CR: COVID-19 --Political Talk

[ChuckNorrisActionJeans 2678]

Anastasis makes threads unreadable and it's fucking tiresome ... puts his predictable take out but can never, ever let it rest...literally has to respond to every fucking single post that doesn't validate his stance. Ignore finger getting real itchy... 

[FondrenRoad 4378]

4 minutes ago, ChuckNorrisActionJeans said:

Anastasis makes threads unreadable and it's fucking tiresome ... puts his predictable take out but can never, ever let it rest...literally has to respond to every fucking single post that doesn't validate his stance. Ignore finger getting real itchy... 

Under that, there is a real guy with a lot of knowledge who can provide a lot to this board. Sometimes like today I try to get him to be that real guy on here, but it never works out. He doesn't drop character until he's done the DVD commentary.  So it's a waste of my time and yours. So I apologize to you for carrying this on. 

[Anastasis 23477]

 

12 minutes ago, FondrenRoad said:

You wouldn't even have to say you were wrong.

The modeling tells us that we need to get shots in arms and do our best to manage the supply chain. It is not just one analysis, there are a few pointing the same direction. Vaccines don't do anything sitting in a freezer. Nothing I am saying is particularly contrarian or controversial. The CDC guidance is now talking about extended intervals and starting to consider mixed regimens in extenuating circumstances. The Israeli data as well as the trial-based clinical data indicates risk reduction after first shot. 3-4k people are dying on a daily basis. Don't let perfect be the enemy of good in the setting of a global pandemic.    

 

[Anastasis 23477]

27 minutes ago, ChuckNorrisActionJeans said:

Anastasis makes threads unreadable and it's fucking tiresome ... puts his predictable take out but can never, ever let it rest...literally has to respond to every fucking single post that doesn't validate his stance. Ignore finger getting real itchy... 

Sorry to interrupt your tweet feed bro. 

[FondrenRoad 4378]

1 minute ago, Anastasis said:

 

The modeling tells us that we need to get shots in arms and do our best to manage the supply chain. It is not just one analysis, there are a few pointing the same direction. Vaccines don't do anything sitting in a freezer. Nothing I am saying is particularly contrarian or controversial. The CDC guidance is now talking about extended intervals and starting to consider mixed regimens in extenuating circumstances. The Israeli data as well as the trial-based clinical data indicates risk reduction after first shot. 3-4k people are dying on a daily basis. Don't let perfect be the enemy of good in the setting of a global pandemic.    

 

Go back and respond directly to every sentence in that post. Otherwise just shut the fuck up. 

[Anastasis 23477]

2 minutes ago, FondrenRoad said:

Go back and respond directly to every sentence in that post. Otherwise just shut the fuck up. 

Sorry that you don't like facts you find inconvenient. I hope that the Councilman is able to tweet his way out of the precarious situation he finds himself in. 

[Wanker Bob 379]

4 hours ago, lemonlime said:

Meanwhile, 

 

Missing? As in possibly routed by trump people to someone who can sell to the highest bidder and kick back millions to trump? 

[Beantown Express 2.0 6559]

After trying to read the cat fight in this thread for the past 24 hours can someone answer if there is actually enough supply of the vaccines?  I keep hearing the obstacle is the “getting the shot in the arm” but it seems there aren’t enough doses anywhere.  I mentioned this months ago and I believe Anastasis shot me down but why can’t the President enact the National Defense Act and have Pfizer, Moderna, (J&J shortly), share their “recipe” with every other pharmaceutical company in the US and get 500 million doses done in the next month or so.  I get they would lose money by taking their patent but so what. We are at war and we can maybe cut those companies a deal if necessary but they don’t get to make an extra few billion dollars while we as a country watch another 250K people die that didn’t have to.  Every doctor and pharmacist in the country should be jabbing needles in peoples arms all day long starting yesterday so we can go back to normal which would be good for everybody including the 4K people dying every day that may not have to die if we take BIG action.  Maybe I am naive but this should have been Biden’s first Executive Order and honestly Trumps months ago when the vaccines first started.  Now tell me where I am wrong because I am all ears.

[Doc Sam Beckett 5793]

So moderna is good against the new variants for now, but could be in trouble as this continues to mutate? Is that correct? Has there been any update on the Pfizer vaccine in regards to the new variants? Sorry if already answered

[Captainant 27680]

16 minutes ago, Beantown Express 2.0 said:

After trying to read the cat fight in this thread for the past 24 hours can someone answer if there is actually enough supply of the vaccines?  I keep hearing the obstacle is the “getting the shot in the arm” but it seems there aren’t enough doses anywhere.  I mentioned this months ago and I believe Anastasis shot me down but why can’t the President enact the National Defense Act and have Pfizer, Moderna, (J&J shortly), share their “recipe” with every other pharmaceutical company in the US and get 500 million doses done in the next month or so.  I get they would lose money by taking their patent but so what. We are at war and we can maybe cut those companies a deal if necessary but they don’t get to make an extra few billion dollars while we as a country watch another 250K people die that didn’t have to.  Every doctor and pharmacist in the country should be jabbing needles in peoples arms all day long starting yesterday so we can go back to normal which would be good for everybody including the 4K people dying every day that may not have to die if we take BIG action.  Maybe I am naive but this should have been Biden’s first Executive Order and honestly Trumps months ago when the vaccines first started.  Now tell me where I am wrong because I am all ears.

There is not a big enough supply of vaccines due in large part to the inaction of trump et al. Annie would rather us not remember this, so he shitslings and whatabouts and both-sides to derail conversation. 

It tips his hand that he gets along and doesn't do this shit with cheeseweasel and dcar and the rest of the deplorables

[Beantown Express 2.0 6559]

1 minute ago, Captainant said:

There is not a big enough supply of vaccines due in large part to the inaction of trump et al. Annie would rather us not remember this, so he shitslings and whatabouts and both-sides to derail conversation. 

It tips his hand that he gets along and doesn't do this shit with cheeseweasel and dcar and the rest of the deplorables

Yeah I know Trump and his administration fucked this up royally but we now have a new person in charge so the question I had was how quickly can we use the defense act to get vaccines out there.  In my county near DFW we had 110K people sign up in the first group but only have 6K doses.  That shit should not stand, man.

[Neonmoon 38129]

So what is it, 50% chance Trump sold vaccines under the table for a kickback and 50% chance they originally miscounted because they’re idiots?

[BradInATX 9208]

@Anastasis, the modeling that you're referencing, while informative, is pretty basic stuff. I don't think that the model, or you yourself, have all of the data you need to conclude that prioritizing first shots over getting both shots to people is the right move.

From what I saw, the model is a pretty straightforward model that assumes a couple of things:
- Getting shots in arms faster will bend the curve faster (which is basically undeniable)
- The first shot removes ~0.5 people from the risk pool (50% efficacy number), and the second shot removes 0.4 people (90% efficacy for the two shot routine).

If you just look at it that way, then yeah, getting shots in arms is going to bend the curve faster, which is what the study showed. Simple math is simple.

The problem is that the analysis is also missing some things:
- The real-time Israel data shows anywhere from 33-60% effectiveness after the first shot. If It's only 33% vs 90%, then it's a different story. The answer is we just don't know.
- It doesn't account for who the shot is going to. Let's use our 50%/90% numbers. When looking at how much risk of death will be removed from the board, giving a second shot to an 85 year old is more than 50 times more impactful than giving a first shot to a 45 year old. 

So just looking at a dual bar chart that shows first shots bending the curve down faster doesn't tell the whole story. If the goal is to reduce the curve so we can all go to bars and parties sooner, then yeah, definitely just give the first shots out to everyone. If the goal is to reduce death and severe illness, then it's not as clear. 

I think you probably already know this, but you're making value judgements on what New York is doing without all of the information you need to do it. Which, as others have said, makes the whole thing look political.

[Captainant 27680]

1 minute ago, Beantown Express 2.0 said:

Yeah I know Trump and his administration fucked this up royally but we now have a new person in charge so the question I had was how quickly can we use the defense act to get vaccines out there.  In my county near DFW we had 110K people sign up in the first group but only have 6K doses.  That shit should not stand, man.

I hear ya man, none of my at risk family in Austin has been able to get a vaccine yet. The DPA has already been invoked (as of Jan 20) to ramp up vaccine production and distribution. The challenge now is that there is no record or accounting of where the trump admin sent doses, or how many more are coming. They basically left Biden with a shit sandwich 

[HenryJames 66132]

 

[Beantown Express 2.0 6559]

5 minutes ago, Captainant said:

I hear ya man, none of my at risk family in Austin has been able to get a vaccine yet. The DPA has already been invoked (as of Jan 20) to ramp up vaccine production and distribution. The challenge now is that there is no record or accounting of where the trump admin sent doses, or how many more are coming. They basically left Biden with a shit sandwich 

I find it hard to believe that something Donald J Trump was in charge of ended in a total shit show as he walks away from it.  I don't think anything like that has ever happened before with something he was in charge of throughout his entire life.

[Anastasis 23477]

1 hour ago, Beantown Express 2.0 said:

 I mentioned this months ago and I believe Anastasis shot me down but why can’t the President enact the National Defense Act and have Pfizer, Moderna, (J&J shortly), share their “recipe” with every other pharmaceutical company in the US and get 500 million doses done in the next month or so.

As I recall the exchange, what I said was that I have not seen anyone identify specifically how invoking the DPA would address the choke points in production, but if there were problems that could be addressed through the DPA we should use it.  These are very specialized technologies with unique production requirements.  It's not as easy and just passing out the recipe.  Here is something regarding DPA from a few days ago in NYT, which makes the same point...

https://www.nytimes.com/2021/01/21/health/covid-vaccine-supply-biden.html

President Biden said he would use the Defense Production Act to increase supply. Will that help?

Vaccine experts and the companies themselves have said that at least in the short term, using the Defense Production Act will not significantly increase supply, although every little bit could help. That’s because manufacturing facilities are already at or near capacity, and there is a worldwide race to develop vaccines that use a finite amount of resources.

Although the Trump administration was criticized for not using the Defense Production Act more aggressively to ramp up production of testing supplies and protective gear, it did use the act many times to give vaccine manufacturers priority access to suppliers of raw ingredients and equipment.

In a plan released on Thursday, the Biden administration indicated it would continue to use the act to boost supplies needed for vaccine manufacturing, as well as other materials that are required to immunize tens of millions of people. Although the plan provided few details, one example cited is increasing production of a special syringe that can squeeze six doses out of Pfizer vials that were originally intended to contain five.

 

[Anastasis 23477]

2 hours ago, BradInATX said:

The problem is that the analysis is also missing some things:
- The real-time Israel data shows anywhere from 33-60% effectiveness after the first shot. If It's only 33% vs 90%, then it's a different story. The answer is we just don't know.
- It doesn't account for who the shot is going to. Let's use our 50%/90% numbers. When looking at how much risk of death will be removed from the board, giving a second shot to an 85 year old is more than 50 times more impactful than giving a first shot to a 45 year old. 

The Israeli data also shows a significant reduction in hospitalization with first shot, even before second shot is administered. This is aligned with the indications from the clinical data. And in reality this is probably what we should be modeling, covid hospitalizations and mortality are the real endpoints of interest. Agree on your second point.  Risk stratification should be part of the calculus. And it cuts the other way too though, especially when viewed from the perspective of hospitalization and death as the endpoints. That 85 year old has extremely greater risk of both hospitalization and death, and particularly death, compared to the 45 year old. Giving a first shot to an 85 year old has a greater chance to impact the meaningful endpoints of death and hospitalization than a second shot to a 45 year old on day 21 instead of day 28 or day 35 or even day 42. 

2 hours ago, BradInATX said:

I think you probably already know this, but you're making value judgements on what New York is doing without all of the information you need to do it. Which, as others have said, makes the whole thing look political.

I am not picking on NYC.  My response would have been the same if the tweet came from Adler or Abbott. You've been involved with enough exchanges related to vaccination to know that I have been beating this drum for a while. I previously shared the results of a similar analysis modeling different vaccine strategies based on a variety of assumptions regarding supply constraints and dose timing, so this is not particularly new ground we are breaking here. 

Modeling out of Canada:

Figure 2. Predicted Cumulative Incidence of COVID-19 Cases for Days 11 to 60 After First Dose of Pfizer-BioNTech’s COVID-19 Vaccine, by Vaccine Rollout Strategy and Time of Availability of Subsequent Allotments
Predicted incidence of COVID-19 cases after vaccination with Pfizer-BioNTech’s COVID-19 vaccine, per 100,000 individuals included in Polack et al.’s Phase III trial,1 by vaccine rollout strategy and time of availability of subsequent allotments. *Subsequent allotments used to administer the first and second doses to 50% of a population. **Subsequent allotments used to administer second booster doses to 100% of a population. Efficacy of the first dose is assumed to be 85% from day 11 until day 27 after the administration of the first dose (Table 1). Efficacy after the second booster dose is assumed to be 95% from day 8 after the administration of the second dose onwards, based on data by Polack et al.1 As it is unclear how long the efficacy of 85% of the first dose will last, we assumed that the efficacy of the first dose would decrease to 70% from day 28 onwards until 7 days after administering the second booster dose in case of prolongations of the interval between first and second dose to 35 or 50 days. Estimates are for the population of participants included in the Phase III trial by Polack et al.1 and only reflect direct effects of the vaccine on vaccinated individuals but do not reflect indirect effects on unvaccinated individuals through decreased transmission. 

Edited January 26, 2021 by Anastasis

[BradInATX 9208]

That model doesn't make any considerations for the severity of illness, though, which is a huge, huge flaw. That's a lazy analysis.

[Anastasis 23477]

1 hour ago, BradInATX said:

That model doesn't make any considerations for the severity of illness, though, which is a huge, huge flaw. That's a lazy analysis.

You're going to have to unpack that for me a bit. If anything, I think that layering in an element of risk stratification into the model could amplify the effect, in particular if we are looking at a hard endpoint like death. Either way, this debate will hopefully be a moot point once JNJ gets an authorization for their one dose regimen and supply constraints are less of an issue.  I hope that by April the public health discussion will pivot to creating demand in high risk vax hesistant folks and less on optimizing the available supply. 

[TXSG8R 3362]

3 hours ago, Beantown Express 2.0 said:

Yeah I know Trump and his administration fucked this up royally but we now have a new person in charge so the question I had was how quickly can we use the defense act to get vaccines out there.  In my county near DFW we had 110K people sign up in the first group but only have 6K doses.  That shit should not stand, man.

My guess is the MRNA vaccines are probably not something that most normal pharmaceutical production companies are set up to do.  I don’t think this as simple as changing a factory line to stamp metal a different way to make airplane parts. Doesn’t mean they shouldn’t push, but it’s not something that will happen in a week realistically. 

[BradInATX 9208]

12 minutes ago, Anastasis said:

You're going to have to unpack that for me a bit. If anything, I think that layering in an element of risk stratification into the model could amplify the effect, in particular if we are looking at a hard endpoint like death. Either way, this debate will hopefully be a moot point once JNJ gets an authorization for their one dose regimen and supply constraints are less of an issue.  I hope that by April the public health discussion will pivot to creating demand in high risk vax hesistant folks and less on optimizing the available supply. 

It doesn't account for who is getting the shots.

We aren't trying to eliminate cases, we are trying to eliminate deaths. A basic example would be:

- If the "give first shots to everyone" model ends up with 50,000 old people getting one shot and 50,000 young people getting one shot

and

- The "hold 2nd shots back" model ends up with 100,000 old people getting two shots

 

Then even though the first model would probably reduce the infection curve, the second model would save a lot more lives. Looking only at infections is lazy and doesn't capture the problem we're trying to solve.

[jimmyjazz 45981]

In theory, those who have received first doses ARE the high risk people, right?  If "risk stratification" should be considered . . . shouldn't they get their second dose on time as opposed to waiting because we shifted and gave those doses to the lower risk population?

[BradInATX 9208]

1 minute ago, jimmyjazz said:

In theory, those who have received first doses ARE the high risk people, right?  If "risk stratification" should be considered . . . shouldn't they get their second dose on time as opposed to waiting because we shifted and gave those doses to the lower risk population?

 

Yeah, that's what my theoretical above was meant to address. It depends on who we're talking about. Are we talking about shifting 2nd shots for at-risk people over to 1st shots for non-risk groups? And to what extent? That's the data we need to make a real value judgement as to whether or not NY is doing the right thing. Without that data it's a pointless, slanted discussion.

[jimmyjazz 45981]

I agree that we should be trying to minimize death first and hospitalizations second.  If your efficacy numbers are correct (0.5 deaths eliminated with dose #1, 0.4 deaths eliminated with dose #2), then the way I read it is that there isn't much difference in administering second doses over first doses.  It's a 20% reduction in "removed mortality" when we consider the entire population writ large.  Focusing on high risk demographics surely minimizes if not reverses that math.

[Anastasis 23477]

  

49 minutes ago, BradInATX said:

It doesn't account for who is getting the shots.

We aren't trying to eliminate cases, we are trying to eliminate deaths. A basic example would be:

- If the "give first shots to everyone" model ends up with 50,000 old people getting one shot and 50,000 young people getting one shot

and

- The "hold 2nd shots back" model ends up with 100,000 old people getting two shots

 

Then even though the first model would probably reduce the infection curve, the second model would save a lot more lives. Looking only at infections is lazy and doesn't capture the problem we're trying to solve.

You are comparing a scenario with a finite supply of 100k shots to a scenario with a finite supply of 200k? That is not a level comparison, doesn't really reflect the reality, nor the dynamics of the supply chain and flexible dosing options.  That was the purpose of those analyses, modeling infection rates under different supply chain and dosing scenarios. I think that we are on the same page with risk stratification.  I don't think that I have ever suggested that we throw that out the door completely. Likewise, we agree that modeling deaths (and probably hospitalizations) would be informative. I don't think that the early trial data can really provide stable numbers to base assumptions on those outcomes, given the very small event rates, e.g. there were no C19-related deaths in the Pfizer study. However, if you could restrict those analyses to a subset of high risk individuals, say 85+, and could model mortality or hospitalization it would likely only amplify the effect of getting first shots in arms asap. Maybe the Israeli data will be able to support a more robust analysis along those lines.  The early indication is significant reduction in hospitalization, separating even before second dose is administer. 

 

Edited January 26, 2021 by Anastasis

[FondrenRoad 4378]

4 hours ago, Neonmoon said:

So what is it, 50% chance Trump sold vaccines under the table for a kickback and 50% chance they originally miscounted because they’re idiots?

I would put those odds at about 99.9%.  I wouldn't be surprised if there have already been multiple vaccine parties throughout the Trump and Kushner properties.  And there have also probably been a bunch of shipments finding their way onto Aeroflot flights without seeing customs. 

[Anastasis 23477]

38 minutes ago, BradInATX said:

Are we talking about shifting 2nd shots for at-risk people over to 1st shots for non-risk groups?

I don't think that we have exhausted the highest risk groups.  Restrict your analysis to this group, instead of pulling in healthy 45 year olds.  

[BradInATX 9208]

1 minute ago, Anastasis said:

I don't think that we have exhausted the highest risk groups.  Restrict your analysis to this group, instead of pulling in healthy 45 year olds.  

Do you know that or are you guessing?

[Anastasis 23477]

3 minutes ago, BradInATX said:

Do you know that or are you guessing?

It varies substantially by region (see link). Restrict your scenarios to high risk groups, instead of pulling in healthy 45 year olds, build in supply chain dynamics and flexible dosing approach and we are getting somewhere. 

https://www.washingtonpost.com/graphics/2020/health/covid-vaccine-states-distribution-doses/

[BradInATX 9208]

27 minutes ago, Anastasis said:

It varies substantially by region (see link). Restrict your scenarios to high risk groups, instead of pulling in healthy 45 year olds, build in supply chain dynamics and flexible dosing approach and we are getting somewhere. 

https://www.washingtonpost.com/graphics/2020/health/covid-vaccine-states-distribution-doses/

But we don't have enough information to know whether or not prioritizing first shots in NYC would remove second shots from the highest risk populations, correct? Because if not, then we don't have enough information to judge what they're doing.

[FondrenRoad 4378]

2 minutes ago, BradInATX said:

But we don't have enough information to know whether or not prioritizing first shots in NYC would remove second shots from the highest risk populations, correct? Because if not, then we don't have enough information to judge what they're doing.

NYC is in phase 1b which is essentially people who have non-medical jobs with a high risk of exposure and people over 65.  The second shots would be removed from phase 1a people who are primarily medical personnel. 

There are other logistical problems that don't fit Ana's narrative either since, in theory, eligible people could magically transport into a vaccine site. In reality, they are already having to retool registration because people over 65 haven't been able to figure it out.  But once they figure it out, the doses still don't yet exist. 

The primary reason for releasing the numbers was to cajole more doses out of the distribution decision makers. They signed people up based on the expectation that NY state would continue to receive 300k doses a week. Now NY state receives 250k doses a week..  If they dont get at least the original distribution amount per week, they will be canceling both first and second dose appointments out of necessity. 0 doses equals 0 arms.  Around 25k were canceled already.  They are already making either/or decisions on who receives a vaccine, and there isn't anything sitting around more than a week. These are earmarked for existing appointments. It isnt a first come first serve line. 

[Wanker Bob 379]

6 hours ago, Neonmoon said:

So what is it, 50% chance Trump sold vaccines under the table for a kickback and 50% chance they originally miscounted because they’re idiots?

I'm sure that Pfizer/Moderna have record of how many have been produced and shipped out. I think it's far more likely they shipped to where the trump fed govt told them to and at that point millions of doses were siphoned off for sale for profit. Knowing how trump is I'd be shocked if that wasn't the case since we know there's a large discrepancy in how many have been produced and shipped by the manufacturers and how many have reached local health care facilities across the country.  That should definitely be investigated by the Biden Admin and if found to be true start criminal prosecutions for it. 

Biden's admin has been given zero to work with. They're having to start this from scratch so it'll be weeks before it can even begin to get rolling. A big problem is for the most part these vaccines haven't been tested on how well one dose protects and what's the effective range for time between first and second dose. They are pretty sure up to about 12 weeks between doses can still maintain effectiveness but not 100 percent sure and no idea about any longer than that. Therefore, I think they should stick to the 2 dose schedule and make sure whoever gets a first dose can have the next one available to them within 5-6 weeks max. This is just a continuation of the consequences for electing an evil reality show idiot to lead the country and having a political party bow down to his idiocy. 

[Druggist 303]

One argument for administration of second doses on schedule is to remove those folks from the pool of people trying to get a shot.   The roll-out of this thing has been fucked, and I know, being someone in between the two doses, that I will not stop hunting until I get the second dose.  Until the second dose is administered, the pool of people trying to make appointments just keeps increasing.  Having a growing group of people no longer trying will help open things up as supply (hopefully) increases.

Besides, when I got the first dose, I was told there would be a second dose for me.  Changing the rules decreases confidence and we can hardy afford more of that in our current situation.

[Anastasis 23477]

  

5 minutes ago, BradInATX said:

But we don't have enough information to know whether or not prioritizing first shots in NYC would remove second shots from the highest risk populations, correct? Because if not, then we don't have enough information to judge what they're doing.

If delivering an on schedule 2nd dose is the sole consideration, we should keep 100% reserves to ensure that a supply chain disruption doesn't impact.  If on the other hand, the outcomes that are driving your vaccine strategy are reducing cases, hospitalizations, and death, covering the high risk population as soon as possible with the first dose and monitoring the supply chain ramp up while developing contingency plans to deal with severe disruptions is a better approach imo. Again, hopefully we are having a very different discussion a month or two from now with a new one dose vaccine candidate being pushed out. But in the mean time, 3k people are dying every day. 

Here is another analysis that is also informative, modeling mortality outcomes.  Compares a two dose strategy with 95% effectiveness to different one shot alternatives with a range of efficacy and vaccine durability given certain assumptions about uptake. I think that the one shot with uncertain duration is a reasonable approximation of a single shot PFE/MRNA dose for the purposes of this discussion.  The trade off point is 55% effectiveness for the single dose regimen (MRNA's data suggest up to 80% range after first dose). If the supply chain totally collapses, we still come out ahead getting shots in arms.

https://www.acpjournals.org/doi/full/10.7326/M20-7866

Discussion: Prior work has shown that the success of a COVID-19 vaccination program will depend more on the speed and reach of its implementation than on the efficacy of the vaccine itself (4). The analysis presented here highlights the steep clinical and epidemiologic costs imposed by a 2-dose vaccination series in the context of ongoing pandemic response. Depending on the duration of protection conferred—and, of note, considering only a 6-month time horizon—a single-dose vaccine with 55% effectiveness may confer greater population benefit than a 95%-effective vaccine requiring 2 doses. This suggests that now that a highly effective, 2-dose vaccine for COVID-19 has been authorized and vaccination programs have begun, sustained and aggressive investment in pursuit of faster-acting, more convenient, 1-dose vaccine candidates remains justified.

  

Figure. Comparison of vaccine performance.

The figures illustrate the performance of 4 vaccination strategies in 100 000 persons with 0.1% infected and 9000 recovered in a susceptible–exposed–infectious–recovered model: 1) no vaccination (gray line); 2) a 95%-effective, 2-dose vaccine (orange line); 3) a single-dose vaccine conferring lifetime protection (blue line); and 4) a single-dose vaccine conferring an uncertain duration of protection that is exponentially distributed with a mean of 6 mo (yellow line). The vertical axes represent the outcome of interest (cumulative infections [top] and deaths [bottom]). The horizontal axes denote the efficacy of the single-dose vaccine. The crossing point of the blue line with the orange and yellow lines denotes the efficacy levels at which the 2 single-dose vaccines match the performance of the 95%-effective, 2-dose comparator.

   

[Anastasis 23477]

19 minutes ago, Druggist said:

Changing the rules decreases confidence and we can hardy afford more of that in our current situation.

This is a well made point. At some point we are going to be talking about demand creation instead of supply constraints. Changing course midstream could definitely impact confidence if the supply disruptions were broad. 

Here is another concern.  If the supply chain does completely fail, and we have massive numbers of people who are not completing the series and only lightly protected, it's a not great set up to pressure a breakout mutation. That could potentially be devastating. 

[BradInATX 9208]

13 minutes ago, Anastasis said:

  

If delivering an on schedule 2nd dose is the sole consideration, we should keep 100% reserves to ensure that a supply chain disruption doesn't impact.  If on the other hand, the outcomes that are driving your vaccine strategy are reducing cases, hospitalizations, and death, covering the high risk population as soon as possible with the first dose and monitoring the supply chain ramp up while developing contingency plans to deal with severe disruptions is a better approach imo.

Are you purposely avoiding the crux of our conversation? Or are you just not grasping it?

"If on the other hand, the outcomes that are driving your vaccine strategy are reducing cases, hospitalizations, and death, covering the high risk population as soon as possible"

The point is that with your strategy you're possibly neglecting second shots to a higher risk group, by giving first shots to a lower risk group. And if so, that is not a net positive for reducing deaths and hospitalizations. Like you keep saying the same thing but it's wrong.

 

Edited January 26, 2021 by BradInATX

[Anastasis 23477]

15 minutes ago, BradInATX said:

The point is that with your strategy you're possibly neglecting second shots to a higher risk group, by giving first shots to a lower risk group.

Show me one post were I ever said anything about prioritizing lower risk groups. In fact the opposite, I said that risk stratification needs to be part of the calculus and we could limit the discussion to high risk groups.

Edited January 26, 2021 by Anastasis

[HenryJames 66132]

Senior Biden administration officials said Tuesday that the federal government will purchase 200 million more vaccine doses from Pfizer and Moderna as part of a “National Action Strategy” to combat the COVID-19 pandemic. President Joe Biden has promised to deliver 100 million doses in his first 100 days as president. The administration also pledged to vaccinate the majority of Americans by the latter half of this year. “With these additional doses, the U.S. will have enough vaccine to fully vaccinate 300 million Americans by the end of this summer,” the officials said. The additional doses purchased will raise the weekly supply allotted to states from 8.6 million to 10 million, and the administration promised to give states a forecast of vaccine supply three weeks in advance rather than one week, as is the current norm.

Edited January 26, 2021 by HenryJames

[BradInATX 9208]

7 minutes ago, Anastasis said:

Show me one post were I ever said anything about prioritizing lower risk groups. In fact the opposite, I said that risk stratification needs to be part of the calculus and we could limit the discussion to high risk groups.

The people they are holding second shots for would undoubtedly be the 1a group and the highest risk patients, no?

Can you confirm that the people in line to cannibalize those second shots for their first shots are the same? You can't. Ergo the entire argument is incomplete and you're yelling at clouds because you don't have the right data to pass judgement on NY's decisions.

[BradInATX 9208]

1 minute ago, HenryJames said:

 

 

That's great. I wonder how quickly the new doses will actually be seen in the community. The way the blurb reads it will be pretty quick, but I'm not sure that makes sense.

[Anastasis 23477]

16 minutes ago, BradInATX said:

Can you confirm that the people in line to cannibalize those second shots for their first shots are the same? You can't. Ergo the entire argument is incomplete and you're yelling at clouds because you don't have the right data to pass judgement on NY's decisions.

This whole discussion is really more general than NY.  It was just the tweet that started the exchange, but it could have been any number of states or regions. I already provided you with a link regarding vax rates among priority populations.  We got some work to do while 3k people die every day. I've provided you with more than enough data to support the position. You have to contrive a substantial trade off across risk categories because it is really the only way to make it shake out differently. 

[Anastasis 23477]

25 minutes ago, BradInATX said:

 

That's great. I wonder how quickly the new doses will actually be seen in the community. The way the blurb reads it will be pretty quick, but I'm not sure that makes sense.

They are boosting supply from 8.6 to 10MM a week over the next 3 weeks.

Edited January 26, 2021 by Anastasis

[BradInATX 9208]

17 minutes ago, Anastasis said:

This whole discussion is really more general than NY.  It was just the tweet that started the exchange, but it could have been any number of states or regions. I already provided you with a link regarding vax rates among priority populations. 

A general discussion is fine, but as others have said, you're obviously grinding political axes here. I typically think you catch unwarranted heat, but I think this time you decided NYC was stupid (and they've certainly done a few dumb things) and locked yourself into a bad argument.

If we're talking purely theoretical where we're talking 1Bs across the board, then yeah, shots in arms as soon as you get them. But we don't know that. Is it possible what NY is doing is political? Of course it is. But it's also possible if not probable that they see in their data that the people earmarked for the 2nd shots need them more than the people who would receive them as first shots. We just have no idea, and you haven't at all provided enough data to defend a position that NY is doing the wrong thing.

We do agree conceptually, if we're talking about giving a 1Bs second shot to another 1B. 

 

Quote

You have to contrive a substantial trade off across risk categories because it is really the only way to make it shake out differently. 

This good enough?

 

 

[Mrs Whiggins 13050]

3 hours ago, FondrenRoad said:

I would put those odds at about 99.9%. ... And there have also probably been a bunch of shipments finding their way onto Aeroflot flights without seeing customs. 

Based on the last two pages of discussion, I just assumed that Israel received them via Jared Kushner and his friend Netanyahu.

Quote

Israeli officials have been tight-lipped about how many vaccinations the country has ordered, but vaccine makers reported that it has secured 8 million doses of the Pfizer-BioNTech vaccine and 6 million doses of the Moderna vaccine (the first batch of which was due to arrive Thursday).

 

Edited January 26, 2021 by Mrs Whiggins
Edit-forgot to include source: ABC

[Anastasis 23477]

2 minutes ago, BradInATX said:

you're obviously grinding political axes here.

I've been making these same arguments in the Vax thread since early January.  I am not picking on NY.  But I understand that some posters are simply unable to get past the username. Be best Brad. 

 

3 minutes ago, BradInATX said:

We do agree conceptually, if we're talking about giving a 1Bs second shot to another 1B. 

There a still 1As out there as well that have not been covered. I think that you can implement the strategy within the risk categories. And I don't think that I locked anything into a bad argument. You have to contrive limited scenarios where the approach does not result in better outcomes. 

9 minutes ago, BradInATX said:

This good enough?

Well yeah, that's why we should be getting shots in their arms ASAP.  What you contrive is not that there are different risks for different age groups, it is that we would be stealing doses from 85 year olds to give to healthy 45 year olds when the reality is that we still have a lot of uncovered high risk individuals that would benefit from first dose. You seem to be really stuck on this Brad.  

[BradInATX 9208]

2 minutes ago, Anastasis said:

this entire post

[Anastasis 23477]

1 minute ago, BradInATX said:

Gif is definitely an improvement over handwaving away the series of model results that you don't like. I think that the word you used was, "lazy"?

[Foosters 17858]

Ok!

https://www.readfrontier.org/stories/oklahoma-trying-to-return-its-2m-stockpile-of-hydroxychloroquine/

Quote

he Oklahoma Attorney General’s Office has been tasked with attempting to return a $2 million stockpile of a malaria drug once touted by former President Donald Trump as a way to treat the coronavirus.

In April, Gov. Kevin Stitt, who ordered the hydroxychloroquine purchase, defended it by saying that while it may not be a useful treatment for the coronavirus, the drug had multiple other uses and “that money will not have gone to waste in any respect.”

But nearly a year later the state is trying to offload the drug back to its original supplier, California-based FFF Enterprises, Inc, a private pharmaceutical wholesaler. 

 

[gmr548 16580]

- The first shot removes ~0.5 people from the risk pool (50% efficacy number), and the second shot removes 0.4 people (90% efficacy for the two shot routine).

This is basically the “go for two” debate in football. 50 percent chance (yes I know it’s slightly less) of two points vs. virtual guarantee of success for one point.