Coronavirus

[Popeye_Card]

Going back to Iceland, I remember reading a NYT article I think it was where the columnist wrote about taking a trip to Iceland in like May or something. The article really focused on Iceland's complete freedom, comparatively, in their everyday lives. In short, he and the fam went to see some friends or relatives or whatever and were greeted with testing and open arms. They, being from NY, were wary after everything they'd just gone through, and the host basically said:
Look, you've been tested. You're fine. In the event you are positive and transmitting, you'll be found quickly and all will be fine. All is good here, just live your life. Follow the rules whatever they are. And enjoy.

At first, I thought it was kind of a sensationalistic article, but after learning more about what they are doing, it's not. They figured out back in February or March that a lot of testing was key to preventing pre/asymptomatic spread and rigorously tested early...They were the first to realize pre/asymptomatic spread was rampant and tested accordingly, even screening their population early on and focusing in hot areas.

https://www.nature.com/articles/d41586-020-03284-3

Truly amazing we didn't do something similar. And still don't. Mind bottling.

I think one of the bigger strategic errors made was not putting the same kind of emphasis on developing quick screening test methods early on as we did on vaccines. Obviously both are important. But testing wouldn't be subjected to the same rigorous clinical trials, etc. that vaccines are.

Even if you get a screening test that is only, say, 50% accurate with the error being on the false positive side, you could follow that with a more rigorous/accurate test for those testing positive, and really be able to cull the infected out of the herd.

Just imagine if we had a quick screening method developed and ready to deploy at schools starting in September, where kids could be tested coming in every day. That should have been the second highest priority at the federal level from the beginning, right behind developing a vaccine. I don't believe it was ever seriously considered.

[AWvsCBsteeeerike3]

Going back to Iceland, I remember reading a NYT article I think it was where the columnist wrote about taking a trip to Iceland in like May or something. The article really focused on Iceland's complete freedom, comparatively, in their everyday lives. In short, he and the fam went to see some friends or relatives or whatever and were greeted with testing and open arms. They, being from NY, were wary after everything they'd just gone through, and the host basically said:
Look, you've been tested. You're fine. In the event you are positive and transmitting, you'll be found quickly and all will be fine. All is good here, just live your life. Follow the rules whatever they are. And enjoy.

At first, I thought it was kind of a sensationalistic article, but after learning more about what they are doing, it's not. They figured out back in February or March that a lot of testing was key to preventing pre/asymptomatic spread and rigorously tested early...They were the first to realize pre/asymptomatic spread was rampant and tested accordingly, even screening their population early on and focusing in hot areas.

https://www.nature.com/articles/d41586-020-03284-3

Truly amazing we didn't do something similar. And still don't. Mind bottling.

I think one of the bigger strategic errors made was not putting the same kind of emphasis on developing quick screening test methods early on as we did on vaccines. Obviously both are important. But testing wouldn't be subjected to the same rigorous clinical trials, etc. that vaccines are.

Even if you get a screening test that is only, say, 50% accurate with the error being on the false positive side, you could follow that with a more rigorous/accurate test for those testing positive, and really be able to cull the infected out of the herd.

Just imagine if we had a quick screening method developed and ready to deploy at schools starting in September, where kids could be tested coming in every day. That should have been the second highest priority at the federal level from the beginning, right behind developing a vaccine. I don't believe it was ever seriously considered.

Yeah, definitedly agreed, we talked about it somewhere in this thread months ago. The technology is there, but the biggest pushback was iirc due to reliability issues (where the FDA basically said they have to be incredibly close to PCR standards) and the ability to track positives. Then there's the medical community not trusting citizens to do their own tests. It's a situation where there may be legitimate cons/drawbacks, but the pros are so overwhelming it should have been done and done quickly.

It's incredibly frustrating. The companies that have the technology/tests to rapidly screen with either saliva or a less invasive nasal swab have all abandoned hope of getting them approved for public use so they have gone the route of getting them approved for use by medical professionals (pharmacies and Primary Care Physicians) and those pharmacies are charging $95/test around here. That's pretty cost prohibitive imo.

ETA: The issue isn't as much accuracy as it is sensitivity. The technology that exists today is somewhere around 95-99% accurate at a given sensitivity. The issue is, to reiterate what was said earlier in this thread, that the rapid tests detect a CT value of ~35. PCR tests detect a CT value of ~45 where CT is the amount of times the viral rna being detected is doubled. Obviously, a lot of doubling takes place between the 35th time you do it and the 45th time you do it. As such, PCR is picking up what Dr. Fauci describes as dead virus in non-infectious people at those low levels. But, when comparing rapid testing to PCR, PCR has a lot more posistives because those low levels stick around for a while, multiple weeks in some cases and the rapid tests won't pick them up.

In short and again to reiterate, they've sacraficed greatly the speed/ease of testing in favor of sensitivity, even when it could be argued the sensitivity is not needed. Frustrating.

[mikechamp]

Removing that 100M, what does the math look like to get to the similar 230M immune number? You could hold the number of previously infected at 30% and vaccinate 180M people. That would be 126M moved into the immune herd and add it to the 100M already there. 180M people is 360M doses of vaccine. How long would it take to get that out? I have no idea. But, it's probably, what, late 2021? Will that many people even get it? I have no idea. Just stuff to think about.

AW - The number that sticks in my head, from an article I posted somewhere in this thread, is 1.3B doses manufactured by Pfizer in 2021. (Not sure I've seen Moderna's production projections.) Using the 2 doses/person number, that's 650M people. Not all of those will be in the U.S., because we don't have that many people, but I highly doubt everyone in the U.S. would get a vaccine next year anyway. (Not anti-vaxxer comment, BTW.)

Pfizer is going to have to distribute that to the world, along with Moderna. But given the strata of distribution that's been discussed (health care workers/first responders, then elderly/nursing home residents, then on down the age ladder from there), I'm not expecting to get my number in line called until 2022. Conjecture on my part, I know, but that's my mental state/expectation.

[mikechamp]

More info on vaccine distribution and shipment/quantity projections:

Most U.S. states expect to vaccinate healthcare workers within 3 weeks

Most state and local jurisdictions expect to be able to vaccinate their healthcare workers within three weeks of receiving the first dose of a COVID-19 vaccine, an official from the U.S. Centers for Disease Control and Prevention said on Tuesday during an advisory committee meeting. Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, spoke during a meeting of the CDC's Advisory Committee on Immunization Practices to discuss which groups should receive COVID-19 vaccines once they are available, possibly in December.

A CDC presentation released at the meeting showed that the agency expects around 40 million COVID-19 vaccine doses will be available by the end of December, with shipments of 5 million to 10 million doses being made per week once a vaccine is authorized by regulators.

https://finance.yahoo.com/news/most-u-s ... 24797.html

[AWvsCBsteeeerike3]

On the high end, 10 m doses a week is 5 million vaccinations. If it does t scale up, that’s 250 m vaccinated in a year which is probably more than would take it, maybe.

Mrs AW is back on the covid unit starting a couple weeks ago. They haven’t mentioned anything to her about availability and/or requirements. She’s pretty adamant about not getting it to the point she said she’d just as soon quit as take it.

I work with a guy that’s already counting down the days until when he can get his. He estimates because he’s immune compromised, he’ll get it early next year.

So by my calcs, exactly 50% of the us will voluntarily be vaccinated.

[Popeye_Card]

What is Mrs. AW's staunch opposition to getting the vaccine stemming from? General distrust of vaccines or this particular vaccine? The rush to market?

EDIT: I guess my stance is that I'm in no rush to get the Pfizer or Moderna vaccine. The AstraZeneca vaccine seems to have some advantages, but apparently there are a lot of questions swirling around their testing methodology. I hope that all of the companies continue to test and tweak their formulas, and not just declare victory and push forward. We could be headed for dark days if it turns out the vaccines aren't effective after all - nobody will trust the next one.

[mikechamp]

I've got 2 articles for the board to review. Both are in regards to distribution logistics, and really inform the current topic in this thread. While they are similar, each have their own uniqueness to them, and are worthy of a quick read (despite their length).

The first article below also delves into what some individual states have said they are going to in regards to priority:

What does UK vaccine approval mean for US?

With the UK granting approval to a Covid-19 vaccine that is currently being reviewed in the US, 330 million Americans are left wondering when they will be able to get the potentially life-saving jab.

There are two US vaccines, made by Moderna and Pfizer, that are both seeking emergency approval. Pfizer's treatment was approved for the British public on Wednesday. The US Food and Drug Administration (FDA) plans to meet on 10 December to discuss approval for the Pfizer vaccine. They will meet again on 17 December to discuss Moderna's request.

On Monday, Vice-President Mike Pence told US governors in a conference call that rollout of the vaccine could begin "as soon as the week of December 14".

Federal officials at the Centers for Disease Control and Prevention (CDC) agree that the nation's 21 million healthcare workers should be prioritised first, as well the three million elderly Americans living in long-term care homes. But there is less consensus on how states should distribute it to other groups.

https://www.bbc.com/news/world-us-canada-55149138

This article is lengthy, but is written in Q&A format so it's easy to skip over a section if you want to:

So When Exactly Will a COVID Vaccine Be Ready?

Vaccine development is a typically lengthy process: Under normal circumstances, it can take anywhere between a decade and 15 years to get one approved and on the market, ready for distribution. But when epidemiologists began to raise the alarm in January over a new worrying virus that was ravaging a sprawling Chinese capital, it became evident that we were not facing normal circumstances, and drug companies responded accordingly. Now, less than a year after embarking on the frenzied race to develop a safe and effective COVID-19 vaccine, it appears likely that not just one, but multiple vaccines may be ready in the U.S. next month.

So far, two major U.S. pharmaceutical companies have formally applied to the Food and Drug Administration for emergency-use authorization: Pfizer and Moderna, both of which have developed vaccines with efficacy rates hovering around 95 percent, according to final analyses. And then, there’s a third vaccine from British-Swedish pharmaceutical company AstraZeneca, which reported last week that its COVID-19 vaccine was up to 90 percent effective. However, some public-health experts and journalists have since poked holes in this last vaccine’s data, and in at least one instance, called it “shaky.”

Here, everything you need to know.

https://www.thecut.com/2020/12/when-wil ... -know.html

[Jocephus]

[AWvsCBsteeeerike3]

What is Mrs. AW's staunch opposition to getting the vaccine stemming from? General distrust of vaccines or this particular vaccine? The rush to market?

EDIT: I guess my stance is that I'm in no rush to get the Pfizer or Moderna vaccine. The AstraZeneca vaccine seems to have some advantages, but apparently there are a lot of questions swirling around their testing methodology. I hope that all of the companies continue to test and tweak their formulas, and not just declare victory and push forward. We could be headed for dark days if it turns out the vaccines aren't effective after all - nobody will trust the next one.

The lack of time between testing and approval. They're waiting two months after the 2nd dose to evaluate safety which in her mind simply isn't enough time.

This is conjecture on my part, not coming from a medical professional, but if you want an example of why 2 months isn't enough time, take a look at the onset of type 1 diabetes. Something causes the body to attack the beta cells in the pancreas. And, it can take months if not years in some cases for the body to kill enough of the beta cells before symptoms are noticed.

That's not to say that will happen here, obviously there's no reason to think it will and I'm certainly under no circumstances saying these vaccines will cause diabetes. It's just an example that changes to the body aren't necessarily readily known within months. I use diabetes only because I'm familiar with it. I'm sure there are other physiological changes that take well over two months to present themselves.

ETA: She's fully vaccinated, as am I, as are our kids. But, she's pretty adamant she won't be and the kids won't be for at least a year or two. She'll let me do whatever I want...so, there's that

[Popeye_Card]

What is Mrs. AW's staunch opposition to getting the vaccine stemming from? General distrust of vaccines or this particular vaccine? The rush to market?

EDIT: I guess my stance is that I'm in no rush to get the Pfizer or Moderna vaccine. The AstraZeneca vaccine seems to have some advantages, but apparently there are a lot of questions swirling around their testing methodology. I hope that all of the companies continue to test and tweak their formulas, and not just declare victory and push forward. We could be headed for dark days if it turns out the vaccines aren't effective after all - nobody will trust the next one.

The lack of time between testing and approval. They're waiting two months after the 2nd dose to evaluate safety which in her mind simply isn't enough time.

This is conjecture on my part, not coming from a medical professional, but if you want an example of why 2 months isn't enough time, take a look at the onset of type 1 diabetes. Something causes the body to attack the beta cells in the pancreas. And, it can take months if not years in some cases for the body to kill enough of the beta cells before symptoms are noticed.

That's not to say that will happen here, obviously there's no reason to think it will and I'm certainly under no circumstances saying these vaccines will cause diabetes. It's just an example that changes to the body aren't necessarily readily known within months. I use diabetes only because I'm familiar with it. I'm sure there are other physiological changes that take well over two months to present themselves.

Completely understand, and I agree. That's why in a way I'm kinda glad that I likely won't be in line to get a vaccine until perhaps next summer, where we will likely know more about potential long-term effects if there are any.