial spread, but as we have seen, it only takes a single "superspreader" event to infect an entire country. Out of the various actions taken to fight the pandemic, closing borders was among the least effective. Basically, it only worked on islands and in combination with strong local actions (testing, tracing, quarantine, lockdowns, ...).
20 years ago wasn't the middle ages, air travel was a thing (9/11 was almost 20 years ago). In fact, it wasn't that different than it is today.
The difference is in how the disinformation is propagated. In the past media companies would self censure idiotic or untrue ideas to protect their reputations and while you could find information if you looked hard, the things would tend to spread slowly. Social media doesn’t profit from reputation but from engagement, and untruth is more engaging.
I often wonder this and perhaps it would be less bad because people were less mobile (or it'd spread slower) - but worse because of the presumably worse treatment options.
Perhaps we today would be 20 years ahead in terms of medicine and tech given the real pressure for innovation that would have been needed ('war is the mother of invention' - or something), but for a higher cost in casualties back then.
So many variables! - It's an interesting thought experiment.
People weren't that much less mobile 20 years ago. And it would have been much harder for many businesses to go virtual relative to today, a lot of online delivery was early days and certainly not at today's scale, etc. So "shelter in place" would probably have been much more limited. 10 years earlier and most of the things that let people stay at home would have been off the table.
20 years ago my boss orders my to work from home the next day because it was important for me to finish a critical piece without the distractions of the office. Of course as a programmer we have always been on the bleeding edge of this just be the fact that until our tools work we can't make anyone else's work.
100 years ago people regularly ordered things for delivery. Sure it wasn't online, but all online gives you is some time.
We actually had a milkman for a period when I was growing up.
Certainly, as you go back in time, there was a lot of local delivery especially in urban areas. Mail order, Sears catalog notwithstanding, less so. Just to pick one random example, ordering music, movies, or books pre-Amazon was really pretty limited.
20 years ago, some people could work from home at least some of the time; I did personally (for pretty much the first time). There was fairly decent broadband availability, etc. But just barely. Go back just another 5 years and it gets much harder.
>but all online gives you is some time
And a lot more types of goods available. Again, 25 years ago, it would not have been practical for people to have wholesale pivoted a huge amount of shopping online. (And companies like B&H Photo couldn't have scaled.)
20 years is probably just about the cusp of it barely being possible.
Oh my. Today's polarized online discourse. All right, let me be more precise, since multiple people seem to be jumping to the conclusion that I'm some rabid anti-mask, anti-lockdown, science-hating, Trump-voting neoliberal. I was hoping to contribute fruitfully to the discussion in short form, but seems like I'll need more words.
The coronavirus pandemic is a terrible natural disaster. We are right to take extreme measures to control it until proper mitigating measures become available, and we are very lucky that it did not happen ten years ago. Our societal surplus thankfully allows us to do the right thing and protect our weak and unlucky, as well as be more precautionary regarding long-term effects than others would have.
Reiterating my point -- if we were unable to use modern science and technology to combat the pandemic, the death toll and long-term health effects would be comparable to a minor global war. This would be a catastrophe that would be remembered for generations. It still will, but thankfully writ small.
Compared to other historical catastrophes -- the Black Death, the World Wars, five centuries of European warfare, Mao's Great Leap Forward, it would be a mild event, mostly because the death toll would hit the elderly and the weakened hardest. It would be bad, but it would not mean sacrificing a whole generation of our most ambitious young and capable people. It would certainly not be a catastrophe that threatened societies, although political follow-on effects would have lasting impact.
It's also worth noting that many authorities around the world have bungled the response terribly, both being ineffective in their measures and causing more economic damage than necessary. But that's dangerous territory to discuss, since you risk being branded and shut down with the terms I mentioned above.
(For reference, I made a fool of myself in my social circle in early March by suggesting 'extreme' quarantine measures before any Western governments did. I've been supportive of most science-based measures to slow and contain the pandemic, while at the same time being critical of many authorities' slow adaption of the best available science -- including lack of early mask recommendations and reluctance to consider aerosol contagion).
I think it wouldn't have been as big of a deal. Most people had their minds made up about severity in early 2020 after seeing Wuhan and Italy. No amount of new data pointing to the fact that _those_ were in fact the outliers, and that COVID-19 is bad-but-not-apocalyptic will change their mind. I attribute this to the speed at which information travels now, and the way that social media works to reenforce existing beliefs rather than encouraging a constant reassessment.
Even ten years ago WFH and online school just would not have worked, this was when the iPhone 4 was hot new tech and most people still had single digit mbps internet. There's no chance that you could try the sort of 'online everything' we've been doing this year. The lockdowns become far less palatable when the consequence is clearly "no school or work for a long time".
Newspapers were still pretty good at spreading nationwide narratives and fear back then, probably much better than current media because people couldn't talk back at scale.
Without social media and news organizations forced to whore themselves for clickbait money it would have been just written off as "damn those two pneumonia seasons were really shitty" .
This is pretty typical. The big companies tend to invest in the little ones so that if the little one finds something good they can buy it and put the rigor of large scale manufacturing (and marketing of course) around it. If the little ones fail to find anything they can cut their losses without having the moral hit of laying people off.
For now: Pfizer has already got what they want: a license to produce a useful vaccine. Conversely BioNTech also got what they need: someone able to run a large trail and scale up manufacturing while giving them some profit.
In a few years both companies will re-evaluate their relationship. Partnerships can last for years at times. Other times one company is bought. Other times they go their own ways. All are normal and mean nothing, though if you are an investor each has different implications.
BNTX's market cap is pretty large already, it's unclear how desirable a buyout would be by a Pfizer-type company. It seems better to split profits / contracts.
With the first two vaccines above 90% efficacy, this does look very promising in general. If the other vaccines also turn out this well, this makes it look like a more optimistic timeline for vaccinating enough people to stop the pandemic is possible. Moderna is planning for 500-1000 million doses in 2021, BioNTech/Pfizer for up to 1.3 billion doses. Not sure how many more promising candidates there are that can be ready early in 2021, but I think there were a few more.
Slightly off topic but its interesting that Moderna's market cap is $38bn and Zoom's market cap is $113bn. Obviously Moderna's vaccination directly saves life's and has much more impact than Zoom. A sign of the times/market we live in.
According to Wikipedia, "As of November 2020, Moderna was valued at $35 billion, and while none of its drugs had been approved" since its creation in 2010.
$38bn ain't bad for a company without a single product released for the past 10 years.
I work in biotech so I may be able to share some of my experience in the field. That said, I may also be sharing my mis-experience too ;)
Biotech startups are longer term things than software startups. Typically, your product doesn't get to the market until years 10/12 of the business. This is due to the regulatory issues like with the FDA or the EMA and other countries. Critically, that approval to be on the market or not is made near the end of those 10/12 years.
So, yes, you bust your butt to get the business going for a decade or more and then the regulatory agency decides if it can be sold[0]. Many other biotech people complain about this (and rightly so!), but I personally feel that this is the 'lesser evil'. We do not want pacemakers, knee joints, or pharmaceuticals to be developed like exercise equipment.
That said, the new product is likely to be a new market entirely, and one that you now have a near total monopoly on.
Like with any start-up, it's a risk/reward calculation. And biotech tends to be a high risk business, thus leading to high rewards that are economic, psychological, and spiritual.
[0] To be clear, this is a very complex process, and I have simplified it down. Each business and use case is very different.
My personal recommendation for anyone unfamiliar is to begin by read the relevant literature re: the field being worked in by the company. You can access most things through pubmed.
Admittedly that will most likely be a slog. But realistically you need a deep understanding of the molecular/biological context when investing in this space to understand whether or not a drug will be successful.
I worked for a YC biotech (S18) this last year in a scientific role, but bridging the gap between investor to startup has been something I've been thinking about as a possible career in the future...
One way I have seen is to have a cadre of scientific/medical advisors with skin in the game (usually, on the board). This is also one of the paths out of debt for MDs that don't want to practice or MD/PhDs in general. With a few people that actually know the science/art, you can then focus on the finance and other issues.
The science part isn't always hardcore mol-bio, as many devices can be a bit more like traditional engineering (even internal ones). But many of the problems that the various agencies will cite will be mol-bio related. Even as a hardcore investor, unless you have the many years of background, or can get people with background to put their own money in it, you are going to have a hard time. Paying just for consulting isn't likely to be appropriate due-diligence. Biology is monstrously complex and frustrating even in one individual, let alone a population. As such, it takes a lot of research to have a good clue of what is going on, more so that you can likely pay consultants for.
EDIT: Again, I want to stress that every situation is different and that I am only relating my personal experiences here.
I've invested in a few smallish ($200M to $2B) biotechs over the past decade or so. While I eventually got out with a small profit, I have sworn off ever investing in one again.
Too much time and too many grey hairs from following the hope-and-disappointment cycle as you read the tea leaves from ambiguous trial results and FDA announcements.
Mesoblast. I won't bother to share the full story of all this company's ups and downs over the last decade but let's just say that the amount of time I spent tracking the news on it was far out of whack with its importance to my portfolio.
Market value is hypothetically based on present value of future earnings, not immediate value to society. Unless Moderna's business plan is to ransom humanity to extract the most value possible from covid, it should not be surprising that there is more value in a longer term business.
It also says something about the in incentives that drug companies trying to maximize market cap have.
Really great news for the Biosecurity industry because the mRNA vaccines are far easier to manufacture. Main hurdle now seems to be to freeze dry (“lyophilize”) them for transport, cuz otherwise you gotta keep em at extremely cold temperatures, which adds a ton of cost (and may not even be doable)
Isn't the big advantage of the Moderna vaccine over BioNTech that it doesn't have to be stored at -80c? This one should be stable at normal refrigerator temperatures for up to a month and -20c for longer, according to the article. That doesn't seem hard to transport at all
BioNTech didn't get to perform testing regarding storage and is therefore giving the safe numbers. Might as well be possible to transport and store their vaccine at much friendlier temperatures - but since that isn't verified this risk won't be taken with today's knowledge.
I have worked at two different companies that have been accelerated by the FDA; once during the HIV crisis for a sequencing application and at a medical imaging company that demonstrated overwhelming quality of care improvements. Acceleration is unusual but not "conspiracy level" unusual.
My former colleagues in the viral research space (the HIV team above) basically flagged this type of vaccine as our best hope for an 2021 vaccine. No one I know from this space thought a 2020 vaccine was ever in the cards.
Though these vaccines may get approval in 2020, they aren't really 2020 vaccines in the sense that they will have significant enough production to have an effect in 2020.
I don't work directly on vaccines, but given the number of attempts, a 2020 approval definitely seemed possible to me, and even Fauci saying that in the summer. But I've also said that it wouldn't have a significant effect in 2020.
Edit: Here is Fauci saying on May 27 that we might have a vaccine by end of year:
>No one I know from this space thought a 2020 vaccine was ever in the cards.
Normally vaccines take longer to develop because years of studies must be done to confirm the absence of longer-term side effects, not always because the actual vaccine development itself takes years. This requirement seems to have been bypassed for potential covid19 vaccines, allowing the vaccine to be released faster, at the expense of not having time to test for the absence of any long-term side effects (e.g. if a side effect takes 2-3 years to manifest, it's impossible to detect this with a trial that only lasts 6-12 months).
Well, like I said, the people I know are familiar with both vaccine development and have experience with FDA acceleration in times of crisis and they still thought 2021 was the earliest we would see a vaccine.
RNA vaccines as an idea are a pretty recent thing. The fact that this one exists at all is literally a first. Remarkable how quickly they've gone from mRNA as an idea that they've been working on to a full-fledged vaccine for a novel coronavirus in under a year.
“ No one I know from this space thought a 2020 vaccine was ever in the cards.”
I’m not in science, but friends who had colleagues more involved in biological sciences said those fellows were total skeptics that anything like 6-8 months would be possible.
Imagine if this would have happened ten years ago. Think we’d have any prayer for a vaccine? Wouldn’t be surprised if the technology didn’t even exist within some point in the last couple decades.
> I’m not in science, but friends who had colleagues more involved in biological sciences said those fellows were total skeptics that anything like 6-8 months would be possible.
Yes. I have an academic friend in a high-level biotech research role who said a vaccine wouldn't be possible in this timeframe, that we ultimately could only delay the spread but not save people, so to avoid economic harm on top we should let the virus "run its course" and kill however many it's going to kill.
Well this vaccine isn't approved yet, and there are still more testing phases left to go. So they "might be" wrong is more appropriate than "were" wrong.
I also have a lot of safety concerns about something developed this quickly.
That was the concensus ... 2021 was possible if we get really lucky and either an existing coronavirus vaccine platform could be repurposed or a RNA vaccine works out.
Just to be clear, there was a real risk that a vaccine would turn out to be impossible for this type of virus. It looks like completely dodged that bullet.
There were plenty of people, including communications from the different vaccine teams, saying a 2020 vaccine was possible as far back as this June/July. There were of course plenty of naysayers too, but the people most deeply meshed in this 'space", the actual leading vaccine teams, were bullish from very early on.
This is fantastic news! There is light at the end of the tunnel. We are a very resourceful species and I hope that at the end of all this we learn to have a little faith and trust in each other. Sometimes it takes a crisis to force us to innovate but we can do it when we have to. I really think that when we get around to recognizing climate change as an actual crisis, we will deal with it as well, because we will have to, and we have always had the capacity.
This just goes to show how difficult a problem cancer is. These companies were working on therapies for cancer, switched direction and in 11 months developed and successfully tested a vaccine against a newish virus. What's the progress in cancer treatment in those 11 months with vastly larger resources? Is there even a 1% improvement in survival across all cancer types compared to last year?
Consider that you can quickly get 30,000 people to sign up for a trial (which is what I saw as the AstroZeneca trial size) but you really have to work to get a sufficient sample size for the right kind of cancer.
Oncology trials can take years. On top of that, teams threw their entire effort into a single vaccine because billions of people will need it, and they may need it multiple times depending on how this vaccine goes. Cancer drugs are often for one type of cancer, which has fewer people and thus less priority.
If 7 billion people were at risk of developing one type of cancer, I think we'd have a better chance at developing it. Cancer is hard but that's not the only reason it's slow.
In a limited US-centric look, it seems like the resources are at about the same level, with funding for cancer at ~$5.6 billion for the NCI[0], and ~3.6 billion for COVID19[1] (in June, not sure if more funding has been approved since).
Not sure what metric you want to consider for cancer survival, but the rough trend in 5-year cancer survival seems to be in the ballpark of improving between 0.25-1% yearly (until 2013)[2].
Ah yes, you're right. I just couldn't believe the number is that low since it looks so big from the inside (AACR had like 100k attendees). Especially when you compare this number to tech acquisitions...
Cancer, as a whole, has gotten way more money than Covid has. Half of all biotech VC money was going into cancer. No to mention big pharma's R&D budgets are heavily focused on cancer.
Cancer and heart disease each killed more people than Covid this year. But a working covid vaccine a lot easier to produce (this is something I'm saying on hindsight - 6 months ago I wouldn't have been so confident in the ease).
I have hope that the mRNA based vaccines will enable economies of scale and provide insights into delivery mechanism and safety which will then in turn speed up the development of cancer treatments.
Neither pfizer or moderna has released the full analysis of the phase 3 data, but both interim data releases have been basically identical in terms of efficacy. It's good to be skeptical, but phase 3 trials are pretty tightly controlled and subject to independent analysis. I don't think there's really anyway you can read this data as being manipulated. Unless there's massive fraud in both studies.
I don't think it would be outright fraud that I would be looking for, but rather them glossing over things like composition of the group, the novelty of the RNA approach and how that could affect different subgroups given we'll be giving it not to 30k but hundreds of millions of people at least. A kind of crazy thing that occurs to me, how does it interact with someone that has a retrovirus infection? I get that those reverse-transcriptase proteins act specifically, but weird stuff out of left field could be a problem once deployed widely.
I figure a peer reviewed article would at least have to address the "known unknowns".
Well, the data will be published at a high-level (by the physicians who work with the company and ran the trial), but you won't get to see the level of data the FDA sees. You don't have much choice but to put some faith in them.
This is a big differentiator versus the Pfizer/BioNTech vaccine....
"Moderna had previously said their vaccines could ship at -20 degrees, refrigerated for up to 7 days, and kept at room temperature for up to 12 hours. Now, the company says they’ve devised a formulation that can stay refrigerated for up to 30 days and kept at room temperature for up to 24 hours."
So, the current working theory about Africa is that they have really good contact-tracing systems (because they still have lots of infectious diseases) and people comply more with infection control measures (because they still have infectious diseases).
The trouble with the developed world is that public health has been so successful that people appear to have forgotten why we need it.
Among other factors, South America seems to show the strong winter seasonality pattern typical of coronavirus infections (not just SARS-CoV2). Much of Africa does not (the continent spans northern and southern hemispheres to a greater degree, and has far more population in a tropical belt), though South Africa seems to.
The majority of people in South America are partially or mostly of American Indian descent. It's been generally known for a long time that American Indians are hit harder by the flu. Some research papers on covid seem to indicate a similar trend. As such, it may not be so surprising to see worse numbers in a continent of people genetically susceptible to the disease.
Africa is also pretty easy. Median age in Africa is 19.7. Median age in Europe is 42.5. Median age in the US is 37.9.
We know that young people are very unlikely to die from covid, so a place that skews so young would have fewer deaths.
Likewise, given the large number of much more lethal diseases in Africa combined with young age and poor medical facilities, people with preexisting conditions are much less common and are much more likely to be killed by other, more lethal diseases.
This is not correct. If you adjust for population size, most of highly-developed Europe is doing much worse than the USA right now. That includes Germany, Switzerland, etc.
The US has had 34k cases and 760 deaths per million people. Germany has had 10k cases and 152 deaths per million people. So Germany has done 3 to 5 times better than the US so far. The only Western European country that has clearly worse numbers than the US is Belgium and in part that may be because they have a much broader definition of deaths with COVID19.
But it does show that you cherry-picked data that didn't give the full story. The follow up comment only made things more clear, which I think you should appreciate.
I didn't cherry pick, I was in fact exhaustive. I was looking for cases that supported "most of highly-developed Europe is doing much worse than the USA" and specifically mentioned Germany. I looked at the specific cases mentioned and any others that could be classified as "much worse".
I agree, I just wanted to make it extra clear for others how several large European countries seem to have numbers similar to the US (Ironically... I could have phrased it in a way that made that more clear to you.)
It seems to me that all remaining levels and sub-sectors of American society have responded reasonably competently, despite the grossly negligent and incompetent response (potentially even criminal?) from the administration.
How do you figure that? Taking the example of Germany, their numbers of new cases and new deaths from the same source are ~2x less than the US per population. By what metric is Germany doing much worse than the USA right now?
Germany is basically the best case for Europe and had 199 deaths today, with a quarter the population of the US (who had 485 deaths).
* 506 deaths in France (a fifth of the US population)
* 213 in the UK (equiv. to 1000/day in the US)
* Switzerland tracking at 100 deaths a day, equivalent to over 4000/day in the US
* 162 deaths in Czechia, equiv. to 5346/day in the US
EU cases started climbing earlier than the US, and new daily cases have peaked and are descending.
Plotted here, 1 September to present, are the largest EU states: France, Spain, UK, Germany, and Italy, vs. US. (The tool is capped at five comparisons). Shown are new daily cases, normed to population, 14 day smoothing (to clarify trend).
Substitute otheer countries as you prefer. Note that Poland, Czechia, and Switzerland have comparatively small populations (38m for Poland v. 84m for Germany).
US cases are still climbing, EU are falling. France peaked on 2 November, 14 days ago, deaths attributed to those cases are just now being reported, but willdecrease rapidly.
Meantime US cases are still growing exponentially, with over 1 million new cases (at a 3% CFR) in the past week alone.
Calling the US situation "better" than Europe is ignoring the inevitable tragedy facing the US. As with this past spring, a few weeks lag on the epidemic curve can not be represented as evidence of superior situation. The future is here, it's just distributed more in Europe than the US presently. The US will get what's due it within 2-3 weeks, possibly sooner.
We're just discussing different things. I'm talking about the number of deaths occurring right now in Europe, as a response to the original comment I replied to. You've added a lot of context about the number of cases and what's likely to happen in future. I don't disagree with any of that.
1. Cases today translate directly to deaths in the 2--4 week future, at a best-case rate of 0.5% CFR and far more plausibly 1.5--3% CFR, based on present reported cases.[1]
2. US new cases per capita are at least on par if not worse than Europes's.
3. EU daily case rates are trending at worst flat, and are generally decreasing.
4. US case rates are rising, at an acellerating rate.
The US today reports 158,363 new cases (7-day average), and a 3% CFR. In ~2--3 weeks, likely daily deaths will be 2,375--4,750, or 7.5--15 per million.[2]
Germany, to use your favoured example, reports 18,363 new cases (7-day average), and a 2% CFR. In ~2--3 weeks, likely daily deaths will be 367--550, 4.4--6.6 per million.[3]
All Europe reports ~220,000 new daily cases (16 Nov 2020, not smoothed). in ~2--3 weeks, likely daily deaths will be 3,300--6,600, 4.4--8.8 per million.[4]
To provide an analogy, you're laughing at Europe being in a ditch whilst the US is racing toward a cliff's edge. Assessments of present health or wealth must include obvious future consequences or risks. You entirely ignore these, and reframed the initial criterion to do so.
Your analysis suffers from presentism and risk blindness and is utterly flawed.
________________________________
Notes:
1. I'll ignore the fact that reported fatalities undercount true COVID-19 fatalities as demonstrated by overall excess deaths by about 30% per an August 2020 New York Times report and other independent studies and data.
2. Using 1.5--3% CFR.
3. Also using 1.5%--35 CFR, despite Germany's lower experienced CFR.
4. Again at 1.5--3% CFR. Based on reported values, whic undercounts recoveries, experienced CFR is ~4%.
I did not "redefine" or "reframe" anything. From the beginning I chose to use recent daily deaths per capita as my measure of how badly a country is being hit by COVID "right now". It is true that my first response did not make this explicit, and in retrospect I should have done so. Please read all my comments charitably, as I have done with yours.
I have already agreed that the measures you are using are also valid and that the trends are bad. However your points 1-4 are entirely about cases, trends, and the future, which has nothing to do with the point I made.
Accusing me of "laughing at Europe" is the sort of toxic rhetoric which doesn't belong on HN and frankly says more about you than it does about my argument. I live in one of the worst-hit yet most-developed countries, and some of our ICUs have run out of beds.
"Beginning" means from the moment I conceived the idea in my mind. Again, please try interpreting things charitably, otherwise you will make poor assumptions and end up arguing against your own imagination.
If you re-read this thread you will see that I am not arguing against the points you made, at all. I'm saying (over and over) that you have failed to address the extremely simple point that I made. I've replied to your other comment, so let's leave it there. All the best.
I did look it up myself. I used the 7 day moving average to get more stable results and Germany is 2x better than the US in new cases/deaths per million right now even while having 3 to 5x less cases/death in total since the start which means it also has a more vulnerable population at this point. I didn't pick Germany, you did, and claimed it was "much worse". And it's not the best case, there are several countries doing better or much better than Germany.
As for the other examples Europe is now having a second wave after successfully suppressing the first one. The US has never suppressed the pandemic, or at best is now at a third wave, and thus has a currently less susceptible population from all the cases and deaths it has already had. And even then it's still having more new cases and new deaths than the well managed countries in Europe (Germany, Norway, Finland, Denmark, etc). It's hardly in a better situation right now as you claim. The worst countries in Europe are at the US accumulated average, some are catching up but the US is also spiking right now.
Over the past few weeks (i.e. right now), the number of deaths per capita in the European country I live in is far higher than the number of deaths per capita in the USA. Some of the best hospitals on Earth are running out of ICU beds. My country is not alone in this, as you can see in the numbers I provided. This is the context for my response to the original commenter.
You have a different way of measuring the problem and you are extrapolating into the future, and that is also fine. We are just making different points.
I'm not measuring different things. I've used initially the definition that seemed most appropriate to me as you didn't provide any and then the definition you chose. You're now using as an example an unnamed country. With the examples you gave it wasn't true in either of the metrics.
I've already given you the numbers for Germany which was your other example. It is actually 2x better than the US. Your claim was "most of highly-developed Europe". Germany isn't even the best case and the total EU metric also says the opposite.
Germany is at 177 deaths per day with 84 million people, for 2.1 deaths per million per day. The US is at 1170 deaths per day with 332 million people, for 3.5 deaths per million per day. That's a factor of 1.7x worse by the US. In number of new cases it's worse.
You're doing math with the "Today" numbers that are not always reliable because not all US states have reported sometimes. The 7 day moving average numbers are more reliable.
It's also very easy to lookup countries like Denmark, Finland and Norway that are much much better. Picking individual small countries is not a great methodology, particularly Czechia that did extremely well in the first wave and thus has a much more susceptible population.
231 million people, 1807 deaths, more than 2x as bad as the USA. And that's before adding Switzerland, Czechia, and other countries where things are worse.
It's also irrelevant that Czechia did well in the first wave. This is about who is doing worse right now as measured by actual humans dying. The reasons don't matter.
So from "much worse" it's now "not materially worse". In reality the numbers say Germany is actually much better, and it's 84 million people that you are now excluding from the analysis.
Picking other individual countries is a poor analysis. Take the whole EU or another group that's comparable to the US. Otherwise the same can be done for US states. But you were also given numbers for those that showed the opposite and doubled down. You already have a conclusion are are making the data fit.
> It's also irrelevant that Czechia did well in the first wave. This is about who is doing worse right now as measured by actual humans dying. The reasons don't matter.
It's not irrelevant in the context I used it. Which was to explain how you were cherry-picking a very specific case.
Population - Country - Deaths
60,427,888 - Italy - 731
65,328,048 - France - 506
68,021,208 - UK - 213
37,831,020 - Poland - 357
8,678,393 - Switzerland - 72
83,783,942 - Germany - 257
11,608,351 - Belgium - 195
Look at the map. These are reasonable choices. I haven't cherry picked them, e.g. I included Germany and excluded Czechia.
This is 335M people and 2331 deaths.
That is AT LEAST DOUBLE the current daily death rate in the USA.
There are many other ways of grouping European countries to achieve the same outcome, which is to show that contrary to the original commenter's position, right now, the USA is not the worst hit place on Earth, if you measure the problem by the number of people who are currently dying every day. I live here and that is the number that matters the most.
Here is my original comment, which is totally consistent with the numbers above (with the exception of Germany as an individual nation, but this is irrelevant as it's now in the aggregate):
"This is not correct. If you adjust for population size, most of highly-developed Europe is doing much worse than the USA right now. That includes Germany, Switzerland, etc."
Of course you can select many other ways of grouping the data and many other ways of choosing the numbers to achieve the outcome you want. That is not relevant to the point I have been making.
At this writing, Europe as a whole has a population of 747.8 million, and 14.1 million COVID-19 cases, for a population-adjusted rate of 18,900 per million.
The US incidence rate is 34,400/1M, 182% of Europe's.
EU has 8.57m active cases for a 11,500/1M active case rate.
US has 4.23m active cases, for 12,800/1M active case rate.
Note that Spain, UK, Netherlands, and Sweden don't report on active or recovered cases. Nor does the US state of Oregon.
The margin is much thinner, though reported data still give the edge to the EU. Given that Spain and the UK represent large current EU outbreaks, that margin could shift to the advantage of the US.
I'll note that US cases are continuing to grow largely unhindered whilst several EU outbreaks (notably France) may have peaked as lockdowns' impacts are seen.
Only by the least charitable interpretation of the point I am making. There's nothing wrong with using the current death rate per capita as a proxy for the problems a country is experiencing "right now". Which is the context for this sub-thread.
Assertions aren't arguments, and I've already addressed that comment.
Switzerland had 142 deaths in the past 24 hours. That is FOUR OR FIVE TIMES the number of daily per capita deaths in the USA at the moment. It is perfectly reasonable to believe that on this basis, Switzerland is having a tougher time right now than the USA.
I don't know why you are so doggedly refusing to accept the very simple point I have made here, which relies on nothing more than public facts and basic arithmetic.
Thanks for the discussion, but I have to assume you're not here in good faith, so I'm done. All the best.
It is difficult but its not because of the price, although that's there too. It's that developing countries may not have the infrastructure to transport and store the vaccine at the recommended temperature of -70C.
The moderna vaccine does not need -70c, juste -20 to be stored indefinitely (regular freezer), and even higher than that if you can ship relatively quickly (i.e weeks)
Developed countries don't have infrastructure for -70C distribution. The US is going to struggle to actually distribute the Pfizer vaccine. It's not like your local CVS has a freezer that goes down to -70C. Dry ice is possible but there's a shortage of that, too. Nobody has ever distributed a vaccine that needs to be stored at -70C.
The Moderna one is much easier, you just need a normal freezer. Which is fine for developed countries, will still be a challenge elsewhere (but one they're used to, it's not the first vaccine that needs to be kept cold)
There is no shortage of dry ice. The input (CO2) is a byproduct of industrial processes (ethanol in particular) and so the market is completely glutted. It is also used for a number of industrial process so there is plenty of infrastructure to produce it in any city.
Poor countries might face a different issue even if they get hold of vaccines - some of them (not sure if just Pfizer's) need to be kept in really cold environments [1]. Thus some countries will struggle with distributing it.
Pfizer's is the worst, and they give you 5 days at more normal temperatures. It will be more much difficult logistically, but if needed anywhere in the world is 5 days from any place else if it is important enough.
It doesn't seem to be rich vs poor countries in this case. The Moderna vaccine is expensive. Too expensive, even for some developed countries that rejected it as an option.
If the US government is happy to hand out billions in funding and then pay a high price for the doses, why would a private company not take advantage of this?
Somehow the EU/UK convinced AstraZeneca to sell the Oxford vaccine at production cost.
> If the US government is happy to hand out billions in funding and then pay a high price for the doses, why would a private company not take advantage of this?
The US government paid Moderna $1B to fund the development and $1.5B for 100 million doses. They are paying Pfizer $1.9B for 100 million doses of their vaccine. I don't consider $25/dose (maximum) or $19/dose to be "a high price".
It is a high price when you consider low income countries. For example, in Sudan the average monthly income is about ~$49. That's less than the cost of a 2 dose regime of this vaccine. That's a $2 billion price tag to vaccine all 40+ million Sudanese. Africa has 1.2 billion people. It is going to be extraordinarily expensive and difficult to eradicate COVID globally, so we are going to need cheaper vaccines to help us do that.
There is no reason other than political will stopping the WHO and developed nations from subsidizing the purchase of vaccines for places like Africa. In fact, I don't think there is any vaccine that a country like Sudan could afford to administer without such subsidies. Additionally, I suspect the cost of distributing and administering the SARS-CoV-2 vaccine in those areas is going to dwarf the raw cost of the doses anyway, considering the temperature sensitivities of the front runner candidates.
That said, the person I was replying to was claiming the price was too high for some developed nations.
> Moderna said it would charge other governments from $32 to $37 per dose. The charge to the United States, which has already committed about $2.5 billion to help develop Moderna’s vaccine and buy doses, comes out to about $24.80 a shot
Yes, they're expecting to profit to some degree, but those charges don't look to be particularly out of line for a newer vaccine from a quick skim of price data.
------------
I can't see how any developed country would choose to pass on it at that cost if available to them while others are still under development/not available in sufficient supply.
The economic damage this is causing is massive and anything that gets you past this even slightly faster is more than worth that price.
You could vaccinate the whole UK population for $2.3bn (in medication costs). The pandemic is causing vastly more economic damage than that to the UK.
Through only August, COVID has cost just the UK government (to say nothing of other economic damage) over $277bn (@current exchange rates). The vaccine could cost half, it could cost 5x as much, but it would still be absurd to do anything other than pay it and get it out to as much of your population as you can if it's available to distribute and other vaccines aren't.
Even if you've got something else in the works, if buying what you can of this gets you "reopened/normal" a month or two earlier than not, it's still an obvious economic win for any developed country.
The cost to manufacture is cheap as chips - governments pay $3-$10 per shot when they buy millions. Transporting and administering increases the price but not significantly.
Of course a country that could pay $1bn half a year ago in advance on the chance that the vaccine works will be ahead in the production queue in front of a poor country that only now puts in orders.
Bill Gates was there looking for answers as well. And he has been working with some companies for long enough to get ahead of the line just because he was there before this need.
Is it common practice to measure effectiveness in this way?
They only evaluated ~90 of their 30000 test group, and out of that tiny sliver of the data there were more in the placebo group that got covid than the vaccinated group. My questions would be:
Does their small subset have the same number of vaccinated vs placebo? Are the ~90 evaluated cases representative of the whole group, or are they only from one area or health profile? How long have they followed this group?
It still seems like this early on in the study you could cherry pick the data to show any amount of effectiveness that you want.
This is how you do it. They evaluated the ~90 that got covid. There were equal amounts who got the placebo vs the vaccine, so if the vaccine doesn't work you would expect ~45 of that ~90 to have got the vaccine. However only 5 of that ~90 got the vaccine, that implies that the vaccine works.
You can cherry pick it if you want: the full data isn't released so they can hide something. There is no reason hide anything though: all the data will be given to the FDA (and other national equivalents) so you aren't hiding anything for long. There is every reason not to: this release is legally binding to the SEC, so if they are hiding anything there are legal implications: CEOs go to prison for less.
I read the method used to measure efficacy: They have tested 44,000 people. 50% got a placebo, 50% got a vaccine. Then has been giving them the freedom to get the covid.
95% of the 50% who got the vaccine haven't contracted the virus.
Correct me if I am wrong. Supposing a random person has a 5-10% chance of contracting the virus (according to average cases/testing worldwide), should the efficacy be 5-10% * 95% = 0.7%-0.5%?
> 95% of the 50% who got the vaccine haven't contracted the virus.
Much more than 95% of the 50% who got the vaccine haven't contracted the virus. They looked at the first 95 people in the entire test to get the virus. Of these 95 people, only 5 were in the treatment group.
Nothing is misleading. Half the participants got the vaccine, the rest placebo, before going about their usual lives. Now, a few months later, 95 cases have been confirmed across both groups. Of these, 90 had received the placebo and only 5 the vaccine. If the vaccine didn't work at all, the split would be roughly 50/50. A somewhat effective vaccine might result in a 70/30 split, and so on.
It's the standard method, and I see nothing wrong with it. What you suggest (deliberate exposure) is called a challenge trial. This is normally considered ethical only when an effective cure (e.g. antibiotics) is available. Even so, there are plans to conduct such a trial in the UK, and there's no shortage of volunteers. We'll see if they get approval.
"No significant safety concerns have been reported, but nothing, including paracetamol, is 100% safe."
Is it just me, or is this language very irresponsible? They are just talking about having small side effects, like headache and fatigue - just like the flu vaccine has. Likening this to "safety" seems incredibly dangerous to me, as it will give people already predisposed to dislike vaccines more ammunition to speak out against them and refuse them.
I think it could have been worded more clearly, but I don't think it's irresponsible. The study looked for both. Part of the result is that the study looked for and did not find safety issues. The other part of the result is that it did find minor side effects.
Does all the vaccine manufacturing happen in the same fabs / factories? Moderna says they can make a billion does by next year, Pfizer says the same, so does that mean we have 2 billion doses available? Or do they share factories and we get either of them but not both? And it seems like there’s many of these companies working on this, so if we have 10 promising vaccines from 10 big pharmas we can get 10 billion doses?
I believe that if Moderna found their vaccine didn't work they would license the Pfizer one as I assume their factories can be converted in a few months. Note that these are mRNA factories - I wouldn't expect a someone working on a different type of vaccine to be able to convert their factory. I would also expect that the process of conversion to produce a different vaccine will takes some months and cost us half a billion doses next year. This is just speculation though, there is no reason to make a license deal so we won't find out.
You can assume all manufacturers are watching each other. Some of the "getting ready to enter phase one trials" vaccines will probably be canceled as there is no point. If one of the promising candidates in trials fails Pfizer and Moderna will build (or license) more factory space because there is less competition for the demand.
The dream of operation warp speed was to build a factory for each possible vaccine. Some npr about this. I haven’t seen a formal “here’s the 10 factories we built” picture, so not 100% sure how to confirm what happened?
Its mostly in the form of advanced purchases of product and grants. No one is building new factories. This is more about distribution and R&D grants than it is about factories.
> In July, Pfizer got a $1.95 billion deal with the government’s Operation Warp Speed, the multiagency effort to rush a vaccine to market, to deliver 100 million doses of the vaccine. The arrangement is an advance-purchase agreement, meaning that the company won’t get paid until they deliver the vaccines. Pfizer did not accept federal funding to help develop or manufacture the vaccine, unlike front-runners Moderna and AstraZeneca.
> April 16: HHS made up to $483 million in support available for Moderna's candidate vaccine, which began Phase 1 trials on March 16 and received a fast-track designation from FDA. This agreement was expanded on July 26 to include an additional $472 million to support late-stage clinical development, including the expanded Phase 3 study of the company's mRNA vaccine, which began on July 27th.
> May 21: HHS announced up to $1.2 billion in support for AstraZeneca's candidate vaccine, developed in conjunction with the University of Oxford. The agreement is to make available at least 300 million doses of the vaccine for the United States, with the first doses delivered as early as October 2020, if the product successfully receives FDA EUA or licensure. AstraZeneca's large-scale Phase 3 clinical trial began on August 31, 2020.
> October 16: HHS and DoD announced agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to residents of long-term care facilities (LTCF) nationwide with no out-of-pocket costs. Protecting especially vulnerable Americans has been a critical part of the Trump Administration's work to combat COVID-19, and LTCF residents may be part of the prioritized groups for initial COVID-19 vaccination efforts until there are enough doses available for every American who wishes to be vaccinated. The Pharmacy Partnership for Long-Term Care Program provides complete management of the COVID-19 vaccination process. This means LTCF residents and staff across the country will be able to safely and efficiently get vaccinated once vaccines are available and recommended for them, if they have not been previously vaccinated. It will also minimize the burden on LTCF sites and jurisdictional health departments of vaccine handling, administration, and fulfilling reporting requirements.
> November 12: HHS and DoD announced partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains. Through the partnership with pharmacy chains, this program covers approximately 60 percent of pharmacies throughout the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Through the partnerships with network administrators, independent pharmacies and regional chains will also be part of the federal pharmacy program, further increasing access to vaccine across the country—particularly in traditionally underserved areas.
Good question. In a sane world, we'd be allocating the total manufacturing capacity (whatever it is) to maximize optimal vaccine production (whether that's only the most effective one, or a diversity of vaccines at certain proportions) without regard to intellectual property, but this is not a sane world.
One article said the reason of these vaccines can be stored more easily than the other is they use different proprietary formulations of inactive ingredients to carry the mRNA. Again, in a sane world, the most effective one would be shared, right? In the US, this is the kind of thing the Defense Production Act could be used for (instead of keeping meat plants open!!).
I’d assume that the developed countries take the vaccines that require super refrigeration and give the low-drama vaccines to the developing countries, but that’s just me being naively optimistic.
That would be rational, those with the least capacity to do the super refrigeration (developing countries also tend to be the hottest temperature-wise) get the one that need the least.
You might find this article interesting: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906799/ - especially under safety. I can see how some of those concerns might be present especially given that we didn't have large scale human mRNA tests.
It's a new type of vaccine that's never been been approved for use in humans before, was rushed through development and testing, for preventing a disease with a fatality rate between .3% and 1%. I'm worried. I hope there's a successful adenovirus vaccine.
They're supplying regulators with more data often. At least that was reported a few months ago, that was part of the changes to accelerate the testing and approval processes.
Do note that there is no safety data yet for children, "youngest" in this case, is ~20 year olds; and that there has been a famous case where a vaccine that was safer for over-20 significantly increased the risk for narcolepsy 6 fold for under-20. (Safety profile was established for adults, but the vaccine was given to children). More at https://en.wikipedia.org/wiki/Pandemrix#Narcolepsy_investiga...
Since top comments here are anecdata about how terrible covid is for a young person, just thought I'd share my experience. Everyone I know who has gotten covid - several neighbors (and their households), most of my wife's hometown (400 people) - including her parents (in their 70s) and two of her siblings and all their children (15 people) all had it. For everyone it was somewhere between nothing and a bad cold. Nobody has any lingering issues. We don't want to paint our picture of the situation using only extremes. How about we include the "average" anecdata too?
Because even those who are vehement supporters of lockdowns/wide spread health measures understand that this only affects a small percentage of those who contract it. We don't need examples of people who had no issues, 99%+ of people won't have issues.
Everyone knows its not going to kill most people, that's not what they're trying to prevent. They're trying to prevent it getting into long term care homes, or into at risk communities (indigenous, low income, obese, etc). They're trying to give you good reasons to want to wear a mask, want to cut down on your social interactions, and want to help stop the spread.
> [everyone] understands that this only affects a small percentage of those who contract it
This is highly questionable. There are many articles (whether factual or not) suggesting widespread lasting effects, e.g. just last week on HN one suggested 1 in 5 patients develop mental illness: https://news.ycombinator.com/item?id=25046157. With all these articles floating around, I just wouldn't agree that there's some sort of consensus that 99%+ of people won't have issues.
I remember that thread, and that claim is disingenuous. From the actual study:
>The incidence of any psychiatric diagnosis in the 14 to 90 days after COVID-19 diagnosis was 18·1% (95% CI 17·6–18·6), including 5·8% (5·2–6·4) that were a first diagnosis.
So only 5.8% of people got a first diagnosis, and the remainder of the 18% were people who had been previously diagnosed with one of these conditions.
Further, if you looked at the normal flu the same way, you'd see a 13% incidence rate.. and that's without the impact of lockdowns or media hype.
> Comments like this are gonna quickly turn this place into just another /r/science, where people of no particular qualification chime in and try to make themselves feel smart by contradicting a peer reviewed study without taking the actual effort needed to properly question a peer reviewed study, especially one in as prestigious a journal as the Lancet.
Thank you. Nobody’s interested in your level of incredulity, however you italicize it.
>especially one in as prestigious a journal as the Lancet
While I agree in principle, the Lancet aren't immune to crummy papers (indeed, no-one is). Even just this year, they published that super-dodgy Surgisphere paper that turned out to be completely irreproducible (to put it kindly).
Scientific papers are written by people, and the peers of people who (for example) don't really understand statistics are likely to also not understand statistics, so while peer review is definitely helpful, one should always read scientific papers sceptically.
That being said, low-effort dismissals based on anecdotes are much, much worse than the average scientific paper.
It is a garbage number- 18.1% took a diagnostic test that showed they had any mental illness- with no accounting for whether they had one before. For 5.8%, they hadn't received a diagnosis before, but it was not shown whether they were undiagnosed or developed the condition as a response to the pandemic itself, rather than the infection.
Sure, nobobody is saying that anxiety disorders aren't a mental illness. But it's also likely the reason why the rate of mental illness was found to be 1 in 5. From your own link, 1 in 5 adults already have anxiety:
>Over 40 million adults in the U.S. (19.1%) have an anxiety disorder.
So it follows that undiagnosed anxiety disorder would be found in abundance in people recently diagnosed with covid.
It looks like they accounted for that or at least did as much as they could to account for that.
>In patients with no previous psychiatric history, a diagnosis of COVID-19 was associated with increased incidence of a first psychiatric diagnosis in the following 14 to 90 days compared with six other health events.
So it looks like they compared it to six other health events and it (anxiety, insomnia, dementia) was still higher with COVID, but they add "we cannot exclude possible residual confounding by socioeconomic factors."
Yes - but when we only hear about, think about, and look at the extremes, it becomes too easy to let our thought-processes about the situation become (even subconsciously) skewed. It's too easy to forget that the constant barrage of stories and information is actually about the extremes. It takes deliberate effort to keep the balanced view.
For sure; that's why people reiterate the 99%+ metric. This isn't a cataclysmic virus that will wipe out life on earth, but it will tax health care systems far beyond what they're capable of handling. It will devastate economies, lock downs or not, globally.
It's far to easy to dismiss the effects if we see it "only" hurts <1% of people; which is why people feel the need to constantly reinforce the negative impacts.
Serious question, I don't have a political agenda by asking this:
How will a virus that hurts <1% of people devastate economies, lockdowns or not?
Economic devastation from lockdowns is clear.
Economic devastation from a virus that primarily hurts the elderly is not clear to me.
Again, I'm not making any points about the value determination of lives saved vs GDP saved, only asking how you quantify the economic impact of a virus.
> 1% is not insanely high, it's roughly how many people die each year.
So another percent on top of that is a doubling. As many people again dying from Covid-19 as die from all other causes. How is that NOT “insanely” high?
The economic impact isn't coming from people dying, its from the measures being used to prevent people from dying. It seems like the economy operates on such a knife edge a little push has serious repercussions. We shut down restaurants because they're a prime locus for spreading. Now those employees are out of a job. The restaurant closes or can't pay its rent, now the owner of the building has knock-on effects.
Even without mandated lockdown, the effect is the same. If I have a 1% chance of dying/long term effects, and I can reduce it if I don't go to restaurants, I won't go to restaurants.
>The economic impact isn't coming from people dying, its from the measures being used to prevent people from dying
I would say the economic impact is from the fact there is a pandemic. Even Sweden, which tried to avoid lockdowns, still saw an economic impact because people will avoid going out during a pandemic.
The fact that businesses are forced to close, or in the other case, that people would have been forced to work during a pandemic for fear of being homeless is a public policy failure.
The economy is impacted by people not spending as they were pre covid due to the desire to both avoid contracting the virus in locations they would have previously frequented as well as people saving more in fear of a weakening economy.
My savings rate has increased significantly since Covid as I am barely eating out at all due to the risk of contracting Covid via restaurants as well as worrying that the economy could get much worse and wanting to be prepared. I am just an average person so I would assume that there are many hundreds of thousands of people doing the same as me, thus the economy contracts.
My state is essentially not shut down at all, so very little impact is due to government regulations and almost all of it is due to personal spending choices. The less restrictions in place, the more the virus spreads and the less money I spend.
The economy is highly dependent on people spending and many people dont want to spend right now.
how so? Is there proof getting covid grants lifetime immunity? If not, how does that effect the plan if we assume that everyone gets covid at least once a year? Every year you now have a chance of dying from Covid, and overall life expectancy is chopped globally. Are you ok with 250k deaths a year from covid every year going forward?
Why would people spend more if the virus just keeps going?
Again, my state has no restrictions in place that I am aware of and no one is spending and businesses are closing.
That does not seem like a great plan.
I think a better plan is to keep the virus under control, prevent needless deaths and then get vaccinated, especially now when we are so close to a vaccine release. Why risk the lives of tens of thousands of people when we can just all wear a mask and get vaccinated?
> Is there proof getting covid grants lifetime immunity?
No, and there never will be since medicine is not mathematics. But nor is there any reason to believe our immune systems can't deal with this virus like they deal with any other virus.
> Are you ok with 250k deaths a year from covid every year going forward?
250k/7.8 billions = 0.003%. Yes, I'm fine with that.
> Why risk the lives of tens of thousands of people when we can just all wear a mask and get vaccinated?
That's a hypothetical question considering we don't have a vaccine yet and masks are hardly the only restrictions.
Doctors and nurses dying is a negligible concern IMO. Yet again - there have been a few highly publicized cases of things like this, but at scale it is just not something that happens at a non-negligible frequency. I have multiple family members in the medical field. None of them report any such issues - including my sister who is a doctor working in a covid unit in Indianapolis.
I suspect that if the system gets overwhelmed, various processes will break down as they start accumulating tent cities outside the hospital and run out of equipment.
They may not die, but I'd bet a lot of them want to leave, or will have significant psychological trauma after dealing with this.
The UK NHS is recruiting at the moment, in the most visible campaign I can remember. I'm wondering if this is linked - certainly I wouldn't want to be faced with the upcoming winter in a medical role dealing with this, given what happened in March to June this year.
Comments level getting to deep - trying to reply to a sibling. But 1% of planes crashing kills more evenly across demographics. The 1% here are almost exclusively the elderly and infirm who were contributing (directly anyway) almost nothing to the economy - and in many cases actually being a drain on the economy. Just like the parent comment - I'm not saying they aren't worth saving at economic cost, but just saying that them living also is an economic burden.
Just because the elderly are more vulnerable it does not mean other age groups are not experiencing a higher death rate due to covid.
Per the CDC:
"Overall, an estimated 299,028 excess deaths have occurred in the United States from late January through October 3, 2020, with two thirds of these attributed to COVID-19. The largest percentage increases were seen among adults aged 25–44 years and among Hispanic or Latino (Hispanic) persons."
I ask this in all seriousness - do you have parents who are still alive? Do they have any chronic conditions that make them more vulnerable?
The economy is not the only thing that matters, and if children can have their grandparents for another 5-10 years, then that's massively important to them, while being irrelevant to GDP.
Full disclosure: Both my mother and my wife's parents are in the age group that is super vulnerable to Covid, and I'd like my daughter to remember them.
Not having vulnerable people close to you is not the only way you can hold my position/view. I have three grandparents who I love dearly in their 80s - one with diabetes, one with rheumatoid arthritis, and the other with lung scarring from tuberculosis. My parents are approaching 60. My wife's parents are in their 70s (both have had covid already). And I have several of my own children. My position is that, yes covid sucks. In my personal view/opinion, the danger/risk levels of covid don't warrant anything nearly so severe as what has been going on all over the world. Let people live. Don't treat them like babies that need to forced to take their medicine. We've long since crossed the liberty/safety threshold I'm comfortable with.
It seems you were lucky enough to not have a detrimental COVID experience with your immediate family members. I wonder how much your view would change, had you lost one or more family members. You seem to lack empathy for the 1M+ people that have lost someone (globally), and probably millions more that were potentially permanently damaged by COVID.
I bet the experience differs a lot for different people and different cultures. My mother has diabetes and is in the vulnerable age group but from all the adults I know, she and her friends around her age are the people who were the least concerned about the virus since the beginning of the epidemics. No isolation, no masks, they just don't care and even get angry at the attempts to keep them isolated. And to be fair, I totally get it. Kind of, it is better to die standing than to live kneeling. We'll all die sooner or later.
for what it's worth, my mom and aunt are in their 70s and will have cleared COVID this coming Thursday. When she said they both had COVID i was in tears thinking it was a death sentence given what I've read online. My mom had a fever for one day and just sniffles and body aches since. Same goes for my aunt who is also a breast cancer survivor.
My understanding of the numbers is that < 1% of people will die. ~20% of cases require hospitalization (~10% including asymptomatic infections). It's that hospitalization number that's the worrisome. 10% of the population is way more than the hospital capacity of anywhere - in the U.S. we have about 1 bed for every 300 people, 0.3%.
Without hospitalization a fair number of the 9% that is hospitalized but won't die will instead just die. This is why you see death rates of close to 10% in areas like Lombardy or NYC where the hospital system was overloaded. And even if they don't, they're too sick to go to work. Most industries will have serious problems if 10% of employees call in sick. Then there are issues with people who have non-COVID illnesses (say car accidents) who won't be able to find beds because all the hospitals are filled with COVID patients.
When #FlattenTheCurve came out people had very legitimate criticisms that centered around them doing the math and computing that if we flattened the curve enough to avoid overwhelming the hospital system, we'd be locked down for the next 20 years. Realistically, the only solution was to lockdown, social distance, and wear masks long enough for a vaccine to come out, then vaccinate everyone who hadn't already gotten it. It looks like that'll actually be the outcome in wealthy coastal areas like the Bay Area or New England, but in the middle of the country we'll just overload the hospital system and see what happens.
The fear and media has convinced people like you that crazy things are true like a 20% hospitalization rate. But check out the cdc: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidvi... . It looks like the hospitalization rate of (cases) is hovering around 7%. That means the positive hospitalization rate of _infections_ (which would include people that never got tested and never went to a hospital, but also got covid) would be even considerably lower than that. Which would square with my experience - being acquainted with ~100 people that have had covid and knowing nobody that went to the hospital.
So you're saying my media is evil and trying to make me fearful using false exaggerated information, but somehow your media has no motivation besides giving you perfect accurate information. I'm an easily fooled rube while you're able to float above it and extract only the good info .
You've just cited the overriding mantra (for everyone) of our times.
"Everyone I disagree with is either acting in bad faith and trying to manipulate people or is a rube who's being manipulated. All of my opinions come exclusively from rational philosophical means achieved independently of any external media influences."
Also many of those people who didn't die will have anywhere from mild effects to serious impairments for the rest of their lives.
A huge amount of people who survive will deal with increased depression, anxiety, etc.
Even though its easy and callous to write off the lives of millions of (easily preventable) deaths with a hand-wave, there are going to be serious and long-term effects for those who didn't die and for their families, jobs, etc...
I personally know many people who are suffering from severe pandemic-related anxiety and depression who have not contracted the disease.
The current discourse and societal response to the disease seems likely to have as big or larger of a mental health effect than the immediate consequences of the disease itself.
The lack of a proper societal response to the disease, and what that reveals about the fragile state of our civilization is what's responsible for severe pandemic-related anxiety.
There's truth to this, but I don't think it's the whole picture. It's certainly possible to be concerned about the state of civilization without "doomscrolling" or checking covid death numbers each morning. These behaviors are consequences of the media landscape more than of the disease itself.
That is simply not true and just speculation - especially for a disease that has been around for less than a year. Most of the studies that reported things like heart damage and other kind of side effects were retracted, but the retraction never made it in the press and social media, just the initial poorly ran studies that got hundreds of thousands of shares. One of the so called long COVID studies was done through people recruited through Facebook groups and Reddit communities, all of them having self reported symptoms, but none having actual positive tests.
I don't agree that it would necessarily tax health care systems "beyond what they're capable of handling" (for my definitions of those words). I also disagree that economies would be devastated if we had avoided all lockdown and economy-affecting mitigations. But I understand that reasonable people could disagree with me on both those issues and that is fine.
Durinng their peak earlier this year, Italian doctors were choosing who lives and who dies in the normal course of triage. That's the definition that matters to public health policy.
That is not true on two fronts. First, doctors were not choosing who lives and who dies. They were deciding who would have the higher chance of survival if they were treated. There is no certainty that a) the selected treatment group would survive or b) the unselected would have survived but for the triage.
Secondly, that is exactly what triage is! People die, doctors are trained to decide of a group of people which are dying, who has the better chance of not dying.
I think this is missing the mark. Italian doctors were choosing who would get an ICU bed and who would not. There were more patients needing ICU beds than the beds available. Not giving an ICU bed to someone in need meant basically a death sentence. That is not the normal state of affairs, as far I can understand.
Well again, not _really_. We were also ventilating people who didn't need it. You don't need an ICU bed if you aren't vented. Furthermore, the mortality rate of being on an ventilator is non-negligible.
I would be interested in seeing if there is data to say whether being put in the ICU actually _increased_ risk of death. Of course this would be hard to prove as only the most sick went to the ICU etc.
To me, beyond what it is capable of handling - means that the system gets damaged - not the people that it is treating. What you described is what I would call "beyond it's peaking capacity for treating patients". Not a general "beyond capacity to handle". Imagine driving a car. Not being able to fit all your friends in the car is different than the car frame being crushed because too many people climbed onto it. I'm saying that the former is what we have/will experience - not the latter.
This feels a bit tortured. COVID has, is, or is threatening to overload our healthcare system as evidenced by:
1) Severely reduced in-take of new patients of patients due to lack of beds available (and longer COVID recovery time)
2) Reduced ability to effectively care for other patients due to limited beds and transmissibility of the disease, and workforce reductions as healthcare workers get sick (this is not a hypothetical, this is happening in the hospital my wife and brother work at).
3) Forcing healthcare works to perform their jobs without subsequent PPE for their own protection, increasing their own health risks and creating serious issues for mental well-being when working in this environment day-in and day-out.
The healthcare system is designed to treat patients. Believing the system is not exceeding what it can handle because somehow "the system itself" is not damaged (which I'm not even sure what you mean by that) but dismissing patient care and outcomes is like evaluating a vehicle's crash rating, but not evaluating the damage to the vehicle occupants.
(from another post)
>To me, beyond what it is capable of handling - means that the system gets damaged - not the people that it is treating
I think your definition of "what they are capable of handling" (for some reason I can't reply to your other clarification of this definition) isn't one that many people would think is a good one. It may be technically correct in some domain, but this isn't it. Healthcare systems are there to provide healthcare for people, and if they can't do that (as in this situation) then they are incapable of handling it. In addition (in the UK at least, can't speak for anywhere else), this has led to not only ICU capacity being exceeded, but also routine healthcare being diminished - either because of people being unable to visit a hospital, or unwilling to do so.
I think the 99%+ metric is reassuring. However the 1% will have a massive cost to our healthcare system, we are in extremistan as Nassim Taleb likes to say. For example, in normal times 10% of the US population represent 64-66% of the health care costs (https://youtu.be/2qhrPa7paAU).
The thing is, it's more likely to be skewed in the wrong direction, the direction that it is safer than you think. So actually its important to understand how bad it is for those who get it. We have consistently had >1k deaths per day in the US and then many others with longterm issues.
Assuming 99% of people had zero issues then you would see 52 million people completely fine and 520,000 hospitalizations except many people get severely ill without going to a hospital so we would easily be approaching herd immunity.
Instead it’s likely closer to ~3-6% hospitalizations with nearly half of those people dying. With 70,000 people currently in the hospital, expect the death toll to keep increasing. The numbers do look better for young people, but if your thinking of 55+ as old, a huge hunk of the population is old.
PS: The recent bump hit 1,000 deaths per day, but daily peak is still increasing rapidly so expect that to rise significantly.
I'm the father of an at risk child, there is absolutely no way we can totally isolate ourselves from society at large.
I could go into depth about our situation, but what I came here to say is: don't believe any hand waving politician who says we can set up some sort of parallel society, where all the venerable are sheltered, whilst the rest go about our lives. It's just the latest incarnation of survival of the fittest.
If New Zealand, with probably the world's best geographic / technological isolation, can't prevent infection, how can we expect that from a family of 4, an old man living alone, a recuperating heart patient?
And it makes enough people sick enough to require hospitalization to the extent that lockdowns can keep our healthcare infrastructure from being overwhelmed (and driving up deaths because people still get sick, need surgery and treatment for all the non covid reasons and they need access to healthcare too).
These arguments about whether the virus is 'bad' or not are entirely subjective. Not having to hear them anymore will be one of the biggest upsides of this vaccine.
When hospitals are overwhelmed by the so called “nothing but a cold”, and you have a heart attack or some other emergency and waiting outside the hospital, you will then understand when it’s too late.
Take a look at what’s currently happening at El Paso Texas. There’s no hospital to go to.
This. A million times. I live in an area where people are so more often than not downplaying how big of a deal Covid itself is because "99% have no lasting symptoms. Just a bad cold is all." or "My spouse had it. NBD."
Mostly, you can't convince them otherwise. But I wish they could just see the effect it would have on non-covid hospital cases and think about that, if nothing else.
Yeah, that's always my take on wearing masks: it's a decision of risk management. The potential downside of not wearing a mask is just too much larger than that of wearing one, especially when we still have much to know about the virus.
Most no longer make eye contact. Or shake hands. I can't tell whether someone is genuinely smiling or laughing. Voices are muffled. They're a distraction.
I miss face to face conversations with strangers. I miss talking fast, getting excited, and not having my glasses fog up because I apparently breath fast when excited.
There's an element of humanity that's simply been lost.
EDIT: This isn't a response to what is the appropriate trade-offs for lives lost.
It's specifically a response to the idea that "nothing" is lost when wearing a mask.
I do my part and wear a mask in public but I can't wait to stop breathing so much re-circulated CO2... I can practically feel my blood-oxygen levels dropping after prolonged use (perceived or actual)...
I expect that the pandemic will follow Bill Gates's prediction—the developed world will be back to "normal" sometime near the end of 2021. For at least a decade, I expect it to be socially acceptable to wear a mask. However, I think that we'll be comfortable going to concerts and grocery shopping with no social distancing or masks long before then.
Its also extremely disappointing that we don't treat the seasonal flu more seriously. People talk about this, it just took a pandemic for most people to pay attention.
Folks should be wearing masks when they are or even might be sick with ANY transmissible disease. Its actually pretty insane that pre-covid, folks would go into public and work while endangering who knows how many people (I know a lot of people don't have the option, which is a whole other bag of worms).
I find it extremely depressing that people compare this to other easily preventable deaths (I see it often online and from my own family) and say: "See we handle the seasonal flu pretty horribly, why are we trying so hard with COVID-19?"
I heard a stat that in the southern hemisphere's 2019 flu season, the rate of flu tests that came back positive was something on the order of 13%. This flu season, the test positivity rate is 0.6%. Obviously lockdowns and even significant social distancing aren't going to happen for the flu, but I think you're right that we could easily do so much better when it comes to other transmissible diseases, and I hope that at the very least masking sticks with us.
Amen! We should all:
- Wear a mask when even slightly ill
- Stay home as much possible (even getting another person to pickup food) if you have symptoms
- Get the flu shot
Stores, schools, etc. should also really think about circulation, hand sanitizer, and perhaps even nightly UV-C disinfectant.
Company culture needs to change: when sick, people should work from home for a job like programming and companies need give more sick leave for jobs like teaching where telecommuting doesn't work as well. Businesses really need to think about their part to play in protecting their customers.
As a side note, my mother who is older wasn't interested in the flu shot and I always wondered why. Even if it's 60% effective, that's just halving your chances of a sometimes fatal disease for $20 and a fifteen minute visit to a pharmacy. The US in particular needs to figure out how to do public health better.
Our healthcare systems are designed to handle a bad flu season. COVID is different in so far as it's far more deadly, and that it puts a higher burden on the health care systems because the average time spent in an ICU is way longer.
What about the people who don't have that luxury to lock them selves away but want protection. The people stocking shelves, picking and packaging your food, delivering your stuff from Amazon
> Since top comments here are anecdata about how terrible covid is for a young person, just thought I'd share my experience. ... We don't want to paint our picture of the situation using only extremes. How about we include the "average" anecdata too?
The reason for those anecdotes is to counter the false narrative that young people are basically invulnerable to Covid, and should therefore live like it doesn't exist. That false narrative has been quite prevalent, even here, as an oblique way of arguing against public health measures.
There's no actual prevalent narrative that no one escapes Covid unscathed that needs to be countered.
> There's no actual prevalent narrative that no one escapes Covid unscathed that needs to be countered.
Maybe not on HN, but if you talk to regular people that get their news from newspaper or cable news, they tend to be very misinformed about Covid-19’s severity and prevalence.
A poll done in the UK found that people, on average, thought Covid-19 deaths were 100 times more numerous than they actually are.
Nobody is invulnerable to anything. But we should never make generalized/universal policies to the detriment of the masses motivated by long-tail extremes. Just because we don't know how to reliably measure the (real and large) impact of mitigations, doesn't mean we can/should pretent that impact doesn't exist. It's all about tradeoffs. And I'm tired of emotional heart-strings cases that are "easy" to measure stamping out all the real effects of mitigations that are "hard" to measure. And I've also heard way too much about, "but if we could have responded effectively/quickly like China/Vietnam/New Zealand then we wouldn't have been _forced_ to do these other damaging mitigations" - that is a theoretical idea/world that we don't live in. Given the actual situation - that we live in a country with free-spirited/selfish people with pretty significant individual liberties, how should we address the virus? That is the real question.
> 1700 people under the age of 35 have died in the USA. Let that sink in. Out of EVERYONE in this country, only 1700 have died under 35
That's the wrong way to look at it. How many people over 35 in the USA have died or was hospitalized because an under-35 was a link in the transmission chain? How many people under 35 have expereinced short or long term medical harm because of an infection that didn't manage to kill them?
The reason why extreme cases are showcased, is because it fits a certain narrative. We all know what that narrative is - that Covid prevention should take precedence over everything else.
The fact that the prevention is worse than the disease, in terms of economic hardship, depression, deprivation of education, etc; the fact that prevention measures hit poor people and minorities much more than rich people (who can move around and educate their kids in private schools that largerly do not shut down) - these are all inconvenient facts.
At least be honest - say you know lockdowns are horrible for many people that even if they got the disease would be fine (save for the extreme anecdotes!) but we still decide to impose them.
Really hard to have an honest conversation based on facts these days.
Countries that actually are serious close bars not schools. Life is basically normal in Wuhan and New Zealand. Meanwhile Christmas is cancelled this year because Western governments didn't do exactly what China did.
Wuhan's lockdown was extreme however; literally locking people inside their homes. Most western societies will not stand for that.
New Zealand had the advantage of having a huge amount of experience with protecting their biodiversity. I'm willing to bet a lot of that experience was transferrable to this situation.
Nonsense. Everything New Zealand or Taiwan or South Korea or now also Australia has done is public knowledge, very simple, and easily implementable in any developed nation that cares to. Australia had a big second wave surge with anti-social anti-maskers protesting too (not surprisingly most of their press is owned by Murdoch). They took the necessary action, enforced mask rules, got case numbers down to zero. Now they can start to live like normal.
Being an island. Yada yada. Has nothing to do with it. It’s all about the simple actions they took that we could repeat but some people don’t want to because they’ve been conned.
Being anti-mask and knowing it puts others at risk is purely an antisocial behavior. It’s a FU to everyone else. It costs nothing to do, it saves lives, and ironically is what would enable us to be as normal as we possibly can by controlling this thing. Being anti-mask and believing it doesn’t put others at risk is a sign they were conned by a few sociopaths who wanted to exploit this for their own political gain.
You tell them that it's in the noise w.r.t. the danger of being alive - because it is. But instead we have news and social media shouting from the rooftops that everyone is going to die or have some nightmarish long-term effects. All of which are no more significant than the risks people take every day on _purpose_. Driving, hiking, swimming, socializing, getting drunk, etc. Sure it's communicable - we've been happily spreading communicable diseases for millennia that kill people. Nature is cruel. But don't expect society to stop "living" to avoid dying.
>You tell them that it's in the noise w.r.t. the danger of being alive - because it is.
If you remember, this is exactly what China did. It failed because despite how hard you try to tell people that it's nothing to worry about, people will start to realize that hospitals are overrun. Your solution is not only demonstrably poor, but is also how we ended up in this mess. It's a tall order to tell people there's "nothing wrong" while nurses are working 12 hours shifts.
What data is this based on? Can I see the source? I would hate to think you are suggesting actions that would lead to the deaths of hundreds of thousands of people based off nothing but an ignorant opinion.
It's a matter of extrapolating the fatality/damage rates out to everyone on the globe. We take that hit plus a bit of fallout - or we can try to continue dealing with things in the big, long, drawn-out, messy way much of the world has been doing. Sucks both ways. Some people prefer one suck - and others prefer a different suck.
If someone told me that the increased risk of dying from covid is just a part of life and that I should ignore it, I would very much ignore that person's advice on all things going forward. I would also very much not vote for that person.
Covid is additive risk, its additional, controllable risk on top of existing risk. As its controllable and communicable, I choose not to contract it and not to spread it. My spending choices reflect those choices; so do the spending choices of hundreds of thousands of other people. Get the virus under control and lets get the economy back.
Your advice is very much in the nature of 'lets not use seat belts, wear helmets, or masks'
I would argue a large part of the economic hardships in the US are not due to lockdowns but due to changing spending habits caused by the virus. There is a large amount of economic uncertainty right now and so people increase savings. Restaurants around me are open right now but I don't go to them as I have no desire to risk getting Covid, I used to spend ~$500 a month eating out. I now spend close to 0. I think many tens / hundreds of thousands of people are doing the same as I am. So despite a non locked down economy, restaurants are going out of business.
Until the virus is cured, people will continue to increase savings where possible as the virus causes economic uncertainty regardless of lockdown status. To think that if we just lifted all restrictions life would go back to normal is not accurate. If we lifted mask requirements in stores, my spending would sink even lower as my risk would go up.
Let’s try to keep snark and sarcasm out of the discussion, and instead argue out of data or first principles. HN is a rare bastion of light on the internet - a refuge of civil discussion
I think it’s too soon to declare that, with long term lung/organ damage being indicated for people (of course, this also depends on a few different factors).
So why is it too soon to declare about long term covid damage, even tho we had it for almost a year now and have data of millions of people who had it, but it’s not too soon to declare that a vaccine that was created in 2 months and tested on 50k healthy adults is safer?
Because no one knows what potential problems people may face in 1, 2,5,10,15,20, to years after being sick with Covid. Think of elevated risk of cancers, stokes, and other maladies.
Before we get this thing under control, in US we will at current rate expose almost 10% of population to COVID-19 (now at some 11M people[1]). We should really pray that long term effects are negligible because otherwise we have non-insignificant part of population that are partially damaged and further hinder US in the global competition against China and others.
You seem to misunderstand the point I was trying to make. That same argument can be brought up against potential problems of a vaccine which is based on a novel technology and has not been tested for 1,2,5,10,15,20 years.
We understand that covid is causing scarring on the lungs heart and kidneys and other organs, in some cases. This would reduce function of those organs, and that reduction may not impact people until they are older. That's why it's too soon to declare it for covid in any individual case. Vaccines work differently, if they caused such scarring for example, it would be accompanied by a bunch of other symptoms which would have been spotted and tested. As a result you can't point to something like I have for covid and make the same argument. Yet, we do understand the vaccine protects us from covid, so we can make an argument about it being a net positive overall.
Because long-term effects require a long term to show up, and the vaccine was created using a very well-understood technique for which that type of data is available.
Are you sure about that? AFAIK both Moderna and Pfitzer vaccines are novel mRNA vaccines, of which (according to Wikipedia) none have been yet approved for human use.
Long term lung damage is indicated at least among those who have had severe symptoms and suffering. I never said anything about the efficacy or the safety of the vaccines in my comment. I personally think that these preliminary results from these trials are also not completely reliable. While we should all be thankful for the results, the current announcements aren’t the end of the story. Even when they get to further trials, we wouldn’t have had enough time and enough broad range tests to conclusively state certain things (and the unfortunate fact is that we don’t have the luxury of time).
If you look at what the experts say, you’d find them being cautious with their words when commenting on vaccines, efficacy, etc. It’s in people’s best interests to follow precautions like wearing masks, washing hands with soap and maintaining some distance from other people, regardless of what news comes on the vaccine front.
The people you know don't matter. The goal is not to overburden the health system. Hospitals have a limited amount of intensive care units. And if Covid patients fill them up doctors need to do triage (that happened on the first wave in Italy). Then it's not only an issue of people who have Covid, but also a problem of other people who need an intensive care unit.
Also just because you don't know anyone doesn't mean it's bad. If we can reduce people dying it's worth doing it. And it's just not a few in this case.
That's the thing though. If we scare the shit out of everyone then they will all run to the nearest hospital the moment they have even mild symptoms. And then things will get worse for everyone. Doctors who are already exhausted might catch it and die, patients who entered the hospital for other reasons might also catch it and die, and the list goes on. We need to chill the f*ck down because there's enough panic spreading around.
Of course we don't need panic. People should go to their family doctor first (and before going there just call, mine now only works with appointments for flu like symptoms). Here in Germany doctors can also give out a sick leave over the phone. The hospitals should only be visited in severe cases.
Hospitals are already filled with Covid patients. There’s almost 70,000 people who are hospitalized with the virus. Elective surgeries are being postponed again. People don’t understand the seriousness of the virus and it continues to spread uncontrolled straining our medical infrastructure.
Yes, and most of them shouldn't even be at the hospital. That's the point I'm trying to make. By making everyone hysterical they run to hospitals like flock, hindering the ability to nurse other patients with serious problems. Just stay home if you have covid, in the majority of cases hospitals can't help you either way.
Most of the people in the hospital have been there for days or weeks. There is a small admissions of figuring out who needs to stay in the hospital vs just send home, but that is comparatively easy, just run a few tests and you will know. The real problem is those who need special care in a hospital bed. So long as there is a bed with staff to treat 80% will walk out after a few weeks. But as soon as there are not enough staff 100% will die in a few days.
Humans are excellent at recognizing patterns, and as a result, we have strong heuristics for determining which things are worth worrying about, based on our own experiences. This particular virus has landed in a weak spot in our collective judgement mechanisms. Most people would consider a 1% chance of some event happening low enough to not worry about the impact of that event, and indeed, in a typical group of people that number is low enough that probably none of your friends or family will die of it.
But if we recalculate the odds in terms of a particular in-group, and tell you that, of the 25 people you know and care about, there's a 22 percent chance that one of them will die, that seems like a large risk, and one you would work hard to avoid.
And if we then polled all of the people like that, the majority of them wouldn't know anyone that had a bad case! We'd have anecdotes popping up constantly telling us "actually it wasn't that bad" and "stop worrying so much", alongside other anecdotes like "my sister was in the hospital for 3 weeks" and "my wife died in the waiting room". And if you look around in reality, you do in fact see both sets of anecdotes.
(I used a 1% rate for serious cases because it's easy to work with, and not because it's accurate. Reality is as always more complex.)
> if we recalculate the odds in terms of a particular in-group, and tell you that, of the 25 people you know and care about, there's a 33 percent chance that one of them will die, that seems like a large risk, and one you would work hard to avoid.
Isn't that 25% chance that someone will die of the personal cohort?
Last night my neighbor suffered heart failure as a result of COVID. We won’t know how he got it, but it torments me that the movers he hired last week refused to wear masks while in his house. You’re right that catching COVID is unlikely to kill you, but if you flaunt precautions the loved ones of those who died will remember and be pained by your lack of concern.
Keep in mind that most people on HN are white and middle/upper income with good health insurance, so I'm not sure you'll get a good representative sample here. This disease is exacerbating existing differences in health and healthcare access. Black Americans are twice as likely to die from this than white, and have higher risk of infection as well.
Some of my family members work(ed) at a south-side Chicago hospital that treats mainly low-income black people. The hospital is shutting down because of the pandemic (or at least using it as an excuse to get out of a low-value market). The area already had poor healthcare access, and it will get much worse in the near future.
I feel a lot of well-off people are not considering effects like these, which will likely be quite large, when they weigh the long term consequences of our disease response. And it's weird to me that even the most progressive people in my life are happy to use grocery delivery and similar services that essentially transfer disease risk from privileged groups to poor minorities. It's like people don't have the emotional bandwidth to be worried about the disease and inequality at the same time.
> use grocery delivery and similar services that essentially transfer disease risk from privileged groups to poor minorities
Is using a grocery delivery service a greater risk vector than making a trip to the store in person? That's not obvious to me, certainly poor minorities can work at grocery stores too.
Is is it necessary true that grocery delivery service providers are poor minorities? At the risk of revisiting the Prop 22 debate, my downstairs neighbor is a college student who's happy to go out and do some deliveries as time allows.
If you order through e.g. instacart somebody usually still has to make an in-person trip to the store and take things off shelves. It's the same vector, but you are paying someone else to be exposed to it.
It's not necessarily true but it is statistically true. Gig workers are more likely to be non-white and have lower educational attainment than traditional workers, and non-white gig workers are more likely to rely on gigs for primary income than white workers.
Overall you could posit that a single gig worker doing the shopping for 20 households is safer for everyone that 20 individuals doing the shopping for 20 households. The gig workers are often shopping for multiple clients at once - fewer trips, fewer people, fewer chances of infection.
The delivery person could have a higher risk due to visiting all the households, but my experience is that they are all hands off. The gig worker drops the groceries at the door and leaves.
It certainly reduces risk for the clients, but also increases risk for the gig worker. It might reduce societal risk overall, though I'd argue it's hard to say without a deeper understanding of overall behavior, especially since poor people are already at higher risk due to a number of other factors.
Concentrating harm in an already disadvantaged group in the name of the 'greater good' is ethically thorny though. It can be used to justify a lot of not-so-great things.
There are more people involved here than the gig workers and the advantaged, The grocery store employees are at a decreased risk if one person does the shopping of. The managers may have a pretty comfortable salary but the bag 'boys' or the workers stacking pallets behind the scenes could also be disadvantaged.
If a gig worker reguarly goes to multiple grocery stores (which is pretty common, moreso than for individual shoppers), there might not be much benefit for grocery store workers. The ability to transfer disease between grocery stores might increase risk in a major way. It's also not clear that interacting with one high-risk gig worker is better than interacting with twenty low-risk remote workers.
I'd be wary of coming to strong conclusions here without data; you can easily come up with plausible arguments either way.
We had it in our family few weeks ago. Total 6 persons got it. Thankfully for most was very mild, including me. One person had a bit prolonged cough/cold for 5-6 days.
Saying that isn't going to stop the news from running a story about the one healthy young person who died from it. The only way to counter this sort of disinformation campaign from the media is to individually tell the story of the 99,999 other healthy young people who got it and we're fine.
I think a lot of criticism is quite fair. I'm actually very keen to learn much more about the covid cases around you.
What symptoms did they display? What was the timeline of their symptoms, or how did their illness develop/proceed? How soon after initial infection, did person-to-person infection begin? When were the infections/illnesses occurring (Feb/Mar/Apr? Or more recently?) What are the symptoms that stood out to you/them the most? What made them think that it was covid vs another upper respiratory disease? Did they get tested, what tests were used, and how accurate were those tests? What were the treatments, and treatment modalities that were recommended to them by public health officials or private physicians? Do they have post-illness physical records you're willing to share?
I, too, (and I'm sure we all do) have quite a bit of other anecdata I could share - in my workplace, a number of people and their families have been infected. There's a wide variance of experiences - from very mild, to multiple deaths. I chose not to include that information because I couldn't verify their disease progression, or symptom development, or treatment regime. I can provide that actual in-depth information on my experience, based on counsel from my physician and medical health professionals.
Ultimately, the most important questions: how do you create policy for a population, when their experiences are so different? Is this really the best we and our governments can do?
Sex workers have continued to see clients without using masks or observing social distancing rules. Yet they have not been noticed as a particularly affected group or even as a large transmission vector.
So either we're not collecting the data that would reveal them as actually a problem, or something else has to explain why they are immune to the devastation that is supposed to be associated with Covid.
Sex work is largely illegal (at least in the US) so there won't be any sort of official data collection on it. There's no legal entity/association/etc. representing them to do that kind of work.
Yes, but we have a world wide sample to choose from, even countries where it is legal. Yet it has not been identified as a problem point. Not to mention that there is enough awareness of Covid that if there was an issue it would surely be shared informally amongst those workers. Yet, such warnings are absent.
Individual interactions 1:1 aren't the primary spread concern. Super spreader events and individuals are. Covid-19 is primarily spread by a small set of individuals who spread it to a large number of people.
And people aren't likely to mention the sex worker they saw to a contact tracer, meaning the vector will be overlooked.
Combine that with a relatively young demographic, and an ability to control who you interact with fairly carefully.
So you're saying there are a lot of situations where masks and social distancing aren't important. This is a message you should spread more widely because it is currently lost in the noise.
You might, might be able to interpret my comment as saying that for the very unique set of circumstances that involve sex work, masks aren't important. But that still wouldn't be a charitable interpretation. Please follow the hn guidelines.
Masks and social distancing are always important, and always reduce the likelihood of spread. There are situations when those aren't possible. For example my dentist can't exactly maintain 6 feet of distance from me at all times. But can I wear a mask while in the office.
For that reason we should maintain social distancing and mask precautions where possible, to keep the chance of spread low. While most transmission is via super spreader individuals, you can't know if the one person you give covid-19 will end up a spreader.
> Individual interactions 1:1 aren't the spread concern
I don't think my conclusion from your assertion is abusive to your position. There are many many 1:1 interactions in this world.
For instance, we could simply say, as long as your store is low volume, only has 1 cashier, and only lets 1 healthy looking person in at a time, you don't represent a "spread concern".
> While most transmission is via super spreader individuals, you can't know if the one person you give covid-19 will end up a spreader.
Yet as far as we know, no such event has ever been tracked back to a sex worker. Not conclusive, but if you're honest you have to at least wonder why and if we have some mistaken assumptions in our models.
> Like I said, you're parsing my comments with an agenda. Please stop.
Just because I have an opinion that is different than yours, does not make my attempt at refuting your assertions, or at least showing their weaknesses, any more agenda based than you doing the same to mine.
Stop putting yourself in the position of moral superior and arbiter of truth. Make your arguments and refute mine to the best of your ability. I will do the same, thanks.
You seem to not want your reasons for dismissing any concern about sex workers considered or applied anywhere else. But that is a good test of their truth, if they can be used to judge other situations too, which is all I was doing.
Geez, because there are more than first-order effects from the person who contracts the virus... this argument ticks me off so much, as if the only concern is "well, I don't die/get sick/have lasting effects, so what is the big darn deal?"
Let me tell you what the big darn deal is, from the perspective of someone who likely won't get sick either.
My wife just suffered through sepsis from a previous surgery. She ended up being admitted into the ICU for three days. I learned after the fact that there are roughly 40 staffed ICU beds in the entire county, population ~400,000. Those beds could easily be taken by COVID patients in a situation where you have uncontrolled community spread, and the hospital is now making difficult choices of who deserves those beds.
Now as she recovers her immune system is still fragile. In her normal condition, she probably would be OK after contracting COVID-19. Now, perhaps not so much. If others around me assume that contracting COVID-19 is "no big deal" and end up transmitting it to her, that may not be a problem for those people. It would be a huge deal for me.
What's missing in these rosy pictures of COVID-19 is the lack of awareness that... gasp... we live with other people, and that we all have a duty to protect each other, not just ourselves! What is so wrong with that? If wearing a mask helps me protect others around me, then why not do it? Honestly, if that's the worst encumbrance you've encountered in your life so far, then you've had quite the privileged experience, and as I'd say to my children, you're damn spoiled.
If you don't want to listen to me, listen to the people who have taken an oath to protect my life and yours: https://www.propublica.org/article/the-enraging-deja-vu-of-a.... It's absurd the entitlement that some people display, thinking "well, if something bad happens to me, there will be someone to save me". At the end of the day, the nurses and doctors that treat you are people too. Respecting them means more than sending flowers or banging on pots, it means doing your part to help ensure they can care for the true emergencies and not just idiots who can't be bothered to follow some simple rules to help out the greater good.
Just because people drive like A-holes around me when I'm riding my bicycle on the road doesn't mean that I should try to get the government to take away their cars by force. Or to force them to never go over the speed limit. Or to force them to only drive smaller cars with better visibility out the windows. Sure it would be nice if people did all these things. But I don't think it's right to force any of it. I'm sorry about your wife - that would be really scary and suck. I hope that both of you are able to stay safe and healthy.
You've made your own argument against your point. There are rules about all those things. You speed too much or in the presence of a cop, you'll get pulled over. In my state, you go more than 20 over and you have a mandatory jail sentence. There are strict rules and crash tests from insurance associations for all vehicles to reduce the risk from car crashes.
Furthermore, as a bicyclist you can manage your own risk and the risks aren't correlated. Viruses don't listen to Fox News or MSNBC. You can't wish away exponential growth. Just because a car crashes into your bicycle, doesn't mean that three other crashes occur in close proximity. I'm sorry, but your comparison doesn't make any sense.
That was a good rebuttal. My point, which apparently I didn't make very well, was that we accept some danger in order to avoid some limitations on liberty. It is not a binary tradeoff. We could choose to enforce those rules or make them more strict and save even more lives potentially, but we don't. Because society has decided to draw our line in a certain place on the liberty/safety spectrum. You and I and many others draw our lines in different places on this spectrum. That's fine. I don't dismiss other arguments against my position as being made by dumb, uninformed people. We need to be careful to avoid judging all the sides by their "worst" proponents.
I think we can find some common ground here. For example, I find 'helicopter parents' to be very frustrating. I am closer to (but admittedly still fall short of) the "free range parent". On the whole, our society overemphasizes "zero risk" policies of which I am not a fan, especially when it comes to children. In summary, I am not a fan of the "nanny state". So perhaps you find my vehement defense of masks incongruent.
However, I have a strong sense of duty to a cause larger than myself. So when there is a tradeoff between a minor inconvenience to myself (say a vaccine or in this case a mask in public places), I tend to err on the side on a minor personal inconvenience to help out the larger whole. When it comes to matters of personal responsibility that have consequences limited to the individual engaging in the activity, I tend to say that is their choice.
I'm curious - you haven't mentioned any concern with other communal health mandates. After all, clothing mandates for private businesses aren't even all that crazy. Have you tried entering a restaurant--or indeed any business--without a shirt or shoes? (I have) You'll be politely asked to leave. Why should your freedom to wear (or not wear) clothing of your choice be infringed by the proprietors of these establishments?
BTW- I used to think that these requirements ("no shirt, no shoes, no service") were part of local health codes, but as I was researching my comment here I came across this: https://people.howstuffworks.com/where-did-shirt-shoes-requi.... I have no idea if that's true or not, but I find it even more interesting that nobody has a problem complying with that rule but when it comes to reducing the risk of a highly contagious airborne virus, wearing a face covering is suddenly a huge imposition.
Here's the thing though. You (and the others you mention) are not likely to have had any diagnostic testing done to see if there have been knock on effects from the virus. That you may not have symptoms of other problems does not in itself mean there has not been damage done to organs or nervous system.
The small minority who get serious symptoms are enough to overwhelm hospitals if many people get the disease. Then hospitals cannot treat heart attacks, strokes, car accidents and other serious emergencies.
I had it too. Symptoms were pretty negligible, a medium severity headache and an exhaustion for a day. Slept for 12 hours straight, next day I was as good as new.
I did an antibody test a few months later. I couldn't be tested when I had it because I didn't think it was covid. Only after talking to someone who have had covid and developed similar symptoms I realized that I might have been infected too.
Including it is fine. Amplifying it to the point where people don't recognize the potential for suffering the serious effects of the virus or passing it on to others that will suffer the serious effects is dangerous.
I find it unlikely that you would have much insight into the severity of disease in the 400 people in an entire community unless you just mean that no one died or hospital admissions were low. Because covid (or the flu for the matter) can be awefully severe and miserable and long lasting without requiring hospitalization.
Thanks for posting this. While the rate of cases in my vascinity isn't as high as your seems to be, I only hear about mild to "strange weird cold". I am glad for them. Doesn't seem like the big danger the media is trying to sell. At least not in my circles.
Why not just use the actual data and not anecdata at all?
And also, the extremes are important because statistically more people hit those extremes than with other respiratory viruses. There are states reporting nearly full ICUs right now. There are states (re)opening field hospitals.
The whole reason for lockdowns and restrictions isn’t to prevent a huge amount of deaths. Most people don’t die from Covid. The whole point is to keep our hospital system above water.
It's now competition and one of the best ways to score points in this competition is by manipulating the empathy of your fellow human.
I wish the internet was still about real discussion but now it's about heartstrings and upvotes.
Haven't you notice the same pattern with the "long covid" stories? Light on science, heavy on heartstrings.
An internet based off of rational discussion is long dead, even here on HN. Just watched the mods (hi @dang ) wipe nuke a story about Sweden's Covid-19 success off the front page. [1]
Mods? Users flagged that one. No mod even saw it. (Edit: I've restored the post now.)
Edit: would you please stop using HN for political and ideological battle? It turns out you've been doing that a ton, and basically exclusively. That's not what this site is for, and we ban such accounts. Please view https://news.ycombinator.com/newsguidelines.html and stick to the rules.
It's surprising to me how difficult it is to have a discussion in the (cyberspace) open holding what I consider the internet-minority-viewpoint on covid. Even on HN (among other platforms), which is one of the places where I often go to find good balanced viewpoints, when sharing anything remotely different from toeing the covid line (i.e. vaccines will save the day, everyone must get vaccinated, we must force people to wear masks, schools should be closed, the virus is causing the economic disaster, etc.) I see people get downvoted, censored, etc. to oblivion. It's nice to see that there are other folks out there that don't exhibit the wild levels of fear and concern for what I consider to be much ado about nothing.
> It's surprising to me how difficult it is to have a discussion in the (cyberspace) open holding what I consider the internet-minority-viewpoint on covid.
The thing is, not all viewpoints are equally valid, and some are both unreasonable given the facts and have actually dangerous implications.
For instance, minority viewpoints like promoting herd immunity as a solution at this point (like some prominent people were doing as recently as a month ago [1]) is about the dumbest thing ever. It's pretty much "let's try to get everyone sick (with the death and disability that entails) just before our vaccine effort bears fruit and would make that pain unnecessary. It's nonsense, and at this point it makes more sense to downvote than to beat the same dead horse yet again.
Why isn't it valid to acknowledge all the data/risks, and still feel like we should just let the virus run its course? I know of tons of people who feel this way. You are arguing against a straw-man. Yes, there are many conspiracy theory nutcases out there. But people who believe all the numbers and still think we are overreacting are still being censored/ignored to oblivion. Not only that, but my (highly reliable ;-) anecdata tells me that most of these people are busy raising kids and growing the food you eat. Just because they don't have the time to spray their opinions all over the internet and petition their govt officials to freak out doesn't mean that their viewpoints are less valid.
> Why isn't it valid to acknowledge all the data/risks, and still feel like we should just let the virus run its course?
It's technically valid, but tiresome to rehash the same broadly rejected viewpoints over an over. What you called "toeing the covid line" above is basically agreeing with the consensus of experts who actually know what they're talking about.
> But people who believe all the numbers and still think we are overreacting are still being censored/ignored to oblivion. Not only that, but my (highly reliable ;-) anecdata tells me that most of these people are busy raising kids and growing the food you eat. Just because they don't have the time to spray their opinions all over the internet and petition their govt officials to freak out doesn't mean that their viewpoints are less valid.
Oh, I know some of those people, and they're part of the reason the state my parents still live in has been a covid shitshow for several months and only just came around to imposing a mask mandate and occupancy limits. Their viewpoints are definitely less valid, being either wishful thinking or lack of concern for others.
I live in one of those "shitshow" states. And the vast majority of the population here is completely fine with how things are panning out - except maybe the reduced restaurant capacity and part-time schooling - those are pretty annoying. You can't force people to care about things they just do not care about. I acknowledge that some people (legitimately) have different values w.r.t. tradeoffs of dealing with covid. They don't have to be stupid or uniformed or brainwashed to think differently than me. And neither do I or many of those shitshow makers have to be brainwashed or uniformed to think/feel differently than you.
> You can't force people to care about things they just do not care about.
Exactly, so don't complain about downvotes again next time you want to resist "toeing the covid line." To make an analogy, there are probably people (maybe even whole communities) who want to resist "toeing the drunk driving line," but the ship has sailed on that and few people care to hear their arguments that they should be able to drive when the blow a 0.12 or whatever.
So after initially saying there's no way I'd take a vaccine that has been rushed to market I'm now thinking that, as a middle aged male with no kids, I sort of have a duty to take the risk. I suppose the vaccines will go to higher risk groups and front line medical staff first, but once they're available I'm signing up.
I've been jokingly telling people, "As a software developer, I know never to trust the first version of anything".
I'm definitely planning on getting the vaccine, but I'd really feel better with it being out in the field for longer. Especially with this type of vaccine (mRNA).
Since someone just self-censored, I can only repeat that. As a young healthy individual, I'd much rather catch COVID then get vaccinated with a wide-spread mRNA experiment. In my childhood, I have been used by a doctor for an experiment without consent of my parents, and this cost me my remaining eye-sight.
You can bash, downvote, laugh at, deminish, and in general say whatever you want about sceptics, our reasons to not want to be vaccinated are as valid as your reasons to want it are.
I don't want to fully argue that you should be forced to be vaccinated.
I do however, want to point out that vaccination isn't just meant to protect you from getting COVID. It is also meant to prevent you from spreading COVID to others. Hence an argument "It's my safety so it should be my choice" is wrong, because it is not just your safety at stake here.
That doesn't mean that it shouldn't be your choice, but it does mean that there is a public stake in whether people get vaccinated. Certain people have medical reasons for opting out. I could see you having psychological reasons for the same. But that doesn't necessarily extend to "anyone can refuse vaccines for any reason".
Maybe the point of the comment is to share their own experiences with the medical system and describe how often they get attacked for sharing their experiences? I do not think the proper response to such a comment is to attack them for sharing their experiences and tell them to "screw [themselves]".
If I were to take a minute to share my own feelings I'd say that the responses to that comment have proven its point. I am glad that they were able to openly share their experiences and I do not feel the need to censor them or attempt to censor them with personal attacks. I would say that the people making personal attacks are making it easier to empathize with the parent comment and are making themselves look rather foolish.
Try to take a moment to put yourselves in their shoes. Tell me that if you were blinded by the medical system you would continue to trust it.
Right, I understand the pull towards individualism, and I default towards it. We are in a pandemic. We’ve been here for months. It’s not a time for individualism, and in fact, poorly expressing individualism will merely reinforce collectivism.
That’s the root problem. If I was blinded by the medical system, I’d shut the hell up in a global pandemic, because it’s not all about me.
We've lived in an individualist society that has left behind people like the OP. Almost no one, if anyone at all, argued for collectivism to undo the bad thing that happened to them.
You're argument seems to be that now that something bad has happened to enough people, it's time for collectivism. That is one massively bitter pill to swallow for all the people who have been left behind in the past and had to fend for themselves.
And why does it have to be all about what you want? Because you are part of a majority? Does that make it okay to steamroll other people, because you, as a member of the majority, have more value? Because more people agree with you, and you add all those people together, and you have more value than a minority? Do you not see how your argument has been used to justify all the terrible things that have been committed against minorities in the past?
All of this could be moot though if these vaccines are truly 95+% effective. Not everyone will need to get it for herd immunity. The most likely scenario seems to be a combination of natural immunity and vaccine immunity before we even have enough doses to give everyone.
I mean that’s just patently untrue in the US with programs like medicare/medicaid. There is not no one thinking about these things and arguing for making them better, so the rest of this is fruit of the rotten lazy argument tree as far as I’m concerned.
He replied to me telling me to behave and I would normally be banned. Looks like the "disabled bonus" was not getting banned for speaking up. GO figure. I am massively disappointed by what turns out to be the true nature of my fellow hacker community.
Frankly, if there was a way to fully delete my account including all the posts I have ever done here, I would do so. Sadly, there isn't.
>Frankly, if there was a way to fully delete my account including all the posts I have ever done here, I would do so. Sadly, there isn't.
I really wish this was true as well. I know you can request to have your username obfuscated. I do not want my handle or my content (think NLP identification) to be associated with this site. I want to be erased. I do not want this on archive.org. I did not consent to this.
No, I am sharing my personal experience to allow people lacking empathy like you to understand why sceptics might not be as happy with the current outlook as you are.
I dont give a fuck about scientific evidence, personal experience is all that counts, for me, PERSONALLY!
Hey, your comments today have been breaking the site guidelines super badly. We ban accounts that do that. I don't want to ban you because you've posted good comments in the past, but could you please review https://news.ycombinator.com/newsguidelines.html and stick to the rules, regardless of how wrong others are (or you feel they are), or how frustrating a situation is? We all have to do this because if we don't, the inevitable result is a downward spiral.
It's clear that you've been through a lot and you're of course welcome to share your experiences. But it needs to be done without attacking others, without stoking flamewars, and so on.
I still need to adjust to the new world order where bringing up unusual perspectives intentionally is viewed as striking flamewars. I totally admit to having spet over a line by using swear words, and I apologize for that. As you have noticed, it is a tough time for anyone, however, that really shouldn't serve as an excuse. The truth is, that it is pretty hard to get your point across with english not being my first language, and that makes me frustrated when trying to make a point. In any case, thanks for the heads up, this thread has been enlightening enough that I will actually quit HN.
One of the things I really like about this site is that personal attacks on others are a strict taboo.
It seems increasingly common on the Internet to believe that personal attacks are okay, in some cases even virtuous. To each their own I guess, but personally I greatly prefer HN's model.
If you choose to stay, I think that you will find that bringing up unusual perspectives is highly welcome here, as is disputing other people's points. But, for me at least, an accusation that any other poster lacks empathy will always be met with a downvote.
I agree with your comment that while empathy is much needed especially as you had a very traumatic experience with, what sounds like, a rogue doctor.
The commentator might be implying that your experience, while terrible, cannot justify denying the significant benefits accrued to the entire population. Personal experience is, of course, very important it cannot however guide general policy decisions for large populations. And, it should be noted, that if we all lived solely through the lens of personal experience we would still live in a what we would believe is a flat world and our scientific evidence would be scant.
Please dont try to belittle my experience by implying things you have no knowledge about.
Rogue doctor? no. I was used for an experiment in the year 1986 by the head ophthalmologist of the biggest clinic in the second largest city of the country where I am from. I was supposed to be screened every 6 months. From one of these "screenings", I came back with signed of an invasive operation. Weeks later, I was 100% blind. It turned out that this ophthalmologist in chief did all sorts of malicious things.
I even met another of his victims at my time in the school for the blind. And no, before you ask, he was never convicted for anything.
This is not a backward country mind you. At least we believe we are not. And we have a socialized medical system, so we pay nothing for hospital visits.
The fact that this extremely dismissive comment can be upvoted makes me despair about ever fixing a broken healthcare system. Covid may have killed 250K in the US, but negative interactions with the medical system kill 150K year at the minimum each and every year. https://www.hopkinsmedicine.org/news/media/releases/study_su... This makes medical errors (which include negative effects of properly prescribed drugs) the 3rd leading cause of death in the US. More aggressive number such as Peter Gotzche's put that number even higher by including more nuanced side effects. He estimates that psychiatric drugs alone kill 500K people a year in the west. https://vimeo.com/178943789
Doctors as a general rule are very bad at listening to patients and our medical system simply does not track drug efficacy or side effects. You might be in a privilege situation to have never had to experience this, but there are millions of people who have.
I live in a country with socialized medicine. People trust the healthcare system since we "pay" 0$ for access. (pay in quotes since obviously taxes are significantly higher)
And Drs. I know are great at listening! I'd honestly go as far as to say they listen too much at times; I don't tell a mechanic how to do his job, it's not my place to tell a Dr. how to fix me since I have literal 0 understanding of the human body.
Again, maybe its a socialized medicine vs privatized medicine problem, but it absolutely boggles my mind the level of distrust in what should be a respected profession.
My comments aren't meant to disparage, but point out that colloquial evidence is not a substitute for research and the scientific method. I will call baloney on people who spew it.
Having lived in both privatized and socialized medical systems I actually find that the privatized health care system was better at listening. It cost more money, but it was definitely better bar none.
I think doctors are as good as their tools (education) and the feed back they get. They can only listen to what patients say, however most people aren't able to explain in detail what is going on. As well, western medicine tries to focus on specific locations/ailments and can miss the holistic portion of sickness. This challenge is compounded by the fact that many illness have similar symptoms and human bodies are intensely complicated.
I don't trust a doctor 100% (many of my friends do) however I do put a fair bit of faith in their training. Anything serious requires more research on my own as doctors are fallible.
The thought you raise that you shouldn't challenge or ask questions of what a doctor is telling you is quite alarming and I would wager that kind of laziness leads to poor health outcomes. As I said, doctors are human and are fallible, the research (i.e. human health systems) is not complete, and they are working on deeply complex issues that have incredible amounts of interactions that are unknown and incredibly challenging.
That said - the doctor better be able to explain in a straightforward manner in order to gain trust. And any profession that you should just "inherently trust" allows openings for laziness, abuse and bad outcomes. Strongly disagree with you.
The best doctor’s office experiences I’ve had were in a country with socialized health insurance (not socialized health care). I’m pretty convinced that private providers with public insurance is the optimum for providing a high standard of care.
There was also a supplemental private insurance market which covered a range of elective treatments. Best of both worlds!
What if there aren't straightforward explanations to what needs to be done? Should I not trust my Dr because they can't bring complex medical concepts down to my level? Do clients of software development companies require that the developer explain things in "clear terms" for them? I thought we called that marketing wank.
Drs, nurses, and all other medical professionals are required to do training/recertification in my country. I "inherently trust" them because the system allows me to.
As for private vs. socialized, that will always be a point of contention. Some people want to be able to choose, but even being able to choose shows some amount of (and I hate this word) privileges. The vast majority of people simply do not have the financial means to "choose" a Dr in a privatized system; if they can even get access to one.
My mechanic might know what to do, but his incentives can include things that are in opposition to mine, such making more money from an issue (real or not), doing less work, even getting more social attention and status for making their work more important.
By the way I'm an expert investment structured, and you might be interested in these neat things called CDOs I can hook you up with ..
I agree with the statement about privatized - and that wasn't what I was referring to. You had said that they public health care listened better, I wanted to refute that. I also recognize that in private health care your insurance and ability to pay impact the health care you receive. I don't think that is the best mechanism to provide good care for the entire population.
All I am saying is that if they can't explain things better than take this pill, than I wouldn't trust them. Like I said, I trust their education (which is the certifications) but I will certainly run questions up the flagpole if I have them. They shouldn't be given "god like" carte blanche status in terms of no questions.
That last question is a tough one - I would wager it is because everyone knows someone who has had some bad experiences, and there have been many a story about seriously effed up medical experiences. Most people can't do statistics and then get deeply concerned that the likelihood that they might have bad experience then spills over into lack of trust. That's my two second hot take.
I should make clear my opinion - I do trust western medicine, vaccines, science et al. I do not however trust them 100% - mistakes are made, and this is my life. I can question them, and I should. Their role is to instill trust and not disregard peoples concerns out of hand.
For sure; and I'm not saying we should give people carte blanch. But those mistakes, errors, whatever we want to call them, are the exception, not the rule.
Do you distrust your co-workers if they make a single mistake?
Do you have factual references for the claim about errors in medical care being exceptional? From impartial sources?
I'm honestly skeptical of the claim based on my life experience. I've heard directly from people of numerous of terrible errors that destroyed their lives. e.g. bone implants that were poisonous, different implants that weren't sterilized properly, forced saving of patient life to charge/steal his assets instead of passing to family - direct from people I know well, that happened to them.
Then I've personally experienced a common pattern of doctors not being able to identify things that weren't common or obvious based on their flowchart style diagnosis. I've also experienced a lot of successful diagnosis of simpler obvious issues.
My co-workers aren't responsible for the quality and length of my life. Their mistakes have an incredibly small impact compared to a mistake by a doctor (depending on the scope of problem).
I agree. Its hard to counter the feeling that HN is getting too big for its boots. In certain "culture war" threads the easy to digest opinions are beginning to dominate. Maybe I just payed less attention a few years ago but I never noticed this in the past. Will it spread past the culture war threads or will it not? Who can tell at this point.
Hacker News is only pro science in some areas. Try looking at threads about organic farming or GMO seeds and you will discover a different side. That but one example, easy for me to see because my biases are different.
Being pro-science is very unpopular with the anti-science culture. It implies global warming is real, humans evolved from apes, and a whole host of other implications.
Considering the GGP of this comment is on the verge of dead and it includes two citations, with one being https://www.hopkinsmedicine.org/ which is a world class medical institution, I think the answer is obvious.
And should those people who chose to endanger others and get the virus themselves be denied medical treatment? We're getting to capacity in many cities now. If we want to talk about taking personal responsibility, then they should see it through to the end, and not burden our medical system with care if they knew the risks but ignored them for their own choosing.
No worries. While I can not speak for others, I am 1. not afraid of needing medical treatment, and 2. if I did, I am willing to not accept any life prolonging measures. The things I have heard from people in the past few months saying to each other, dropping democratic freedoms left and right, gives no real reason to want and stay on this planet. If it hits, it hits. I can manage dying, I have managed living for 40 years in this society. Question is, can you life with the comment you just wrote?
I took your comment through to the logical conclusion of what you're suggesting, which is personal freedom and responsibility to not take precautions but that being linked with getting deprioritized if you then need a respirator or a bed compared to someone who did take precautions, you should then be lower on that list, because of the consequences you said you'd rather live with. Kind of idiotic, right? But hey if that's how you'd rather die, maybe do that in the woods than taking a whole cluster of people with you as an asymptomatic carrier.
You're such a sweet and kind individual. Again, no worries, my social interactions have been put to such a minimum that me dying in my flat will effectively be the same as me dying out there in the woods as you'd like it to be.
So you are "healthy" but on the other hand you are blind?
How do you feel about inadvertently infecting others who are at high risk from Coronavirus? That's the big factor why people are angry about anti-vaccers. They are a danger for others who cannot get vaccinated for medical reasons.
There will likely be non-mRNA options, assuming they're also found to be safe and effective.
I personally will be getting whatever comes first for the general population, on day one. But it'd be dishonest if I didn't admit having concerns over safety we might not be aware of at the time this is administered that would only be known many months or years later.
That's overridden by the fact that I lost one family member to the virus and another who survived it but is already seeing long-term effects in her lungs from when she had the virus. She was just hospitalized again for those effects. If folks have more info about measuring long-term impacts of a vaccine, I'd love to hear it for the peace of mind. Again, I'll be getting the vaccine regardless, because of very clear long-term effects of the virus.
I guess this is as good a place as any to ask: Do we have any other mRNA vaccines in circulation? If so, which ones? If not, how do we know that they're generally safe after only a few months of testing?
Not the person who you're asking, but I'd personally prefer as many months (or years) as is needed. I have no idea if that's a few months or years and would love an answer grounded in science.
Could somebody just explain how scientists know decades-long effects after only months of research? I'm taking a vaccine, 100%, no matter what. I'm pro-vaccine. And even if we're unsure, what we know is the massive numbers of deaths we'll have without a vaccine.
I'm asking because I want more peace of mind about it.
A vaccine is "nothing" more than a way to tell your body what it needs to fight before it actually has to fight it. Whether that's via mRNA, DNA, dead virus, live virus, whatever. The method used to do that is less important than your body getting the message. If the vaccine causes decades-long effects, so will the virus itself. We're damned either way.
> If the vaccine causes decades-long effects, so will the virus itself. We're damned either way.
Any long-term effects from a vaccine seems unlikely to be as bad as the virus itself.
But still, is that really the answer? That there's no way to know about long-term effects until it's been out there for decades? I was kinda hoping there was an answer like "what we know from other vaccines is that any bad effects almost always show up in first few months -- never, or almost never, many years down the line."
>If not, how do we know that they're generally safe after only a few months of testing?
Afair mRNA and DNA based vaccines are being studied since about 1999 without ever finding side effects that stem from the method itself.
The way it works is actually safer than "traditional" vaccination via dead pathogens, mostly because only a tiny and harmless part of the actual pathogen is used.
The testing is done mainly to make sure that it actually works and the "harmless" bit is actually harmless...
So while a Phase 3 trial is still sensible to make sure that all assumptuions hold, I would argue that the expected side effects of these kind of vaccines are close to zero.
And honestly, even traditional vaccines have very little side effects... Neutering pathogens so that they stay neutered is a pretty well understood technique, and these new techniques basically do that on a genetic level by removing the neutered parts altogether.
That's encouraging. Traditional vaccines are well-studied and very widely deployed, so we know pretty much exactly what the side effects are and how rare they are. I wouldn't be nervous about getting a traditional vaccine, but I'm nervous about one that hasn't been deployed to people before...
no, these are the very first vaccines to use mrna technology successfully. same with the vaccine delivery technology -- lipid nanoparticles.
that's why there is a lot of concern about their potential long-term side effects. in animal models, one of moderna's older vaccines (not for covid) was found to cause severe liver damage... likely as a result of the nanoparticle formulation they were using, rather than the mrna itself, but who knows.
personally, given the data that i've seen so far, i'd be more comfortable with taking the pfizer mrna vaccine than the moderna one. especialy when you add in moderna's reputation for peak sleaziness and non-transparency, it seems especially risky to be one of their guinea pigs in the general population.
I'm with you on this one. I feel like many people these days are overly manifesting 'trust' in newly developed medicines or vaccines just not to be called anti-vaxers ('I saw this facebook post...' researchers kind) or worse ('vaccines contain microchips so that lizard people can control our minds' kind). When in fact there is no data at the moment to support their safeness.
Also claims and data from clinical trials produced by company which develops medicine itself is not really convincing until it gets verified with independent trials. Not like there were no frauds in clinical trials:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340084/#S2titl...
> When in fact there is no data at the moment to support their safeness.
That’s patently untrue. We have data, from the phase III trials. Is the data final? No. But it’s good evidence for general safety. As for long-term problems, we have good theoretical reasons (based, in turn, on experimental data) to suspect that no such risks exist. In fact, we know quite a lot about how foreign RNA behaves in cells and while there are potential mechanisms to cause issues (most importantly strong immune reactions), there are no known plausible mechanisms to cause long-term problems.
We can’t fully exclude the possibility of long-term averse effects, but we do have data supporting the vaccines’ safety (both direct and indirect, experimental data), and most experts are confident that there won’t be any such effects — confident enough to put their own health on the line: many are enrolled in the ongoing trials.
I'm sorry I guess I wasn't precise. I meant in general I feel like a lot of people would take any untested drug just to not be named anti-vaxer.
But to your point, as I wrote trial data from company that produces said vaccine (given that it's for sure high pressure case and stakes are pretty high) that hasn't been verified by external entities is not convincing to me. And shouldn't be to anyone, isn't peer review and repeatability a part of scientific method?
This vaccine is incredible because of mechanism of action! If it continues to prove to be safe, we can treat all sorts of rare diseases easily and cheaply.
Genuinely asking - is the timing coincidental or is the decision to release these results after the election politically motivated for either Moderna or Pfizer? COVID has of course hurt Trump’s candidacy and one could see how good news prior to voting would help his chances. There’s a saying that goes “everything in an election year is about the election”. Thoughts?
Either decision (release or not release) would be seen as political; my preference would be to adopt something like France's system of complete media blackout within a couple days to a week before the election - otherwise we'll be endlessly debating whether certain things were timed in order to help one side or the other.
They're still looking at late this year/early next year:
"Late-stage trial results of a potential COVID-19 vaccine being developed by the University of Oxford and AstraZeneca could be presented this year as the British government prepares for a possible vaccination rollout in late December or early 2021."
I had that misunderstanding at first, too. But as far as I understand it now, this was a trial with ~30,000 people, and they report the first n number of people to get covid. In this case, n=95, and 90 of those 95 were in the control (placebo) group. The assumption is that with an ineffective vaccine, the control/experimental covid ratio would be 50/50, so the heavy skew to the control group is good and significant news. So this is not a sample where just 90 people were given the vaccine, which would be less reliable.
Well the anti-vax conspiracy crap already started on my local Whatsapp groups here in S.A - some UK women doing a wikipedia search around the terms recombinant DNA and used a human cell line (MRC-5) from the packaging of the trial Oxford vaccine.
If it was up to these ignorant people we would still have kids getting polio in 2020.
Some UK woman did research causing a WhatsApp group in South Africa to question the vaccine, and this is the fault of the president of the US? That is quite the stretch considering none of the players are citizens of the US.
Re-paste from my comments below, because I believe people should share their experiences:
I currently have coronavirus. I'm a young male in my 20s (don't want to divulge too much info), 6'1", 170 lbs, non-smoker, rarely drink, pretty healthy. Waiting on test results.
Started off about 2 weeks ago, rash on my chest, lots of night sweats and chills. Didn't think it was covid at first. given the weird symptoms. I did not feel too sick, in general. Slight fever, slight cough and sore throat. For most of the time, it felt mild. Still have the rash, night sweats, and sore throat at the moment.
However, 4 days ago I started having issues breathing. I felt out of breath multiple times throughout the day, and at times it was hard to even suck in air (like my diaphragm was calcified or something). I woke up a few times at night, trying to suck in air. Today was better but the difficulty breathing is still there. I realized today, that even though it's not as bad as the worst flu I've had, it involved a symptom (difficulty breathing in air) that I have never experienced. Not with strep, not with the flu. This is something to note for everyone, in my opinion.
I think it's both milder AND worse than people think it is - I'm a healthy young male who exercises and eats well, and yet I'm having trouble breathing. This is a symptom that has continued for multiple days, and while it hasn't gotten worse, it's not getting much better. The rash is still there, my throat's still sore. If you are part of the obese/overweight American population (35% of us, including my family), and are a chronic smoker/drinker, and have chronic conditions (diabetes, hypertension, mental health conditions), I think you should still be careful.
Unless you have a respirator, there isn't anything you can take to resolve "difficulty breathing". It's not like fever/sweats/nausea - where you can just take a Nyquil and it's all gone. Not to mention, we have antibiotics and antivirals to attack the flu/cold/strep infections as well. Covid's a bit different - difficulty breathing can only currently be helped by equipment that's located in hospitals. There isn't some magic pill that will get your diaphragm pumping up and down again. This is something to note, in my opinion.
I'm not sure how much longer my symptoms will continue. The initial symptoms started 2 weeks ago, but the breathing related ones only started recently. I hope it gets resolved soon - I may provide a comment as an update.
Please wash your hands, avoid touching your face/eyes with your hands, socially distance if you can, and wear a mask when in public. Having trouble breathing is no joke.
> I currently have coronavirus. I'm a young male in my 20s (don't want to divulge too much info), 6'1", 170 lbs, non-smoker, rarely drink, pretty healthy. Waiting on test results.
Wait... how do you know it's COVID?
I mean, given how prevalent it is right now it certainly could be COVID, but to your own point, a rash isn't a particularly common symptom, in the ~15% range. Fever, chills, cough, night sweats, breathing problems. Could be any of a range of upper respiratory diseases. In any other year I'd say you have bronchitis - there's 3 million cases of that every year in the US too.
Stay strong! Just thought I'd share my experience with you:
Couple days of the cold, followed by a fever and increasing difficulty breathing for 3 days. Just getting up from the couch felt like having just run a marathon and having to 'make' my body breathe. Actually having to force the air into my lungs. To the point where I called the hospital and was told there wasn't anything they could do ATM.
Then, one moment I will never forget. I went to sleep with the biggest worries I've ever had about how the next day would look. If there was even a next day. I woke up at 3:00 AM. And I could just breathe normally. All symptoms were just gone. No fever, nothing. The biggest relieve of my life.
Followed by 3 months of weird pains and discomforts. One of which was a stabbing pain that would travel from my lungs down to my side during the course of 4 days. Something that my SO also experienced.
Also, most of the issues I experienced in the months after the whole ordeal where psychological in nature. I could make myself short of breath by just thinking about it and I would have to go lie down. I also experienced chest pains 4 months after. All of that went away when I started to breath differently. I had been taking very short breath right from my upper chest area. This was actually causing me pain. I learned to breath by expanding my abdomen and after forcefully breathing very slowly like that for 2 days, everything went back to normal. So there's a big tip for anybody reading this. I think it's called diaphragmatic breathing, Google it.
Anyway, good luck to you and anybody else that needs it! When all of this is over and we're back at the bars, first round is on me! <3
> Also, most of the issues I experienced in the months after the whole ordeal where psychological in nature.
Interesting proposition not many people bring up. We’ve just had eight months of constant media coverage saying how bad it is, changing everyone’s daily lives, making the awareness of it literally inescapable. That has to play into account for some people.
Right or wrong, justified or exaggerated, there is definitely a psychological component now.
> I had been taking very short breath right from my upper chest area. This was actually causing me pain. I learned to breath by expanding my abdomen and after forcefully breathing very slowly like that for 2 days, everything went back to normal. So there's a big tip for anybody reading this. I think it's called diaphragmatic breathing, Google it.
And the moderate version of the other way is called "shallow breathing" or "chest breathing". From what I understand it's actually really common but not very good for us, because it doesn't really expand the bottom of the lungs, so we're not getting as much breath as we should.
I spoke to my physician, who performed a differential diagnosis over the phone. I eliminated environmental considerations, and did a quick "patient history" with him and my contacts, which eliminated other possibilities.
The list of diseases which could explain my symptoms is extremely short. The only one which crosses all the boxes is coronavirus.
Indeed, I know two people that went to the hospital because they thought it was covid, but in both cases it was pulmonary embolism, which has very similar symptoms. I'm not even close to a medical expert, but I wouldn't be surprised that because of less physical movement due to being home more, embolisms are more common.
And if you only use raw disease incidence[0] as your prior, you're approximately just as likely (-ish?) to have pulmonary embolism. This obviously does not include other very important priors, like age, exact symptom list or incidence of SARS-CoV-2 in your area right now.
Well... there's a lot of hoofed animals out there.
- 3 million annual cases of bronchitis in the US with practically identical symptoms.
- 45 million annual cases of the flu in the US and yeah, some people get those symptoms too.
- Common cold, pneumonia, whooping cough, strep, mono.
There's a whole host of upper respiratory tract infections [1] that can and frequently do present this way. We've been getting these exact symptoms practically forever.
Given the sensitivity of the topic right now the least we can do is get data before adding to the discourse. It's hard to take panic back. Given you can get a PCR test with same-day results, it would be nice if OP could wait 24 hours to confirm :)
I got super sick back in February, basically the same exact symptoms OP posted, and a cough that lasted 6 weeks. Took an antibody test a few months later. I tested negative.
Your priors should be remarkably different now vs. last February. At the end of February the U.S. had 60 active reported COVID cases. Assume a 10:1 underreporting and that's about 600 total cases, then assume about 100 million cold + flu cases at any given time in the winter and there's about 200,000:1 odds that a given respiratory illness was actually COVID.
Now there are 4.1 million active COVID cases in the U.S. Assume a 5:1 underreporting (we're better at testing, but still seeing close to 50% test positivity rates in the Midwest, worse than NYC at the peak) and that's 20 million active cases. Meanwhile flu cases have dropped by ~90% [1], so if we assume that holds true for colds as well, estimate about 10 million active cases of cold & flu in the U.S. A random respiratory illness with no further differentials then has a 2:1 chance of being COVID.
Obviously things like location, differential diagnosis, etc. will change those odds. A random respiratory illness in the Bay Area (where COVID numbers are low and we just had a bunch of wildfires) is most likely to be allergies or smoke inhalation, while if you had a random respiratory illness in NYC in April there was a decent chance it was COVID. Given the OP's differential diagnosis though (rash and shortness of breath are way more common in COVID than bronchitis or flu), it's not unreasonable to conclude he has COVID.
I've had a bad flu (negative COVID test but possibly a false negative) in September, and one morning when I woke up and felt difficulty breathing I ended up riding an ambulance to a hospital. (Ambulances are and doctors doing home visits are widely available and free where I live).
Turns out, it was a psychological thing; something similar to a panic attack, with my lungs completely clear. They gave me anxiety medication and the feeling has gone completely. Not saying that it's necessarily the same with you, but if you experience hyperventilation and feel like you can't breathe, try to relax and breathe slowly and deeply. May be it's not as scary as it seems.
I'll share my experience as well. My wife tested positive after having a slight fever, some body aches, and loss of taste/smell. A few days later I also lost taste / smell but had no other symptoms fortunately. We are both in our late 30's. My children never had any symptoms.
If you have trouble breathing there might be some asthma advice that is useful. Mine got better, but a long time ago a doctor told me to try restricting the outward airflow when you are exhaling. Surprisingly this helped me feel better. You do it by puckering your lips as you exhale instead of just opening your mouth. It's unintuitive, but his explanation was that you increase the pressure in your lungs by creating some pressure in your mouth. No idea about any evidence behind it. Also your breathing problem might not be similar to an asthma attack.
They’re relatively inexpensive and it’s worth picking one up to track O2 levels to know when you should go to the hospital.
Breathing difficulties start in week two and can get really bad in week three - from what I’ve read week 3 is when you starting getting better, or when you start getting worse.
I'm actually shocked that pulse oximeters have not become a standard piece of a home diagnostic kit. Everybody has a thermometer, and everybody should have a pulseox as well.
I noticed in your video instruction for doffing (removing) the mask, the lady pulls it up over her face.
I wear a 3M 6800 full-face respirator on airplanes, and the instructions I got were to pull from the back and down when doffing, to avoid possibly spreading virus across the face.
Thanks! That's interesting. You can do that with Narwall too and I do see the advantage.
I generally advise wiping the mask down with an alcohol wipe or equivalent prior to doffing (also servess as a reminder to sanitize one's hands before exposing the face). Perhaps I should include a gif of this too.
Would love feedback from you (or other hn'ers) on the preview of the full website which goes live tomorrow, by the way! http://next.narwallmask.com
Already had a few orders come in through HN, will be shipping those out today.
I have a few friends in their late-20s/early-30s who have gotten this.
Only one has had to spend a night in the hospital for low oxygen, but overall, I know of 5 people who have been made absolutely miserable for 2 weeks because of this virus. Seemingly no permanent side effects, but it was an awful slog to get there.
Sorry to hear your experience. There have been similar tales elsewhere. For sleep time breathing, I saw a recommendation that it’s better to sleep on the stomach (rather than on the back) to reduce the weight on the lungs. Please check about that and see if that helps.
Try to find a pulse-oximeter if you can. I've heard it's the main reliable way of telling how serious the breathing issues are in a timely way, or at least workplace was convinced enough to buy one for everybody.
> Unless you have a respirator, there isn't anything you can take to resolve "difficulty breathing".
As a private person you can realistically get an oxygen concentrator. These are simpler and less expensive than ventilators (I am not even sure if an untrained person should operate a ventilator).
I was involved in getting a concentrator for my friend who got a very bad case of covid though not bad enough to get into a hospital. The concentrator got his oxygen saturation level from low eighties (dangerous) to low nineties (still below the norm but less dangerous).
Sorry to hear about your shortness of breath. It may be alleviated by lying on your front, not your side or back. This key insight helped many hospitals after the initial wave hit.
I don't know if I have coronavirus, but my symptomps are similar to yours, without the night sweats and chills.
I feel good for the most part, but in May I developed a difficulty breathing, and It's still there.
Nothing major, but many days I need to artificially force yawning to feel good. It's like I cannot forget breathing as something automatic. Some days I'm ok, tough.
I am also recovering from Covid, One of the things you need to be aware of your oxygen level, Oximeters are very cheap. Keep track of them if level is below 95 Get Chest X Ray or/and Chest CT Scan done to check lung calcification. If there is significant lung damage then get hospitalized for emergency.
I don't understand why when you say "I have covid" people want the proof that you have it and ask you "did you do the test ?".
I personally think I got it twice and never did any test. Just had symptoms I never had before in the 2 waves we had in france, just after meeting persons who also got seek at the same time. This is enough coincidence for me to think I have covid.
I also think that this reasoning may be more accurate that the official not very accurate covid tests.
Doing this reasoning myself also saved me money and the 4h waiting queue to do the test (the last thing I want to do when I have fever).
On the other side, I know people who had symptoms, tested negative (and trusted the test) and still when out to meet (and maybe contaminate) friends or colleagues.
There has been 25 documented cases of COVID reinfection worldwide, so assuming you had it without actually doing tests is likely false. There are many diseases with similar symptoms in the upper respiratory system, and given no more than 25 people on earth have confirmed having it twice, unless you have positive tests Occam’s razor suggests otherwise.
Definitely consult with your physician, but in case you didn’t know — lying prone (on your stomach) can help a lot with this.
(I’m not a doctor, this is just from personal experience, and seems somewhat backed up in practice — standard disclaimer, etc.)
Edit: If you can get a pulse oximeter, it can be useful for making sure your blood oxygen level isn’t dipping into dangerous territory.
But again, can’t emphasize this enough — definitely speak with a medical professional if you can for advice on how to proceed with the symptoms you’re experiencing.
> Unless you have a respirator, there isn't anything you can take to resolve "difficulty breathing"
It's too late now, but I suppose what you can do is have a pulse oximeter at hand, so you can see breathing problems coming before you get into trouble. At least, that's what I hear people say.
It's not relevant to Moderna's vaccine, you are correct. However, the discussion in this thread swerved very strongly away from vaccines (and the related thoughts, emotions, and feelings about vaccination) and veered towards coronavirus, its impact on society, and people's behaviors re:covid.
It was only at that point (I think the thread had about 200 comments or so) that I added my 2cents. Ideally, this whole thread should have been ONLY about vaccination.
My mother worked out on the Peloton every single day, didn't miss one workout, and said that she was fine. She experienced mild symptoms and loss of smell and fevers, but other than that she was fine.
My grandmother was rushed to the hospital because she is in the prime age range and has just about every single previous condition you could imagine for someone pushing 90. She was diagnosed with Covid and Pneumonia, felt like shit for a while, and was release and is now fine.
I am not saying the virus is not real or isn't serious, but at some point we need to stop only looking at number of confirmed cases, and start digging a little deeper before we start spreading all of this rash fear.
This is anecdotal evidence and trying to derive patterns from it is dangerous. We know that COVID-19 is much more dangerous than the typical annual flu and we are at risk of overrunning the icus.
Their final paragraph goes beyond just sharing an anecdote and into making prescriptive judgements about how society should approach the virus based on those anecdotes in contravention of the medical consensus. I presume that's the issue people have with it.
At this point the disease has been with us for a year, and we do have a lot of evidence. It's not particularly serious for certain demographics, and incredibly dangerous for others - particularly that of your grandparents. I'm happy your grandparents are okay, though I suggest you not over index on anecdota too. God forbid one of them had died, that anecdote wouldn't necessarily tell us the disease is 50% fatal.
What are you talking about? This isn't trolling. The president is a negligent menace, who, had he had any interest or capability to lead, would have done his job and enabled earlier prevention measures...
Paracetamol would almost certainly never be approved today; the lethal dose is much closer to the effective dose than almost any other medication. Many countries have more deaths from paracetamol than, say, ecstasy. So much so that it's commonly used for suicide attempts; do not try this because the likely outcome is survival with severe liver damage.
What do you mean by "third testing phase"? I think that phase III of the clinical trials is actually happening right now and is where these positive results come from.
Normally this phase takes multiple years. You cannot shorten this. Long term effects, you guess it maybe, only show up in the long term.
You can have my dose, if you like. No problem for me. Please downvote me further.
It still does. That hasn't changed or been "rushed". We are now getting preliminary Phase 3 results and there will continue to be Phase 3 results for a long time to come. The question is, do various health agencies believe these initial results are sufficient for emergency approval?
But to be perfectly crystal clear, absolutely nothing has been "shortened".
>But to be perfectly crystal clear, absolutely nothing has been "shortened".
That's obviously not true. The approval process has been shortened (or more accurately, is very likely to be shortened), even though the trials will continue after emergency approval.
The initial results from the Phase 3 trials are to show if the vaccine is effective. They enroll a bunch of people, inject them with the vaccine or a placebo, and then wait. Everything up until the "waiting" part can be and was expedited. The waiting part depends on how quickly the pathogen is spreading. In this case, very fast, so it took months instead of years to get enough data to draw conclusions.
That part can't be rushed. There was no shortcut to proving efficacy.
The Phase 3 trials haven't stopped and they will continue to record information about safety and side effects. But the Phase 2 trials already proved the vaccine to be safe, which is necessary before injecting it in to tens of thousands of human beings, as was done for Phase 3 trials.
New information about safety and side effects could emerge, but in the meantime, the various national health agencies will have to decide if the data on safety is sufficient to give emergency approvals.
>But the Phase 2 trials already proved the vaccine to be safe
This sentence implies that it is not possible for any unsafe condition to remain undetected until some time after the phase 2 trial is completed. Is that actually a claim you're making?
Yeah, sorry for that. I am just a little bit confused. Because to speed the things up, phase I and II were combined here. That's why we are actually at phase 2.5, so to say, sold as phase III.
Where in my previous comment did I say I knew? You are basing your dismissal of my comment on something I never said in a quite frankly unnecessarily passive aggressive tone.
I am not trying to attack you personally. Your comment is FUD because you’re making it seem as if it was undisputed that long term risks exist, and we just don’t know them yet. In your words these risks are even „significant“. Now that we’re pointing fingers, how do you know this?
The fact that they are dumping stock just means that they think the company is overvalued, which I think any sane individual that is looking at the market will infer. They want to sell on the upside.
It doesn't mean that it's a scam. The vaccine may work, they may be profitable, and they may have developed tech and processes that can be used to create other mRNA vaccines on a fast timeline even without all the world aligning to help them. It may also be that the amount of growth priced into the current stock price is just unrealistic even if all of this is true.
Yeah sure man: if I finally made a product that worked, that I bet the future of my failing company on, and it is actually a product which every human on earth needs to take, possibly many times: first thing I'm gonna do is lower my S&P500 correlation risk. That totally makes sense. Not.
People have been calling them the new Theranos for years for not publishing anything, and basically having zero useful products. They just got a half billion in bridge funding from the government on top of the 2-3 billion they've lost over their history. These are scammers taking the money and running.
Depends on the point in time, though obviously you have better data than me. I am pretty sure you'll eventually be able to say the same about Moderna, assuming they don't get away with a giant placebo swindle.
Curious myself, I used the HackerNews search feature to find the first few theranos articles with significant points/comments.
First article, Sep 2013, top-rated comments include "The website design hides the message in frills and imagery, but the essence appears to be: Faster/cheaper blood-testing, via a smaller/quicker samples", "Yep, I still have no idea who they are or what they do.", "There are more soldiers in that board there than doctors. The only way I'd give them my blood would be to infect them with a disease." https://news.ycombinator.com/item?id=6349349
June 2014, top-rated comments include ".. zombie ... apocalypse". "What an odd cast for a startup board. I wonder what connects all these people, other than all being high-profile," and "The whole article was pretty weird. Anyone care to speculate what's going on here?" https://news.ycombinator.com/item?id=7951019
Oct 2015, top-rated comments include "Everything I've heard about this company is just weird", "investors throwing good money after bad, both to save face and to chase the glimmer of hope that they were getting somewhere with this," "Very smart. And very deceitful," and "Suddenly a company that looks like a Kickstarter page has the valuation of companies like Quest Diagnositics." https://news.ycombinator.com/item?id=10397149
I'd say HN was indeed appropriately skeptical (for the right reasons) by 2014 if not 2013, and certainly by 2015 (wikipedia says the first article seriously questioning Theranos was WSJ in 2015), HN was fully in board with the questioning of Theranos, commenters were not defending them from accusations.
But then, I don't know if that shows HN collective insight, so much as the tenor of HN comments tends to be skeptical/critical/negative. But they definitely were on theranos.
I appreciate you doing this. However .... what HN search feature?
I went and read the 2013 comments; they certainly were critical of the website: almost a trope on HN, I guess considering how many people make a living at that. Nobody really seemed to notice anything untoward. Many/most were as gee-whiz fanboy about it as people on this article on Moderna.
True. I don't know if there was enough info available to know what a scam it was with the first announcement of the company? In 2013 HN comments, there were definitely people interested in the promise of quicker/cheaper blood tests (I mean, that's pretty appropriate with hindsight in 2020), but also people who thought the business plan seemed pretty sketchy and the board of directors was suspicious, that the company seemed more about marketing than any actual product (which turned out to be pretty on the nose, and there were some comments to this effect in 2013).
By 2014, the level of suspicion was much higher. By 2015, when reports first started to come out of untoward behavior form the company, HN commenters was totally on board with those reports and there were few trying to defend the company.
That's about what I'd expect, I think? Or the best I'd expect? Are you saying you knew in 2013 that the company would turn out to be fraudulent? Do you have some documentation showing that? I'd be impressed.
My bad, I meant to say it in the other thread which is flooded with "As a young healthy person who could yet have more children, I’d rather get covid than take a genetic vaccine that might affect me or my offspring" type of comments.
I bet every company will go to a hybrid style setup. Thus requiring less physical space... so corporate RE still down. WFH companies like what? There's really no secret sauce in any of them, doubt their values go up that much.
Why do you think companies will want people back in the office? Many have switched to work from home permanently, and the vast majority of workers won't want to go back either after having experienced it.
Maybe a good gauge is to look at studies that examine people's dislike of commuting. Google shows several results on this.
For some anecdata, our 5000 person software company held a survey early in the year and 30% said they wanted to be remote. Then the company shaped policies around that to allow remote work in the future. When the time came for people to proactively request to be remote, it turned out to be around 50% (and I assume that will rise as people figure out what they want, where they want to be, how life is during non pandemic shutdowns etc.).
I think what it ultimately comes down to is a significant number of people will want to continue to be remote; it's not just a few people.
From the article: "Moderna's vaccine appears to be easier to store as it remains stable at minus 20C for up to six months and can be kept in a standard fridge for up to a month."
The trial is big; tens of thousands of people would be normal. One problem with this sort of trial is that the sort of person who volunteers is also quite likely to be careful, so they're not getting COVID enough. Pfizer/BioNtec trial showed similar numbers.
“ More than 30,000 participants at 100 clinical research sites in the United States are participating in the study, which launched on July 27, 2020, after results from earlier stage clinical testing indicated that the vaccine candidate is well-tolerated and immunogenic.”
Maybe a stupid question: Is this the standard measurement of effectiveness? I.e. you give the control group a dummy vaccine, the test group the real vaccine, and you just wait for them to be infected? Why not test for antibody development?
Exactly. It's a good sign if people develop antibodies, but that does not ensure protection. As I understand it, it is difficult to predict, in advance of actual testing, what immune response will actually be protective.
The immune system is complex and has multiple mechanisms to recognize and attack pathogens; besides antibodies I've seen mention of multiple types of T-cells and also there's apparently a dimension of mucosal immunity vs. systemic immunity.
Antibodies are easy to test for (the chemistry required can be put into mass-produced home test kits), while it's more difficult to test for other responses (a recent long-term study of covid-19 T-cell response was with only ~100 subjects).
A hypothetical vaccine that produced a meh antibody response but mobilized the T-cell or mucosal systems could be effective at preventing the disease but not look like much on an antibody screen.
>"Just watch - these Covid med pharma cos are going to cut each other by few points now - just to acclaim their top spot"
It is funny to see the market reaction. MRNA spiked 15% this morning while BNTX (The Pfizer vaccine maker) tanked 13%. All over a few percentage difference in a sample size so small that it came down to the difference of one or two cases.
Maybe it's not about a few percentage points but about it being a legit alternative. A few days ago it looked like Pfizer is in position to milk the market and now there is competition.
> Moderna's vaccine appears to be easier to store as it remains stable at minus 20C for up to six months and can be kept in a standard fridge for up to a month.
Pfizer's vaccine needs ultra-cold storage at around minus 75C, but it can be kept in the fridge for five days.
I think this is a big difference. I don't know if many hospitals and clinics, especially ones in remote locations, can have cold storage the Pfizer vaccine requires
It was common knowledge that Moderna’s vaccine was releasing efficiency results this week, and that the technology used to provide protection was very similar to Pfizer’s.
The small difference in efficacy is less important than the difference in required transportation and storage temperatures: the Moderna vaccine can be kept in a fridge (2C) for a month, or a freezer (-20C) for 6. While the Pfizer vaccine requires ultra cold storage (-70C).
This may also be because the Pfizer shot needs to be stored at nearly a hundred degrees below zero, while the Moderna one needs to be stored at only a few degrees below zero. This makes Moderna's option much better for distribution.
I don't know about this particular one, but there are a number of vaccine trials going on right now. You can try searching for "covid vaccine trial" in your area, or reaching out to your local department of health. My wife is in the Oxford-Astrazeneca trial here in Minnesota. She was recruited through a Facebook ad. The downside is you don't know whether you got the placebo or the real thing :) My wife has a 2/3 chance of having the vaccine. It's unclear to me when they will unblind her. It seems unethical not to unblind participants if a safe, effective vaccine is available, but I'm not an expert on trial methodology.
If you unblind patients, that will change their behavior and alter your results. If they told her she had the vaccine, she'd be more likely to go out and take risks. Conversely, if they told her she had placebo, she'd probably stay in and take less risks. Overall, this would lead to a dramatic reduction in the power to observe an actual protective effect, as vaccinated would be riskier and unvaccinated would behave safer.
Hang in there, she is doing a good service, I hope you are both well!
Yes, I understand the purpose of blinding. I'm wondering if that purpose still holds once a vaccine is approved and is widely available. Surely for her safety they will unblind her so she knows whether to go get the real vaccine?
The vaccine is being manufactured now and is in cold storage awaiting approval. When it is approved, it will go to healthcare professionals and those in the highest risk categories. If you are in one of those risk categories you will be prioritized accordingly. This is best for all of us because it will rapidly expand our healthcare capacity and reduce deaths and serious cases. Even a few million doses can make a big dent in the death rate if given to the right people. And with 2 highly effective vaccines heading towards approval, you are now looking at half the wait before a dose is ready for you.
I think the real question is, will the distribution of this and the Pfizer vaccine cause the lockdowns to stop? Everyone seems to assume that they will, but we haven't heard any statements from our bureaucratic elite to suggest that vaccines will obviate the need for lockdowns.
Yes, and hospitalization numbers are one case statistic. That's a "why should we lockdown" and not "what metrics do we use to decide how hard to lock down"
Political support for lockdowns etc will surely drop hard once significant parts of the high risk population are vaccinated and intensive care utilization goes down (support was eroding even before vaccine news hit). We'll then see a heavy third wave challenging the immune systems of those who didn't qualify for early vaccination.
Currently we don't even know wether the vaccines can cause herd immunity effects or not. It's perfectly possible that they just reduce heavy sickness infections into symptomless spreader infections. The tests didn't check for that (you can't do daily PCR on a test population of ten thousands). If that was the case the vaccines would still be a great improvement, but the third wave during partial vaccination would be particularly nasty if the vaccinated are not firewalls but stopovers.
Falling infection rates will obviate the need for lockdowns. That can be achieved either by successful anti-infection measures (masks, distancing, etc) or by vaccination.
> This is great, now get some safety testing done or else it can't really be responsibly deployed.
Safety testing is done in preclinical and phase 1 testing. They wouldn't be injecting something unsafe into 30,000 people. Phase 3 is mostly about efficacy.
I believe that, in different conditions, we should reasonably ask that more people be tested over a longer period of time.
But Covid is wracking absolute havoc on people's health, on the economy, and on everyone's lives. Personally, I plan to take the Pfizer or Moderna vaccine as soon as it is available. There are associated risks -- but in my estimation, they are not as bad as the risks of Covid infection or the downsides of continued social isolation.
So what exactly does the 95% protection represent? 95% protection of people who wear masks and are good about social distancing and avoiding crowds/bad indoor situations? Or 95% of people going about their lives in the manner that we all did pre-Covid?
I really don't know how this is made to be some great news if it is the former and not the latter.
It's a double blind study. Nobody (including the researchers) knew who was getting the vaccine vs a placebo until the end of the study. That's the point. So both groups were taking the same precautions. So roughly none of that 95% is attributable to difference in precautions.
The important part is that 15000 apparently did not get serious side effects, so clearly much less people experience problems from the vaccine than they would from the disease.
So now it’s time to stop delaying and start distributing these vaccines.
No. Timetables can be compressed for everything else but not for safety evaluation.
The number of people vaccinated is increased gradually. Even after phase III and approval, the monitoring for side effects continues and the vaccine can be withdrawn if necessary.
Vaccines can cause autoimmune responses detected months later. These two vaccines are RNA vaccines never used n this scale Residual DNA risk is probably not significant, but there is small potential blowback.
On positive side, RNA vaccines can open new era of programmable vaccines for viral infections and cancer treatments.
Remember that the threshold shouldn't be "fully safe", the threshold should be "better than the alternatives". If the alternative is COVID, that's a pretty low bar to clear. Given that we may have several vaccines to choose from it's worth a bit of effort to weed out any unsafe ones, but remember that every day of delay may cost thousands of lives.
> If the alternative is COVID, that's a pretty low bar to clear.
It's really not a low bar. A healthy 35-year-old has maybe 0.01% chance of dying, 1% chance of lasting side-effects from Covid. Untested medicines can be way more dangerous than that: thalidomide, for example, has a 50%+ chance of causing stillbirth or birth defects for pregnant women [0].
If you just vaccinate the old and sick, risky vaccines start to look more attractive. But those people also have a greater risk of side effects and are underrepresented in the clinical trials, and most vaccination strategies mooted so far for Covid are based on mass vaccination of healthy people. So it has to be really safe for that to work.
So may every day of rushing. These testing/approval protocols aren't designed simply to provide job security. They were much cheaper and quicker before events like this one: https://en.wikipedia.org/wiki/Thalidomide_scandal
15000 also becomes a much smaller number as you start to consider factors which may change how someone reacts to the vaccine (gender, race, age, preexisting conditions, etc)
If you are willing to wait for years. Waiting a few weeks or months is just going to cause more people to die from the disease and isn’t going to make any vaccine more safe.
For all previous vaccines all side effects happened within two months. (with most of them in less than 15 minutes). We have no way of knowing when an unknown side effect might wait 10 years to show up, but there is every reason to think that won't happen.
Trials for these drugs have already been running for months. They stared in July and over 15,000 people have already been vaccinated.
They started with with just handful of people, gradually increasing the number of people.
The likelihood of hitting some genetic combination that triggers some autoimmune reaction decreases as the sample size increases and no side effects are found.
So again, some vague conjecture about ‘likelyhoods’ and vague handwavy timeframes. While in reality chances are all of these people already got the vaccine months ago; the study started in June.
What is it that makes people lust for delays? Some irrational fear for side effects? The fear isn’t going away, there’s just more people dying every day you wait, both from corona and the measures.
No, these people aren’t wrong. People in politics who say well thank you, now we’re going to sit on it for a few months while we think about it are wrong.
I'm not implying these vaccines are unsafe at all, but when you're vaccinating close to the entire world' population (eventually), a side effect of 1 death for every 50,000 people vaccinated, might not be seen in a trial of 15,000. But vaccinate 6B people and that's 120,000 dead. So your vaccine can go from "safe" to "it kills people" pretty quick when you're treating millions of people.
Edit: And sure, Covid has killed more than 120,000, but what do you think will happen when people find out the vaccine kills people? They won't care it's 1 in 50,000, they'll just refuse any and all vaccines. Then what?
That's true. But currently just a fraction of global population got infected and already 1.3 million people died. I still think though they shouldn't rush and do enough research because any bad side effects would have long term effect for any other future vaccine treatments.
But you don't need to be anti-vax to understand the game theory implications of neither vaccine undergoing a normal longitudinal study (waiting >1 years for side effects to develop), and both being based on new mRNA vaccine tech. Better for you and your family not to take the vaccine in the short term, and benefit from people around you taking it. I understand that is anti-social, but the logic cannot be denied if you're interested in optimising risk for you and yours.
Taking a vaccine that no trial volunteers have lived with for more than a year is a _substantial_ risk whichever way you slice it.
If your game-theory is correct, we are dealing with a tragedy of the commons like game.
These types of games have highly un-optimal Nash-equilibria. Hence, it makes sense to take collective measures to prevent that Nash-equilibrium.
Such collective measures would either be 'a sense of duty' or 'mandatory vaccination'. People ignoring the first option are kind of asking for the second option.
We are just going to have to prevent people who do not take the vaccine from mixing into society until they do or the pandemic is gone. Bars, restaurants, plane flights, etc.
The choice is between having to be quarantined or taking the vaccine.
Ahh, I am glad I live in the United States, where that sort of response is clearly illegal as it is a violation of multiple rights recognized as natural rights. Rights not granted by the government, but recognized as inherent to being human.
Private parties can discriminate like this, and for better or worse air travel is essentially a private party allowing someone onto their private property, but no law can or should be enacted by the federal government allowing discrimination based off vaccination.
If such a state does enact a law (similar to some states prohibiting religious exemptions from school vaccination requirements), I would be surprised if it didn’t end up being heard in front of the Supreme Court. The one now with a solid majority of constitution originalists.
So, if we were in a situation where a virus was 90% lethal and could spread easily, you wouldn't mind people walking around spreading it because otherwise we would be infringing on their natural rights?
And by my example you don't see the flaw in your logic?
Plus, you are now switching to free speech. That is a false equivalent because your speech cannot inherently harm someone (we aren't talking about hurt feelings here, I mean physically injuring/killing someone).
To sum: supporting 100% free speech no matter what is "fine" because it does not affect anyone else (aside from hurt feelings, so let's ignore that). Supporting 100% free movement no matter what cannot be compared to freedom of speech because you can literally harm/kill other people by your actions.
Ok, the right of assembly, or the right of privacy. They all work equally well to push back against government mandated widespread medical intervention.
Let's just be perfectly clear- if there was a virus that is 90% lethal and easily air-borne transmittable.. you are OK with infected people having "the right" to go anywhere they want in public and transmit the virus to others?
It's a silly question because if the virus was 90% lethal, people wouldn't just walk around. It's a self solving problem. We wouldn't be discussing lock downs, because everyone would lock down without being told they should lock down.
The virus we are talking about, COVID-19, is incredibly low risk for 90+ percent of the population. I don't think we should enact policy that infringe on freedoms, so that vulnerable people can move around freely. Or rather, it's important to balance the two. Mask mandates are a reasonable compromise, but an immunization mandate isn't. Focus policy making on vulnerable people - give them wage replacement to not go out in public or to their job if they are overweight, have diabetes, if they are elderly, immunocompromised, etc. But, don't mess with our natural rights. Do not trade liberty for safety, do not build the social will and legal foundation for future erosions of liberty, regardless of the purity of the motive today.
Edited to clarify mask vs immunization mandate above.
>It's a silly question because if the virus was 90% lethal, people wouldn't just walk around. It's a self solving problem. We wouldn't be discussing lock downs, because everyone would lock down without being told they should lock down.
No, it's not a silly question. You are making the ASSUMPTION that people will make the best decisions for everyone (including themselves). I don't think you have been paying attention this year.
And you didn't even answer the question- would you be for forced lockdown if it was that lethal? Saying "it's not even a question" is skirting the issue. Because what about 70% lethal, or 60%, or 50%.. maybe even down to 10%. If your view is there is NO level that liberty can be sacrificed- then prove it by thinking about this simple situation and saying it.
I do agree with your general sentiment. However you are acting as if there is NO situation in which limiting liberty is the right choice. And I am arguing that is simply not true by giving you some extreme examples.
>Mask mandates are a reasonable compromise
Yeah, and people can't even follow THAT. It's arguments like yours that people are like "A mask!? what about MY FREEDOM!". Your freedom becomes less relevant when it DIRECTLY IMPOSES ON THE SAFETY OF OTHERS.
>But, don't mess with our natural rights. Do not trade liberty for safety
Buzz. Wrong. Your natural rights don't give you the right to harm others.
Think of risk vs response to that risk as a sliding scale. Right now with COVID, the risk is low, so we don't have anywhere near a universal response to that risk. But, as you slide right along the risk scale toward "really risky", you'll see more and more of the population self-selecting to not play the risky game. I am merely proposing that people be able to choose their responses based off their risk tolerance. The problem with doing anything else, is that you make policy that will have winners and losers. A good example is the current school shutdown. We have millions of families with two working adults that rely on the school system in the United States to both educate and to supervise their kids while they are working. Those kids are now self-educating using remote learning techniques while parents are at work. When viewed in aggregate, that cohort of kids are just about guaranteed to have a lower overall outcome in life compared to the cohort where the family earned enough income to have one parent stay home.
Rushing school closures is one thing (it's a policy that when made early in a pandemic with unknown risks, can be reversed once risk factors are more understood). Rushing novel vaccines out is another, it's not something that can be reversed.
Life is risky. I am not trying to argue that COVID isn't real, that masks infringe on my liberties, etc etc. I am just trying to say that there are direct and indirect consequences to policies, and a general rule of thumb that I and millions of your fellow citizens use when developing our opinions on topics, is that personal liberties are a fantastic tiebreaker.
What about the morality of the situation? From a purely self-interested perspective I think its pretty obvious there is limited benefit given the risk. But if you are relatively young and healthy, expecting others to get the vaccine so you can benefit seems immoral.
It depends on the poster's age group. If they're not elderly or obese, getting the virus is no more dangerous than commuting to work daily or giving birth, which wouldn't normally be described as a "substantial risk".
Giving birth doesn't risk killing others and commuting to work by driving requires a license given the risk of killing others.
If you want to risk your own life in a way that doesn't risk other's, fine by me.
But don't equate that to an activity that also risks the lives of others.
If you want to get natural immunity without risking the lives of others, I could imagine a service where you quarantine at home after intentionally being infected with the disease, but even then, there is the negative externality that a certain percentage of young people will need medical care, resulting in increased risk of spread and reduction of healthcare capacity.
When the person I was responding to said "Not taking the vaccine is a substantial risk", I believe they were referring to the risk to the person not taking the vaccine.
That aside, driving a car, even with a license, is a non-trivial risk to others, possibly the greatest chance the average person has of killing somebody, so I don't see how they're not comparable. Moreover air pollution kills seven million people worldwide each year, which everyone contributes to when they drive, and that's way more than covid19's killed.
You're right, but I'm not really convinced that a vaccine with a few months of safety testing behind it is a substantially larger risk. If I've gotta take a small but nonzero risk either way, I might as well pick the one with prosocial advantages.
1) You're talking about risk of death, right? Have you met one of the many people with "long haul" symptoms? I really don't want that! 2) You did not include the risk of sickening friends, family, and those around you.
I'm not discouraging people from "taking vaccines" in general. My 2 year old daughter is fully vaccinated. I'm just indicating that in the current scenario, where the vaccines on offer haven't undergone any longitudinal trails is extremely unusual and the usual calculus where people may weigh up the balance of risk does not apply.
I read today, they’re saying between this and the Pfizer vaccine. They’ll be 40 million doses available this year. Enough for 20 million people. Because we only have a month and a half left of this year, when were these vaccines going to come online? And where? Obviously it’ll go to at risk people, but when exactly will it start to roll out if it’s already Nov 15th?
The National Academies have a set of recommendations for the priority of vaccine distribution. Upshot is that it's going to mainly be high-risk people like healthcare workers and folks with severe risk factors first.
Surprised to see "previously had covid" isn't on the list of criteria. Given that 30%+ of US will have had it by then, makes a big difference in early days of distribution.
I do think they should eventually get it but they should be back of the line.
The obviousness of this strategy has been challenged over the last 10-20 years. At-risk people in some cases do not respond fully to vaccines, and the reaction can be stressful to their systems.
Last I heard, the recommendation for influenza was 100% vaccination for nursing home staff and a strong recommendation for visitors to also get vaccinated. The bubble of protection from this strategy has, apparently, lower overall risks.
Doctors and nurses, especially urgent care, will likely be first in line (or perhaps due to an abundance of caution, half of them first in line, half later). I'd like to see the people we have labelled 'essential workers' up next.
The rollout of these will likely be fast-tracked by the FDA for an emergency use authorization and rolled out to healthcare providers first. How long, who knows – the fact that this vaccine doesn't require cryogenic cooling like Pfizer's does may be an accelerator.
Can someone versed in immunology explain to me why both this and the Pfizer vaccines are both borderline-experimental mRNA vaccines (versus attenuated or recombinant)?
I understand that bog-standard protein vaccines don't protect much beyond 3-6 months, but why didn't we pump out tons of S1/S2, N, and E protein vaccines the second this virus was sequenced? At least it would have been better than nothing, and the safety issues are very well known.
I'm not anti-vax, by any means. Just trying to understand why we chose this path rather than tried-and-true. I'm sure plenty of people would be a lot less conspiracy-minded if the vaccine was just a run of the mill recombinant protein particle one, even if we needed boosters 2-3x a year.
Perhaps I’m wrong, but I feel like you’re slightly wilfully misunderstanding what he’s saying there.
He’s not saying that it will make people less inclined towards believing conspiracies, he’s saying that people will be less likely to believe that this thing specifically is a conspiracy
It is sad that you have to defend yourself by saying “I’m not anti-vax”. Anti-vaxxers are rightly criticized for denying the overwhelming decades of evidence that the standard repertoire of vaccines is safe.
That’s totally different than questioning new, unproven vaccines, especially when no vaccine of the same type has ever been widely deployed. There are very legitimate concerns about genetic vaccines. And for vast swaths of the population, getting covid might be less risky than getting this vaccine.
I think a big one is that there is simply no long-term data available pertaining to injecting an agent that directly modifies your DNA, as opposed to triggering your body's established process to make such a change itself.
Well an mRNA vaccine isn’t supposed to directly modify your DNA. But we really don’t know enough to be sure. We don’t know all of the pathways in the body. It could very well be that mRNA floating around in your cell does have an effect on your DNA. We know that some organisms do reverse transcribe from RNA to DNA. There is no long term testing of this stuff.
It also introduces the possibility of transcription errors and such. You inject the mRNA expecting it to be synthesized into antigens but it could end up creating something else altogether. Again, we don’t have decades of testing to be sure. We’ve never injected millions of people with mRNA.
> I'm sure plenty of people would be a lot less conspiracy-minded if the vaccine was just a run of the mill recombinant protein particle one, even if we needed boosters 2-3x a year.
I’d be surprised if it made a difference. Most people, myself included, have literally no idea what the relevant differences are between a protein vaccine and an mRNA vaccine (I’ll look them up after writing this, of course), let alone what S1/S2/N/E protein vaccines are.
I trust the medical establishment for much the same reason I trust our civilization in general, but people like my mum who thought they knew better are unlikely to start trusting them regardless of the names of the technical methods involved.
> The trial involved 30,000 people in the US with half being given two doses of the vaccine, four weeks apart. The rest had dummy injections.
> The analysis was based on the first 95 to develop Covid-19 symptoms.
> Only five of the Covid cases were in people given the vaccine, 90 were in those given the dummy treatment. The company says the vaccine is protecting 94.5% of people.
Aren't those numbers way too small to make any statistically significant claims?
Not at all. That is why the N on these trials is so huge. 5/15000 vs. 90/15000 is going to be statistically significant anyway you slice it. It’s a 45-fold difference. You can approximate it yourself with a t test.
No. The full trial was on 30,000 people, every phase 3 trial picks a certain number of infections to stop at in order to draw results. Of the control group, 90 something got COVID, while only 5 of the vaccinated group got it in the same timespan. This is considered a big enough difference to call the vaccine effective (so far).
It’s not. I can’t remember all the details but if you read the moderna cove study 95 people after a month or two gives a very high statistical confidence.
The 94.5% value certainly seems like it has too many significant figures. If just 1 more person had happened to contract covid in the vaccinated group, the success rate would be reported as quite different.
People are taking more risks because the vaccine is close[1]
When the vaccine is close you should be taking fewer risks. The potential cost to those risks stays the same, you can still kill your elderly relations and/or develop "long COVID" yourself. But the benefit is much less. Going back to normal life now only nets you a few weeks of normal life with the vaccine in sight vs an indefinite time without.
Also, the hope of a vaccine helps immensely with the mental stress of isolation.
The end is in sight! Hang in there folks, keep being careful!
"Coronavirus in Scotland: People are taking risks because vaccine is close, says John Swinney"
This reminds me of the speculative rationalizations that are given after-the-fact whenever the stock market rises or falls.
So let me chime in with the speculation:
The biggest factor is probably the realization that COVID is not as big a personal risk as feared, no matter what the media or the government says. People are gladly using COVID as an excuse to work from home or avoid meeting their elderly relatives, but when it comes to avoiding infection in order to save "the system", enough people simply don't care anymore. It's too abstract.
Doesn’t feel that way in the Midwest. My Wisconsin relatives had been actively downplaying the existence (not just severity) of COVID until people they know started being hospitalized. So it goes, I guess - but the tone has changed.
Of course, the perceived risk is quite different from the statistical risk.
Currently, about one in 4000 Scots is hospitalized, which says that approximately only one in 40 Scots directly knows someone hospitalized with COVID, assuming they know 100 people each.
However, the chance of directly knowing someone that had a positive COVID test is 1 in 40, which says most Scots will know someone who had a mild case of COVID.
Exactly, early on we weren't sure what the risk of covid was to the average person. It feels like now their is enough data on cases, broken down by age, where you can assess your own risk.
If you are under 25, the risk to you from Covid is basically tiny. I can understand young people not accepting having their life destroyed from living under a lockdown over a virus that is unlikely to do them harm.
I think we need something smarter than a blanket lockdown that affects everyone the same regardless of age. How we are 9 months into this and still haven't figured out anything better is really disappointing. We are destroying peoples lives, income and mental health when for the majority of them there is no risk.
"I think we need something smarter than a blanket lockdown that affects everyone the same"
We have this in NY and CA among other places. That the Midwest and South are going from "pretend everything is fine" to "full scale lockdown again" was a decision those states made. But NY and CA are still far from requiring a second full scale lockdown and are instead focusing on specific areas and counties.
Due to a limitation in technology, people are forced to take the population risk as their own, which aligns self interest with collective interest. However, that will not always be the case and, at some point, people will be able to see their own individual risks. I find it interesting that people have no problem justifying their selfishness by showing that they are just being selfish. It will be interesting to see how that will develop.
It may not be a risk to the young people, but they need to understand that their actions have consequences for the people around them (which is exactly why people are encouraged to wear masks). A lockdown may not be the best solution, but it surely makes it so young people have a harder time infecting those who are immuno-compromised.
Even if the risk were greater, it would be unreasonable to assume that the age group of 15-25, which is most likely to die from risky behavior, could easily be convinced to change said behavior.
That’s reading people’s mind. I do my own mind reading and I say that compliance to lockdown is down because people are fed up, and because the virus turned out to be nowhere near as dangerous as initially claimed by the media (I remember a headline dated from end of April from The Times claiming covid was as deadly as ebola...)
No the headline was a very misleading statement based on the fact that people showing up in ICUs with severe forms of covid had about the same death rates than Ebola.
Just because the media did a horrendously bad job at reporting on this virus does not mean it isn't a serious threat. We see now in the US how it can spiral out of control if we let it.
And meanwhile some people actually took the time to look at the statistics. A lot of countries with lockdowns had more trouble than countries without lockdowns. e.g. Argentinia with masks and lockdowns has one of the worst curves of the planet... while Sweden is doing fine.
And COVID-19 is strictly following Gompertz-Mathematics - just like a seasonal corona-virus. For any usual outbreak (f'/f) is falling exponentially all the time... There are no visible trend-changes around most policy-changes.
And there's no statistical epidemiological evidence that masks did anything good. In some countries with masks things got a lot worse. (more efficient catch+inhale? Or catch+transmit without being infected?)
Most of the hype around COVID-19 is just cheating by using "reporting date" instead of "date of death" to make Gompertz-Functions look like seriously dangerous exponentials...
If you have some datasets that allow to compare "reporting date" with "date of death" it is astonishing to see how many reporting-anomalies appear around policy-changes...
I think you should take another look at Sweden's data. Sweden (and a lot of countries) were doing fine, likely because the weather is nice and people were spending their time meeting outdoors, where infection risk is way lower. Now that it is getting cold, their case counts are on the way back up as are their deaths. It is worth noting that most of my Swedish friends say that many people were staying home anyways, just because they did not have a government mandated lockdown doesn't mean many people did not decide to avoid the risk themselves.
There are plenty of datasets that include date of death instead of reporting date and they show the count of deaths increasing again as well, on a lag, just like you would expect.
The low fatality rate we have enjoyed recently has been partially a result of the availability of improved medical care. Unfortunately that is a stepwise function where once you have surpassed the amount of available care, the improvements we have made in care revert to some extent. We don't know how much.
I see that you only really post about COVID stuff on hackernews, and I don't know why anyone would bother, but what truly blows my mind is the amount of hubris it takes to sit at home, read a few news stories, and say "I know better than the majority of people who have spent their lives studying disease because I know some statistics and read a few articles that disagreed with the mainstream."
The mathematics of COVID-19 is not that hard - and has been known since pretty much the beginning. No need for hatred and personal attacks..
Lets do some real mathematics.
1) Get good data (e.g. death by date).
2) Take a look at the Logarithm of the growthrate ln(f'/f)
3) Spot all those straight lines - those are the curves of outbreaks
4) Turn those lines into a working formula for an outbreak
5) Calculate predictions - evaluate trend-changes - look when new outbreaks happened.
It's just that simple. Results won't give you insight about the mainstream, but it will give some insights about reality.
Some countries are easier (Mexico, Germany, ...).. Some have more outbreaks and complications. But the basic principles of the mathematics of COVID-19 outbreaks around the globe are the same.
Calculating the new outbreaks of Sweden is more advanced because the start of the new curve is hidden behind another outbreak. But now there's at least enough visible to give good estimates.
I just looked at the data for Sweden today. Looks like a seasonal outbreak starting mid-September (infection date).
Parameters of the curve look like the first wave (Gompertz-Exponent ~0,06) with less force.
Start is hidden under other smaller outbreaks, so it's not so easy to measure it exactly. But soon it should peak (if it hasn't already...).
If they don't do any nonsense that changes the mathematics of COVID-19 completely Sweden will be fine. The curve has normal size of a seasonal flu. Other countries in Europe are doing a lot worse.
What puzzles me is those serology studies in Spain and Italy that show that people who were locked down were infected at the same rate than essential workers who were not locked down (except, understandably, for healthcare workers). It seems to be a major data point on whether a lockdown actually has any impact and it seems to have been completely ignored.
Well it's still going to be until next Spring at the earliest when most of these vaccines will get widely distributed. A lot can happen in half a year...not to mention many of the people taking the most risks believe in some Bill Gates/Deep State conspiracy about vaccines.
At the rate we're going now, many of the people taking the most risks will be infected with the disease, if they haven't been already. Prior infection has largely the same effect as a vaccine.
I agree with you. We're in for a rough winter, at least in the US -- but it seems that there is a bright light at the end of the tunnel.
" many of the people taking the most risks believe in some Bill Gates/Deep State conspiracy about vaccines"... oh, how many have you talked to?
Most people I know who are engaging in "risky" behavior when it comes to covid spread are either (1) just tired of being coped up and so being reckless (2) old enough that they don't want to spend 2 of their final years of life not seeing their family, and think the risk of catching it is worth it (3) young and relatively risk free (e.g. x3 flu mortality rate range) so don't worry about it for them or those they're seeing (others in the same boat).
You are putting words in my mouth. I said the majority of people engaging in risky behaviors believe the whole thing is "about control" and other conspiratorial nonsense. Most others are just following the recommendations as best they can.
And a vaccine doesn't immediately solve the problem; distribution is a thing, plenty of people who will refuse to take the vaccine (especially early adopters). Basically, even if there was a vaccine released TODAY, it would still take at least six months before we can start going back to normal, and (I believe I read about) three years before we can consider the disease to have ran its course.
>plenty of people who will refuse to take the vaccine
Hopefully this doesn't turn into a very messy public fight given that I fully expect a lot of schools and workplaces to require vaccination to physically enter a school or an office.
People are taking more risks because it's been 9 months of restrictions.
The first month or so in the Bay Area people were super diligent. There was nobody on the streets, hardly anybody shopping. Within a month you noticed more people on the streets, by 6 months, traffic was 75% of what it was before Covid.
You can't expect people to put their lives on hold indefinitely, especially people at low risk. I know that in Canada 20-30 year olds accounted for the vast majority of new cases. They were just willing to take a chance.
And even though these two vaccines look promising, you won't get a significant number of people vaccinated until the second half of 2021. That's another 7-8 months away.
Reminds me of that movie scene in Apocalypse Now when they are getting mortared on the beach while trying to surf - "The tide doesn't come in for six hours, do you want to wait here for six hours?" - Lt. Col. Kilgore
It’s still indefinite until someone defines it, and I haven’t seen any public health official who’s willing to specify a date when things will be back to normal. Many aren’t even willing to say that we can go back to normal once we’re vaccinated.
I'm now at July. Before this I was at early 2022. Every successful trial pushes my date back a bit. If the oxford and J&J both successfully finish trials by the end of this year I might push back to as early as march.
Of course roll out matters. Rochester MN (Home of the Mayo clinic) might open before the rest of the country just because the ratio of health care vs everyone else is enough that they may as well vaccinate the whole town and let it open up.
I think there’s going to be a lot of anti-vaccine agitation about this.
It’s a type of vaccine that has never been approved and deployed past the research phase before, and it’s going to be super easy to wrap “modified RNA vaccine” in scare quotes like I guess I just did there. “It’s genetically modified?!” I can imagine my neighborhood Facebook group blowing up already.
Me? Get it in my veins, I’m disappointed I was not selected for the trial. But I think the political climate may be toxic for this.
This entire HN discussion is insane. Every comment that is even slightly skeptical of mass-injecting the global population with a substance that we do not fully understand is being down-voted.
What would you expect from a crowd of people who routinely test their code in production "because run fast, break things, yada yada". :D
"I've run my unit test 10 times and it always passes! Rock-solid. Deploy to prod! Why do you want to waste our time executing it on staging env?! What are you, some kind of a unit-test denier?! There's a production issue affecting customers, there's no time for that. Anything goes wrong, we're just restore the prod DB from the last good backup."
The way I see it... if the vaccine creates some long lasting complications in 0.1% of people who took it, than it is not going to be much better than the disease itself, given that it shifts the problems from the older population to the younger one. This wouldn't be a problem if the vaccine was rolled out at a normal pace with plenty of controls to figure out any issues and put breaks on it if any unexpected problems were detected.
But it looks like the crowd is already set on mass delivering it ASAP, starting with the kids. So, oh well... YOLO.
BTW. Funny how "big oil" and "big tabaco" "evil, greedy, corrupting science", but "big pharma" ... "real scientists! our noble saviors that can do no wrong, and make no mistakes motivated by financial gain".
It's because the alternative is millions of deaths in the US alone. It's a risk/benefit analysis. Yes, there is some risk to a new vaccine. That is an unknown. But there is a known risk to not widely distributing a vaccine, which is millions of deaths. Vaccines have been studied for a long time, their mechanisms are fairly well understood, and they have been going through full safety trials, even if somewhat accelerated. So those are your options on the table: guaranteed millions of deaths, or possibly some unknown long term implications from a vaccine, but unlikely given the understanding and safety trials.
Ask any reputable doctor, virologist, or epidemiologist: they all are backing the vaccine. Discussion is fine, but you have to provide some thoughtful justification behind your worry, and make a case for your alternative plan. Otherwise you're just spreading fear and doubt, which may impact vaccine uptake, and directly cause more deaths.
Well, that's the third option of "lockdown" and "hospitals overwhelmed by dying people". Both of which are also bad.
And almost all of us have had our vaccinations for the common diseases, in childhood or as adults for travel purposes.
And many of us are tired: tired of lockdown, tired of unsubstantiated nonsense on social media, tired of anti-vaxers, and tired of worrying whether someone we know will suffer severe consequences from this disease (I know many people in the "vulnerable" category, and a couple who've already experienced severe symptoms despite being young).
> And many of us are tired: tired of lockdown, tired of unsubstantiated nonsense on social media, tired of anti-vaxers, and tired of worrying whether someone we know will suffer severe consequences from this disease (I know many people in the "vulnerable" category, and a couple who've already experienced severe symptoms despite being young).
So you’re projecting your wishes onto others ?
The trials of this vaccine aren’t even over, we don’t know if it stops the spread or for how long it’s effects last.
When it comes to medicine, science and civil rights it can’t be about emotions.
I’m likely to end up taking a vaccine, but I don’t want to be forced to against my will because others want me too. I also think it’s important the results of the trial are properly assessed when completed.
This whole, “just f*^king take the vaccine already” attitude being forced down our throats is the idiotic, reactionary view to me.
There's a cost-benefit analysis to be made here, and with 240,000 deaths in the US over the course of about eight months, there's pretty widespread agreement among experts where the rational answer lies.
Do I think the vaccine is risky? Sure. Do I think it has anywhere close to the risk level of COVID-19 with an unvaccinated population? No.
Maybe other countries can rationally hold off on it, but the US cannot. We've messed up our response so awfully that the risk of mass-vaccination is almost negligible compared to what we're experiencing without.
You’re making out like me taking this vaccine (not even finished with trials) is the be all and end all. We don’t even know if this vaccine stops the spread to others or just mitigates symptoms. If you think the risks outweigh the rewards, that’s a personal decision you’re making, you don’t make it for me.
We know there are other ways to slow the spread of the virus (Australia), the problem in the USA isn’t the rest of the worlds problem.
Im all for setting up the equivalent of leprosy colonies for anti-vax folks that want to be left alone. They can be left to their own devices and free to live without vaccinations away from the rest of us.
I see you’re being immature to take such a one sided view of the problem.
I wasn’t advocating people shouldn’t take it, I’m asking for patience and understanding, not everyone is ready and eager to inject medicine they don’t understand using a new vaccine technology in 5 minutes, is that so hard to believe ?
What would be the benefit for people 70 years or under taking vaccine that has "95% protection". Can anyone elaborate on what that figure actually means?
For example, of the <1% of people who would die with the virus, is a vaccine that is 95% effective going to save 95% of them? Or is this just about reducing severity for the few who have more than mild symptoms?
95% protection means you get 95% less infections in a test group that got the vaccine compared to a placebo test group. It doesn't have much to do with the mortality rate.
But if you use that number on the whole population: Instead of a 5.4% mortality in 100.000 infected people of 70+, you end up with 5.4% mortality in 5.000 infected people of 70+, or basically having 270 death instead of 5400.
For the other age groups the mortality rate looks good, but "not dying" doesn't mean you're having a great time. A sizable amount of people end up in the hospital (in some places more than there are beds available), that costs huge amounts of money. So if we could reduce that by 95% there is going to be way less pressure on the hospitals and less costs.
Thanks for clarifying instead of downvoting. There's a lot of confusion about these numbers and it seems asking a question about them here is being taken as inherent criticism.
For HN that usually gets you upvotes. But apparently the virus is heavily politicised, particularly in America from what I can tell. So the result now is a thread full of dead/buried comments.
No problem. I think a lot of people respond very strongly to the "mortality on young people is only 1%" data, because it can be taken as a reason not to take the virus serious.
Small correction: it means you get 95% fewer cases. People might still get infected, but never show enough symptoms to prompt them to get tested - and therefore never become a "case." This is the difference between "protective" (no disease) and "sterilizing" (no infection) immunity. The latter is the gold standard that you'd ideally like to shoot for, but the former is what the studies are actually measuring.
The distinction matters because there are vaccines (such as the original polio vaccine) that protect individuals against disease, but which still allow the vaccinated individuals to act as carriers and infect others. Those vaccines do not create herd immunity, because vaccinated people still contract and spread the virus. They do, however, protect the people who get vaccinated.
No, because for herd immunity to set in, far too few people have SARS-CoV-2 antibodies simultaneously (even if we let COVID-19 run rampant). That, in a nutshell, is the main reason why the “herd immunity”-based mitigation strategies are being dismissed by the vast majority of immunologists and epidemiologists. In fact, “natural” herd immunity (without the help of vaccines) might never have eradicated a single disease — at best, it leads to a temporary reduction in numbers.
The “standard example” for natural herd immunity eradicating a disease is the black plague, but most experts now believe that herd immunity isn’t actually responsible for its disappearance from Europe.
Right. We have about 3% of the US population who has had COVID, and 235,000 deaths. To get to herd immunity, we need about 50% of the population to be immune (exact numbers vary depending on the study). So to get there with the virus, we would expect around 4 million people to die in the US alone.
Not if you can get re-infected. That's why the cold and flu virus are still doing the rounds every year despite pretty much everyone you know having had a cold or flu at some point.
The protection figure is the based on the comparison between the people who received the placebo and people who received the vaccine. The group who received the vaccine had 95% fewer cases.
Also while improving the immune response of at-risk groups is of course important, the main goal is to reach herd immunity. Eg, if all the people _under_ 70 got the vaccine then the virus would never reach the aged care home in the first place.
And if those people under 70 were exposed gradually to the virus, they'd survive in higher rates than the vaccine? So would it be more effective to expose them to the virus instead?
By "expose somebody gradually to the virus" you're describing certain vaccine technologies.
Live viruses have a nasty habit of reproducing, spreading uncontrollably and killing a lot of people along the way. The people who survive do gain an immune response though.
Some virus technologies use "live-attenuated" vaccine, which are weakened (but living) versions of the virus which promote an immune response without causing illness.
The vaccine doesn't kill you in the cases where it doesn't work.
If you are in the group with 0.5% chance of death without the vaccine, then with a 95% effective vaccine, you would have a 95% chance of being immune (0% chance of dying from the virus) and 5% chance of having the normal 0.5% chance of dying.
No, the virus can kill and cause long term problems to people under 70, at a rate that would be unacceptable for any vaccine.
It could be a last resort solution if we had no hope of an effective vaccine, but it looks like the results are quite promising so far, so no need to go to such extremes.
"get people sick in a controlled manner" is a form of vaccination. Just a particularly dangerous kind, because you are using live viruses instead of non-infectious lookalikes. It is like training soldiers by putting them in real gunfights.
Beyond the damage the virus does without killing, there is also a massive pressure on health care. Keeping someone with a severe case of Corona (I think 5% of cases are this?) from dying requires a lot of care. I know that in my country (the Netherlands) this has caused significant delays to other forms of care.
Hence, even if people who get Corona get out without any long-term damage, their en-masse admission to hospitals still has long-term health effects. Just not on them, but on others that were denied care.
R0 would drop to nothing if they all vaccinated, pandemic over. Furthermore it's genuinely awful to have even if you survive it, and there is evidence of lung damage to healthy young survivors.
Great news. Seems better than the Pfizer vaccine, especially because transportation of the vaccine seems easier (the vaccine can be transported at a much higher temperature, -7C instead of -80C out the top of my head). Both vaccines seem to require 2 doses a couple of weeks apart which is unfortunate but workable.
But...
How long does the immunity last? We now know 6 months, but what about after that?
What are the long term side effects?
Does it prevent spreading (read: keep wearing masks after vaccination) or does it "only" prevent symptoms? If you don't get what I'm talking about: look up asymptomatic shedding. Kids do it all the time with SARS-CoV2 [0].
Answer: we don't know. Let's not rush this.
Also interesting to note: so we can develop and approve vaccines for new diseases within months? It doesn't have to take 10 years if we really want to eradicate a disease badly enough? My conclusion: we're under-funding research in microbiology. "We" as in: the entire world. In general.
> we're under-funding research in microbiology. "We" as in: the entire world. In general.
Yes, definitely?
Someone I know in immunology reported that only 5% of grant proposals received funding. There are absolutely huge areas that would benefit from more funding.
> Someone I know in immunology reported that only 5% of grant proposals received funding.
And what percent deserve funding? Given the incremental publish or perish nature of academia most of it likely isn’t (if it’s anything like the other sciences).
Part of that pressure comes from the lack of funding though. When you have to fight against 100 other applications for a grant showing you have a recent track record of well-cited papers helps you stand out.
If researchers had steadier access to funding there would be less pressure to constantly publish 'breakthroughs' to secure next years funding.
In my experience, when resources become too scarce and competition too tight, actors start working on the surest bets, or playing the authority card or the most sensational moonshots.
IOW, real science gets shown the door and politicking sets up camp.
A major reason that this happened so fast is due the US government’s operation warp speed program.
Moderna worked with NIAID on this vaccine closely, and the us gov funded it without regard for if it actually worked or not.
So it’s funding...but it seems extremely unlikely that we would fund most other diseases this way. The way warp speed works is that the federal government funds the vaccine even if it doesn’t work. This allows the drug maker to work faster because they don’t have to worry about losing billions of dollars on a vaccine that does nothing. The federal government eats the risk.
It’s was a really good strategy for the vaccine development and I think the federal team deserves a lot of credit for where we are with the vaccines.
Warp Speed is a mix of R&D funding and of guarantees to purchase a given number of doses if the vaccine is approved. Some companies get both, some just get a purchase guarantee. (I don't know if any got R&D funding without a purchase guarantee).
The EU has been doing commitments to purchase if approved with substantial down payments to promote R&D. Japan has been doing purchase commitments, but I don't know if they have paid any upfront.
For Moderna, they got both a lot of upfront R&D funding and large purchase commitments from Warp Speed. They got a large purchase commitment from the EU.
For Pfizer, they got no R&D funding from Warp Speed but a 100 m purchase commitment. From the EU they got a 300 m purchase commitment and a big down payment. They got a 120 m dose commitment from Japan.
AstraZenica got a big down payment in the EU and a large dose commitment, and they got R&D funding and a large dose commitment from Warp Speed.
I believe this is how it is going with all the major COVID vaccine efforts.
maybe not as the "warp speed" program is being prevented from interacting with the incoming administration who will be in charge of administering it, all for petty political reasons. this will likely cost tens of thousands more lives. pfizer did not participate in "warp speed" at all as they wisely determined that the federal government is completely corrupt for the time being.
Here's the CEO of Pfizer explciitly telling a journalist on the record they wanted to stay out of the "politics" of the program, which I think the non-naive reader can tell exactly what that means; they certainly would not announce that the very government they rely upon for drug approvals is "corrupt", they correctly identified that Trump has turned every US program into his own personal quid-pro-quo machine and they wanted no part of it:
> "When you get money from someone that always comes with strings. They want to see how we are going to progress, what type of moves you are going to do. They want reports," he finished. "And also, I wanted to keep Pfizer out of politics, by the way."
Reading your source, it seems the bureaucratic limitation was their #1; then comes politics.
"Pfizer declined the R&D funding in order to "liberate" scientists from bureaucratic limitations as they worked to develop a COVID-19 vaccine, the pharmaceutical company's CEO, Dr. Albert Bourla, said in a September interview with CBS News' Margaret Brennan."
What does this have to do with the news that this vaccine was developed so quickly? Regardless of if the program evaporates in January, the vaccine won’t.
It would mean all the work to prevent a vaccine would be undone by not disseminating the vaccine to the public. The end results are the metrics of success.
The vaccine isn't owned by the federal government. It's owned by these private companies. The Trump administration cannot prevent the vaccine from being disseminated to the public neither here in the US, or in the rest of the world.
The thing is: I’m not even giving trump credit here. There are hundred or maybe even thousands of people working in the federal government on warp speed.
But you should know better than to have anything other than total condemnation for anything even adjacent to the Trump administration!
If people react this strongly to something as non-controversial and objectively true, it’s no wonder that people might be suspicious about some vote tally accuracy in certain critical districts.
You for real? That guy has caused the outbreak to skyrocket by politicizing science. The research for the vaccine would have been driving intensely fast without his efforts given the scale of the problem and the opportunity to help one of the more acute problems humanity has faced before.
Additionally if you cause/exacerbated the problem you can't be credited for fixing it.
"Fauci also told CNN that Trump has not attended a meeting of the White House coronavirus taskforce in months. CNBC has reached out to the White House for comment."
You may be right about funding, but it can also be attributed to incentives: has our desire to eradicate a disease ever been expressed in such an intense way, with the benefits being so enormous?
> Moderna was the first vaccine to enter clinical trials back in March. Only 63 days after the genetic sequence of the virus was posted online, the company injected the first volunteer with their candidate. They were able to move so quickly because they used a gene-based technology to create their vaccine. Those types of vaccines are relatively simple to create once researchers know the viral gene they’re trying to target.
> Pfizer and BioNTech’s vaccine was built using the same method. The two are made from tiny pieces of mRNA, which gives the human body instructions to produce copies of the coronavirus spike protein. Then, the immune system learns to defend against that protein. Gene-based vaccines are the long-promised future of vaccine development, but they’ve never been approved for use in people by the Food and Drug Administration. The early successes of the Moderna and Pfizer vaccines are a promising sign for the method.
And of course, being in the middle of a pandemic 'helps', in terms of funding, clearing red tape, and also seeing results in testing (with so many people being infected, you can start to see differences between placebo and not-placebo groups much more quickly).
I don't just mean in terms of external funding, but also internal approval for funding.
It's obviously much, much easier to justify a generous budget (and rapid timeline) to higher-ups for a vaccine when there's a pandemic caused by said virus going on.
Not that governments are the only way to get funding, but BioNTech received $400m from the German federal government to support the Covid vaccine development.
Sure, but what about the other 10's to 100's of Corona vaccines that are currently undergoing phase 2 and 3 trials?
I'm not convinced by the argument that developing and approving a vaccine this fast is mainly possible because of technological advances that happen to be in sync with the pandemic.
It's NOT the development that is fast ... it's the green lighting for proceeding through the phases. The FDA accelerating these trials very much "happen to be in sync with the pandemic"
Are you arguing that it's the norm to go from we want to develop a vaccine against this new disease to here's a vaccine ready for trials within months is the general norm?
Regardless of the massive speedup and exceptions given by the FDA, you don't agree that the lab part of the development was slightly (understatement) faster than usual?
It's not underfunding of drug research and development. It's the FDA restrictions, which have been relaxed for this drug, and they've been expedited through the approval process.
So maybe more funding for FDA, contingent upon them speeding up the process.
If we consider that recovered patients are immune between 6 and 8 months at least, that timeframe seems likely.
> What are the long term side effects?
I keep on asking myself. What vaccines do truly exhibit long term side effects? Narcolepsy with the 2009 swine flu vaccine or the Guillain-Barré syndrome for the 1976 flu vaccine do not fit the bill, because they actually showed up in the early months after administration (although some were found out later).
> I keep on asking myself. What vaccines do truly exhibit long term side effects?
Dengvaxia also comes to mind. Weird corner cases that only show up after an accelerated phase 3 trial when you start vaccinating way more than 30k people.
Same goes for the Guillain-Barré syndrome cases which are estimated at about 1 in 100.000 persons vaccinated. If the Moderna or Pfizer vaccines are able to cause any trouble that is as common as that, we would very likely have no idea right now based on the data that exists.
> Also interesting to note: so we can develop and approve vaccines for new diseases within months? It doesn't have to take 10 years if we really want to eradicate a disease? My conclusion: we're under-funding research in microbiology. "We" as in: the entire world.
Perhaps, perhaps not. This is far outside my field of expertise, but here is an analogy: the fact I released 9 games in 9 months a decade ago does not imply that all games can be coded, foley-ed, and art-ed, in one month by a junior developer with Eclipse, Photoshop Elements, Bryce, and Audacity.
I assume there are many diseases where the treatment is the equivalent of an indie platformer while others are the equivalent of a AAA-headliner and yet more are the equivalent of currently fictional games like The Oasis.
Is it possible to spread a virus without an infection? It seems like other than being a surface, any ability to spread would be predicated on also testing positive for the virus -- wouldn't it?
> Is it possible to spread a virus without an infection?
No, but it's possible to spread a virus without having symptoms, without feeling sick or requiring medical attention. i.e. mild, asymptomatic infection.
This isn't about funding... this is about taking a giant leap into mRNA vaccines, that until now have not been approved for human use. We aren't injecting processed proteins into our bloodstream to trigger and train our immune systems... We are reprogramming our bodies into vaccine factories.
Not sure what you are being downvoted for. Your tone may seem pretty alarmist (but that has been the norm for anything cornoa related). Otherwise it's true.
“Reprogramming” actually has a specific meaning in genetics, and it’s not editing of DNA, it’s the editing of (transient, i.e. epigenetic) DNA modifications. It’s definitely true that this is not what RNA vaccines are doing.
But I guess the parent comment was using “reprogramming our bodies into vaccine factories” as a hand-waving description rather than a technically precise term. And that description is then roughly correct: with RNA vaccines, it is correct to say that our bodies are being triggered to produce the actual “vaccine” themselves; namely (at least in one type of RNA vaccine), the body’s cells are translating the injected mRNA to produce antigens, which is what a conventional vaccine contains, and which, in turn, produces an immune response.
Except your "backyard shed" is actually an uncountable number of your cells that are "edited" (changed using the reprogramming abilities inherent to mRNA, but god forbid you refer to it as such) into not being "backyard sheds" anymore, but being factories for spike proteins that can't be stopped other than waiting for the fire to burn out. After a few weeks, you don't get your "backyard shed" back, because the craftsman destroyed it.
> so we [the world] can develop and approve vaccines for new diseases within months?
Approving vaccines could be done in days, if we are willing to ignore the obvious problem of that approval being completely worthless. Situations like the current one with a heavily incentivized race to the mass market are favoring crooks willing to fudge tests. In the last two decades multiple bad actors (GKV, Ranbaxy, Cetero) had been found in the economy of clinical trials. Due diligence takes time.
> Also interesting to note: so we can develop and approve vaccines for new diseases within months? It doesn't have to take 10 years if we really want to eradicate a disease badly enough? My conclusion: we're under-funding research in microbiology. "We" as in: the entire world. In general.
Given the harm caused by this vaccine, we consider a higher cost of development to be acceptable. That includes monetary cost, the cost of redirecting many other research resources to this research, and the potential cost of rushing development with less testing than normal.
This is all sane to do, because corona also has a really high cost. Other diseases have a much lower cost, and hence investing less in them makes sense.
Sure, the world could probably focus all its attention on fixing a disease, and make meaningful process. But what would the world have to give up in order to do that? Would that trade-off be worth it. With Corona, it becomes worth it a lot sooner than with something else.
> Does it prevent spreading (read: keep wearing masks after vaccination) or does it "only" prevent symptoms?
There would be no reasonable mechanism for a vaccine that prevents infection but somehow still allows "spreading". Either you're sick or your not, the immune system doesn't "prevent symptoms" (strictly: it's the cause of them). This isn't how things work.
As far as "long term side effects"... that's also an extremely rare kind of interaction. Vaccine delivery is extraordinarily safe. I worry that your phrasing is invoking anti-vax paranoia.
> There would be no reasonable mechanism for a vaccine that prevents infection but somehow still allows "spreading".
Sure. I agree.
But there are mechanisms for a vaccine to prevent symptoms and still allow for some infection and spreading.
> Either you're sick or your not, the immune system doesn't "prevent symptoms" (strictly: it's the cause of them).
You seem to be contradicting yourself here. Being sick = having symptoms = the immune system being (overly) active. The main goal of all the vaccines under development is to prevent the immune system becoming overly active (AKA: fight the symptoms). Not necessarily to prevent any virus from being made in the body and being spread. Although we all hope that it also prevents spreading, it's not a given and it's not proven to do so (yet).
It's perfectly possible to be infected and infectious without "being sick" (no symptoms). Children do it all the time with SARS-CoV2.
> As far as "long term side effects"... that's also an extremely rare kind of interaction.
We're about to vaccinate some 5 Billion people. That means we have to take into consideration "extremely rare" kind of interactions. Especially if you don't want to feed the anti-vax conspiracy theories.
> I worry that your phrasing is invoking anti-vax paranoia.
I worry that releasing the vaccine too soon could invoke irreparable anti-vax paranoia.
I'm all for the vaccine and I would be willing to participate in the trials (if they had space available). But I don't think that it's a good idea to just rush this vaccine and start immunizing the herd en-masse with the risk of serious disease in 1 in 100k people (for example). Now that would really feed the anti-vax paranoia.
What, specifically, are those mechanisms that you think prevent symptoms but allow for infection and spreading?
Additionally, even if this mechanism exists, why would we care? The goal is not eradication of the virus at a molecular level, it is stopping the disease at a societal level. Stopping the disease is accomplished when symptoms are prevented. Because symptoms kill people, not the virus.
There is an incredible misunderstanding about the difference between a disease (i.e., symptoms caused by a virus) and the virus that causes it. Viruses, bacteria, spores, and other toxic material is everywhere constantly. COVID is the only virus I can think of where we have been actively scared of the mere existence of the virus.
> What, specifically, are those mechanisms that you think prevent symptoms but allow for infection and spreading?
Asymptomatic spreading. Kids do it with SARS-CoV2 all the time.
In other words: the body sheds virus (cells fabricate virions), but the immune system reaction doesn't cause symptoms.
> Additionally, even if this mechanism exists, why would we care?
Because the virus will keep spreading and killing people as long as < 70% of people remain infectious.
In case the vaccine doesn't prevent much of the spreading, we'd be looking at years before everything is like it was before the pandemic. This is because we're not going to vaccinate 5 billion people in a matter of months all at once (too risky). This will take a while.
Additionally humans would be a reservoir for the virus to evolve in, potentially causing mutations that cause symptoms (years or decades in the future). It wouldn't actually solve the problem in the long run.
You think... a vaccine is going to CAUSE asymptomatic spreading? I think you need to start citing some science here. Things you are saying really aren't making sense.
Warp Speed funded ~$800 million in R&D and $1.5 billion for Moderna to make 100 million doses — whether it is approved or not.
Similarly, Pfizer received $1.95 billion to make 100 million doses whether it was approved or not. (EDIT: Pfizer’s agreement is an advance purchase but unlike Moderna’s it is contingent on FDA approval.)
Warp Speed provided ~$5 billion in guaranteed prepayments which meant the companies could ramp up manufacturing without waiting for approval first in order to have a large number of doses ready by the end of the year.
That’s never been done before, but the bet has certainly paid off spectacularly so far.
Novavax got $1.6 billion and GSK got $2 billion for another 100 million doses each.
Assuming all 4 companies produce highly effective vaccines, the US has prepaid for 400mm doses / 200mm courses of vaccine. This will save a lot of lives not just in the US but worldwide as well, because it shifts the manufacturing curve sooner until the point where several billion doses have been made.
With a number of promising vaccines, and governments around the world already producing large numbers of doses, the question may become: "which one do I take?".
After the 737-Max debacle, I am less inclined to trust US regulators (is the FDA less prone to regulatory capture than the FAA?). Or, perhaps I should say, I'd be wary of a vaccine that was cleared by a single regulator, especially given the economic pressure to find a vaccine.
I'll probably go with the one that has had the most oversight, from the most agencies around the world. Is that information available anywhere?
This is great news. I've been following this vaccine since February when it was created. https://www.modernatx.com/modernas-work-potential-vaccine-ag... It's a little frustrating knowing this cure was out there so long and some of the pain from pandemic could have been reduced only if we had faster testing. IMO we needed a faster pandemic vaccine protocol.
I strongly feel that the FDA should have used challenge trials where they deliberately infect healthy people with the virus after vaccinating them. The approach the FDA chose to use was maybe easier ethically for them to swallow where they just let people in experiment get sick naturally in their every day lives. Using challenge trials we would have gotten these results back weeks faster and with less error bars. Weeks with COVID-19 cost 10,000 of lives.
The FDA still has not approved this vaccine. Everyday that the FDA does not approve this vaccine after results like this is SOME blood on the hands of the FDA.
Or...the USA could have followed the likes of Taiwan et al and rolled out exemplar non-pharmaceutical interventions early and thoroughly, resulting in no more than a handful of deaths.
Even at this point it'll take months and months to roll it out to the population at large, over which time 10s of thousands more will most likely die.
10s of thousands of people will die from Covid-19 in the next couple weeks in the US. And we don't looked to be peaking anytime soon. Maybe mid December if more people recognize the situation we are in more or less immediately?
> The analysis was based on the first 95 to develop Covid-19 symptoms.
> Only five of the Covid cases were in people given the vaccine, 90 were in those given the dummy treatment. The company says the vaccine is protecting 94.5% of people.
Is it me or it's incredibly light to shout victory yet and to announce any number? Unless you literally expose people to the virus in a laboratory setting you can't guarantee that both groups had equal exposure to the virus.
The two groups would actually be the same. You can start with a number of people, randomly pick half of them to be given the vaccine, and the other half get the placebo. So there should be no difference, apart from getting the vaccine/placebo, between the two groups.
It's you. Vaccine development has been going on for more than a century and got extremely safe. Do you really think you just found a flaw in their process? Yes they still need to be validated by the FDA, being peer reviewed, etc but this process is already started and continuing.
The experiments were setup to pass, so we are seeing record high numbers of successes.
A lot of companies are specialized in hacking the standards for testing.
Depending on the company they use some of these tricks: These are all small sample sizes (around 100) picked from huge numbers of tested people (10s of thousands).
They look at short term results, long term effects failed dramatically in animal testing.
They use tests that can give false positives (PCR>26 cycles), and/or false negatives. Or just look at symptoms that are similar to flu.
They do not have a proper (long term) placebo group (why not also use untreated patients as well).
Other factors with huge impact as health, habits, food, Vitamin-D.
Big pharma wants to collect "their" billions for their medicine. Which is why we cant have nice things. (Or cheap medicine that do work well).
These are pre-registration trials, which is a mechanism specifically designed to avoid this kind of cheating. Your comment also contains other, specific false statements:
> long term effects failed dramatically in animal testing.
That is incorrect.
> They use tests that can give false positives (PCR>26 cycles)
This false claim about how PCR works is a deliberate lie spread by conspiracy theorists. This is emphatically not how high cycle numbers of PCR are used.
> Or just look at symptoms that are similar to flu.
What does that mean?
> They do not have a proper (long term) placebo group (why not also use untreated patients as well).
They do that.
> Other factors with huge impact as health, habits, food, Vitamin-D.
That’s why you use large, randomised cohorts.
> Big pharma wants to collect "their" billions for their medicine.
I’m in favour of socialising big pharma companies. But this claim is still bullshit. Pharma companies can hike prices for working medication. They don’t need to invent fake medication that will be exposed in the long run and leads to company-destroying lawsuits.
This touches on a question I had. Out of the tens of thousands of people vaccinated in countries where COVID runs rampant, how were there only 90ish people in the control group? I would have expected thousands.
Both groups have (approximately) the same size, in the tens of thousands. The first evaluation is done when 90 or so cases have been confirmed, not knowing which group they belong to. The blinding of these subjects is then unsealed, in this case revealing that 90 of the 95 confirmed infections occurred in the control group. This distribution means the vaccine has been highly effective at preventing infection.
Sorry, I meant just 90 people infected (obviously the vaccine arm has much fewer), but after running the numbers that's actually about right for the prevalence rate we see in the US.
This isn't the final evaluation. There will be another at ~150 cases. The numbers may seem small, but this is enough for the purpose of deciding for or against approval. Anything over 80% effectiveness would likely be approved, so it doesn't matter whether the true value (insofar one exists) is 90%, 95%, or something in between. It's useful regardless.
Oh, I didn't know that, thanks. I'm sure it's enough for statistical significance given the difference, I was just wondering why there were so few cases in 30k people, but it looks like that's just the normal case rate.
Thousands (30) of people are in the trial, half were assigned randomly to the control group. So far 95 people in the trial have caught COVID and, when they unblinded the data, they discovered that 90 of those infections where in the control group. Since participants were randomly assigned into the test group vs the control group and so both groups should have the same amount of exposure, this is a strong signal that the vaccine was effective. Here's an article about Moderna's trial with a link to their 135 page (!) design doc https://www.livescience.com/moderna-vaccine-trial-protocol.h...
The protection rate oddly correlates with the hearsay that ~95% of people testing positive experience mild to moderate symptoms. I think I’m in the wrong business.
I don't think the study has measured whether vaccinated people are less contagious (or get infected). It's primarily measuring protection from disease.
Not even a baseless conspiracy theory, it's such a failure of basic reading comprehension that it borders on bad faith.
They gave the vaccine to a bunch of people, people in the control group got COVID 20 times more often than in the vaccine group, what's there to dispute?
No, that’s not what the statistics is saying. The compares the rate of symptomatic disease between vaccinated and unvaccinated groups in a double blind study.
The incidence of symptomatic people in two equal sized groups over time has reached 90 versus 5 in the unvaccinated versus vaccinated group.
With COVID's 99% survival rate and the newness of this vaccine, I would treat this vaccine like LASIK - let the first adopters take it and wait 10 years for the effects.
Just compare the GDP hit taken by Japan and Korea, which had essentially no lockdowns, with that taken by the European countries that locked down. Places with extensive lockdowns had GDP fall by 5-10 percentage points more. Or compare US states with more lockdowns vs those with less or no lockdown: https://www.washingtonexaminer.com/news/red-states-are-outpe....
Not GP, but it seems to me that given the large consumer spending portion of GDP (~70% in the US) in developed countries, anything that will limit folks going out and spending money, like:
1. Retail sales;
2. Air/rail/bus travel;
3. Going to bars/restaurants;
4. Hospitality (hotels/cruises);
5. Theater/concerts;
6. Public transportation.
Is likely to have significant negative effect on the economy as a whole until the majority of the population is convinced that they won't become sick and/or put their vulnerable loved ones at risk.
As such, it seems to me that we won't be able to resuscitate the economy fully until we have some semblance of herd immunity.
Whether that herd immunity comes from a vaccine or millions of deaths and tens of millions of long-term effects, or from a broadly deployed vaccine will also have significant economic impact.
tl;dr: if many/most won't go to the mall, the pub or Mallorca, the economy will continue to flounder. We won't get past that until people feel safe around others.
I'm not an anti-vaxxer, but I'm not eager to be a guinea pig for anything that's been rushed through every approval stage. Especially since those approval stages were created in response to very real issues with vaccines that hadn't been discovered in early development and testing
If the comorbidity is obesity, which in most cases results from lifestyle choices, it's hardly fair for them to ask others to make sacrifices to protect them from the consequences of their own lifestyle choices.
It's not "fat people deserve to die", it's "people who made good life choices don't deserve to have their livelihoods destroyed to reduce the risk of fat people dying".
There's much more to it than just surviving right? There's more nuances than just survival rates, and there are other related complications at play here.
One of the huge challenges of the medical industry. Their metrics are binary but quality of life is incredibly difficult to measure.
That said - I am not advocating for not taking a vaccine - I am merely commenting that the medical industry has some deeply flawed analytics for tracking success.
Yes, absolutely. Currently in day 5 of "having trouble breathing". I'm going to paste my comments/experience from a different forum below:
I currently have coronavirus. I'm a young male in my 20s (don't want to divulge too much info), 6'1", 170 lbs, non-smoker, rarely drink, pretty healthy. Waiting on test results.
Started off about 2 weeks ago, rash on my chest, lots of night sweats and chills. Didn't think it was covid at first. given the weird symptoms. I did not feel too sick, in general. Slight fever, slight cough and sore throat. For most of the time, it felt mild. Still have the rash, night sweats, and sore throat at the moment.
However, 4 days ago I started having issues breathing. I felt out of breath multiple times throughout the day, and at times it was hard to even suck in air (like my diaphragm was calcified or something). I woke up a few times at night, trying to suck in air. Today was better but the difficulty breathing is still there. I realized today, that even though it's not as bad as the worst flu I've had, it involved a symptom (difficulty breathing in air) that I have never experienced. Not with strep, not with the flu. This is something to note for everyone, in my opinion.
I think it's both milder AND worse than people think it is - I'm a healthy young male who exercises and eats well, and yet I'm having trouble breathing. This is a symptom that has continued for multiple days, and while it hasn't gotten worse, it's not getting much better. The rash is still there, my throat's still sore. If you are part of the obese/overweight American population (35% of us, including my family), and are a chronic smoker/drinker, and have chronic conditions (diabetes, hypertension, mental health conditions), I think you should still be careful.
Unless you have a respirator, there isn't anything you can take to resolve "difficulty breathing". It's not like fever/sweats/nausea - where you can just take a Nyquil and it's all gone. Not to mention, we have antibiotics and antivirals to attack the flu/cold/strep infections as well. Covid's a bit different - difficulty breathing can only currently be helped by equipment that's located in hospitals. There isn't some magic pill that will get your diaphragm pumping up and down again. This is something to note, in my opinion.
I'm not sure how much longer my symptoms will continue. The initial symptoms started 2 weeks ago, but the breathing related ones only started recently. I hope it gets resolved soon - I may provide a comment as an update.
Please wash your hands, avoid touching your face/eyes with your hands, socially distance if you can, and wear a mask when in public. Having trouble breathing is no joke.
Covid can do a lot more than just kill you or leave you alone—it can cause all sorts of long-term side effects as well. The longer-term issues caused by covid are a higher priority than the potential issues posed by the vaccine. These issues are both more common and more severe than any known side effect of any vaccine in trial right now.
Well just by searching the terms "Long Term Covid effects" would yield you a lot of results.
But the ones talked about most are the long lasting Mental Fog, Depression, Muscle Pain, Long lasting Headaches, Heart and Respiratory issues.
And anecdotally, I know of a few folks in my Hockey league community of which I am involved in that have said that after having had COVID, that they have either felt in the ranges of nothing at all (super lucky), or have had extreme issues where they could not get back to any strenuous activity much less any activity involving more than walking. Most of these guys would be considered pretty fit, ranging from the ages of 16 to 50.
In one case, they have had a constant headache for over a month which is just resolving now.
Hold on a second. The Russian vaccine has 92%? And is available for months already. WTF is happening actually? Did the governments around the world smeared Russian one on previous months mocking it and ridicule it in order to allow a Western company to achieve the same protection for the love of money? If that's the case I hope people with deaths in their families will sue their governments/health organizations to hell and back. This screams of greed for money not on back of ordinary citizen, but literally on their life.
The Russian vaccine (Sputnik V) was not available and as far as I can tell still isn't. The Russian government rubber stamped it before it had gone through proper trials.
Emergency approval ≠ rubber-stamping. The “Western” vaccines are still going through proper (if accelerated) clinical trials. The Russian vaccine’s supposed efficacy and safety was announced before starting the phase III trials. That’s what’s rightly being mocked.
We can’t know about long-term effects from the clinical trials. But that doesn’t mean that we don’t know anything about possible long-term effects — in fact, that’s categorically false. We know quite a lot about the underlying biology of these vaccines, and we have extensive data from animal testing. We can’t exclude all long-term effects but we know that they’re rather unlikely — mostly because there’s no plausible biological mechanism to cause them.
In particular, based on our biological knowledge, we can categorically exclude claims from conspiracy theorists about the RNA likely being integrated into our genome: this just isn’t how any of this works, it’s fiction.
"mRNA vaccines are new, and before 2020, no mRNA technology platform had ever been authorized for human use, and thus there is the risk of unknown effects, both short and longer-term."
A lot more than you’ll find easily digestible in a single Wikipedia article.
> The UK government is producing AI software to "to process the expected high volume of Covid-19 vaccine Adverse Drug Reaction (ADRs)"
The volume is expected to be high not because many actual, serious averse reactions are expected but because the vaccines are expected to be given to many people at once, and every potential averse reaction will be recorded. Most records in such ADR databases are causally unrelated to the vaccine, and merely occur coincidentally; and the vast (>99%) majority of the rest are occasional mild reactions.
> But yes, label people questioning the rushed out vaccine as "conspiracy theorists".
I’m not. I’m labelling specifically those people as conspiracy theorists who make up bullshit that isn’t based on actual biology but rather on complete fiction. In other words, who spew baseless lies. I’m all for robustly criticising these vaccines. But it has to happen scientifically, and by experts.
You clearly know nothing about the long term effects, but are happy to parrot an "it's all safe line". With an "experts says so" appeal to authority. This place is getting worse than reddit.
I’ll reply again: a lot. You can’t possibly expect me to summarise the vast, complex state of the art knowledge of RNA biology for a lay person here — it literally fills books. At the very least ask more specific questions, I’ll be happy to answer them, if I can.
> You clearly know nothing about the long term effects
Wrong. I’m no expert on all aspects of RNA vaccines, but I am an expert on RNA biology. What I do know allows me to conclusively exclude the possibility of the RNA in vaccines incorporating into the host genome (because that notion is simply not coherent). I’m not parroting any line here.
I didn't ask for a summary of RNA biology. I asked what we do we know about the long term effects of RNA vaccines? Preferably in humans. But as they the vaccines are new and haven't been authorized for humans I am skeptical that we can say anything conclusive. So far you haven't named one thing that we know. "Lots" isn't an answer.
> What I do know allows me to conclusively exclude the possibility of the RNA in vaccines incorporating into the host genome (because that notion is simply not coherent).
You are just using a strawman argument that some conspiracy theorists have come up with. I never suggested that would be the case.
> I asked what we do we know about the long term effects of RNA vaccines?
But that’s a completely open-ended question that really can’t be answered without referring to a primer of the underlying biology. I really don’t understand what you expect me to do here. It seems like you’re asking me to prove a negative and don’t tell me which negative to prove.
> … I am skeptical that we can say anything conclusive.
As I said we can say some things. And, contrary to your claim that I haven’t yet “named one thing that we know”, I’ve actually given a very concrete example: we can completely exclude the (often-cited, but completely unscientific) risk of viral RNA incorporating into the genome. This isn’t a straw man, it’s a frequent claim by opponents of the COVID-19 RNA vaccines. In fact, as far as I can tell this is by far the most prominent claim.
In the same vein, one can of course make long lists of potential long-term risks (cancer, Alzheimer’s, diabetes) — but unless these are plausible, this is unproductive. For most of these, there’s simply no biological connection at all. Demanding that all such far-fetched risks be rigorously excluded is unreasonable. By the same logic you could never cross the street because you can’t rigorously exclude the possibility of getting hit by a car, or a meteor. Rational risk assessment is always tempered by likelihood estimates.
The most likely, rational, long-term side effect of RNA vaccines was hypothesised to be a severe immune reaction, which might lead to the development of an autoimmune response. However, if that was the case, we would see the same effect in long-term animal trials, and we would see the start of this effect even short-term in human trials. But by now we have evidence against both of these: long-term animal testing shows no indication of an autoimmune response, and human trials don’t show any short-term ramping up of such a response.
So the most likely, hypothesised possible long-term effect is contradicted by existing evidence. Which goes back to my point: we do know some things.
Do I claim that the vaccine is risk-free? No. For conventional vaccines we have decades of data showing their safety. The evidence for brand new mechanisms obviously isn’t on the same level, and we can’t categorically exclude unknown interactions. But it’s really hard to communicate the magnitude of this risk, except to say that it’s really very small — because we can exclude plausible risks.
You seem to be implying that it was "mocked" because the protection rate was "only" 92%. That was never the reason that it was mocked, and I'm curious where you got that impression.
No, I did not implied that. It was ridiculed because it got approved before proper trials, or at least that's what Western media that I am reading daily told me. I don't speak Russian so I can't read their media to see what's happening there.
And now the same Western media that is praising Pfizer / Moderna is telling me Russian one is on par. So what happened? is the Russian one just as good, in which case past months were used to let people die or is not?!!
What media were you reading that implied the Russian one was on par? Most reporting that I've read has always included the caveat that the drug never completed serious clinical trials.
There was no data on the Russian Sputnik vaccine before, but it get inject folks anyways. They got rightly criticised for this reckless and unscientific behaviour.
Also before Pfizer and Moderna results, we just got a scary mutation on the spike protein in Minks farms in Denmark. This could easily make any vaccine based on the spike protein worthless, which may explain why suddenly western companies starts selling their vaccines...
And a personal comment : you should forget the idea that the Law will protect you from bad government/institutions decisions.
Is this also an mRNA vaccine like the Pfizer? No genetic vaccine has ever been widely deployed. As a young healthy person who could yet have more children, I’d rather get covid than take a genetic vaccine that might affect me or my offspring.
DNA vaccines have never been deployed because of serious concerns about the patient’s genes being modified by the vaccine. Scientists are saying they’re “sure” that mRNA vaccines can’t do that, but that seems overly sanguine. There is still so much we don’t know about genetics. How can you possibly have that certainty when observed epigenetic effects, for example, challenge many of our preconceived notions about the body’s genetic machinery but are so poorly understood. It seems that at least some processes currently thought to be “one-way” are actually not.
From the article:
"Mark Lynas, a visiting fellow at Cornell University’s Alliance for Science group, debunked the idea that a DNA vaccine could genetically modify an organism. Lynas told Reuters that no vaccine can genetically modify human DNA.
“That’s just a myth, one often spread intentionally by anti-vaccination activists to deliberately generate confusion and mistrust,” he said. “Genetic modification would involve the deliberate insertion of foreign DNA into the nucleus of a human cell, and vaccines simply don’t do that. Vaccines work by training the immune system to recognize a pathogen when it attempts to infect the body - this is mostly done by the injection of viral antigens or weakened live viruses that stimulate an immune response through the production of antibodies.”"
>Vaccines work by training the immune system to recognize a pathogen when it attempts to infect the body - this is mostly done by the injection of viral antigens or weakened live viruses that stimulate an immune response through the production of antibodies
Not great for that guy’s credibility that he doesn’t even know what a DNA vaccine is. He’s described the kinds of vaccines in wide use. Not genetic vaccines, which work by introducing genetic sequences that encode the antigen, as opposed to introducing the antigen itself.
Key word being "mostly" in that quote. If you want to hear his description regarding DNA vaccines, just read the next paragraph of the article - quoted below:
“The DNA [in DNA vaccines] does not integrate into the cell nucleus so this isn’t genetic modification - if the cells divide they will only include your natural DNA. But this approach is incredibly promising for COVID because it can be scaled up very quickly, and is very versatile - it is easy to synthetically produce DNA sequences that match the required bits of viral genetic code.”
We can’t rule out reverse transcription in the human body. It’s a very real possibility that introducing RNA results in longer lasting genetic change. Probably not! But I’d rather risk covid myself. So should all fertile people. At least until we know more.
An mRNA vaccine slips into your cells via some lipid nano particles, a ribosome binds to it manufacturing and releasing COVID spike proteins. This provokes an immune response. Does not enter the nucleus, or touch your DNA.
Reverse transcription is a real biological process. We can’t rule it out in the human body. We don’t have enough experience to be sure. If this was the Black Death, the risk would be justified. It might be justified here for people above child rearing age. But fertile people need to be more careful with their genetics.
