[HN Gopher] Vaccine hopes rise as Oxford jab prompts immune resp...
___________________________________________________________________
Vaccine hopes rise as Oxford jab prompts immune response among old
and young
Author : pseudolus
Score : 741 points
Date : 2020-10-26 10:34 UTC (12 hours ago)
(HTM) web link (www.reuters.com)
(TXT) w3m dump (www.reuters.com)
| nickcotter wrote:
| Good news but still a long way to go. How's it going to be rolled
| out? Here in the UK we have tried and failed to get a regular flu
| jab (our GPs have run out of a very small supply and the
| pharmacies don't have any to sell) and I'm not optimistic about
| our chances of getting this next year or whenever it arrives.
| ck425 wrote:
| I'm not sure if I can share details but there is emergency
| vaccine work going on in the UK. The NHS has been using the
| winter flu vaccines this year as a way to test systems for
| future rollouts, such as a covid vaccine.
| d0ugal wrote:
| I was able to get the flu jab easily in Scotland (as was my
| wife and my daughter is getting it tomorrow). It was incredibly
| well organised.
|
| I think if you are unlucky it can be hard to get, but it is
| rolling out fast and many people are thankfully able to get it.
| benlumen wrote:
| I think you might be surprised. The government knows that this
| is the silver bullet they need to rescue the economy from
| oblivion.
|
| I'm expecting that once this thing is ready there'll be a
| logistical effort for the history books to roll it out. See
| what they can do with the military involved, like the
| nightingales.
| cmrdporcupine wrote:
| Sad to say, given how testing, lockdown, etc. has proceeded,
| I'm losing confidence that most western governments are
| capable of any "logistical efforts for the history books" at
| this point.
|
| I heard a lot of bluster about testing here in Ontario in the
| spring, but here we are in the fall with rationing of tests
| again.
| mikepurvis wrote:
| Testing in Waterloo Region was really good over the
| summer-- minimal wait times, multiple drive-in sites,
| results turned around in 24-36hrs. I think they just failed
| to account for the bump that would come from school
| starting and people wanting to get tested in advance of
| Thanksgiving.
|
| I think the "military involved" piece is key, especially if
| you're talking about the US. It's maybe a bit trite at this
| point, but a lot of comparisons were made about the stark
| contrast in how quickly a national response mobilized in
| response to BLM protests vs the pandemic. The basic
| takeaway being: executive priorities matter, and even Trump
| has made it clear on a number of occasions that getting the
| vaccine out is important to him.
| cmrdporcupine wrote:
| I guess that's the thing; the gov't is the one who made
| the decision to bring kids back fulltime, how incompetent
| do you have to be to not know there'd be a bump in
| testing demands?
|
| Re: Waterloo region, I work at Google Waterloo, so
| although I don't live in KW (I'm in rural Flamborough)
| most of my coworkers do. I had one who showed up at 7am
| to get a test, lineups were around several blocks and
| they shut the whole thing down because people were
| getting rude. He then had to wait a bit and drive to
| Guelph. People were driving out from Toronto to London,
| Woodstock, etc. to get tests.
|
| In our industry if we provisioned data centres or server
| instances like this, we'd be in a bit of trouble, no?
|
| EDIT: FWIW I have a political leaning and bias towards a
| strong public sector and am a big believer in public
| service. I'm not one of those "government can't do
| anything right" and "less government is better" types.
| But I do think that several decades of "government can't
| do anything right" people being a dominant cultural and
| political force now means that government can no longer
| do anything right. We're losing our ability to act
| collectively :-(
| mikepurvis wrote:
| Oh yeah, definitely. Can't help thinking of how much
| better things would likely be if we'd had a Horwath
| administration through this crisis. :(
| cmrdporcupine wrote:
| I like Horwath but I think her admin would have faced
| insurmountable ideological opposition, the same way Rae
| did. And then the whole COVID response would have been
| framed in those terms, as a right-left politicization
| like it is in the US. At least now, with a right wing
| government administrating the COVID response, only the
| far lunatic right (cough Randy Hillier cough) has
| politicized it. For conservatives, it's "their guy"
| delivering the tough medicine, and they just blame
| Trudeau for anything they don't like, even things the
| feds have nothing to do with. While it hasn't been great
| the management of this situation is not _nearly_ as bad
| as it could be. Just look at Jason Kenney's gov't.
| toyg wrote:
| _> I 'm losing confidence that most western governments are
| capable of any "logistical efforts for the history books"_
|
| Oh, they are. Just don't ask too many questions about money
| disappearing in the darker corners of such effort.
| zests wrote:
| I am glad that western governments are not capable of
| lockdown.
| cpmsmith wrote:
| For what it's worth, our testing has steadily increased
| since then. Perhaps we ought to expect more than
| "steadily", but the recent rationing is more to do with
| dramatic uptick in demand for tests (schools reopening,
| immediately followed by Thanksgiving) than with a change in
| capacity.
|
| There's no way (AFAICT) to link to it directly, but try
| charting "Total tests completed in the last day" and "Under
| Investigation": https://data.ontario.ca/dataset/status-of-
| covid-19-cases-in-...
| mercer wrote:
| I suspect the government will magically be much better at
| logistical efforts when there's a clear economic pay-off.
| Neoliberalism might not be great when it comes to helping
| the little man, but I suspect it can swiftly get its act
| together when it comes to a short-term solution to economic
| malaise.
|
| Or at least I hope so.
| Wintamute wrote:
| What sources are you using here? The UK has one of the best
| vaccination coverage rates in the world, and the largest ever
| roll out of the winter flu jab is well underway (reaching a
| record breaking ~50% of the population).
| standardUser wrote:
| "but still a long way to go"
|
| It's actually an "indeterminate way to go". Assuming it is
| "long" has no factual basis. Phase 3 results could be released
| literally any day now, and good results would lead to
| government approvals in the following weeks.
| nickcotter wrote:
| You're right, it could be anytime soon. But I was more
| concerned with what comes after that: distribution, stock
| piling etc.
| codeulike wrote:
| They are manufacturing it already supposedly. But I think the
| current UK plan is not to vaccinate everyone, but to start with
| the high risk groups. Perhaps they will then expand out to
| everyone else later.
|
| They have massively expanded the flu jab programme in the UK
| this year (to try and avoid hospital overloading) so thats one
| of the reasons flu jab is in short supply. Apparently its
| mainly a logistics problem, the doses are there, somewhere,
| see: https://www.theguardian.com/society/2020/oct/04/gp-
| surgeries...
| DanBC wrote:
| Can I check: are you in the priority group for flu jabs?
|
| Because GPs (in England, I don't know about the other nations)
| should have enough stock. They are prioritising higher need
| first, and then the expanded programme later in the year, and
| then anyone else who wants one after that.
|
| If you're not priority need you can try a pharmacist.
| nickcotter wrote:
| According to my GP they had a batch for the over 65s but they
| ran out pretty quickly. I usually get free flu jabs due to
| asthma but although it's strongly recommended I'm not aware
| of it being a definite priority group.
| gnfargbl wrote:
| Suggest trying again with your GP. I'm also in a lower-
| priority group and didn't get the jab during the first
| round, but my local surgery contacted me later when stocks
| had been replenished.
|
| Aside: It was, for the NHS, an _exceptionally_ efficient
| process. I was given an exact time slot and was in and out
| in less than three minutes.
| nickcotter wrote:
| Pharmacists don't have them available. Boots for example are
| "working hard to acquire additional stock" but have suspended
| their service.
| shermheadryder wrote:
| I'm in the priority group for a flu jab and I managed to get
| a jab from a pharmacy no problem. YMMV, though.
| cmrdporcupine wrote:
| Here in Canada we were able to get our flu shot at our family
| doctor's last week, but it was kind of a "first come first
| served" and "you have to ask about it" scenario. My employer
| usually does a flu shot clinic at work every year, but as we're
| all home we were not able to do that. In some ways there's been
| more barriers to getting it than in previous years, despite it
| being more urgent to do so.
|
| If this was rolled out properly people would be actively
| contacted by phone, etc. with assistance on how to get it.
| That's the kind of aggressive roll-out I'm hoping we see
| if/when a COVID19 vaccine becomes available.
| hikerclimber wrote:
| hopefully this doesn't work.
| maxehmookau wrote:
| I'm in the trial. It's really exciting, not least because form a
| purely selfish point of view, I might be immune already! ...or
| not. But it's exciting either way!
|
| AMA?
| jobigoud wrote:
| Do you get to know, at the end of trial, in which group you
| were?
| vmurthy wrote:
| Not OP but from the reports I have read, people who have been
| given placebos _will_ be informed _if_ the actual vaccine is
| found be really effective. This is for ethical concerns (in
| the sense that it would be unethical to not vaccinate people
| who have got a placebo if the real vaccine is really
| effective)
| aphextron wrote:
| >AMA?
|
| Have you experienced any side effects, even mild like injection
| pain or fatigue? I'm in the Moderna study and feel pretty
| disappointed that I may have gotten the placebo.
| divbzero wrote:
| ... or you might have been lucky with getting minimal side
| effects.
|
| Double blinded placebo controls are critical to clinical
| trials so you shouldn't be disappointed one way or the other.
| Even if you are in the control group you'll have the
| opportunity to get the vaccine after you've helped prove its
| efficacy and safety.
| xwdv wrote:
| What if something goes horribly wrong and the vaccine trial
| causes unwanted side effects? Why risk it, what are they paying
| you?
| tgsovlerkhgsel wrote:
| What if something goes horribly normally and you catch the
| virus the vaccine is supposed to prevent?
|
| It's a risk tradeoff, different between the phases. I'd
| probably volunteer for a phase 3 trial if one was available
| in my area. Phase 1 would be a bit too hot for me.
| maxehmookau wrote:
| I'm receiving no money for my participation. I wasn't in the
| initial Phase I trial, a few hundred people had already
| received the vaccine before me with no unexpected side
| effects.
|
| I guess I'm risking it because someone has to. Vaccine trials
| are incredibly safe and highly regulated. In reality, the
| worst-case was that it didn't work rather than my head
| exploding.
| xwdv wrote:
| How do you prove to people you are in a vaccine trial, do
| you have a card?
| maxehmookau wrote:
| I have a "red alert" card so if I'm found unconscious a
| paramedic knows to contact the study team to find out if
| I'm in the control arm or I've had the active vaccine so
| they can rule out if it's important to why I was found
| unconscious!
|
| But it is just a piece of paper that the team printed
| out, and I think I lost it.
| behnamoh wrote:
| >> But it is just a piece of paper that the team printed
| out, and I think I lost it.
|
| _loses the single most important medical document that
| 's going to save his life_
| neuronic wrote:
| Paramedics won't go through your wallet anyways.
| standardUser wrote:
| It's worth remembering that Phase 3 trials follow Phase 1/2
| trials, and those earlier trials are responsible for
| assessing the general safety of the vaccine. Phase 3 helps
| assess safety concerns among a much larger and more diverse
| group of people, but it is primarily about proving efficacy.
| They don't give out tens of thousands of vaccines (Phase 3)
| without a lot of data already showing the vaccine is safe.
| rlpb wrote:
| > Why risk it?
|
| It's worth pointing out that during a pandemic, while
| participating in a trial does carry a risk, so does _not_
| participating. A participant has some substantially greater
| probability* than the general population of avoiding an
| infection which apparently carries a risk of death or long
| term debilitating effects.
|
| * You'll have to incorporate the probability of being in the
| control group, of course, but the overall probability is
| still significant.
| aphextron wrote:
| >It's worth pointing out that during a pandemic, while
| participating in a trial does carry a risk, so does not
| participating. A participant has some substantially greater
| probability* than the general population of avoiding an
| infection which apparently carries a risk of death or long
| term debilitating effects.
|
| Participating also carries risks beyond simply that of the
| vaccine. Being exposed to any kind of healthcare setting is
| extremely dangerous right now. I'm taking part in the
| Moderna trial, and honestly I'm considering dropping out
| before the second injection. The risk of going into a
| clinic multiple times where I hear people coughing all over
| the place is starting to seem unacceptable to me given that
| I'm fairly certain I've been given the placebo.
| lbeltrame wrote:
| FTR, most side effects appear (according to what Moderna
| published so far) only after the booster shot. So IMO you
| can't tell yet if you were given the vaccine or not.
| [deleted]
| maxehmookau wrote:
| Oh yeah, that's for sure. The idea that there's a pretty
| decent chance that I've been vaccinated already which means
| I don't have to wait for a vaccine is great.
|
| My life can begin to go back to normal potentially months
| before it otherwise would.
| pbourke wrote:
| Are participants eventually informed whether they're in
| the treatment or control groups?
| whimsicalism wrote:
| At the end of study.
| elevenoh wrote:
| >My life can begin to go back to normal potentially
| months before it otherwise would.
|
| Howso? Socialization is a multi-party dynamic. Folks
| might not care/believe you if you state 'I'm vaccinated'
| until it's widely accepted.
| whimsicalism wrote:
| Maybe I'm a dunce but I would believe a friend if they
| say they're vaccinated or already got covid.
| tgsovlerkhgsel wrote:
| Right now, many, many folks don't seem to care that
| people aren't vaccinated either.
| jjulius wrote:
| I'd assume that one would be socializing with the same
| groups of friends/family that they had pre-COVID. With
| that in mind, wouldn't OP have already established a
| foundation of trust within those groups? Maybe this
| sounds naive, but why have friends if they're not capable
| of trusting you?
| ksk wrote:
| By the time human trials commence, we're as sure as we can be
| that it's safe. Due to how the system is set up at the
| governmental level, whenever any participant in the trial
| experiences adverse reactions, the trial is halted, until an
| explanation can be given. It's a serious concern that can and
| does lead to products not being approved by the FDA. Not
| being approved = loss of tens or sometimes hundreds of
| millions of dollars. People take this stuff very very very
| seriously :)
| phreeza wrote:
| How many people are in the trial, is the fact that two of the
| responses on this thread are from trial participants indicative
| of a bias towards nerds in the selection?
| baron816 wrote:
| Does anyone know why challenge trials haven't been done? They
| should be much faster, right?
| White_Wolf wrote:
| Are the full results of the human trials available anywhere?
| blackbear_ wrote:
| Here [1]. It will be updated with the results, eventually.
|
| [1]: https://clinicaltrials.gov/ct2/show/study/NCT04516746
| sabersei2 wrote:
| Mehhhhhhhhh
| aokiji wrote:
| I hope that by coincidence, the vaccines do not magically get
| safety approval after the day of the United States' elections.
| fallingfrog wrote:
| Bet you they give it to everyone for free everywhere in the world
| except for the USA, where they charge 600 dollars a dose and
| consequently we never reach herd immunity and have endemic Covid
| indefinitely.
| dang wrote:
| Would you please stop posting flamebait to HN and not use the
| site primarily for ideological battle? We ban accounts that do
| those things and have already had to ask you a few times.
|
| https://news.ycombinator.com/newsguidelines.html
| fallingfrog wrote:
| I'm genuinely surprised..
|
| Does this comment really read as flamebait? The article is
| about vaccines. A vaccine has to be administered to everyone
| to work. But I'm very skeptical that it's actually going to
| happen given the way our medical system works here. So, I
| predict that there's a good chance we won't get herd
| immunity. I just don't see how that's flamebait. It's more,
| known facts and extrapolation.
| pvg wrote:
| _known facts_
|
| You can look up the moderator commentary on 'facts' and
| flamebait (tldr is, you can flamebait with facts) but these
| aren't even facts - free vaccine has been the stated
| official plan in the US for months.
| dang wrote:
| Sure it does. This may be a case of "comments in the rear
| view mirror are much larger than they appear", i.e. people
| underestimate how provocative their posts are.
|
| US healthcare differences are a classic flamewar topic and
| nationalistic flamewar is particularly ugly and pointless.
| Your comment wasn't thoughtful/substantive, it was
| snarky/hyperbolic. Ergo flamebait.
| hans1729 wrote:
| 800 for the dose, 300 for a list of other things on the bill,
| and you're required by law to get the injection _today_. if you
| can 't afford it, that's prison time, where you'll get the
| vaccinee but also need to work for the bill, probably producing
| maga-caps or substituting sick/dead medical personnel.
|
| _eagle screeches_
|
| are we there yet?
| curiousllama wrote:
| The good ol' Oxford Jab
| barbecue_sauce wrote:
| Very awkward use of informal english in this article's title,
| particularly from Reuters.
| ageitgey wrote:
| The word jab is standard UK English for 'shot'. It might be
| slightly informal, but it's definitely standard to see it in
| the news and in government publications.
|
| Example: https://www.bbc.co.uk/news/health-54337585
| cwhiz wrote:
| Can someone explain to me why double blind is necessary or useful
| for a vaccine trial such as this? It seems obvious to me on
| something like a pain medicine, but on a vaccine it seem a
| pointless. Is placebo an actual issue with a vaccine?
|
| It honestly seems borderline unethical to give people a placebo
| vaccine.
| tgsovlerkhgsel wrote:
| If you tell people whether they're now vaccinated, they're
| going to take a lot more risks.
|
| You may still have increased risk taking behavior if you don't
| tell them whether they got the real vaccine or placebo, but it
| will be equally increased across the experiment and control
| groups.
| raverbashing wrote:
| And?
|
| Having them expose themselves more to the virus is a "good
| thing" (though tell them how long should they wait for the
| immunity to set in)
|
| Yes, with the control group you would have a base for how
| many people you would have expected to be infected, so
| there's that, but you "could" get that from other
| observations
| whimsicalism wrote:
| > you "could" get that from other observations
|
| No, if they change their behavior, you couldn't.
|
| Why are so many people commenting when they clearly don't
| understand knowledge-creation/statistics/methodology?
| keyme wrote:
| Placebo can have an effect on side effects.
| cwhiz wrote:
| Are they testing for side effects in all three stages? I
| thought the first two trials were for safety and the third
| was for efficacy. Is that incorrect?
| ksk wrote:
| Data on adverse reactions is captured by the CDC/FDA/HHS
| throughout the lifecycle of the vaccine, from all the
| phases of clinical trials to its use in the general
| population. Its required by law.
| tcoff91 wrote:
| They're absolutely monitoring side effects during phase 3.
| some safety effects can be rare enough that they don't show
| up in phase 1/2.
| cwhiz wrote:
| Okay. I'm still having a hard time understanding how
| placebo helps them test for side effects.
| Izkata wrote:
| I imagine: If a given side-effect occurs at the same rate
| in both groups, it's unlikely to be caused by the vaccine
| and is more likely to be psychosomatic.
| koboll wrote:
| You're right, and researchers are aware of this:
|
| https://www.statnews.com/2020/09/03/placebos-arent-needed-ch...
|
| Also, there is a very strong risk, given the global situation,
| that the longer placebo-controlled trials go on, the _less_
| reliable the data will be, because control-group subjects will
| ignore the rules of the study and go get vaccinated as soon as
| it 's broadly available just in case. So even just looking at
| data quality and excluding other considerations, placebos have
| major risks that probably outweigh the benefits of
| administering them for months or years like a usual vaccine
| trial would.
| bausano_michael wrote:
| You might like Greg Egan's short story "Blood sisters" which
| addresses exactly this topic. It's one of the short stories in
| the book "Axiomatic".
| DiogenesKynikos wrote:
| People who know they've been vaccinated will behave more
| recklessly than people who haven't been vaccinated. You need to
| have a control group, in order to assess the efficacy (and
| safety) of the vaccine. If the control group is wearing masks
| and socially distancing, but the vaccinated group is going
| partying at bars and clubs every night, then comparisons of how
| often each group gets infected won't have much meaning.
|
| It's only unethical to withhold the vaccine if you know that
| it's safe and effective. The whole point of the study is to
| figure out if that's the case. It's possible for vaccine
| candidates to be ineffective, or even harmful (e.g., antibody-
| dependent enhancement).
| cwhiz wrote:
| What you're describing as "reckless behavior" is just normal
| behavior in a non-covid world. If vaccine candidates are
| social distancing, wearing masks, and staying home how will
| the researchers get the data they need? If you are following
| "covid best practices" it is extremely unlikely that you will
| contract covid. Would the researchers not want people to go
| out and live their normal lives?
| jberryman wrote:
| The point is if the two groups behave differently wrt risk
| then the trial is probably ruined. Maybe you're assuming
| the vaccine will be 100% effective; experts I've heard are
| saying to expect something like the flu shot.
| kortilla wrote:
| > If you are following "covid best practices" it is
| extremely unlikely that you will contract covid.
|
| It's spreading like wildfire to people following best
| practices too all over the world. It only takes a small
| subset not following these practices to spread it all over.
| DiogenesKynikos wrote:
| You need both groups to behave in the same way. Phase III
| trials are enrolling enough people (tens of thousands) so
| that a sizeable number will likely contract the virus
| within a few months. They specifically run these trials in
| places where the virus is spreading (this is why Chinese
| vaccines are being tested outside China, in places like
| Brazil).
|
| > Would the researchers not want people to go out and live
| their normal lives?
|
| That would be great for the trials (assuming both the
| vaccinated and placebo groups behaved identically). But
| most people would consider it unethical for researchers to
| encourage the trial participants to increase their
| likelihood of exposure to the virus. People who sign up for
| vaccine trials are not signing up to get CoVID-19.
| Polylactic_acid wrote:
| The researchers only need a group that acts in the same way
| as the test subjects. Plenty of people will still catch
| covid while being careful.
| whimsicalism wrote:
| Just think critically for a few minutes before commenting
| your next new objection to see if you can come up with what
| the problem might be.
| [deleted]
| marketingPro wrote:
| This article reinforces that herd immunity between young healthy
| people would have been the best solution.
|
| Our old are going to get sick from vaccines, so the young are
| going to get it anyway. Next year under 50 year olds will line up
| for their vaccine.
|
| Meanwhile 1.5 years worth of old, obese, and sick people will
| have died from coronavirus.
|
| Wouldn't it have been better if healthy kids and adults caught it
| in q2 2020?
|
| (Please no ancedotes of a sick 5 year old child dying from
| "coronavirus", statistics are necessary when discussing billions)
| jmull wrote:
| > Wouldn't it have been better if healthy kids and adults
| caught it in q2 2020?
|
| No.
|
| We have one population. There's no way to segment it to allow
| people at low risk to catch the virus without also allowing
| people at high risk to get it.
|
| How do you think it could work otherwise?
| im3w1l wrote:
| I was considering bug chasing and then isolating. I regret not
| doing so.
| glotgizmo wrote:
| (In the UK) Young healthy adults and kids live with
| old/unhealthy/frail parents due to the enormous financial
| difficulty of leaving home.
| jedimastert wrote:
| And in the US too
| henearkr wrote:
| This is a virus with bad long-term effects on the body.
|
| Not a good idea to catch it just to get immune.
| rimliu wrote:
| Nobody knows its long term effect on the body. Especially if
| you were asymptomatic.
| feanaro wrote:
| Your response is phrased in a way that all the meaning lies
| in the exact definition of what you mean by "knows". There
| is certainly evidence that there are long-term effects.
| Example: https://www.medrxiv.org/content/10.1101/2020.10.20
| .20215863v...
| henearkr wrote:
| This huge uncertainty is in favor of avoiding taking the
| risks, rather than the other way.
| anoncake wrote:
| Put another way: Nobody knows of any long term effect on
| the body.
| cheph wrote:
| > This is a virus with bad long-term effects on the body.
|
| In what percentage of people who get COVID-19 are there bad
| long-term effects? What other conditions did the people get
| bad long term effects have? How does these numbers compare
| with other diseases?
|
| Would appreciate citations.
| 3np wrote:
| We don't know. Which is why it's preferred to play it safe,
| in that regard.
| henearkr wrote:
| Damage to the heart, the brain, even for mild or asymptotic
| cases. My references are previous posts on HN or on
| phys.org as you can easily search it.
|
| As you said there are scarce data yet, but the risks are
| scary. In these conditions, it's obvious one should avoid
| relying on a herd immunity induced by the virus.
| anoncake wrote:
| Exactly. There is scarce data. If after almost a year
| there is still no evidence of long-term damage, it's
| reasonable to assume there is none.
| cheph wrote:
| > My references are previous posts on HN or on phys.org
| as you can easily search it.
|
| And you could cite a claim you are making. Without
| numbers it is hard to say if this is a good basis for
| decisions.
| henearkr wrote:
| The statistics are in the making, and researchers
| discover more illness mechanisms each day.
|
| As I said, we are in the presence of a huge risk and
| there is no "reassuring numbers" anywhere to
| counterbalance that.
|
| As one reference on the risks I'm speaking of, here is an
| article about the action of the virus on the nerve cells:
|
| https://www.scientificamerican.com/article/what-we-know-
| so-f...
|
| By the way, between "relying on virus-induced herd
| immunity" and just keeping safe with mask and waiting for
| the vaccine to come, why the rush to get the virus??
|
| There is a risk, there is the possibility to wait it
| over. So why just not do that and wait the safe solution?
| marketingPro wrote:
| Suicide, abuse/trauma, avoided medical treatments, drug
| and alcohol addictions, and depression have all been seen
| to increase since we first had lockdowns.
|
| There is no safe solution, it's a decision between
| protecting the 0.5% old, obese, and sick or the 99.5%
| henearkr wrote:
| The fact that catching the COVID should be _avoided_
| instead of _looked for_ is really obvious.
|
| How to avoid it is the real discussion.
|
| I could avoid it easily until now because everybody wears
| a mask here.
|
| In some cases or in some countries, this is not possible,
| or too much people are infected already, and lockdown
| becomes the best solution.
|
| Nobody is saying that lockdown is the only solution in
| every case, and absolutely nobody is even thinking that
| lockdown is making people happy.
| singemonkey wrote:
| Please provide evidence for this.
|
| (To avoid misunderstandings, evidence does not mean your
| unverified opinions).
|
| I'm particularly interested in your methodology for
| arriving at 0.5%, so a detailed data dump on that from
| you would be very useful.
| chimprich wrote:
| > Suicide, abuse/trauma, [...], drug and alcohol
| addictions, and depression have all been seen to increase
| since we first had lockdowns.
|
| Correlation versus causation.
|
| We're in the middle of a major health emergency. Why are
| you attributing those to the effects of lockdowns, rather
| than the effects of the pandemic? You don't think that
| the risk to personal health of a potentially lethal
| virus, seeing older friends and relatives dying, and
| worrying about the risk of health systems collapsing are
| causing any of the above?
|
| In March, someone I know in Italy passed on the virus to
| his grandfather, who died at home. All the ambulances in
| the area were tied up for hours. You can imagine the
| effect on his mental health. I doubt the impact was
| comparable to the effects of intermittent lockdowns.
| graeme wrote:
| We don't know yet. It's a gamble.
|
| A uk study suggests 12% have symptoms longer than 30 days.
| Beyond that, hard to say. We also don't havea good measure
| of invisible damage: do survivors have reduced lung
| function from pneumonia? Damage to endothelium predisposing
| to pneumonia? Too soon to tell.
|
| About 20% of people are hospitalized.
|
| https://www.bbc.com/news/health-54296223
| celticninja wrote:
| Given that immunity from infection is currently questionable
| your suggestion doesn't make sense. The reason the findings
| mentioned in this article are important is because the immune
| response seems to be stronger than that seen in people that
| have been infected and recovered. So this vaccine would be
| better at creating herd immunity than just allowing everyone to
| get infected. At the same time vaccinations will have a reduced
| impact on people than actually catching the virus would.
|
| There is a difference between the level of illness experienced
| by those who are vaccinated Vs those who get infected, so more
| old people will die as a result of infection than would die as
| a result of vaccination.
|
| So no, it would not be better for healthy adults and kids to
| get it in Q2 2020. Also how do you propose that you only infect
| the healthy adults and kids?
| cheph wrote:
| > Given that immunity from infection is currently
| questionable your suggestion doesn't make sense.
|
| If you can't get immunity from the infection, how will the
| vaccine work?
| regularfry wrote:
| We don't know if it does yet. We know it causes an immune
| response. We don't know if that stops you from catching it,
| and we don't know if it stops you from being infectious. It
| tips the scales in that direction, and all we really need
| is for it to be effective _enough_ to drop R0 low enough
| that coupling it with reasonable restrictions makes the
| virus go away, which is why it 's worth pursuing, but
| that's a different goal to ensuring you can't catch it at
| all.
| rimliu wrote:
| How is immunity from infection questionable? We had 43
| million cases and about a dozen or so reinfections. Not sure
| if confirmed reinfections reach the double digits yet.
| graeme wrote:
| So studies of other coronaviruses show immunity lasted 6-12
| months. We're a but early to see mass reinfections.
|
| That said, my guess would be normal reinfections would be
| less severe, more like a cold. There have been some severe
| reinfections but any reinfection under six months suggests
| something atypical in the immune response.
|
| Also SARS-Cov-1 produced a longer immune response so that
| may happen here.
|
| But lifelong sterilizing immunity seems pretty unlikely
| based on what we know so far. The vaccines aren't aiming at
| sterilizing immunity actually, their goal is to greatly
| lower the severity of the infection.
| rimliu wrote:
| Studies also show that the immunity for original SARS
| (the close relative) lasts many years.
| graeme wrote:
| Yeah that's what I meant by SARS-Cov-1. But I prob should
| have gone with the clearer term
| celticninja wrote:
| Read the papers on it, antibody tests in people who have
| previously tested positive for covid have found little or
| no antibodies in tests taken 3 months after infection. So
| it appears as if there is a limited/short term immunity
| after initial infection. The vaccine appears to produce a
| much stronger immune response, such that antibodies can be
| identified in tests some time after the vaccination.
|
| You can get limited immunity from the common cold after
| being infected but you are just as likely to catch it 12
| months later anyway. With covid that means we are dealing
| with it annually, which our health services cannot keep up
| with.
| dtech wrote:
| antibodies disapear quickly, but the B-memory cells that
| produce them are still in the body ready to be mobilized.
|
| "Common cold" and "flu" is not 1 virus, but hundreds of
| different viruses which is why you get them repeatedly.
| You do build immunity though. It's why children always
| have a cold and adults a lot less common.
| rimliu wrote:
| There are more immune mechanizms beside antibodies
| (T-cells, B-cells). For the common cold there are
| different viruses, so you may get a cold caused by
| different ones.
| gnfargbl wrote:
| That option was apparently actively considered by the UK
| Government's scientific advisory group, but rejected on the
| basis that it would not actually be possible to prevent
| transmission from less-vulnerable groups to more-vulnerable
| groups. Reference: https://archive.is/43ir5
| LatteLazy wrote:
| Why would old people get sick from the vaccine?
|
| If we let everyone get it in Q2 2020, millions would have died
| when we ran out of ventilators.
| mav3rick wrote:
| Not supporting the OP's assertions, but vaccines have some
| timid / less potent form of the virus.
| roman030 wrote:
| Imagine throwing your phone at the wall and it shatters
| into 1000 pieces. Now try calling someone with one of these
| pieces.
| ourcat wrote:
| A certain amount of 'reactogenicity' is expected with most
| vaccines. ie: "expected" adverse reactions.
| LatteLazy wrote:
| Thanks, I guess people do get mild flu after the flu
| vaccine so it would make sense for it to be the same.
| toolz wrote:
| The implication that we even slowed the trajectory isn't well
| established. It's likely, but not proven. Let's not get ahead
| of ourselves by pretending there's evidence millions would
| have died when there's not even a strong correlation between
| mandates (as defined by the Oxford stringency index database)
| and reduced death.
|
| and nowhere that I'm aware of came close to running out of
| ventilators. New York, one of the hardest hit places in the
| world may have used a third of their available ventilators.
| They used around 1/2 of the ventilators they reported
| available to them in 2015 so it wasn't even close to being
| the limiting factor in healthcare.
| umanwizard wrote:
| > If we let everyone get it in Q2 2020, millions would have
| died when we ran out of ventilators.
|
| How do you explain countries like Belarus, Serbia and Sweden,
| or parts of the US like South Dakota, where no or very lax
| measures were taken but what you describe didn't happen?
|
| In fact, is there _any_ evidence that this happened anywhere,
| or is it all just conjecture based on modeling?
| disgruntledphd2 wrote:
| Probably too early to tell about South Dakota, to be
| honest. Let's see what things look like in a few months.
| LatteLazy wrote:
| Last I checked Sweden had 110k cases and 5.5k dead. That's
| an almost exactly 5% fatality rate. Compare that to
| neighbouring Denmark with 40k cases and 700 dead gives you
| a 1.75% fatality rate.
|
| Seems to me that there is good basic evidence right there
| for Sweden's approach being much more deadly.
|
| We can argue back and forth about the relative value of
| freedom vs lives or whether Denmark will ultimately have as
| many dead etc. But right now, it seems that controlling
| numbers saves lives...
|
| https://www.google.com/search?q=sweden+covid+deaths&rlz=1C1
| G...
| ghufran_syed wrote:
| Comparing the case fatality rates makes no sense unless
| you have the same ability to get a test in both
| countries. If one country were to test _everyone_ ,
| including asymptomatic people, then their CFR would be
| lower than a country with more limited testing, simply
| because the denominator would include those large number
| of minimally symptomatic or asymptomatic patients that
| would be missed in the other country.
|
| Also, the CFR is likely intrinsic to the virus, modified
| slightly by patient population and type of medical care
| available (both of the latter are probably very similar
| between the two countries). So any differences in CFR
| between the two countries mostly reflects the testing
| issue.
|
| If you _do_ want to compare the two countries, then
| compare the per capita death rate from covid (assuming
| everyone who dies in both countries actually gets a covid
| test - that might not be the case for old people who die
| at home, where even in developed countries, their primary
| doctor will just issue a death certificate saying "old
| age" or "heart attack" in the absence of any information
| to the contrary. )
| turing_complete wrote:
| Wow, that is just classic lying with statistics.
|
| 1. You cannot just rely on how many sick people happen to
| be tested. Every single serology study implies a IFR of
| well under one percent. I am willing to bet that it will
| end up between 0.1 and 0.6 % for any developed country.
|
| 2. You cherrypick your data if you compare Sweden with
| Denmark or Germany and not with France or the UK.
|
| My hypothesis is that countries that protect the elderly,
| and especially nursing homes, well have much fewer
| deaths. In every country this is were the deaths are
| concentrated.
| lazzurs wrote:
| It's super easy to make those decisions as an abstract
| mathematical problem. It is another when someone puts your
| family in front of you and asks you to roll the dice.
|
| As an abstract mathematical problem if somehow herd immunity
| could be achieved without a vaccine then it sounds like a fine
| idea. The fact is that immunity after infection does not last
| long enough to achieve significant enough immunity to get to a
| useful herd immunity. This of course is what all the medical
| experts understand which is why Europe is going through
| lockdowns and Putin has been hiding in a bunker. There have
| been strict lockdowns in China and most other major governments
| have taken some sort of similar response, even Sweden
| eventually. There is almost nothing all of these governments
| have ever agreed on so universally.
|
| Don't expect a reply justifying my comment on HN with robust
| data, I have better things to do with my time like play in a
| park.
| 02020202 wrote:
| you can take your vaccine and shove it up... you know where.
| Contax wrote:
| TIL about the "jab" word in this context (English is not my first
| language). I thought the author had misspelled "lab".
| iamatworknow wrote:
| I'm a native English speaker (American) and have thought it was
| odd for a few weeks that Reuters in particular likes to use the
| word "jab" for "vaccination". It's not commonly used that way
| in the US.
| NoodleIncident wrote:
| It's a holdover from print news media to use uncommon-but-
| short synonyms in headlines. There might be some benefit
| online as well, but since it's an established
| jargon/vernacular/dialect/etc of English, they probably just
| continue to use it out of habit.
| TillE wrote:
| It's extremely weird until you remember the American
| equivalent is "shot".
|
| I think the British media goes for the colloquial version a
| bit more, but it's hard to say for sure.
| justnotworthit wrote:
| It's mine, and the one I study. I'm guessing it's slang for
| injection? Looking it up now...
|
| I sympathize with your pain of learning a new language (or
| system or whatever): It's hard to tell if it's a mistake on
| their part, a mistake on your part, some kind of regionalism,
| some kind poetry...
| [deleted]
| dblooman wrote:
| Not knowing anything about big pharma, does Astrazeneca make all
| the money here? How much does a vaccine like this cost per person
| given the scale of the distribution and manufacturing?
| lettergram wrote:
| Usually there is an IP agreement. Also, ever notice the media
| calls it "Oxford study/vaccine" for good news and "Astrazeneca
| study/vaccine" when it's bad news (like a few weeks ago when
| they had to shutdown to multiple people getting an unknown
| illness).
|
| I work in an area where we make agreements with university's.
| It's often shared IP or publicity. Alternatively, one can
| publish, once the other makes profits. Or it could be something
| in between.
|
| In this case, I bet everyone is doing this pro-Bono from a
| future profit perspective, because the government is paying for
| all of it.
| lbeltrame wrote:
| IIRC, the expected price is around $3.50/dose, but I can't
| find the source for that anymore. AZ and Oxford have pledged
| not to ask for royalties or whatever, at least until the
| pandemic is ongoing (that would likely mean all of 2021 at
| the earliest).
| dbetteridge wrote:
| OK, someone tell me why this isn't the good news it sounds like
| faitswulff wrote:
| Well, it's still good news, but an injected vaccine may not
| lead to sterilizing immunity - i.e. vaccinated persons might
| still be able to transmit the disease:
|
| > Without a strong mucosal response, injected vaccines may be
| less likely to produce so-called sterilizing immunity, a
| phenomenon in which a pathogen is purged from the body before
| it's able to infect cells, Dr. Durbin said. Vaccinated people
| might be protected from severe disease, but could still be
| infected, experience mild symptoms and occasionally pass small
| quantities of the germ onto others.
|
| https://www.nytimes.com/2020/07/14/health/coronavirus-nasal-...
| mantap wrote:
| It seems that COVID-19 is often passed at superspreading
| events. If the vaccine could nevertheless prevent people from
| superspreading then it might still have a substantial effect.
| mcv wrote:
| Even so, reducing the severity would be great. Even if a
| patient doesn't die, Covid-19 can have devastating and long-
| lasting effects. If a vaccine could reduce it to just a mild
| flu, I think that's good enough. You just have to inject
| everyone and probably add it to the standard child
| vaccination set.
| RobertDeNiro wrote:
| There's never been any belief among the scientific community
| that any of the vaccine candidates would provide sterilizing
| immunity. That was just a pipe dream.
| zzzeek wrote:
| hundreds of thousands of people died preventable deaths.
| barry-cotter wrote:
| Because by the time this passes clinical trials the Chinese
| vaccine will have been in mass production for months. The FDA
| will delay adoption of any vaccine in the US for many months in
| order to keep to the same standards they use when the world
| isn't on fire.
| Neil44 wrote:
| It's already in production pending approval, which is set to
| be fast tracked to "save christmas"
|
| Personally I would argue that the standards should be kept to
| even when the world is on fire, I mean they do exist for a
| reason.
| hannob wrote:
| It's a surrogate outcome. "Prompts immune response" means "we
| hope it prevents infections". It doesn't necessarily mean it
| will.
|
| This is still good news. But it should be put in perspective,
| this does not automatically translate to "this vaccine will
| work fine in both young and old". It just means we can have
| some higher hopes that it will.
|
| Only RCT results of the real infections will show if it really
| works. (RCT for the vaccine is running and first results are
| expected soon.)
| The_rationalist wrote:
| What's RCT? You mean voluntarily injecting the covid on
| vaccined very young humans (so negligible risk of death) ?
| jhfdbkofdcho wrote:
| Randomized Control Trial
| dewey wrote:
| Randomized Controlled Trial:
| https://en.wikipedia.org/wiki/Randomized_controlled_trial
| [deleted]
| benchaney wrote:
| RCT means a randomized controlled trail. GP is confused.
| This announcement is about an RCT.
|
| Injecting a disease into volunteers is called a human
| challenge trial. It is a type of RCT, but it is not what is
| being discussed here.
| marksomnian wrote:
| Randomised Controlled Trial - essentially, take a
| population, give half of them the vaccine, and half a
| placebo, and study the reaction.
|
| What you're referring to (voluntarily infecting people) are
| challenge trials, which are also being discussed, but are
| still somewhat ethically dubious.
| cesarb wrote:
| Wikipedia tells me RCT is "randomized controlled trial",
| that thing they are doing where half the volunteers receive
| the experimental vaccine and half receive a placebo, and
| they wait to see how many get the disease (and how many get
| side effects) in each group. I don't think there's any
| "human challenge study" (in which they deliberately infect
| the volunteer,
| https://en.wikipedia.org/wiki/Human_challenge_study) so
| far.
| jlokier wrote:
| There was a human challenge trial announced a few days
| ago. I.e. people are volunteering to be infected with the
| virus in an RCT.
| lukevdp wrote:
| RCT = randomised controlled trial - a trial where some test
| subjects are given the vaccine and some are given the
| vaccine, then you follow the subjects and see which ones
| get COVID and how bad.
|
| There are already a bunch of vaccines going through this
| process.
|
| Challenge trials is where you purposefully infect subjects.
| TheY are highlY controversial but according to Oxford,
| would speed up the research and they are planning to do
| one.
| [deleted]
| Anka33 wrote:
| The IQ lowering serum is soon ready for deplyment,Trump and
| Brexit may never be allowed to happen again.
| jlokier wrote:
| It's definitely good news.
|
| Though, sometimes people think vaccines just prevent someone
| getting a disease. Stop it completely in its tracks. That's
| true for some, but it's not that simple for others.
|
| Unfortunately a measured immune response does not ensure:
|
| - That the virus can't be transmitted to others
|
| - That you are less likely to catch and replicate the virus
|
| - That you can't get ill from the virus
|
| - That you can't get "long covid" symptoms
|
| - That you can't die from covid
|
| - That the immune response lasts for more than a few months
| (this is why we keep getting some of the same cold viruses; our
| immunity to them doesn't last)
|
| - That the R number goes down (if it doesn't prevent
| transmission)
|
| - That the R number doesn't go up (if people change behaviour
| in response to knowing they or other are vaccinated)
|
| - That the virus won't evolve a workaround in response, like
| the rapidly mutating flu viruses
|
| An immune response certainly _suggests_ those things. But we
| can 't be certain from immune response alone. Consequences need
| to be measured as well. We'll have a real solution when those
| sorts of things can be demonstrated, but it will take much
| longer to find out unfortunately. Probably we have to deploy a
| vaccine on a large scale somewhere before we can even find out
| how effective it is in the ways that ultimately matter.
|
| Still, if a vaccine combined with uptake and people's behaviour
| reduces R below 1.0 at scale, that's enough to be a
| breakthrough. The greater the reduction the better, but 1.0 is
| the magic number.
|
| Even if there's one good vaccine, having multiple good vaccine
| types in the world will be better. The virus is less likely to
| evolve a defence against multiple vaccines than against a
| single type deployed everywhere.
|
| The fact this vaccine targets the spike protein is also good
| news, because even if the virus evolves, there's evidence that
| the spike protein is key to its harmfulness, so any evolved
| strains that keep it will likely trigger an immune response,
| and evolved strains that change the spike protein seem likely
| to be less harmful too.
| dogma1138 wrote:
| The virus cannot replicate, the genetic material inside the
| virus cannot create new viruses as in there are no
| instructions inside the payload to replicate and assemble new
| virions.
|
| To make the virus for the vaccine you need to use a different
| virus that when it replicates it creates copies of the actual
| virus used in the vaccine.
|
| Think about it as a self extracting archive that creates
| copies of an uncompressed file (the actual vaccine) the file
| that it outputs doesn't have the information to reconstruct
| the self extracting archive itself.
| jlokier wrote:
| Thanks.
|
| I guess the thought is that a really unlucky evolutionary
| accident would be when the other virus capable of
| replicating and the vaccine meet in a body, and by chance
| transfer some of those instructions across. I presume
| that's rare or never seen, but I don't know, and (with a
| safety-engineering mindset on) I'd automatically consider
| that a "chance" unless it is ruled out by something.
| dogma1138 wrote:
| Anything can happen however we've been using weakened,
| inactivated and closely related viruses in vaccines for a
| long time now without any such natural selection
| accidents occurring.
| jlokier wrote:
| From Wikipedia under "attenuated vaccine" (which I know
| this is not):
|
| > In extremely rare cases, natural mutations can cause a
| reversion to virulence. In this case, the virus can
| revert to wild type or develop into an entirely new
| strain.
|
| Now, the Oxford vaccine is _not_ an attenuated virus as
| is usually meant by that term.
|
| On the other hand, it's not the same as an "inactivated
| virus" vaccine type either, where a virus is broken
| apart.
|
| It's a different sort which doesn't fall into either of
| those categories. It's described as a "weaken adenovirus"
| and "replication-deficient" because of replication genes
| being deleted, and spike protein coding added. (There's
| no coronavirus at all, just the spike protein. This is
| completely different from other vaccines.)
|
| The replication-deficient adenovirus has been studied
| thoroughly, not just for Covid but earlier as well. There
| are good reasons they selected it.
|
| _I will certainly take that vaccine when it 's
| available, if that counts as any sort of endorsement_.
|
| I have high confidence in the people engineering and
| studying it. (I'm in Oxford, btw ;-) But can you really
| generalise the observations of inactivated virus vaccines
| to this relatively new kind? I think no, it has to be
| studied and monitored with care. Thankfully, I think they
| are doing exactly that.
| kalaido wrote:
| You mean because of the 2 deaths?
| henearkr wrote:
| This IS good news.
|
| Now (soon, hopefully) people can acquire immunity through a
| vaccine, instead of through a virus that leaves long-lasting
| damage to the body (in particular, but not limited to, the
| brain).
| cheph wrote:
| > leaves long-lasting damage to the body (in particular, but
| not limited to, the brain).
|
| In what percentage of people who get COVID-19 is there long-
| lasting damage to the body? What other conditions did the
| people who get long-lasting damage to the body have? How does
| these numbers compare with other diseases?
|
| Would appreciate citations.
| henearkr wrote:
| Most people with COVID even with few symptoms have a loss
| of smell. If you like numbers, I read that around 80% of
| people with COVID report loss of smell.
|
| And this is one kind of neurological effect. This is a more
| global view of how the virus could affect the brain:
|
| https://www.scientificamerican.com/article/what-we-know-
| so-f...
|
| And I'm not even touching the subjects of damage to the
| heart, clotting problems, etc.
| jlokier wrote:
| The loss of smell is thought to be sensory, not due to
| affecting the brain.
|
| However, those covid-induced strokes definitely affect
| the brain.
| henearkr wrote:
| Yes you're right indeed, the Scientific American article
| even mentions what you say.
| OJFord wrote:
| Nobody had it long enough ago to answer that. SARS-CoV-1 (
| _1_ ) patients have suffered years afterwards, see e.g.
| this article from 2010:
|
| https://www.thestar.com/life/health_wellness/2010/09/02/sar
| s...
| anoncake wrote:
| SARS was 20 times as deadly as Covid.
| singemonkey wrote:
| As well as acquiring immunity without being infectious.
|
| However, the efficacy of this vaccine (and all the other
| candidates) still needs to be clarified - ie is it like a
| measles vaccination (~90% efficacy) or the flu vaccines (~
| 25% - 50% I believe).
| viraptor wrote:
| Sounds right for the flu. I was curious about the details -
| here's a good starting point.
| https://www.cdc.gov/flu/vaccines-
| work/vaccineeffect.htm?CDC_...
| lbeltrame wrote:
| For the FDA to even consider an emergency use
| authorization, they have put the following requirements:
|
| - Efficacy of at least 60%
|
| - Lower bound of efficacy (confidence interval) >= 30%
|
| - Minimum safety data for at least one or two months post
| vaccination (I don't remember if it's one or two)
|
| - At least five severe cases in the control arm
|
| - Requirements for the trials to go on even if efficacy is
| found for an additional year after the trial end (for most
| of the trials, this means two years in total)
| umanwizard wrote:
| Do you have a source on how common severe long-term effects
| from Covid are? All I've seen are anecdotes.
| mcintyre1994 wrote:
| There are some stats here for the UK, based on a symptom
| tracking app that's been active since about March.
| https://news.sky.com/story/coronavirus-long-covid-warning-
| as...
|
| > One in 20 people with coronavirus are likely to have
| symptoms for eight weeks or more, according to a new study
| by King's College London.
|
| > The research, which uses data from the COVID Symptom
| Study App, suggested so-called "long COVID" affects around
| 10% of 18 to 49-year-olds who become unwell with
| coronavirus.
|
| Whole study is here: https://www.kcl.ac.uk/news/study-
| identifies-those-most-risk-...
| umanwizard wrote:
| From your first link: 10% had _any_ symptoms lasting
| longer than four weeks. That's not "severe long-term
| effects".
|
| The actual study seems to say 1 in 20 have symptoms for
| _eight_ weeks, which might be closer to what you could
| fairly describe as "long-term", but says nothing about
| the severity (though I haven't waded through the whole
| article).
|
| Anyway, the drop-off from 10% having symptoms at 4 weeks
| to 5% at 8 weeks is encouraging - it intuitively suggests
| that the negative symptoms aren't permanent, even if they
| take a long time to go away.
| breakfastduck wrote:
| 8 weeks certainly shouldn't be classified as 'long term'.
|
| Long term health effect claims are being made all over
| the show - if this is the measure that is outrageous
| reporting.
|
| Most people would worry about 'long term health effects'
| as they'd usually assume that it's going to go on for
| years.
| LandR wrote:
| Yeah, last time I was sick I had the flu. I had lingering
| effects for around 8-10 weeks after. Eventually I had to
| go to hospital to get checked.
|
| I feel a lot of Covid effects are being massively
| overblown because people aren't aware that other more
| common viruses that we don't worry about can have these
| "long term" effects as well.
| jlokier wrote:
| People aren't worried about 8-10 weeks of lingering
| effects.
|
| Those 4 week and 8 week statistics are part of an attempt
| to understand what's going on. It doesn't mean 8 weeks is
| considered long covid.
|
| They are worried about effects where people got it months
| ago and are still disabled from it. Things like still
| struggling to walk upstairs 6 months after getting covid.
|
| And that young, fit people are reporting it, not just
| "old".
|
| The worry is that it doesn't appear to be getting better
| for them yet. The greatest worry is that people who get
| it might never recover, or might take years to recover.
| We can't know yet.
|
| Flu and other viruses affect some people that way, but
| it's a small number of unlucky people. The worry is that
| the number affected by long covid in this way are a much
| larger number of people.
| breakfastduck wrote:
| I have a colleague who is essentially disabled from it &
| has not returned to work, after 8 months, so I have first
| hand experience of what you speak.
|
| My fear is that this is super, super, super rare, but
| figures are including long term as low as 8 weeks, so we
| have absolutely no idea how small / large the number of
| people having this critical level of long term effect
| actually is.
| jlokier wrote:
| > Most people would worry about 'long term health
| effects' as they'd usually assume that it's going to go
| on for years.
|
| There are plenty of anecdotes to be found of people
| reporting debilitating long-covid symptoms for 6 months
| so far. That's "still sick since I had it back in
| March/April".
|
| (It hasn't been around for a year so nothing can be said
| about that timescale yet.)
|
| That's significant enough that public health officials
| are talking openly about it as a concern, so it's not
| just a few isolated anecdata.
|
| There are some reports suggesting neurological
| impairment. Along with observed blood changes
| (thickening), which is concerning regarding long term
| damage for rational reasons. If that turns out to be
| true, that sort of damage tends to never completely
| recover. Rather you learn to adapt and live with it.
| breakfastduck wrote:
| Yes, my colleague is one of them. He has still not
| recovered after 8 months and is unable to work.
|
| However, they stating they're also counting 8-10 weeks as
| long term, so the stats are obviously way inflated. I'd
| really like to know the number of people having the
| extreme effects, without the media trying to inflate the
| figure.
| [deleted]
| soulofmischief wrote:
| > in particular, but not limited to, the brain
|
| Judging from our response to Covid-19, if this had actually
| been the collectively-feared zombie virus, the pandemic would
| have been far worse than any fictional account has manage to
| capture so far.
| mcv wrote:
| Future zombie apocalypse stories need to include people who
| deny it as a hoax, blame it on foreign countries, claim
| it's just a mild flu, just continue partying as if there's
| no risk at all, claim it's caused by 5G technology, claim
| it's a conspiracy by the elite to accomplish whatever, and
| political parties split on the topic.
| emiliobumachar wrote:
| It can't get much worse than everybody dead except for a
| dozen people in a basement, can it?
| uxcolumbo wrote:
| How so?
|
| World War Z
|
| Walking Dead
|
| Shawn of the Dead *
|
| 28 Days Later
|
| The Last of Us
|
| What's worse than the above?
|
| * (ok maybe not this one)
| soulofmischief wrote:
| As science fiction is speculative, I do not fault any of
| those listed media however I feel none of them truly
| captured the sociopolitical insanity that would occur,
| the sheer level of ignorance and incompetence which
| causes anything that could go wrong, to go wrong.
| TimPC wrote:
| Also if there was a real zombie virus none of the movies
| so far have captured the sheer absolute terror of hard to
| defend transmission vectors like mosquitos, which would
| be likely to get the virus. Brings a whole new level of
| issues to not getting bit.
| fierarul wrote:
| AstraZeneca has agreements with all governments whereby they
| don't claim any responsibility for the vaccine. It's the
| national governments that will deal with any side effects.
| arethuza wrote:
| That seems fair if they are being expected to rush the
| development of the vaccine?
| jlokier wrote:
| It's fair if the degree of disclaiming is proportionate to
| the need and the pace.
|
| They shouldn't be off the hook completely. They should
| still have to show they have conducted a responsible level
| of testing and checking for the circumstances, that they
| are continuing to refine that verification even after
| widespread deployment, and to motivate that to be done all
| levels requires some degree of moral hazard remains in
| place for them. In other words there should be some sharing
| of risk. Imho.
| dageshi wrote:
| I think they're mostly producing this on a break even/no
| profit basis for at least the initial roll out?
|
| If there is some sharing of risk, but no profit to be had
| (and ultimately profit is what buffers you against risk)
| then why would you be involved at all? Let some other
| company take the risk?
| tpm wrote:
| That's the responsibility of the FDA, EMA etc., to make
| sure all of the above is met. However to be open to
| vaccine injury claims, in the current societal climate
| (lots of malicious actos and antivaccine disinformation
| among the public), would risk the financial viability of
| vaccine makers. That's a longtime problem in the US
| (hence some of the vaccine makers are protected by the
| National Childhood Vaccine Injury Act) and other
| countries.
| celticninja wrote:
| They are still going through clinical trials its just
| that getting to that stage has been accelerated.
|
| So this isn't like we are relying on AZ to create it,
| test it and sign it off. National agencies will
| ultimately sign off on whether it can be used or not.
| Given the high profile nature of this vaccine you can be
| sure that results will be widely studied, and the
| opportunity to hide results they don't like will be
| limited given we all know the trials are occurring.
| benchaney wrote:
| It is extremely good news, _but_ they haven 't published their
| data yet. I will get excited when they do, and the data matches
| the PR (assuming it does).
| erikrothoff wrote:
| "The programme is progressing well, (but) we're not there yet,"
| Hancock said.
|
| Looking good, but still months away from rolling out.
| zhte415 wrote:
| Observing Matt Hancock, I can discern he is:
|
| A: Quite data driven (and frustrated when data's not there)
|
| B: Former work history in monetary policy a fan of fan-charts
| (i.e. central projection isn't the only thing, there is a
| spread from the central projection).
|
| C: Not willing to over-speculate on either side.
|
| D: Perhaps not a super people person, but not negative
| either, see A. Quite nuanced if others listen, and would
| listen to those advising him keenly. And starkly aware of
| causes of death that are not Covid-19, but linked and
| accelerated due to it - avoiding hospitals, mental distress,
| etc.
|
| All in all, not a bad choice for a health secretary. Reading
| between the lines, I'd give it 2-3 months until this is
| rolled out.
| Fumtumi wrote:
| So i understood that its basically done well already.
|
| Okay good so just lets get it shipped!
| calvinv wrote:
| if we're back to normalish by spring next year I think that
| would be a great outcome, if the messaging to the public
| would be, buckle down until then I think lockdown complaince
| could go up
| shotta wrote:
| That'll be extra rough for folks in the depths of winter.
| kuu wrote:
| Let's see, because the vaccination probably requires two
| shots per person with probably 6-8 months in between, so it
| will take time...
| strictnein wrote:
| Where did you read 6-8 months between? I've just seen the
| timespan between shots be listed as 1 month almost
| everywhere.
| kuu wrote:
| I was basing the comment in some other vaccines - Sorry I
| did not state it. I hope I'm wrong and it's much shorter
| time :)
|
| Can you also share some of those sources you mention?
| Thanks!
| strictnein wrote:
| https://www.cnn.com/2020/08/30/health/coronavirus-
| vaccine-tw...
|
| > Two of those companies, Moderna and Pfizer, are now in
| Phase 3, large-scale clinical trials. The 30,000
| volunteers in each of the trials are getting two doses,
| with Moderna spacing their shots out 28 days apart and
| Pfizer spacing theirs out by 21 days.
|
| > AstraZeneca is expected to start Phase 3 trials this
| month. Their Phase 1 and Phase 2 trials used two doses
| given 28 days apart.
| x87678r wrote:
| I dont think any expert is predicting normalish by next
| spring, maybe in a years time if we're lucky.
| https://www.msn.com/en-us/health/medical/the-who-says-
| health...
| Izkata wrote:
| Meanwhile the general populace cares less and less, so we
| may be back to normal in the spring regardless.
| acdha wrote:
| A disease isn't something you can solve by pretending
| really hard that it doesn't exist. People getting their
| news from irresponsible politicians get sick like
| everyone else, and that's why it won't get back to normal
| before there's a vaccine or very effective treatment:
| it'll be the same cycle of open-spike-close and
| businesses not having enough customers to be viable.
| logicchains wrote:
| >A disease isn't something you can solve by pretending
| really hard that it doesn't exist.
|
| This is demonstrably false. Some places are already back
| to life as normal, like Florida and Sweden, with no
| business closures. And in spite of this they still have
| lower deaths per capita than some places with heavy
| lockdowns like New York, Peru, Belgium and Spain.
| anthonyrstevens wrote:
| Come on. Florida is not "back to normal". The health
| department is still advocating the full suite of social
| interventions for citizens, including masks & social
| distancing.
|
| https://floridahealthcovid19.gov/prevention/
| artursapek wrote:
| Not to mention the economic crater, and suicides!
| Izkata wrote:
| > it'll be the same cycle of open-spike-close and
| businesses not having enough customers to be viable.
|
| That's the part I'm referring to by "not caring" - just
| ignoring the close orders, especially since "two weeks to
| slow the spread" has been so completely abandoned.
| acdha wrote:
| Ignoring the law doesn't lead to normal: just more
| preventable deaths and bankruptcies when businesses burn
| capital trying to stay open without enough customers to
| be profitable, even assuming they avoid legal
| repercussions.
| Izkata wrote:
| A few things here:
|
| * What law? In the US, the lockdowns were under emergency
| powers of the executive branch, which are supposed to
| only last a limited time (30 days where I am, for
| example). Several of these were challenged and found to
| be unlawful.
|
| * The US lockdowns were originally only mean to prevent
| hospitals from being overloaded. We are way _way_ past
| that point where that was an issue - all the emergency
| capacity has been dismantled for months.
|
| * As sibling comment implies, something like half the
| states in the US aren't under any lockdown now,
| businesses there aren't having issues staying open, and
| their stats are no worse than the locked-down states.
|
| * Speaking of preventable deaths, suicide and overdose
| are climbing where lockdowns are still in place.
| acdha wrote:
| In the U.S., the lockdowns were issued in compliance with
| local laws. As you could easily learn for yourself, those
| vary from state to state and city to city so you can't
| make a blanket statement without being incorrect. In the
| context of this thread, you specifically referred to
| "ignoring close orders" which implicitly acknowledges the
| existence of an order issued by someone with the
| authority to do so under current law.
|
| In some cases there have been legal challenges to those
| laws so there aren't givens but even if those are
| successful, my point was that even if you do re-open you
| can't force customers to come back when they feel unsafe.
| Even in the states where restrictions have been relaxed,
| a large number of people are not comfortable hanging out
| at a bar or restaurant -- the problem being the risk of a
| serious disease, not the countermeasures deployed against
| it.
|
| > The US lockdowns were originally only mean to prevent
| hospitals from being overloaded. We are way way past that
| point where that was an issue - all the emergency
| capacity has been dismantled for months.
|
| The lockdowns were, as clearly communicated at the time,
| intended to slow community spread. Avoiding hospital
| overload was part of that but so was avoiding large
| numbers of people getting a serious disease with
| potentially life-changing impact when they don't need to.
|
| > As sibling comment implies, something like half the
| states in the US aren't under any lockdown now,
| businesses there aren't having issues staying open, and
| their stats are no worse than the locked-down states.
|
| And that commenter was wrong just like you are wrong.
| Anyone who follows this issue knows that the cases have
| been rising recently (~35%) and there's a noticeable
| correlation with the states which re-opened high risk
| activities and those who did not.
|
| For example, they mentioned South Dakota which is at an
| all-time peak:
|
| https://www.nytimes.com/interactive/2020/us/south-dakota-
| cor...
|
| Compare with, say, New York which is roughly 20 times
| larger even before you account for density differences:
|
| https://www.nytimes.com/interactive/2020/us/new-york-
| coronav...
|
| A common cause of error here are people looking at the
| all-time cumulative stats rather than the last week or
| two and missing that while, say, NYC was hit early with
| quick community spread in a dense environment and thus
| had a brutal spring but the increased lockdown have kept
| levels low since then.
| logicchains wrote:
| >without enough customers to be profitable
|
| I encourage you to visit one of the no-lockdown states
| like Florida or South Dakota sometime and see how much of
| a complete falsehood this is.
| claudeganon wrote:
| Unfortunately, that's not how a disease with a likely
| limited duration of immunity works. Also, the knock on
| effects of uncontrolled spread over the winter will
| almost guarantee that next year won't be normal across
| many domains.
| input_sh wrote:
| I think you're vastly overestimating our capacity to build
| enough vaccines and distribute them over the world, as well
| as dealing with those who will refuse to vaccinate.
|
| Even if we had a vaccine ready for the roll-out today, I
| don't see us going back to normalish until late 2021 at
| earliest.
|
| As with any vaccine, you'd need about 80% of the population
| to vaccinate in order for herd immunity to kick in. I feel
| like we're gonna have trouble reaching that amount for
| years to come.
|
| Getting a working vaccine is only step 1 towards
| eradication path, not the end goal.
| krona wrote:
| _As with any vaccine, you 'd need about 80% of the
| population to vaccinate in order for herd immunity to
| kick in._
|
| Wrong. The herd immunity threshold (HIT) for influenza is
| 33%-44%. HITs are different for every infectious disease.
| Current estimates for COVID-19 are 60-75%.
| tgb wrote:
| Isn't that a different number, though? You have to factor
| in that vaccines aren't 100% effective at preventing
| disease. Wikipedia spells it out in the vaccine section
| here [1]
|
| [1] https://en.wikipedia.org/wiki/Herd_immunity
| krona wrote:
| True but you're also not taking in to account that far
| less than 100% of the population appear susceptible to
| the virus, especially in e.g. Japan and Germany, for
| various reasons.
| wbl wrote:
| Do you have a credible source? I've heard these claims
| multiple times and they done seem to be borne out by
| events or supported by repudiable epidemiologist.
| krona wrote:
| Here is a summary of at least 6 articles on pre existing
| t-cell immunity.
| https://www.bmj.com/content/370/bmj.m3563
|
| Furthermore, I know of at least 3 leading statisticians
| that hypothesized (very early on) that the variance of
| infection trends pointed to pre-existing immunity in
| various populations. The evidence supporting this is
| mounting.
| russholmes wrote:
| The BMJ is not a credible source, it is the Daily Mail of
| medical journals. The author of that article, Peter
| Doshi, has form:
|
| "I think the first thing we to review is who is Peter
| Doshi? And why is he so insistent on getting this data?
|
| Peter Doshi received his BA in anthropology from Brown
| University, MA in East Asian studies from Harvard
| University, and Ph.D. in history, anthropology, and
| science, technology and society from the Massachusetts
| Institute of Technology. Those would be fine credentials
| for someone who is going to teach history or
| anthropology."
|
| https://www.skepticalraptor.com/skepticalraptorblog.php/p
| ete...
| krona wrote:
| I didn't cite the BMJ as _the source_ , but nice try. The
| sources include Cell and Nature, but unfortunately for
| you that might mean you having to read something in order
| to discount it, which you seem unprepared for.
| krona wrote:
| For the lazy (cited 556 times as of now):
| https://www.cell.com/cell/pdf/S0092-8674(20)30610-3.pdf
| komali2 wrote:
| Susceptible in what sense? Getting it and not having
| severe symptoms doesn't count as having benefitted from
| herd immunity - you still got it.
| tgb wrote:
| Wouldn't that be inherently included in the HIT
| calculation?
| jariel wrote:
| COVID is special though in that if it were only as deadly
| to the young as it were to everyone, I don't think we'd
| be referring to this as a pandemic.
|
| Literally, right now we are seeing case rates explode,
| but the number of casualties is paradoxically very low
| because it's mostly the younger cohorts getting sick -
| which is probably a social function of things like 'back
| school' and 'risky behaviours' among younger groups.
|
| If we could get everyone 50+ vaccinated, we may be
| largely safe - maybe not 'back to normal safe' - but the
| combination of 'partial herd immunity', 'much lower rates
| of hospitalization' etc. may mean we can 'kind of get
| back to normal'.
| C1sc0cat wrote:
| Some of the longer term effects are scary though - I
| suspect that younger people might not be so blase about
| chronic illness.
|
| At minimum younger people who have had covid are looking
| at a lot more regular check-ups for the rest of there
| life.
| logicchains wrote:
| > Some of the longer term effects are scary though - I
| suspect that younger people might not be so blase about
| chronic illness.
|
| There's not a single peer-reviewed study showing a
| significantly higher frequency of long-term adverse
| effects in healthy individuals compared to other
| respiratory illnesses.
| TheButlerian wrote:
| Don't ruin the doomer parade, thank you.
| C1sc0cat wrote:
| There's initial results that indicate that its likely -
| you wont get hard data for another decade plus - but take
| it from me you don't want to get CKD or similar organ
| damage.
| gadders wrote:
| Given the low fatality rate for COVID, wouldn't you just
| want to concentrate vaccination on those most at risk?
| i.e. the elderly, people with underlying conditions etc.
|
| You don't need to eradicate the virus, just stop it
| affecting the most vulnerable. Everybody else can then
| carry on as normal (albeit with a slight chance of
| getting a nasty flu-like illness).
| Jemm wrote:
| Vaccination is not 100% (more like 50%) effective and
| will really only help if we achieve herd immunity.
| warp wrote:
| There some risk of permanent or long lasting damage even
| if you do not die from the virus. (So it is more risky
| than just a nasty flu).
|
| https://en.wikipedia.org/wiki/Long_Covid
| anoncake wrote:
| There is evidence that recovery sometimes takes more than
| a few weeks, but none for permanent damage (except in
| rare cases). The risk is overblown.
| input_sh wrote:
| Even if we vaccinate every vulnerable group, no vaccine
| has 100% success rate. That's why every vaccine we ever
| had relied on a huge majority of people having it to
| prevent the virus from reaching those whose vaccine
| failed.
|
| Not to mention that we already know about long term side
| effects that have nothing to do with a specific age
| group, and that there's a chance of re-infection.
| rhino369 wrote:
| Sure but it would reduce the number of deaths by a lot.
|
| If we just vaccinated 65+ year olds, we'd cut deaths by
| 80X%, where X is the effectivelness of the vaccine. Even
| if the vaccine was only 80% effective, that's still 65%
| reduction.
|
| Add in people with dangerous conditions, heart
| conditions, cancer, morbidly obese, etc., and you could
| probably knock it down further.
|
| And as the percent of the population with immunity rises,
| the spread will slow quite a bit.
|
| We don't need heard immunity to open back up.
| [deleted]
| majewsky wrote:
| SARS-CoV-2 relies on superspreading much more than e.g.
| the common cold. When you hear, for example, that each
| patient in a given area infects 1.2 other people on
| average, this doesn't mean that everyone spreads it to
| one or two people. It means that out of 10 infectious
| patients, 9 patients don't spread it to anyone else and
| the tenth patient spreads it to a dozen people at once.
|
| Because of this high dispersion rate, it may make sense
| to earmark a certain amount of vaccine doses for people
| who are not themselves at risk of complications when
| contracting Covid, but who are at risk of becoming a
| superspreader.
|
| (Disclaimer: I'm not an epidemiologist.)
| gadders wrote:
| I'm not saying don't give it to them as well, just do the
| vulnerable people first.
|
| At least then we stand a chance of getting the economy
| back on its feet.
| majewsky wrote:
| "Just do the vulnerable people first" has the significant
| advantage of being easy to explain and implement, but it
| does not maximize the speed of economic recovery.
|
| For instance, I'm a vulnerable person because of
| preexisting conditions, so I'll likely be offered a
| vaccine relatively soon after approval. But that won't
| have a large impact on economic recovery: I'm in the home
| office in a single-person household and don't have any
| care obligations, so I'm at a comparatively low risk
| anyway. And I won't change my current behavior until the
| disease is fully gone anyway.
| gadders wrote:
| My thoughts in treating the vulnerable first wasn't
| because I thought the vulnerable would then be able to go
| back out to work, but because the vulnerable would be
| relatively safe the people with no pre-exisiting
| conditions wouldn't have to stay home to stop the spread.
| wang_li wrote:
| Pfizer is already mass producing their vaccine and are
| saying they'll have 100 million doses available this year
| and are targeting 1.3 billion next year.
|
| The US has five million people who tested positive and
| have recovered. Likely also another 30-50 million who
| were never tested because their symptoms were to minor.
| And another 66-165 million who have cross reactive
| T-cells.
|
| Some researchers have concluded that the herd immunity
| threshold for sars-cov-2 could be as low as 10% or as
| high as 50%. I don't think anyone sees it as high as 80%.
|
| https://www.bmj.com/content/370/bmj.m3563
| celticninja wrote:
| https://www.mayoclinic.org/diseases-
| conditions/coronavirus/i...
|
| The mayo clinic suggests it could be 70%, and I have seen
| others suggest 80%. I have not seen anyone suggest as low
| as 10/20% so I think that suggestion is a huge outlier
| and even the paper you link says as much.
| bart_spoon wrote:
| There actually has been several papers posted to
| r/COVID19 that have suggested that the herd immunity
| threshold is likely overestimated. This is because
| vulnerability to infection isn't uniform across the
| population. Some people will be more likely to be
| infected, either due to biological reasons, like a weaker
| immune system, or sociological ones, like living or
| working in an area where transmission is far more likely.
| Most of the higher estimates of a herd immunity threshold
| of 70-80% are based on transmission dynamics from early
| in the pandemic, which mostly consisted of these people
| with higher probabilities of infection. Once this
| population starts to get burned out, the transmission of
| the virus also slows, which means that the herd immunity
| barrier also drops.
|
| One of the papers hypothesized that this demonstrates why
| areas like NYC got hit so hard initially and have
| remained stable since. Seroprevalence surveys back in the
| early summer indicated that between 20-30% of NYC
| residents had contracted Covid already. The lockdowns
| obviously blunted the surge, but unlike other areas of
| the country, as NYC has opened back up, there hasn't been
| much of a second wave at all. With more than 2/3rds of
| the population still without any kind of exposure to the
| virus, you would expect a dense city like NYC to see a
| large increase. The paper concluded that this is evidence
| that might suggest that the herd immunity barrier is far
| lower than initially estimated. I've seen some papers
| suggest something closer to 20-50%, but nothing so low as
| 10%. I'll see if I can dig up some of the preprints to
| post here.
| lbeltrame wrote:
| That's because 70/80% estimates assume that the
| population is entirely vulnerable, while instead it looks
| like it's _partially_ vulnerable. Hence the estimates
| would need adjustment.
| Izkata wrote:
| 80% or so is accurate if there was no cross-reactivity
| and if asymptomatic is included in the case count. It's
| what was being reported in March or so when we didn't yet
| have evidence of cross-reactivity.
| jandrewrogers wrote:
| In most models, we currently assume herd immunity is 50%.
| We know it isn't higher than that but we also have
| circumstantial evidence that it likely isn't below 40%. A
| complicating factor is that we know the number of
| infections is _much_ higher than the number of cases but
| we don't know by how much and this is not something we
| can effectively measure retroactively, which makes it
| challenging to model precisely.
| artursapek wrote:
| > dealing with those who will refuse to vaccinate
|
| What's there to deal with? Let people make that personal
| choice and leave them alone.
| breakfastduck wrote:
| Overly cautious about the herd immunity stuff here.
|
| We're not going to eliminate the virus completely. That's
| a given, we should stop aiming for that.
|
| If we get to a point where there's a stable number of
| daily deaths then we're good. (like we have for literally
| every single fatal illness.)
| SECProto wrote:
| > (like we have for literally every single fatal illness)
|
| Smallpox. And if you consider within the borders of a
| given country, a dozen others (polio, measles, mumps,
| rubella, chickenpox).
| breakfastduck wrote:
| None of those are a common type of Flu, which we've never
| been able to cure, though.
| SECProto wrote:
| Covid-19 isn't a "common type of flu" either. The
| diseases I mentioned were certainly widespread and
| endemic. And they're all different types of virus.
| 0xffff2 wrote:
| Which countries have eliminated the latter 4? I would
| consider an illness "eradicated" if the vaccine is no
| longer regularly given. At least 10 years ago (when I was
| in the field), MMR and Chickenpox vaccines were still
| regularly administered in the US.
| ksk wrote:
| >I would consider an illness "eradicated" if the vaccine
| is no longer regularly given.
|
| That's not how it works. Just because you don't see an
| outbreak for a while, that is never a reason to stop
| immunizing children. Pathogens can and do have natural
| reservoirs. This is why when some idiots stopped taking
| the Measles vaccines we had an outbreak here in the US.
|
| https://en.wikipedia.org/wiki/Natural_reservoir
| 0xffff2 wrote:
| Of course that's how it works. We don't regularly
| administer small pox vaccines anymore because it has been
| eradicated except for a couple of very tightly controlled
| samples. That's what "eradication" means. My memory is
| slightly hazy, but I think we might have skipped Polio as
| well for anyone not going oversees, because Polio largely
| meets the definition of "eradicated" _in the US_.
| Meanwhile, we continue to administer MMR and Chickenpox
| vaccines because those diseases still exist in the wild.
| The very fact that Measles has returned is ipso facto
| proof that it was never eradicated, and the fact that
| (normal) people never stopped giving that vaccine to
| their kids is proof that no one ever believed it was.
| SECProto wrote:
| > I would consider an illness "eradicated" if the vaccine
| is no longer regularly given
|
| Fair enough. I would consider a virus eradicated when the
| general population gives zero thought to it, and
| effectively no one dies from it. Doesn't meet the strict
| medical definition, but I thought the description of "If
| we get to a point where there's a stable number of daily
| deaths then we're good" was overly pessimistic.
| artursapek wrote:
| COVID-19 is a slice of apple pie compared to Smallpox
| komali2 wrote:
| Doing so would ignore the sometimes dramatic effects
| survivors experience - from the people I know alone, this
| ranges anywhere from previous marathon runners still
| huffing and puffing their way up stairs despite having
| been otherwise symptom free for 6 months, to a man who
| survived by the skin of his teeth and it now appears will
| never be able to taste or smell again.
|
| I don't know about you but I'm feeling like simply
| "getting to a stable number of daily deaths" doesn't cut
| it. Also, that statement alone doesn't make sense to me -
| a fatality rate of 50% could potentially maintain a
| stable rate of daily deaths... Of thousands.
| nradov wrote:
| The moving average of daily deaths in the US has been
| stable or declining for the past two months.
|
| https://www.worldometers.info/coronavirus/country/us/
| vaughnegut wrote:
| A friend of mine in public health mentioned to me that
| it's not uncommon for second waves of epidemics to be
| less deadly, since many of the people most vulnerable to
| the disease would have already passed away during the
| first wave.
| breakfastduck wrote:
| I mean, that's just common sense, and something the media
| is actively choosing not to raise.
| mikeyouse wrote:
| This idea that the "Media" is this sinister entity trying
| to stop the spread of good news _during a pandemic which
| the entire world has taken drastic steps to curtail yet
| which has still killed over 1.1 million people_ is just
| so silly.
| nradov wrote:
| Technically this is know as "mortality displacement" or
| the "harvesting effect".
|
| https://en.wikipedia.org/wiki/Mortality_displacement
| ffdjjjffjj wrote:
| That was true until last week. Deaths are now rising
| again, and daily new cases are approaching the level of
| the summer peak.
| breakfastduck wrote:
| Daily new cases means nothing - it's a completely
| artificial figure that can be inflated or deflated by
| simply changing how many tests are conducted.
|
| Deaths is the only relevant measure.
| ffdjjjffjj wrote:
| It doesn't "mean nothing", it's another data point. If
| you see test positivity rate remaining low but cases
| increasing - which we do in many areas with sufficient
| testing - then it does suggest more people are getting
| the virus.
|
| You can also corroborate this by comparing it to new
| hospitalizations, which are also up.
|
| "Deaths is the only relevant measure" - not sure where to
| start with this except to say that this is not at all
| what epidemiologists seem to think and I won't address it
| further without some very dramatic reasoning and
| evidence.
| irq11 wrote:
| _" If you see test positivity rate remaining low but
| cases increasing - which we do in many areas with
| sufficient testing - then it does suggest more people are
| getting the virus."_
|
| No, it suggests that you're doing more testing, and
| _finding_ more cases. Which, exactly as the OP said, is a
| metric that can be manipulated by doing more testing.
|
| The whole reason we emphasize positivity rate is to try
| to compensate for the inherent bias in reporting raw case
| counts.
|
| There have been _far more cases_ than we have ever
| formally detected with testing. There's plenty of room to
| increase that number by testing more people, but it will
| not affect hospitalizations or deaths - which is exactly
| what we're seeing.
| chimprich wrote:
| Deaths are not an entirely useful measure to see how the
| pandemic is progressing because they are a lagging
| indicator.
|
| Positive test rates measure what was happening about a
| week ago. Hospital admissions reflect activity a week or
| two before that, and deaths often get reported a month or
| more after the events that caused people to get infected.
|
| You have to look at all the data to get an idea of what
| is happening.
| irq11 wrote:
| There has been a _slight_ uptick in weekly deaths,
| roughly on par with what was observed in the last week of
| September. Given the trend of the line and the delayed
| reporting from most states, it's more accurate to say
| that deaths have flattened:
|
| https://covid-19.direct/US?tab=daily
| impendia wrote:
| Various experts are predicting that the winter will be
| quite bad. See for example:
|
| https://covid19.healthdata.org/global?view=infections-
| testin...
|
| https://covid19.healthdata.org/united-states-of-
| america?view...
|
| But notice, in the latter chart, that in the US the
| number of infections is predicted to peak in January and
| then start going down. It seems plausible that by March,
| we'll achieve some level of herd immunity, relative to
| the precautions that are currently being taken. We might
| have a situation like Europe over this pas summer, with
| small numbers of cases until a second spike in
| Fall/Winter 2021. That would buy us the spring and summer
| to roll out a vaccine.
|
| Of course, I'm far from sure that this is what will
| happen -- but it certainly seems plausible to me.
| Jemm wrote:
| Those charts are already inaccurate. I wouldn't rely on
| them.
| impendia wrote:
| Rely on them? I agree, certainly not. But at least they
| describe a _plausible_ scenario.
| halfmatthalfcat wrote:
| It's been estimated that 80% of the population needs to
| have been infected to achieve herd immunity. That means
| ~240 million people in the United States need to be
| infected. We're at 8.7 million infected. No way we get
| herd immunity anytime soon.
| impendia wrote:
| Herd immunity is relative.
|
| For example, I'm a professor at the University of South
| Carolina. Here we've had around 2,500 confirmed Covid
| cases, and perhaps around 10,000 cases in actuality.
| Nearly all of them happened in the first few weeks of the
| semester, and now the positive test rate is extremely
| low.
|
| Looking around town, it's pretty clear what happened.
| There are some students that have acted like nothing is
| happening, partying and drinking constantly. That
| population has presumably hit herd immunity already.
| Meanwhile, there are many students (and staff) that are
| exercising precautions, and not venturing out a lot, and
| probably few of them have contracted the disease.
|
| Now, we can't just go back to normal, or else cases would
| spike among this second group -- but locally it seems
| that we can afford to relax a bit.
|
| And, also, we're at 8.8 million _confirmed_ infected --
| the actual numbers are presumably much higher.
| [deleted]
| threeseed wrote:
| It likely won't be available to everyone in the US until
| Autumn timeframe. Perhaps even later if the vaccine needs
| repeated dosages over time. Priority will be health care
| workers, essential retail, vulnerable etc.
|
| By then it will kill at least a million people at the
| current trajectory. So US needs to start acting more
| aggressively now.
| hobby-coder-guy wrote:
| What season do you think we are in?
| [deleted]
| numpad0 wrote:
| Spring of 2022 is still more than a year away
| Bombthecat wrote:
| Do we know it keeps working after a year or two? Or do you need
| a yearly shot?
| jessaustin wrote:
| s/year/month/g
| [deleted]
| karma_fountain wrote:
| It is good news if true, but we are rushing the trials of a new
| vaccine and then potentially going to give it to a large number
| of people. What if the vaccine has long term negative effects?
| [deleted]
| ulfw wrote:
| What if Covid-19 has long term negative effects?
| anoncake wrote:
| What if there's a teapot orbiting the sun?
| ageitgey wrote:
| While long-term side effects are theoretically possible with
| any treatment, this vaccine is based on a platform that's
| been safety-tested repeatedly in experiment vaccines for
| prostate cancer, MERS, malaria, tuberculosis, influenza and
| chikungunya virus, so there's a lot of past safety data. In
| addition because the main effect of the vaccine is to trigger
| a strong immune response, you would typically see side
| effects in the short term related to that initial response
| (things like Guillain-Barre syndrome or Transverse myelitis),
| not over the long term as the effect wanes.
| standardUser wrote:
| It's great news, though at first I thought they had released
| Phase 3 results, which would be earth-shattering news. They are
| still the leading vaccine candidate and the one most likely to
| get approval this year (though the US press tends to ignore it
| in favor of covering the various US-originated vaccines that
| are also in Phase 3 trials).
| aphextron wrote:
| >OK, someone tell me why this isn't the good news it sounds
| like
|
| The AstraZeneca vaccine is based on an adenovirus vector, which
| has never been approved for use in humans. It uses a weakened
| live virus that can (and apparently has, in the case of the J&J
| vaccine, which is using very similar tech) cause serious
| adverse systemic reactions. From what we've seen so far, the
| safety profile for these vaccines is far worse than the
| mRNA/lipid nanoparticle based vaccines coming from Moderna and
| Pfizer/Biontech.
|
| It's also not really news. We know that a vaccine will prompt
| an immune response. Dozens of others in progress have already
| shown this with phase 1 and phase 2 data. The question is how
| strong, how long lasting, and how safe is it, along with the
| question of real world efficacy data from placebo controlled
| trials.
| xiphias2 wrote:
| Thanks for your input!
|
| The worrying trend is the ,,signed contracts with
| governments'' part even though the clinical trial results are
| not out yet. It seems that vaccination gets highly political,
| just like how EU made a mistake of paying for Remdesivir even
| though we knew that it's not worth it at that point.
| [deleted]
| MrAlex94 wrote:
| > It uses a weakened live virus that can (and apparently has,
| in the case of the J&J vaccine, which is using very similar
| tech) cause serious adverse systemic reactions.
|
| There is no evidence to prove the vaccine has caused any
| serious adverse effects so far. If that were the case, it is
| unlikely the Data Safety and Monitoring Board (DSMB) and U.S.
| Food and Drug Administration (FDA) would recommend resuming
| the trial.
|
| > After a thorough evaluation of a serious medical event
| experienced by one study participant, no clear cause has been
| identified. There are many possible factors that could have
| caused the event. Based on the information gathered to date
| and the input of independent experts, the Company has found
| no evidence that the vaccine candidate caused the event.
|
| https://www.jnj.com/our-company/johnson-johnson-prepares-
| to-...
| aphextron wrote:
| >There is no evidence to prove the vaccine has caused any
| serious adverse effects so far. If that were the case, it
| is unlikely the Data Safety and Monitoring Board (DSMB) and
| U.S. Food and Drug Administration (FDA) would recommend
| resuming the trial.
|
| There's also no evidence to prove that it wasn't.
| Furthermore, the AstraZeneca vaccine was halted for a case
| of transverse myelitis, a very common (and serious) adverse
| reaction seen in DNA/adenovirus based vaccines like ChAdOx1
| [0]. These complications have not been seen at all in the
| mRNA based vaccines, since they do not involve a live
| virus.
|
| [0] https://medcitynews.com/2020/10/report-fda-takes-
| closer-look....
| MrAlex94 wrote:
| Well, we won't find out until the trials end, but why
| would they have been approved to continue by safety
| boards if that wasn't the case?
|
| Also, the AZ trial was given the go-ahead along with the
| J&J trial.
|
| https://www.reuters.com/article/us-health-coronavirus-
| astraz...
| RobertDeNiro wrote:
| Transverse myelitis was also observed in some people
| infected by sars-cov-2, one case alone is not enough to
| lead to any meaningful conclusion.
| viraptor wrote:
| Likely long-term results are not known yet. We've already had
| one vaccine potentially causing side effects that stopped the
| human trials for a while. (I think it was the Russian one.
| Please correct me if not)
| bigbizisverywyz wrote:
| It was the UK trials of the Oxford and AstraZeneca vaccine
| after 1 person experienced an adverse reaction - but that's
| the whole point of the trials and not uncommon so no major
| worry there, and they were restarted soon after.
|
| [nature.com]
| https://www.nature.com/articles/d41586-020-02633-6
|
| On a separate note - the voting on this thread at the moment
| seems pretty wild with some seemingly innocuous comments
| being downvoted. I don't get it.
| ffdjjjffjj wrote:
| It's just a political thing. You see the same behavior in
| threads about climate change. A seemingly innocuous comment
| to you is a firebrand political statement to someone who
| thinks the virus is a hoax or whatever.
| dmurray wrote:
| Because a vaccine that provokes an immune response isn't the
| hard part. It's making sure it doesn't make people sick, and
| then scaling it to producing and distributing hundreds of
| millions of doses.
|
| I mean, its better news than the alternative, but I think
| "Oxford vaccine produces zero immune response" would be a far
| less likely outcome.
| bufferoverflow wrote:
| Billions of doses. There are only a few vaccines that will be
| approved any time soon. 7.8 billion people on the planet.
| RobertDeNiro wrote:
| The bad news is that we can't really have one vaccine candidate
| released to the general public much before the others, as that
| will impact the results of other vaccines that are still in
| Phase 1/2/3.
| lbeltrame wrote:
| Glass half full: We can measure an immune response also in
| populations where it's more difficult to get a decent one. An
| immune response means that the immune system actually is taking
| action against the viral antigen.
|
| Glass half empty: We don't know how the immune response
| measured relates to protection from or lessening of the
| infection. This is what the ongoing trial is trying to find
| out.
|
| This is, IIRC, the second report of successful immunogenicity
| in older people. There was a (small) cohort of > 65 year old
| people tested with Pfizer / BioNTech's vaccine in the Phase 1
| trial, and even there immune responses were found and measured.
| treeman79 wrote:
| I have at least one autoimmune disorder.
|
| There are tests that can be run to show an immune response.
|
| One thing I've learned is it's extremely hard to get doctors
| to run the tests. AND there are a whole lot of them. AND I've
| run into many doctors that are 10-20 years out of date with
| treatment and diagnosis protocols.
|
| As in, current recommendations are that test X isn't
| reliable. Use test Y. Doctor refuses to run any test because
| you're the wrong gender. AND The moment you see someone in a
| practice your banned from seeing anyone else in the practice.
| So second opinion means going to 20 miles to another center.
|
| Oh, and it's 3 months+ to get a single appointment. You may
| need two dozen appointments until they narrow in on the
| issue.
|
| That something is possible still leaves a massive gap of
| getting it done.
| refurb wrote:
| It is good news, but it's not earth shattering. This vaccine
| produced an immune response (the the vaccine antigen), which
| many of the other candidates have as well. The real question
| is, will it prevent infection? Those are two different
| questions.
| [deleted]
| zoobab wrote:
| Good news for US BigPharma Merck holding the Oxford patents,
| while public funding has paid for its research:
|
| https://archive.is/aGUJd
| sgt101 wrote:
| The story appears to tell exactly the opposite of your comment
| : Merck failed to do a deal because Oxford held out for public
| good outcomes that Merck wouldn't meet, and AZ did.
| FrojoS wrote:
| I'm sure they paid for the patent. From your linked article:
|
| "Merck proposed giving Oxford around 1% of royalties, according
| to people familiar with the negotiations, with a sliver of that
| going to Vaccitech."
| Unklejoe wrote:
| I thought the vaccine was going to be free anyway?
| wffurr wrote:
| _Someone_ is going to pay. It may not be you at the point of
| the needle, but somebody will.
|
| Governments will pay a lot to get their economies going
| again. That burden will in turn fall on taxpayers one way or
| another; whether it's directly via taxes or budget cuts or
| indirectly via inflation or debt service.
| Unklejoe wrote:
| Yes, I realize that. My comment was in response to the
| criticism of these companies being funded by tax dollars
| while being granted a patent. The implication being that
| we're paying (as taxpayers) but getting nothing in return
| since we would have to pay for the vaccine anyway.
|
| My response is that we're getting the vaccine for free in
| return.
|
| That said, I'm not sure that it's actually going to be
| free. That's just what I heard. I should point that out - I
| don't want to propagate bad info.
| reegnz wrote:
| What you get in return is somebody (the government) took
| the risk of a blind faith payment to have a university
| develop a vaccine.
|
| That's what you paid for, not for production, not for
| distribution, not for anything else.
|
| You didn't pay taxes for a free vaccine, because you
| don't pay remotely enough taxes for that to be viable at
| all. Unless every country on earth takes their fair share
| of blind-faith financing a __single __company.
| wbl wrote:
| What the public paid for is nowhere near enough to produce a
| vaccine.
| samwillis wrote:
| Could you please indicate where you heard that Merck has any
| ownership of the patents to the Oxford vaccine? The cited
| article indicates that it's is AstraZeneca who have done a deal
| with Oxford and that the deal with Merch, while an early
| option, fell though.
|
| Is would seem "US BigParma" are not involved, as AstraZeneca is
| a British/Swedish company.
| 0df8dkdf wrote:
| AstraZeneca is BigPharm! May not be as Merck or Pfizer, but
| they are on the big ones.
| Brakenshire wrote:
| Yes, but it's bizarre to complain about the deal while not
| knowing enough about it to even accurately remember which
| company was a signatory to it.
| RobertDeNiro wrote:
| Merck's stock is down while Astrazenca's is up, thats enough
| indication that merck doesnt hold anything.
| simonh wrote:
| According to that article Merck got cut out of the deal and
| Oxford will get 6% royalties on the vaccine, from a UK/Swedish
| outfit. So nothing to do with US big pharma and Oxford will get
| upwards of PS100m. It's not is if they'd have got nothing out
| of the Merck deal either.
|
| This is very disappointing. A lot of people are posting on this
| thread based on this misinformation.
| [deleted]
| dageshi wrote:
| If I'm reading everything correctly then they don't? The deal
| with Merck didn't go through and they don't have the Oxford
| vaccine?
| rolivercoffee wrote:
| I was under the impression there was an exclusive agreement in
| place with AstraZeneca but the general terms for access to
| Oxford's IP was:
|
| https://innovation.ox.ac.uk/technologies-available/technolog...
| SeanLuke wrote:
| Vaccines are far from big money.
| apexalpha wrote:
| Who cares. I'd gladly give this company a couple of billion if
| it means they can get us back to normal.
|
| Oxford _develops_ the vaccine with public money. We also, god
| willing, need to manufacture billions of them and transport
| them around the globe.
|
| For that manufacturing, give me a solid existing multinational
| with a proven manufacturing record and base please, not some
| non-profit startup.
| [deleted]
| eumenides1 wrote:
| The point is that we should reconsider giving (temporary)
| monopolies to companies that are based public research.
|
| I suggest that we should give merek the for profit monopoly,
| but allow for non profit manufacturing. If another
| organization wants to make the vaccine but not derive profit
| from the process, let them.
|
| Manufacturing takes time and money to develop. Revenue should
| pay for those costs. The non-profit gains experience, but no
| profit. The for-profit gains profit. If the for-profit
| decides to raise prices too high, there will be a willing and
| capable competitor waiting in the wings.
| graeme wrote:
| This is completely incoherent. Consider a book author who
| has a monopoly on for profit publishing, but anyone else
| can publish for no profit.
|
| The book author's expected profits would plummet as it
| would be the wild west in production.
|
| What you're really saying is "we should pay massively less
| for vaccine development". Which again, sounds nice,
| but....why would anyone have developed a vaccine? It's a
| complex project which costs billions and has taken 12+
| months while taking resources away from competing projects.
|
| The public money is an incentive to get people to put those
| considerations aside and devote all their resources to
| vaccine development. This is a sensible public investment
| in a return to normalcy.
| notankies wrote:
| Can someone explain profit motive to him? I'm too tired to
| be constantly educating people
| eternalban wrote:
| Society at large is being asked to make drastic adjustments
| because of a collective health issue.
|
| Why is the corporate "right to make profit" sacrosanct when
| nothing else is?
|
| This is a clear case of Eminent Domain. All mandated,
| mandatory, Covid-19 related products must be offered at
| cost, or even better, we should just nationalize drug
| companies. We're all in this together and companies need to
| adjust to "new normal" as well.
| GekkePrutser wrote:
| Totally agree. This is not the time for bean counters. We
| need to fix this and we need to do it now.
| ebg13 wrote:
| > _I suggest that we should give merek the for profit
| monopoly, but allow for non profit manufacturing. If
| another organization wants to make the vaccine but not
| derive profit from the process, let them._
|
| Not-for-profit manufacturing would have to be done by the
| government itself, wouldn't it? Otherwise, what other
| entity would and could actually pay to set that up?
| krferriter wrote:
| Non-profit companies exist all over the US. Even non-
| profit drug manufacturing is done to some extent, but at
| a much smaller scale right now than we could have. The
| companies still charge money for services, the employees
| get paid, but the governance of the company is not
| focused solely on increasing profit margins. Most medical
| core science is done non-profit right now, at US
| universities. Many universities have on-premise small-
| scale manufacturing capabilities which serve their own
| needs, in medical labs but also others, like materials
| sciences and chemical science/engineering. There's no
| intrinsic reason why those couldn't be ramped up, or even
| pooled between physically close universities by creating
| a joint non-profit entity.
| arcticbull wrote:
| > The point is that we should reconsider giving (temporary)
| monopolies to companies that are based public research.
|
| Now we can disagree on term length, but, a temporary
| monopoly to a company is what a patent is defined as and
| lasts 20 years.
| eumenides1 wrote:
| the problem is for a competitor to emerge, they have to
| do a lot of work after X years.
|
| My proposal is to have a company parallel develop
| processes so we can have competitor after expiry
| immediately. The competitor can't profit from it, but it
| can do work at 0 cost.
| brlewis wrote:
| Patents are one tool to promote the progress of science
| and useful arts. Publicly funded research is a different
| tool. Usually, patents are based on privately funded
| research.
| mcv wrote:
| Exactly. The idea that the public funds research, but
| corporations can monopolies the results of that research
| for profit, is just disgusting. Non-exclusive deals are
| fine. Exclusive ones not, at least not within the
| country/countries that funded it; they already paid for it,
| and denying them access is basically theft.
| krustyburger wrote:
| Drug companies also fund their own research, to the tune
| of massive expenditures. What you're suggesting would
| incentive these companies to disengage from partnerships
| involving public funding. Whoever pays for the research,
| each company's goal is to profitably sell a non-generic
| treatment. If the only way they can do that is to eschew
| public funds, they will do this and the result will be
| less cooperation and a far reduced ability for the
| government to influence the direction of private sector
| research, and more importantly shape private sector
| manufacturing and the quantities of specific treatments
| supplied to the market.
| tarboreus wrote:
| Honestly, this is overblown. Most of the budget for these
| corporations goes to marketing, and the R&D mostly goes
| to repatenting efforts or incremental repurposings. They
| rarely come out with anything new, and if you look at
| recent years you may as well say that they never do.
| Domenic_S wrote:
| The FDA has made 42 new drug approvals in 2020:
| https://www.fda.gov/drugs/new-drugs-fda-cders-new-
| molecular-...
|
| Certainly some of those are new uses for existing drugs,
| but drug trials ain't cheap either.
| tehwebguy wrote:
| You hit the nail right on the head. This is the same with
| basically every consumer product in capitalism, which is
| why it's so inappropriate for life saving medicine.
| a_imho wrote:
| Maybe I'm mistaken here, but one such case was Sofosbuvir
| and its pricing was indeed very controversial.
|
| Rant. Prime time TV is now pharma pushing their drugs
| with the occasional programming jammed between the ads.
| All those ads are coming from their extreme markups.
| Placebo and manufacturing artifacts aside, a molecule is
| a molecule, buying generics should be the default. It is
| bad enough, but the real disgrace is pharma salespeople
| masquerading as GPs prescribing meds according to who is
| sponsoring them. Instead of telling people about the
| active ingredient they send them to buy BRAND. At least
| this is my experience in the 2nd world.
| WillPostForFood wrote:
| _Most of the budget for these corporations goes to
| marketing_
|
| Often repeated, but the data doesn't bear it out,
| especially in aggregate.
|
| https://www.raps.org/getattachment/5578195e-ed51-4f03-8ad
| c-c...
| babar wrote:
| The article that graph comes from indicates that is self-
| reported data from the companies which may not be
| consistent in what is considered R&D vs. marketing cost.
|
| https://www.raps.org/news-and-articles/news-
| articles/2019/7/...
| 0goel0 wrote:
| As a US taxpayer, I care. Why am I paying twice for the same
| product, that makes the outcome worse for everyone on
| average.
| Gys wrote:
| Luckily for you, Oxford University is British. Public
| funding refers to the UK governement. Btw AstraZeneca is
| also British.
| alxlaz wrote:
| > not some non-profit startup.
|
| There's no(t necessarily a) question of any non-profit
| startup there. The problem is that the people who paid for
| the development of the product should also hold rights over
| the product. If the vaccine was developed with public money,
| it should be publicly available -- not necessarily (but yes,
| also to) non-profit startups, but also to any other
| manufacturer in the pharmaceutical industry, since they
| (allegedly, in any case...) pay taxes, too, and have
| therefore invested in this product.
|
| If Merck wants to use their proven manufacturing base with an
| excellent delivery track record (which nobody is denying,
| after all), that's great. They can:
|
| 1. Put their money into the development of said vaccine, or
|
| 2. Acquire the license to manufacture it, at a reasonable
| price, like they do with any technology that _wasn 't_
| developed using public money, or
|
| 3. If we don't want stuff that's already been paid for with
| public money to be _sold_ to manufacturers, which I don 't
| disagree with at all, then, sure, they should get it for free
| -- but in that case they shouldn't be the sole owner of the
| rights towards that product, either.
|
| (Edit: FWIW, I'm all for 3. I've worked in the medical
| industry and I know full well that there's a great deal of
| work that goes between first-stage research and final
| production, and that it's incredibly hard and expensive to
| take the result of a publicly-funded research program and
| turn it into a product. That doesn't change the fact that
| said research programs are _publicly-funded_ -- their results
| should be available to anyone who paid for them. If someone
| wants exclusive rights to the result of some research
| program, then they 're welcome to pay for it themselves.)
|
| As it stands now, they own the rights (including licensing
| rights!) to a bunch of products that they haven't paid for at
| all.
|
| All the suits blabber on and on and on about how the
| government should keep its nose out of their business. How
| about they tell the government where to stick it when it's
| about paying for their research, too?
| amyjess wrote:
| The United States Military has the best logistics system in
| the world. I'd rather have them handle manufacturing and
| rollout than either a multinational or a startup.
| apexalpha wrote:
| The US government has one of the worst track records in the
| entire Western world when it comes to access to healthcare
| and affordable medicine.
|
| They also have 0 experience in developing a vaccine and
| it's transport.
|
| But I guess they can transport some tanks and troops
| quickly, sure.
| tw04 wrote:
| Then it needs to be a cost-plus model. They should absolutely
| be able to make a profit for manufacturing and handling
| logistics. They shouldn't be making a 4000% profit when "we"
| collectively funded all the research.
| reegnz wrote:
| The possibility of them 'being able to do that' is because
| of laws that got passed by democratically elected
| officials.
|
| If you don't like that, vote someone in power who regulates
| that more.
|
| The problem with these discussions is that nobody tells
| their opinions to their representative, they just blurt it
| out into the 'aether' on a rando internet forum.
|
| True change starts with calling your representative. If
| they don't do what you ask them to, then have other people
| ask as well. Finally, have them vote them out of office if
| a sufficient ammount of people want the same thing that the
| representative won't do (eg. represent their constituents).
| tw04 wrote:
| >If you don't like that, vote someone in power who
| regulates that more.
|
| That's an awful lot of assumptions on your part. I have
| voted out someone who didn't represent these values in
| exchange for someone who does. I don't need to contact my
| representative on this specific issue because I already
| know where she stands, but if we were in disagreement I
| would (and have).
|
| Posting about it on the internet is to garner additional
| support and discussion... you know the entire reason HN
| exists?
| specialist wrote:
| What about holders of patents funded by govt also paying
| royalties?
|
| Just a notion I've been pondering. Sure, taxation could do
| the same job. Hypothetically. Hollywood accounting and
| such.
|
| Maybe straight up royalties would be less prone to
| gamification.
| monkeynotes wrote:
| > Who cares. I'd gladly give this company a couple of billion
| if it means they can get us back to normal.
|
| This kind of thinking is worrisome to me. It sets a horrible
| precedent. Previously in times of war private business would
| be forced into helping the people fight a common enemy. These
| days a war on a virus has zero help from business and they
| essentially have a position of power to sit on their hands
| taking billions of public subsidy and then take the people's
| money and effort for their own.
|
| Why do we take this with such apathy? Why is it that a
| country run by the people for the people has no power in the
| populace hands? We are doing everything we can to help,
| committing billions of dollars which represents millions of
| hours of public production to solve a problem that CEOs only
| want to assist in if they can up their share price.
|
| Since we care so much about our health and the health of
| loved ones why have we not used these unprecedented times to
| reform the healthcare industry?
|
| We are paying twice for this. Once to fund the research,
| which we then give away, and then again for the manufacture
| and distribution which is priced as if the pharma did all the
| research. These vaccines are going to cost anywhere between
| $15 and $37 a shot. You cannot tell me that's how much these
| vaccines cost to make in quantity. Why is there any profit at
| all? Let's get ourselves out of this shit without encumbering
| any more debt on top of an economy that is already falling
| into a black hole.
|
| This stuff is morally corrupt, and to say 'who cares' makes
| me sad. We should care, maybe we accept the shit we have, but
| we should care about it. This stuff should be criticized, we
| should use our agency to change what is wrong, not to support
| it.
|
| Every day I fear we are all fucked. This sort of thinking is
| why we deserve the likes of Trump and Boris. We bring this
| crap on ourselves and then moan about it.
|
| You talk about getting back to 'normal', well we slowly sold
| normal. These decisions do not have zero impact on the
| future, they affirm a shitty attitude and set the path for
| future generations who won't know any better.
|
| /rant
| nugget wrote:
| Do you think that the more profit available to pharma, the
| more capable the workers attracted to the field will be?
| And therefore the faster results will be achieved? I don't
| mean just the bench scientists, but all the other people -
| programmers, lawyers, managers, fabrication engineers,
| supply chain ops, etc - required to take an idea from paper
| to mass production. Having worked in biotech startups
| myself I understand how inefficient the current system is,
| but at the same time I can't foresee a better one.
| monkeynotes wrote:
| None of this speaks to the social cancer that is
| corporations draining the society they function in.
| Individuals are expected to sacrifice and pull together,
| do the research, finance pharma production, give away
| patents, and yet the big pharmaceutical sits back and
| drains all of this into their stock. It's just not right.
|
| Let them make a profit when we are thriving not while
| everyone else is suffering and making sacrifices.
| landryl wrote:
| Is it needed to hold the patent to be profitable as a
| manufacturer ? If the research has been already paid out, I'd
| prefer healthy competition.
| apexalpha wrote:
| Just because they hold the patent doesn't mean they won't
| license it out. We're talking about the _entire world_
| here.
|
| I know a lot of people, Americans in particular, are weary
| of 'big pharma' and for-profit healthcare. And Americans
| have good reason for that mistrust. But this isn't just an
| American issue.
|
| Other governments such as the EU and India will force their
| hand if needed for the public good. As they've done
| countless times in the past. We just need to get this
| developed and manufactured as fast as possible.
|
| And the linked article said the clash was between this
| pharmaceutical behemoth or a startup from the university.
| I'll take the behemoth now.
|
| _" The scientists' small biotech company--a spinout
| partially funded by Oxford--was refusing to hand over
| intellectual-property rights. To outflank their bosses, the
| scientists asked a London investment banker to help explore
| other potential deals."_
| [deleted]
| bufferoverflow wrote:
| The patent protects from somebody simply copying the
| formula. Which is many orders of magnitude cheaper than
| doing research and development, especially on human
| subjects.
| hobofan wrote:
| > If the research has been already paid out
| JshWright wrote:
| Why does that matter if the research and development
| costs were publicly funded?
| rhino369 wrote:
| Trials and regulatory approvals are a huge cost too.
|
| If the government paid for all of that (including
| opportunity costs + a decent margin), then the government
| should have asked for the patent rights (or at least a
| commitment on pricing).
|
| Has any serious journalist looked into exactly what the
| world governments paid for and exactly what the deals
| with the drug companies look like?
|
| All I can find are biased opinion pieces devoid of actual
| information.
| disgruntledphd2 wrote:
| The FT had some coverage of this, but it wasn't massively
| in depth. The one thing I remember is that the AZ would
| be sold without profit until the end of the pandemic,
| which was contractually defined as June 2021.
|
| Incidentally, if you want serious journalism, the FT is
| worth paying for.
| bufferoverflow wrote:
| Because they can and it will make them a ton of money.
|
| The laws need to change.
| gambiting wrote:
| But, for instance - public money is used to build roads,
| yet companies that build them make money in the process.
| There is no state-owned road building company. What's the
| difference here?
| eecc wrote:
| That's a faulty parallel. The road belongs to the public,
| while only the building is tendered to a private (in a
| presumably competitive market) to maximize quality and
| price ratio.
|
| In this case the building is publicly funded for a profit
| AND the final result donated in "perpetuity" to make it a
| private TOLL road.
|
| Double dip?
|
| (I'm ok with subsidizing the research, and even
| negotiating a bulk manufacturing contract with an agreed
| margin... but a patent? Isn't that bending too far?)
| peterwoerner wrote:
| My village has their own road building and repairing
| department--mostly used for repairing. It's called the
| department of public works. We have our own utility
| company too. Both of those end up being cheaper than the
| having private companies do it.
| onlyrealcuzzo wrote:
| You don't die if you can't afford to drive on the road.
| That's the difference.
| gambiting wrote:
| But most places(at least around the EU) have already
| announced that the vaccine will be free - so there is no
| question about affordability?
| mrgordon wrote:
| The taxes still paid for it twice
| gambiting wrote:
| In what way? Yes, the taxes paid for research, then taxes
| paid to purchase the product. But if everything was state
| owned top to bottom, the taxes would have had to fund
| research, then manufacturing, production and
| distribution. I wager the amount of money spent would
| have been exactly the same, so it's more like an
| accounting trick than an actual difference.
| MereInterest wrote:
| Public money pays for the roads. After the road is built,
| the road belongs to the public. Public money pays for the
| research. After the research finishes, the results should
| belong to the public, the same way as the road does.
| FrojoS wrote:
| The public can of course sell (i), charge (ii) or
| monetize in any other way.
|
| (i) e.g. privatization of telephone networks
|
| (ii) e.g. toll roads and bridges
| hobofan wrote:
| > After the road is built, the road belongs to the
| public.
|
| Depending on where you live, you could very well be under
| the impression that the roads belong to delivery
| companies, taxis, etc. (private companies that make money
| off them) as they are effectively useless to everyone
| else (= the public) while they are constantly blocking
| them.
| reegnz wrote:
| They belong to a publicly funded research institute that
| was given the right by the public to sell it's research
| to private enterprise.
|
| The 'public' wanted that by voting in the lawmakers
| making that possible.
|
| That's how democracy works.
|
| Also we're not talking about physical things, but
| something 'intellectual' like software, so the comparison
| is inaccurate.
|
| More accurate would be IT research done in a publicly
| funded university.
| __s wrote:
| Is another state going to get sued for having a different
| company build a road of the same material? I dunno, maybe
| Asphalt Co should be getting license fees for every road
| built. Maybe even add a toll booth so drivers have to pay
| a license fee to Asphalt Co to drive on their roads
|
| Noam Chomsky has quite a bone to pick about toll roads
| backtoyoujim wrote:
| I care. I care that we look past the end of our nose for
| public health to give the Saulks of the world a chance and
| let the billionaires grab some fucking pine.
| bufferoverflow wrote:
| I care. Just like about the bailouts. Socializing the
| funding/losses and privatizing the profits is just pure
| corruption.
| _Microft wrote:
| The nominal world economy 'GDP' was $90T in 2019 [0]. An
| economic contraction of 5% because of the pandemic would
| mean a loss of $4500B. If a vaccine helps to avoid that,
| even a cost of dozens of billion dollars for it would be
| peanuts in comparison. This is only the economic cost
| avoided let alone the human tragedies.
|
| _Edit:_ german Wikipedia suggest that the contraction is
| only expected to be 3% but because of the numbers involved
| even that doesn 't really matter for the argument.
|
| [0] https://en.wikipedia.org/wiki/World_economy
| bdavisx wrote:
| OR we could look at it as if the pandemic has already
| cost us 4.5T based on your figures, and that's enough. We
| come together and defeat the virus without anyone
| profiting - we all lose, we've all lost already, ffs,
| let's let people profit off of the death, because why
| not?
| strgcmc wrote:
| This is also how criminal mobs operate, in terms of
| protection money, extortion, ransom, etc. The underlying
| economic principle is the same ("gee, sure would be a
| shame if this expensive thing X were to break...").
| Beware of relying on this as the only reason to justify
| the cost.
|
| Hopefully there is some other significant differentiating
| characteristic or attribute to justify this state of
| affairs between society and big pharma, that would
| distinguish it from the same analysis you would use to
| pay a ransom or protection fee.
| _Microft wrote:
| This is not a good argument.
|
| We are talking about a company providing a service. They
| might not have invented the vaccine but they are
| providing the means to bring it from proof of concept
| into mass production. The commenter seemed to think that
| this isn't worth money.
|
| I argue that you get quite a bang for the buck.
| strgcmc wrote:
| It's not an "argument" per se, as in whether we should or
| shouldn't pay the pharma companies. Of course we should
| pay pharma for this for COVID, and of course it is "worth
| it." There is no argument (from me at least) about that
| tactical decision.
|
| My larger point is that for-profit pharma/healthcare is
| not a healthy marketplace (... or at best, it's an
| immature one). In the not-so-distant past (in America, up
| until the Civil War or thereabouts), firefighting was
| mostly privatized (meaning not government-run) [0], and
| brigades would compete (literally sometimes fighting in
| the streets, covering the hydrant to impede rival
| brigades, etc.) to claim the prize of the insurance
| payout for saving a building [1], which doesn't really
| serve the interests of the victims of fires.
|
| I think the incentives of for-profit firefighters are not
| all that dissimilar from the incentives of modern pharma
| companies today (i.e. pay us to save your building from
| this fire, vs pay us to research this vaccine), and I
| would hope to evolve this pharma industry and this
| marketplace (of "demand" for life/health, vs "supply" of
| pharma research and resources) into something more mature
| and with fewer perverse incentives in the long-run.
|
| ---
|
| [0] https://en.wikipedia.org/wiki/History_of_firefighting
| #United...
|
| [1] https://en.wikipedia.org/wiki/History_of_firefighting
| #Modern...
| Retric wrote:
| The question is not if it's valuable, the question is if
| it's subsided. Farmers producing corn add some value to
| the process, but in western countries ~100% of their
| profits are from government subsidies. This does
| incentivize them to be more efficient, but it also means
| their constantly looking for a larger handout.
|
| In the case of farm subsidies it's grown to the point of
| being actively unhealthy both in economic terms and the
| actual root cause of the obesity epidemic. Without
| sufficient calories you can't have an obese population
| due to physics. Medical subsidies have resulted in a host
| of related problems not just in economic costs, but also
| in what research gets done and how efficient that is.
|
| The cost of Medical studies in the US has grown wildly
| out of proportion because their a profit center. This
| perversely slows down the rate of medical research, even
| in the case of emergencies like covid 19.
| kortilla wrote:
| > Without sufficient calories you can't have an obese
| population due to physics.
|
| Sure you can, you just have starving poor people too.
| Retric wrote:
| You don't get a significant percentage of the population
| to obese in a famine. Simply maintaining obesity across
| over 40% of the population takes a lot of energy, let
| alone morbid obesity numbers.
| JoeAltmaier wrote:
| citation? That seems very unlikely. US farmers constantly
| look for greater efficiencies. They are also among the
| most conservative about land policy i.e. erosion,
| chemical application etc because it costs them money.
| Retric wrote:
| Citation for what?
|
| On average your looking at ~90B in net profits from
| farming, the subsidies however are much harder to track
| down. Ethanol subsides for example are often excluded as
| are insurance, tariffs etc.
| JoeAltmaier wrote:
| So, just talking thru the hat were we? As you say, you
| can't point to support for that statement about '100% of
| profits'.
| Retric wrote:
| Ahh, no it simply wasn't clear what you where asking
| about.
|
| There are a lot of ways to slice this up. "Overall
| agricultural subsidies in 2010 were estimated at $172
| billion by a European agricultural industry association;
| however, the majority of this estimate consists of food
| stamps and other consumer subsidies, so it is not
| comparable to the 2005 estimate." https://en.wikipedia.or
| g/wiki/Agricultural_subsidy#United_St...
|
| One example of this is Americans for example pay 3
| billion dollars more for sugar than international market
| rates. But, only a fraction of that directly ends up in
| farmers pockets. You can either take the full 3 billion
| as a government subsidy or exclude most of it. Similarly,
| propaganda and what's allowed in food lunch programs gets
| tricky.
|
| So, I am not endorsing any specific estimate, just saying
| the total industry profits are approximately the same as
| the total subsidy. Add up just direct federal subsidies
| gets you lower numbers especially if you try an exclude
| state, ethanol, R&D, loans, Education, tax breaks, and
| other less obvious handouts.
|
| PS: Silly me, I forgot about all the little exceptions in
| environmental, immigration, labor laws, use of federal
| lands, etc.
| akie wrote:
| You missed the point that we already paid for the
| development of this vaccine by paying taxes. We should
| now only pay for the production, not for the intellectual
| property rights.
| [deleted]
| [deleted]
| [deleted]
| dicomdan wrote:
| Would you rather hold on to your anti-corporate principles
| or have a safe and effective vaccine to protect the most
| vulnerable in the world? These public-private partnerships
| aren't ideal, but there hasn't been any other way in
| history to develop safe vaccines on such short timeline.
| tathougies wrote:
| How is this any different than a government bond program
| meant to finance the projects? Whether the profit is
| derived via increased stock price, or derived from interest
| paid by the government directly through taxes, how is it
| fundamentally different? The government can't typically
| just print money (to keep the economy okay). It has to
| either derive tax to get the funds, or borrow, which again
| privatizes the profit (in the form of interest).
| leemcalilly wrote:
| This is not corrupt. It's money well spent. The benefits to
| us all are most likely more valuable than anything we've
| spent on vaccine research. Government balance sheets also
| probably come out ahead on that investment given that the
| alternative is an economy with a raging pandemic and
| resulting lower tax base.
|
| Then there is the logistical effort of manufacturing the
| vaccine at the scale and speed required. There are huge
| capital investments and risks associated with doing that.
| If a company wants to do that and seek the profits from
| that, great. Literally everyone comes out ahead. You, me,
| the government, the manufacturer, distributor, and every
| other business or person in the economy.
|
| What is the alternative? We create a government agency that
| specializes in manufacturing and distributing pharma
| products?
| mcv wrote:
| Not when it's a monopoly. That means the company gets to
| exploit the results of the research for their own profit,
| without any competition to keep prices reasonable. Non-
| exclusive deals are fine. Exclusive ones are not.
| apexalpha wrote:
| Look, I understand the frustration but they're not going
| to set this price. This thing is way bigger than this
| company and even the entire pharmaceutical industry. This
| is a _global_ crisis.
|
| Many governments have proven that they will put the
| public's need over these companies need. They've broken
| patents and pressured companies before and they will
| obviously do it again.
|
| There are more governments in the world than the American
| one.
|
| For now speed is of the essence and this it's wonderful
| news they've set another step.
| throwaway894345 wrote:
| I'm not a public policy, legal, or economics expert, but
| I certainly favor treating this as a one-off. If a legal
| monopoly is the most expedient way to get us back to
| normal, so be it, and if fears of price gouging are a
| concern let congress or the executive or whomever cap the
| price. Once things get back to normal we can litigate the
| monopoly issue.
| leemcalilly wrote:
| That's a fair point. I guess my underlying assumption
| would be the government funding the research would retain
| rights to the research as well. Thanks for pointing that
| out.
| komali2 wrote:
| > What is the alternative? We create a government agency
| that specializes in manufacturing and distributing pharma
| products?
|
| Yes. Why don't you think that would work?
| uhtred wrote:
| It's laughable that you're getting downvoted. Socialist.
| /S
| [deleted]
| vxNsr wrote:
| Because the government hasn't been able to do anything
| right for 270 years, why do you think they're suddenly
| gonna wake up a figure out mass manufacturing?
|
| We can't educate our kids at an acceptable level without
| billions of dollars being donated on top of all the tax
| collected, we can't figure out how to make medicare work
| responsibly despite literally being able to control
| costs, what do you think makes drug manufacturing any
| different?
| blueline wrote:
| > Because the government hasn't been able to do anything
| right for 270 years, why do you think they're suddenly
| gonna wake up a figure out mass manufacturing?
|
| worked just fine for penicillin during world war 2
| guptaneil wrote:
| In the US, one party has dedicated itself to making sure
| the government is dysfunctional for a _long_ time so that
| it can run on the platform that government doesn't work
| and we should privatize everything. This is not a fact of
| nature, it's a willful decision. For example, the US used
| to be a leader in education. The thing that changed since
| then is one party started defunding education and moving
| that money to private prisons and defense.
|
| If we as a people collectively agreed that we are as
| smart as other countries, there's no reason we can't have
| a functional government that can handle public education
| and vaccine efforts and keep us safe and maintain our
| infrastructure and everything else we expect our
| government to do for us.
| vorpalhex wrote:
| If your statement was true, Chicago and California would
| be bastions of government efficiency and capability.
| Instead we see both Republican and Democratic cities do
| terribly on most measures, and those cities that
| generally prosper have very little to do with who is in
| control other than it not being a single party and they
| have the right conditions for job growth.
|
| School funding happens at the state level too, not just
| the federal grants.
| guptaneil wrote:
| It's funny you bring that up, because my comment
| originally even included a bit about how a lot of our
| current problems can be traced back to Reagan's
| presidency. He was previously governor of California.
| Guess when California stopped offering free higher
| education?
|
| Chicago is in Illinois, which has had a lot of flip-
| flopping between red and blue governors and has an
| infamous history of governors going to jail for
| corruption.
|
| Also I'm not claiming that Democrats haven't done shitty
| things. Daley bankrupted Chicago and privatized a lot of
| our public services while running as a Democrat and some
| of those jailed governors were democrats, but I do think
| the GOP is more homogeneous in its efforts to break down
| the government. I mean privatizing everything is a
| platform they openly campaign on!
|
| If your claim that prosperity has nothing to do with who
| is in charge were true, we wouldn't see a pattern of blue
| states outperforming red states economically or a
| national pattern of economic growth after a democrat
| president and decline after a republican president.
|
| Coincidentally, I live in Chicago and used to live in
| California. People love to use both places as punching
| bags when talking about national problems, despite one
| being a state and the other a city! It's different
| types/scales of problems.
| kortilla wrote:
| > He was previously governor of California. Guess when
| California stopped offering free higher education?
|
| And why hasn't California added free public education or
| expanded housing in the last 20-30 years then?
| ksk wrote:
| You don't get it. Developing vaccines is nothing like
| making cars. Our understanding of how the human body works
| is comical compared to our understanding of materials
| science and engineering, design and other aspects of making
| cars.
|
| Developing vaccines is a long, treacherous journey on a
| narrow ledge with cliffs on either side from start to
| finish. Infectious diseases research has seen a sharp
| decline in funding and commercial interest in general.
| Because of how little we know about the body, most research
| doesn't generate results that can be turned into money. The
| only way to continue to support research is via public
| funds and grants. The public funding of science has been a
| major contributing factor for our advancements in this kind
| of research.
| tomp wrote:
| If "we" gave you $20B to move a vaccine from proof-of-
| concept to production, could you do it? I know I
| couldn't... That's a service, it's worth money, it's worth
| paying for.
|
| Edit: people don't seem to understand that there are
| several stages in pharma development... (1) research, (2)
| trials, (3) scaling production. It sounds to me that _even
| if_ (1) and (2) are "paid for" (with public money), (3) is
| still non-trivial and therefore expensive.
| flyingfences wrote:
| > it's worth paying for
|
| And "we" are already paying for it. Let's not let them
| double-dip.
| reegnz wrote:
| No, we're only paying for part of 'it'. The cure isn't
| just research, it's also logistics and there does not
| exist a capable non-profit to do the logistics part of it
| in such a short time. Also you underestimate how much it
| costs to build such a supply chain capable of producing
| _and_ shipping that many vaccines around the world. Hint:
| the research costs are just a fraction of the logistics
| cost, you just don 't see that up front because it's also
| used to ship other stuff besides vaccines.
|
| These things cost money, and you assume your taxes are
| covering them in full. They don't.
| teucris wrote:
| I think the key desire is that the intellectual property,
| built from publicly funded research, should not be owned
| by a single corporation. Production and distribution are
| of tremendous value and these companies should be
| rewarded for providing that value. But the vaccine
| itself? Why not let others invest capital and try to
| produce & distribute the vaccine?
| fock wrote:
| especially to the shareholders ... holding shares and
| getting dividends (and no, for a 100 year old company
| these people didn't invest at all in the business case.
| They invested in a financial product.)
| overlyresucpp wrote:
| You're being overly reductionist and dismissive.
|
| No one is claiming otherwise. And back to normal is still
| a long ways off.
|
| If you're admitting we're giving them money for a thing,
| it's paid for. I don't know why you quote it like that,
| transfer payments of public money to private institutions
| is a thing, is it up for debate it happens?
|
| Also cost is emotional. Does it have to be 20 billion or
| is the government handing out cheddar for consulting jobs
| later?
|
| There's more too it than high school capitalist theory.
| Just because you can't for $20 billion doesn't mean
| someone else couldn't for $5.
|
| But we hide the work in private accounts. Humanities
| work, built towards by countless hands and minds.
|
| Yeah ok we get it, Murray Rothbard; You're only 1 in 7
| billion. Why does your theory matter? Roll up them
| sleeves. What? He's dead? In the bin with it, no need to
| carry water for a dead man.
| just-juan-post wrote:
| > I'd gladly give this company a couple of billion if it
| means they can get us back to normal.
|
| The government did this. They are the ones who put the
| restrictions in place. They are the ones who choose not to
| remove them.
|
| The government pulled a fast one on most people: They broke
| our leg, they handed us a crutch, and we thank them.
|
| Don't pretend the vaccine is our savior. The government has
| the power to end the restrictions at any time but they choose
| not to.
| zucker42 wrote:
| They don't need the patent in order manufacture the vaccine.
| Only allowing one company to manufacture the vaccine (or to
| control who manufactures the vaccine) will likely rise
| prices.
| skocznymroczny wrote:
| "I'd gladly give this company a couple of billion if it means
| they can get us back to normal."
|
| Sounds like the media panic is working.
| mssundaram wrote:
| Indeed, people willing to give up anything. I don't see any
| return to'normal' anytime soon
| warent wrote:
| it seems more like a collaboration. the private sector doesnt
| have the money or incentive to do such a thing (at an
| individual business level) but they have the ability to execute
| on it if incentivized.
|
| the public sector doesnt have the agility or flexibility to do
| such a thing but they definitely have the money and incentives
| to make it happen.
|
| the two combine to create a big, powerful, fast-moving machine
| that solves a problem.
| throwaway4good wrote:
| All these hundreds of vaccines that are being developed; are they
| all triggering the same immune response?
| wcoenen wrote:
| One vaccine doesn't even trigger the same immune response in
| different people, so it is not entirely clear to me what you
| mean.
|
| The basic principle of a vaccine is that it contains proteins
| that are the same as (or similar to) some of the protein
| building blocks of the actual virus. Your body learns an immune
| response to these proteins, which it can reactivate when it
| encounters the real thing.
|
| Many potential vaccines target the same spike proteins on the
| outside of the virus. I guess you could say those produce "the
| same immune response" in that sense.
| throwaway4good wrote:
| It was in the latter sense.
| jonathanstrange wrote:
| No. AFAIK, they may target different proteins on the virus hull
| and also differ in other respects among each other. Some of
| them might be less effective than others, some might be more
| prone to being rendered ineffective by virus mutations than
| others, there can be substantial differences in the number of
| complications caused by vaccination, and some of them could
| also cause problems with developing future vaccines for deadly
| coronavirus variants that may occur another time.
|
| At least, that's how I understand it from what I've heard.
| Others should please correct me if I'm wrong.
| coldpie wrote:
| Back in May, Ars Technica did a really great overview of how
| each of the various types of vaccines work. It's very much
| worth reading. https://arstechnica.com/science/2020/05/the-ars-
| covid-19-vac...
| lbeltrame wrote:
| Not the "same", but according to a Nature review on vaccines
| from last month, most vaccines exhibit a very strong immune
| response (usually, for the two-dose regimen, after the second
| shot).
|
| The nature of the response varies. Some candidates are more
| efficient at eliciting the production of antibodies, while
| others also activate cellular immunity (T cells).
| covid-69 wrote:
| So who will actually get the vaccine? Not me.
| neilwilson wrote:
| Those who are scared of the consequences of catching Covid I
| guess, and there are plenty of those.
|
| Once volunteer is worth ten pressed men as they say.
| qwerty1234599 wrote:
| Admit it, you're just subconciously afraid of needles as most
| people.
|
| Noticed it with Trump. No way he'd take an experimental COVID
| vaccine, but an experimental antibody drug cocktail through the
| mouth was more than ok to him.
|
| Pro tip: it all ends up in the bloodstream in the end.
| [deleted]
| IgorPartola wrote:
| No worries. I don't think it works on trolls.
| Giorgi wrote:
| I am assuming Pfizer will beat them then? They are expecting
| approval at the end of November if I recall it correctly and will
| probably push their stock
| ageitgey wrote:
| A quick summary of were the Oxford vaccine stands since it's hard
| to follow:
|
| - When will the vaccine be ready?
|
| After the Phase 3 efficacy data is reported, assuming that the
| data shows that the vaccine prevents COVID or reduces COVID
| severity. This happens after enough people in the trial get sick
| with COVID. Then they unblind the groups and see if the people
| who got sick were in the control group or the vaccinated group.
| Essentially we are all waiting for a few 10s of people to get
| COVID. You can guess that the UK, South Africa and Brazil trials
| are getting very close to this since those trials have been
| running for months, but the US trial has recently started and is
| being run separately and wouldn't be very close yet. So the UK
| would probably have the first chance of approving this vaccine.
|
| - What do we know about vaccine effectiveness so far?
|
| So far, they've published initial safety data and immune response
| data in both healthy young adults and now in older adults. That
| all looks good - basically, the vaccine generates a lot of
| antibodies in everyone who takes it. So in theory, it should
| work. Separately, other groups have done testing to verify that
| the vaccine is operating the way it should at a biological level.
| There were also very early animal tests to show that the vaccine
| reduced the severity of COVID and prevented serve lung symptoms.
| In those tests, the vaccine didn't totally prevent transmission,
| but the animals were injected with a large amount of virus and
| it's not clear how humans will react in the real world (hence the
| wait for Phase 3 trail results).
|
| - If it works, how long would immunity last?
|
| No one knows until we wait and find out. But people vaccinated
| with the experimental SARS-1 vaccine still show antibodies over
| 10 years later, so the hope is that it could be long lasting.
|
| - Didn't they have to stop this trial at one point because
| someone got sick?
|
| Actually, at least 3 adverse events have occurred. Early on, one
| person got symptoms consistent with typical vaccine side effects,
| but it was determined that the person had a previously
| undiagnosed, unrelated disease. Second, there was the highly
| publicized case where a patient suffered temporary spinal
| inflammation and recovered shortly. It is unclear if this event
| is related to the vaccine, but trials in all countries have
| resumed so the various government agencies seem satisfied. Third,
| a patient in Brazil died of COVID but it was reported that the
| patient was in the control group and hadn't received the vaccine.
| Very little information from these cases is reported because of
| health privacy laws, so some of this information comes from media
| reports as opposed to official announcements. None of it seems
| inconsistent with a normal vaccine trial.
|
| - Would you feel comfortable taking it yourself?
|
| Yes, I did (I'm in the trial). No side effects worse than a flu
| shot personally.
| jedberg wrote:
| The most interesting part to me is that we require some people
| to get sick. Which totally makes sense. But what if the vaccine
| happens to be 100% effective? Do we ever get to end the trial?
| scrumbledober wrote:
| yes because people in the control group would get sick. Once
| a certain amount of people get sick they see how many of
| those people were in control vs vaccine group. In your
| hypothetical, 100% of the sick people would be from the
| control group.
| jedberg wrote:
| Ah this is true. Thanks. I was thinking that some number of
| vaccinated people had to get sick.
| StavrosK wrote:
| The only issue is that it'd take twice as long to
| conclude the trial, since you thought that you had X
| vulnerable people but you only had X/2.
| senko wrote:
| Thank you for volunteering and putting your health on the line
| for the benefit of us all. Even if the risk is small, it takes
| courage.
|
| I'm assuming you also don't know if you got the active
| substance or a placebo?
| lordnacho wrote:
| > I'm assuming you also don't know if you got the active
| substance or a placebo?
|
| You don't want to bias the study by revealing that
| information. People who knew whether they'd gotten the real
| thing might behave differently.
| ageitgey wrote:
| > I'm assuming you also don't know if you got the active
| substance or a placebo?
|
| Yep. In the UK, they used an existing, unrelated vaccine with
| similar side effects as the control so it wasn't obvious
| which one you got. In some countries and for some of the
| other vaccine trials, they are just using saline as the
| control so it seems like a lot of those people would know.
| [deleted]
| LandR wrote:
| > so it seems like a lot of those people would know.
|
| You can tell the difference in getting a vaccine shot and a
| shot of saline?
| freeone3000 wrote:
| Many people get an immune reaction to the flu vaccine and
| this vaccine - mild flu-like symptoms for a day or two.
| jleahy wrote:
| Yes, the vaccine you'll feel a bit rough for a few days
| after (potentially). The saline you won't.
| [deleted]
| raverbashing wrote:
| You can
|
| Some trials are going to use an unrelated vaccine as
| placebo (I think they're using a Meningitis one)
| garmaine wrote:
| You ever gotten a flu shot? Usually your arm hurts for a
| day or two after, even if there are no other symptoms.
| This is a side effect of the immune response, as your
| body fights the "infection" at the point of injection.
| comfydragon wrote:
| And here I've thought the sore arm was your body reacting
| to a hypodermic needle going into your upper arm muscles.
| I suppose it could be a little of both though?
| dougweltman wrote:
| >Early on, one person got symptoms consistent with typical
| vaccine side effects, but it was determined that the person had
| a previously undiagnosed, unrelated disease. Second, there was
| the highly publicized case where a patient suffered temporary
| spinal inflammation and recovered shortly. It is unclear if
| this event is related to the vaccine, ...
|
| This seems rather worrying as these Phase 1 and Phase 2 trials
| are pretty small, no? What are the odds these patients got this
| from the vaccine vs whatever else they had going on?
|
| I just can't shake the fact that this particular vaccine seems
| to have some safety issues. We'll see in Phase 3 if this shakes
| out, but I would like to understand why governments feel safe
| about these developments.
| gnulinux wrote:
| Out of hundreds people picked random, it's not unlikely
| someone will have some undiagnosed health problem. People get
| diagnosed with new diseases all the time.
| coldpie wrote:
| This is exactly the kind of question the trials are designed
| to answer, yes. We know roughly the background incidence rate
| of diseases, so you can expect some percentage of
| participants will be affected by those diseases. It's also
| important to remember your basic statistics fallacies: the
| question is not, what are the odds that any of our
| participants come down with MS, which is a very tiny chance.
| The question is, what are the odds that any of our
| participants will come down with _any_ background disease,
| which is a much larger chance. It is very likely to happen,
| and indeed it does. They still pause the study to run the
| numbers and make sure the new diagnoses are not outliers from
| the background rate.
| learc83 wrote:
| It's in phase 3 now. I believe all of the above poster is
| mentioning happened in phase 3 as well.
| ageitgey wrote:
| That's right. Out of ~18,000 people total across 3
| countries (UK, South Africa and Brazil), there have been 3
| reported events requiring a pause, of which two involved
| people who got the real vaccine and one who got the
| placebo.
|
| Keep in mind they pause anytime anything serious happens to
| anyone in the trial to give them time to make sure the
| vaccine didn't cause it. Pauses are a good thing - they are
| a sign they are following the protocols and not just
| pushing something through.
| Animats wrote:
| This is only one of 11 vaccines now in phase III efficacy
| tests.[1] Six vaccines already have "partial approval", but those
| are the ones in Russia and China, which may or may not be
| working, and the governments decided to try anyway. All of those
| provoke an immune response. Whether it's enough of the right
| immune response is found out in phase III testing.
|
| Something is probably going to work. The big question is how
| well. A 50% effective vaccine might be an overall lose - only
| half are protected but more than that abandon masks and social
| distancing.
|
| The Johnson and Johnson vaccine, if it works, is the easiest to
| use of the early leaders. One dose, and it doesn't need to be
| refrigerated to dry-ice temperatures like some of the others. The
| Merck/IAVI vaccine is only in phase I, but it's a pill. If that
| works and is highly effective, it will be possible to wipe the
| virus out worldwide in a second round of immunizations.
|
| [1]
| https://www.nytimes.com/interactive/2020/science/coronavirus...
| (or https://archive.is/D6C68)
| neuronic wrote:
| Not happening, recent polls suggest that in Germany, 55%
| percent of the population is willing to get the vaccine.
|
| That isn't enough for herd immunity (at around 60%) and real
| vaccination rate will be even lower.
|
| There is also no chance in hell that Germans will allow a
| government-mandated vaccine. It's unconstitutional and there is
| heavy opposition to government-mandated anything throughout all
| of society.
|
| So we will be stuck with this virus. But you're free to get the
| vaccine yourself for your own protection.
| BjoernKW wrote:
| Well, the rest will become immune the natural way fairly
| quickly: By contracting the virus.
|
| Once a vaccine is available and a large share of the
| population either has been vaccinated or has the opportunity
| to be vaccinated maintaining the current measures can't be
| justified anymore.
| jacquesm wrote:
| That problem will solve itself then.
| LeCow wrote:
| You could make that argument without needing a vaccine.
| harry8 wrote:
| >That problem will solve itself then.
|
| At a considerable cost. There's a large number of people
| for whom the vaccine won't work when it has been taken
| correctly or who cannot take the vaccine because it will
| react very badly with their chemotherapy or whatever.
|
| This "let Darwin deal with the anti-vaxers" solution,
| though initially attractive, ends up being sociopathic when
| you dig into it.
| Viliam1234 wrote:
| > A 50% effective vaccine might be an overall lose - only half
| are protected but more than that abandon masks and social
| distancing.
|
| I remember a similar argument being used against face masks.
| (That they are not perfect, and may cause harm by giving false
| sense of security.) Perhaps we should be more careful about
| perfect being the enemy of good.
| bastawhiz wrote:
| The availability of masks is far higher than vaccines,
| though. You can order a box of masks on the internet and have
| them same-day delivered to your home. The scarcity and
| logistics of delivering a vaccine once it becomes available
| are both factors that make the effectiveness that much more
| important.
| cesarb wrote:
| To us in Brazil, this vaccine is particularly interesting because
| not only is it one of the vaccines being tested here (together
| with FIOCRUZ in Rio de Janeiro; another one is Coronavac from
| Sinovac together with Instituto Butantan in Sao Paulo), but also
| there's already an agreement to manufacture it in the country
| (https://portal.fiocruz.br/noticia/fiocruz-assina-contrato-
| de...).
| godelmachine wrote:
| Is this not the one they will launch in India first?
|
| Edit1: Just to throw in more info, Oxford plans to scale this up
| for mass production with Serum Institute of India and
| AstraZeneca.
| sanketskasar wrote:
| It is the same. But you cannot expect a vaccine to work
| similarly in people of two different regions having major
| differences in their diet, climate and lifestyles. That's why
| many vaccine candidates are being tested in multiple countries(
| read potential markets). Also, I think the UK has preferential
| rights at least on the initial yield of the vaccine.
| hn_throwaway_99 wrote:
| > But you cannot expect a vaccine to work similarly in people
| of two different regions having major differences in their
| diet, climate and lifestyles.
|
| Can you? Do you have any examples of successful vaccines that
| are only given in one region because they have been proven
| ineffective in a different region?
| threeseed wrote:
| AstraZeneca is licensing the "recipe" for the vaccine to
| other countries so yield won't be an issue.
|
| Australia is part of this group that will be manufacturing
| all the dosages locally and independently.
| blackbear_ wrote:
| This is very true and undeserving of the downvotes. A vaccine
| _can_ work globally, but it is not at all guaranteed.
|
| This is because the distribution of certain alleles,
| fundamental for the immune system, is heavily biased
| geographically [1].
|
| [1]: http://pypop.org/popdata/
| geuis wrote:
| I don't think you understand how the biology of vaccines
| work.
| rtx wrote:
| Vaccines do have different effect on different people.
| ksk wrote:
| They are correct. Each country wants data showing that the
| vaccine works for their local population. These ideas are
| firmly based in Science.
| nbevans wrote:
| One interesting point that I read about the Oxford vaccine is
| that it only needs chilling to -5c. Whereas many of the other
| vaccines (I don't know if all others or just some) need chilling
| to -60c. It strikes me that the Oxford vaccine has a distinct
| advantage when it comes to global distribution.
| lbeltrame wrote:
| RNA vaccines (Pfizer, Moderna) require storage at -80C, because
| RNA is a molecule that can degrade easily at higher
| temperature.
|
| Other vaccines can be stored at -20C, usually.
| digitalice wrote:
| Correct me if I'm wrong, but isn't this the vaccine that killed a
| test subject?
|
| https://www.nbcnews.com/health/health-news/volunteer-astraze...
| cesarb wrote:
| What has been reported in the local media, is that the doctor
| who died did _not_ get the vaccine. He was one of the test
| subjects, but half of the test subjects receive a placebo
| instead of the vaccine (the whole point of the experiment is to
| see how the vaccine compares with a placebo); he was in the
| group that received the placebo.
| ageitgey wrote:
| No, that's completely wrong. The person who died was in the
| control group: https://www.bbc.co.uk/news/world-latin-
| america-54634518
|
| They don't release more details officially due to patient
| confidentiality, but the unofficial word was that a young
| doctor treating COVID patients died of COVID during the trial,
| but was in the control group and did not receive the vaccine.
| It is very sad whenever a doctor dies trying to save others,
| but especially because they may still be alive if they had been
| randomized to the vaccination group (of course we don't know
| that for sure though, since the vaccine may still prove to be
| effective or ineffective).
| digitalice wrote:
| Ah, right. Didn't know that! thanks!
| dtech wrote:
| A person who got the vaccine died; "vaccine killed a test
| subject" is quite misleading.
| Fragoel2 wrote:
| Unfortunately that's how most newspapers released the news,
| so I'm not surprised he's confused
| digitalice wrote:
| Maybe yes, but this is the second time there is trouble
| with this specific vaccine.
| digitalice wrote:
| Right, further investigation is needed, but how about this
| one: https://edition.cnn.com/2020/09/17/health/astrazeneca-
| vaccin...
| whycombagator wrote:
| Maybe I missed it in the article but it appears to me this is
| just a spokesperson saying things, not actual data or results.
| dang wrote:
| All: don't miss that there are multiple pages of comments in this
| thread. That's what the More link at the bottom points to. Or
| click here:
|
| https://news.ycombinator.com/item?id=24894622&p=2
| bamboozled wrote:
| Would some of the timing of this announcement have political
| motives?
|
| It's good news, but is this really news at this point?
| Bobblebobble wrote:
| I'm in the trial. Here's the participant information sheet, in
| case anyone's curious:
| https://drive.google.com/file/d/1WB5QPmECchlThnem9wcX0PDaKQW...
| mromanuk wrote:
| at what point you know (or will know) if you were given a
| placebo or the actual vaccine?
| garmaine wrote:
| when the trial is ended.
| xxs wrote:
| ...or in this case if you get infected with the real thing
| as medical history is important.
| Bobblebobble wrote:
| At the end of the study.
| Dig1t wrote:
| ChAd to the rescue!
| pageandrew wrote:
| Virgin SARS-CoV- 2 vs Chad ChAdOx1
| ilyagr wrote:
| I'm surprised they don't seem to do frequent and regular COVID
| testing of participants to catch asymptomatic infections.
| Naively, it would seem worthwhile in order to predict how well
| the vaccine would slow down the spread.
|
| I guess the reason is that the study is narrowly tailored to
| vaccine approval requirements?
| sjg007 wrote:
| It's a pipe dream. We don't have enough capacity. People
| won't get tested either. This issue would be mute if people
| wore masks and stayed apart.
| eznzt wrote:
| Thank you very much for sharing this.
|
| >Until now, this vaccine has only been tested on laboratory
| mice and other animal species and this is the first time that
| the vaccine will be given to humans.
|
| Is it possible to know which species those are?
| kn0where wrote:
| Don't personally know but usually it's monkeys.
| Bobblebobble wrote:
| It has been tested on rhesus macaque monkeys.
| mikeyouse wrote:
| Yep, more detail here:
|
| https://www.nih.gov/news-events/news-
| releases/investigationa...
| ixtli wrote:
| Thank you so much for volunteering.
| erikrothoff wrote:
| Are you given any monetary compensation or compensation at all
| for joining the trial?
| eznzt wrote:
| From TFPDF:
|
| >You will be compensated for your time, the inconvenience of
| having blood tests and procedures, and your travel expenses.
| The total amount compensated will be approximately PS235 -
| PS625 depending on the exact number of visits and whether any
| repeat or additional visits are necessary.
| SamBam wrote:
| To add some context to this, medical trials generally only
| compensate time (at a low hourly rate) and expenses,
| occasionally increased slightly to compensate for hardship.
|
| They deliberately do _not_ pay large amounts, because the
| money is not supposed to overly-incentivize the
| participation, to avoid ethical issues where someone might
| choose to participate in something very unsafe only because
| the reward seems so large.
| zaroth wrote:
| The treatment itself is also free. For a vaccine trial
| that's not much of an incentive, but for things like
| cancer trials it can be extremely valuable.
| xnyan wrote:
| I did various medial trials in college for money and have
| mixed feelings about this. When sitting in the various
| waiting rooms, it was very clear that was only one kind
| of person that did "open" (not targeting people with a
| disorder but rather recruiting healthy volunteers)
| medical trials: the poor. I got to know lots of of people
| well (we were frequent flyers in the medical trial
| world), and our common characteristic was that we really
| needed the money.
|
| It's kind of like non-pay electoral offices. You only get
| candidates that can afford not to work. In medical
| trials, you get the kind of people that are willing to,
| for example, get infected with the common cold and have
| you blood drawn 6x a day for 4 days for about 80 bucks a
| day. It was not horrible, but often uncomfortable. Study
| recruiters still call me, and now that I have a decent
| paying job there is no way I would ever consider doing
| those kinds of studies again. Simply not worth it.
| TheKarateKid wrote:
| Exactly my thoughts. Hardly anyone from these groups is
| doing it "for science." It's for money.
|
| Thinking otherwise is willful ignorance, and this is
| clearly exploitation of lower income groups.
| kortilla wrote:
| The problem is increasing the reward makes the people
| "who need the money" much more willing to engage in
| trials with much worse possible side effects. As long as
| the pay isn't life altering money for anyone, nobody will
| volunteer to do something with a high probability of life
| altering side effects.
| Bobblebobble wrote:
| Yes, they pay a small amount and cover travel expenses.
| teagee wrote:
| does anyone have a similar info sheet for the US trial?
| fcsp wrote:
| Considering all the excluded groups on the trial (page 3, kids,
| 55+, obese, weak immune system, a lot more), it's a lot of
| exclusions, how does one get from results on a study like this
| to declaring the vaccine safe for general use?
| nate510 wrote:
| Generally speaking, experimental drug trials are run first on
| healthy groups and then in at-risk groups (old, young, those
| with co-morbidities). From the article, my guess is that they
| are expediting the sensitive groups trials, but unfortunately
| there's a lack of technical detail.
|
| Source: My partner is an infectious disease specialist and we
| talk about this pretty much daily because I'm so curious.
| ponker wrote:
| But for this disease that's particularly bad because Covid
| has shown to be worst in 55+, obese, comorbidities, etc...
| which means that the trials on healthy groups are proving
| very little, since the virus itself is so much weaker on
| healthy groups.
| HeadsUpHigh wrote:
| It does build herd immunity though.
| kevinventullo wrote:
| Does it prevent young healthy people from being carriers?
| If so, that would be huge.
| IvyMike wrote:
| > trials on healthy groups are proving very little
|
| It's proving it doesn't make healthy people unhealthy
| (see https://www.cdc.gov/vaccinesafety/concerns/guillain-
| barre-sy... and specifically the 1976 flu vaccine, for
| example).
| EpicEng wrote:
| >But for this disease that's particularly bad because...
|
| Doesn't change the fact that, when you're developing a
| new drug, you want to test it in a way which will cause
| the least harm. You don't begin trials with those most at
| risk for obvious reasons. The primary goal of this phase
| it to asses the safety of the vaccine candidate.
|
| I'm also unaware of any disease that isn't more
| threatening to people in relatively poor health.
| lostlogin wrote:
| > I'm also unaware of any disease that isn't more
| threatening to people in relatively poor health.
|
| I had to think a while - sickle cell anaemia and malaria.
| I'm sure there will be others.
| davidhowlett wrote:
| I believe the 1918 flu also had the unusual property of
| killing people in their 20s at a higher rate than the
| middle aged and old.
| https://wwwnc.cdc.gov/eid/article/12/1/05-0979-f3
| dragonwriter wrote:
| For much of 1918, a lot of people in their 20s getting
| the flu were also experiencing trench warfare, which
| can't be an optimal situation, both in terms of immediate
| self-care and co-occurring health conditions.
| lordnacho wrote:
| I guess you should see that it was just men in their 20s
| in the stats then?
| DennisP wrote:
| Older people were less vulnerable in the U.S. as well.
| The problem was that young healthy people were more
| likely to have an immune system overreaction. This
| applied to both genders.
|
| (Source: John Barry's _The Great Influenza_ )
| macromagnon wrote:
| Totally anecdotal but Prodigy of mobb deep had sickle
| cell and he said many times eating healthier, working
| out, etc. had a positive impact.
| EpicEng wrote:
| Ha, fair enough! I made sure to word that carefully...
|
| But in general, good health leads to better outcomes, and
| we know that's the case with covid.
| cookingrobot wrote:
| You say it's "obvious" but it's the opposite of my
| intuition. Can you explain the logic a bit more? I would
| have thought you'd give a risky new drug to the least
| healthy, most likely to die without it population, to
| raise the chance of survival from low to unknown.
| Zenbit_UX wrote:
| It's obvious because you don't test risky shit on people
| already at risk of _everything_.
|
| I've got a 90yr grandma, she shouldn't be the first to
| try new stuff injected I to her body. Is that not
| obvious?
| michaelmrose wrote:
| Even among the 65+ survival is liable to be 90% even if
| infected and stand a good chance of avoiding the virus
| entirely even if they must wait a a few more months. Thus
| the probability of survival waiting isn't low to start
| with.
|
| The proper calculation would be probability of infection
| * probability of death in the intervening months before
| we collect data on the efficacy of various options vs
| expected outcome if they just take the oxford vaccine
| now.
|
| The users chance of survival is already quite high in the
| intervening period and while the benefits of the oxford
| vaccine are highly hypothetical they are also largely
| contingent on vaccinating everyone. People are liable to
| only see IF it works a 30% - 60% effectiveness, lower for
| some with worse immune systems. The real benefit is
| decreasing the spread of the virus until it dies out not
| merely the individuals benefit which will never happen if
| it turns out it doesn't work.
|
| Worse it may be most apt to kill or harm those who are
| also most vulnerable to covid.
|
| At worst the patient trades a very good chance of
| survival for a substantial downside with no upside and a
| future vaccination with a different vaccine they ought to
| have waited for.
| 627467 wrote:
| If you did start experiments with those most vulnerable
| you exposing them to far more risks.
|
| Drug trials always start from learning more about safety
| of treatment (as opposed to efficacy) and once deemed
| statistically safe, you move to test for efficacy.
|
| I assume you're thinking about treatments who could give
| a chance to those who have little hope/time for
| surviving. There's probably a chance they can benefit
| from taking experimental drugs but if we know little
| about it (because they are early in trial phases) we less
| confident this treatment will be useful and worst, we
| maybe not learn much from why it failed
| wolco2 wrote:
| You don't test your new feature on the group who is most
| likely to leave your site. You test on your biggest fans
| first.
|
| You don't test your new med on the group is most likely
| to die.
| Florin_Andrei wrote:
| > _I would have thought you'd give a risky new drug to
| the least healthy_
|
| Yes, but at this stage there is no drug. You're in the
| process of making the drug. And you don't want to test
| your beta versions on sensitive subjects.
|
| Once nothing obviously bad happens, you can expand the
| test circle.
| ska wrote:
| There is always a balance of risks, and this is why there
| are ethics review board.
|
| My intuition on this has become that the more certainty
| there is that you are to die without treatment, the
| easier it is to try relatively risky new treatments on
| you (with your consent). But say having stage IV
| pancreatic cancer is very different than having a
| comorbidity for a disease you haven't contracted yet.
|
| Additionally with something like a vaccine, you are very
| interested in what it will do to the general population,
| not just the most vulnerable, because it should be rolled
| out to the general population. Anything screening
| program, you have to pay attention to the unlikely side
| effects since the denominator will be large.
|
| Finally, you do these trials in phases because you need
| to find out if it is safe for humans first, then if it is
| effective.
| kortilla wrote:
| It's a vaccine, not a cure once you have it. So the
| people you would be testing it on wouldn't be infected
| yet. Therefore you don't first test it on unhealthy
| people when the vaccine might have unrelated nasty side
| effects.
| mithr wrote:
| There are a few factors -- one is that the major goal is
| to measure the side effects and safety of a particular
| new drug, in relative isolation... someone who is already
| sick is more likely to be on other drugs, thereby greatly
| increasing the risk of drug interactions.
|
| Another is that when someone is already sick, they are
| more likely to not do well with any particular new drug
| (pretty much nothing is 100% effective for 100% of
| people), so you'd have to have some way to trying to
| discern whether the fact they got worse or even died is
| related to the new drug vs. just a natural progression.
| This can get complicated to measure.
|
| And specifically for this particular thread, this is a
| vaccine, not a cure -- so in any case, when we say "least
| healthy" in this context, we're not talking about giving
| it to people who are already diagnosed with the virus,
| but rather to those who are _at most risk of
| complications_ from the virus, _if they were to contact
| it_. So it would be giving a drug to people who _don't_
| immediately "need" it to survive, but who are still most
| at risk from any side effects.
| rgbrenner wrote:
| You have a built in assumption in your statement that you
| haven't acknowledged: that the drug helps rather than
| harms. A new drug may help or it may harm.
|
| If the drug turns out to harm people, a healthy person
| may be able to deal with it and recover. While a person
| that is barely hanging on to life may be pushed over the
| edge. There's no data to support a new drug raises the
| survival rate. It may in fact lower it from low to zero.
| During testing you generally want to kill as few people
| as possible.
|
| Once more data has been collected on the drug, then the
| balance starts to shift toward giving it to at risk
| groups.
| kbutler wrote:
| The high-risk population introduces statistical
| complications evaluating the results - were bad outcomes
| caused by the treatment under investigation or by the
| preexisting conditions?
| bentcorner wrote:
| Later on you'd want to give the determined-to-be-safe new
| drug to the least healthy (if possible), or those that
| come in close contact to them.
|
| At this stage they still need to ensure the drug is safe,
| so they test it on healthy people first.
| romanoderoma wrote:
| One of the goals of pre trials is to establish that
| negative effects, if there are any, aren't caused by
| other factors other than the drug itself.
|
| It's already hard to prove it on healthy candidates, it's
| pretty much impossible on candidates whose immune system
| is already weakened by previous conditions.
| Someone wrote:
| In addition to what others said, if you know or suspect
| the procedure is extremely risky, and no other good
| options exist, you _do_ start with the least healthy.
|
| As an example, the patient who got the first heart
| transplant:
|
| _"As a result of heart attacks in 1965, approximately
| only one third of his heart was still functioning. In
| late October, he went into a diabetic coma, but regained
| consciousness. [...] He was also suffering from kidney
| and liver failure."_
|
| (https://en.wikipedia.org/wiki/Louis_Washkansky)
| alex_young wrote:
| Presumably the risks of an unknown response outweigh an
| as yet unknown benefit when testing is starting. These
| risks would be amplified for those with already
| compromised systems.
| EliRivers wrote:
| You don't want people to drop dead from your experimental
| vaccine . As a general rule, the people least likely to
| drop dead from your experimental vaccine are young, fit,
| healthy people. Start with them. If they drop dead, well
| shoot. If they nearly drop dead, lucky you didn't start
| with the people who are one bad day away from the grave
| already.
| 542354234235 wrote:
| Because you may not be raising it at all. The side
| effects could do more harm than the intended effects do
| good. So you need to do a large very controlled study
| with healthy people so you can more easily find side
| effects. Second, many side effects can be tolerated well
| by a healthy person but could be very dangerous in an at
| risk person. A drug that causes hypertension might not be
| a problem for a healthy person, but could kill someone
| with a heart condition. If you skipped this step, you
| could put people at risk of heart attacks and make it
| harder to detect the drugs effect on the heart vs already
| increased morbidity in those heart condition patients.
|
| You are also evaluating the intended effects (as opposed
| to side effects), so you can see if it is actually doing
| what we want it to do, and how well. We could find out
| that the vaccine is very effective at preventing covid
| infections. But we could find out that it does not reduce
| the rate of covid infections, but does reduce the
| severity, or we could find out it does not reduce
| anything for reasons we don't yet understand.
|
| Once that is done, we will have a good understand of A.
| the level of benefit and B. the level of harm. From there
| we can make an educated decision to proceed or not. If we
| do, then it is approved and given to the general
| population, including those at risk. It is at this stage
| that the effects on at risk groups can be studied, during
| the ongoing monitoring of the approved drug.
|
| Hopefully this answers your question and shows why this
| is the best way to do it.
| samatman wrote:
| It's not unheard of.
|
| "Spanish" flu was a notorious example: older people are
| believed to have had some amount of immunity from old
| strains, and the cytokine storms which made that strain
| so deadly are actually a consequence of having an active,
| robust immune system.
| mandelbrotwurst wrote:
| Isn't that true for most if not all diseases?
| ta1234567890 wrote:
| But even if only healthy people get the vaccine, it could
| prevent the virus from spreading as much, thus protecting
| the people who cannot get the vaccine and saving
| countless lives.
| CyanLite2 wrote:
| There's a protective effect of 'herd immunity'. E.g., if
| we vaccinate all the ordinarily healthy people, then it
| should slow spread to better protect the at-risk groups.
| Sort of counter-intuitive, but it buys us time until we
| can figure out if this vaccine is safe for those groups.
| dragontamer wrote:
| Case in point: Doctors and first responders should be
| immune before treating the sick.
|
| Doctors can get COVID then spread it to their patients. A
| vaccine, even just for healthy people, would negate this
| chain of events.
| knappe wrote:
| What is the alternative? Skip testing it on healthier
| groups first? Imagine what would happen if the trial was
| going awry _with_ healthy people. You certainly wouldn't
| want to test this on vulnerable populations.
| OJFord wrote:
| Age and comorbidities (!!) always make a disease worse,
| obesity is a bit less common perhaps, but there's always
| something that's a risk factor, and the point is not to
| do something highly experimental and unknown starting
| with people who are _already_ at increased risk.
| SN76477 wrote:
| "The purpose of this study is to text a new vaccine against
| COVID-19 in healthy volunteers.
|
| So I am assuming this is the control group.
| BurningFrog wrote:
| This is a combined phase 1/2 trial. It tests that the
| vaccine doesn't hurt or kill people too much, and that it
| has some immune system effect.
|
| After that a phase 3 study is done on tens of thousands of
| people from all possible demographics.
| ska wrote:
| The control group will not be given the vaccine, but a
| placebo.
|
| Clinical trials are phased. Typically you start with a very
| small group of people to evaluate toxicity (e.g. below
| treatment levels of a drug), then a slightly larger group
| looking for side effect, then a significantly larger group
| looking for desired effects, and finally a broad group
| looking for safety and efficacy.
| 0898 wrote:
| Why would tabloid glamour models be excluded?
| GekkePrutser wrote:
| Vaccines often cause a minor cosmetic bump. If you see
| people with a triangle of bumps on their shoulder for
| example they have received a common vaccine for healthcare
| workers.
|
| And the smallpox one can leave an even bigger scar. I
| suppose they don't want the liability for that which could
| impact the model's income
| LandR wrote:
| Tabloid glamour models obviously aren't excluded, the
| posters joke was a reference to this
|
| > excluded groups on the trial ( _page 3_ ,
| bun_at_work wrote:
| Not really qualified to answer this, but I would imagine
| follow-on rounds of testing. Also, those groups should be
| protected through herd immunity if everyone else gets the
| vaccine.
| refurb wrote:
| Extrapolation. Is there a scientific rationale as to why the
| vaccine would NOT be safe and effective in a new population?
| If not, approve it for that population. If there is rationale
| why it wouldn't be, ask for more data.
| bosie wrote:
| Why would the reasons used to exclude those cohorts in the
| first place not be used to determine the vaccine is unsafe
| for said cohorts?
| Bobblebobble wrote:
| This phase I/II study's primary objective was to learn about
| the safety of the vaccine, and about whether it causes an
| immune response. I'm no expert, but I expect the phase III
| trials in the US and India will include a broader population.
| fcsp wrote:
| Ah, thanks for clarifying that you participated in phase
| 1/2, I had not gotten this from skimming through the
| document, that makes a lot more sense to me. Thanks for
| sharing!
| BurningFrog wrote:
| It is mentioned up top, but I had to search for it.
| FuckButtons wrote:
| There isn't just one trial - there are other safety trials
| being run in vulnerable groups.
| thebruce87m wrote:
| Maybe a stupid question, but do we need to vaccinate
| everyone? I remember reading that heard immunity is 70% or
| something - so could we get away with leaving the people out
| that it wasn't tested on?
| 24gttghh wrote:
| https://en.wikipedia.org/wiki/Herd_immunity#Mechanics
|
| It varies by disease. Can anyone really say what the %
| is/would be for covid-19?
| hsitz wrote:
| You should be able to see that Covid-19 is in fact a
| disease listed in the table on the wikipedia page you
| reference. You should also be able to see that the
| percentage required for herd immunity effect to begin
| (the 'herd immunity threshold') is a function of the R0
| level for each disease.
|
| In addition, to question of "can anyone really say for
| covid-19", I suppose the answer is 'No, but I would trust
| that the consensus of the scientific community of
| infectious disease experts is the best estimation we can
| get.'
| SamBam wrote:
| It's not a stupid question, and I've heard that some
| vaccines are aiming to be approved only for adults at
| first. This would make sense not only because, as you say,
| you can start to approach herd immunity without vaccinating
| everyone, but also because children are weaker spreaders.
|
| Obviously "herd immunity" is more of a gradient than a cut-
| off, and it's much easier to approach it if we can
| vaccinate everyone, but we can definitely speed up the
| process (including the months-long process to even get the
| vaccines to everyone) if we can start vaccinating some
| people early.
| nabla9 wrote:
| THEORY: _Assuming 100% efficacy vaccine._ In completely
| homogeneous population if people are randomly vaccinated
| the threshold where the diseases effective R drops below
| 1.0 is 1 - 1 /R. For example if R = 3.0 you need to
| vaccinate 66% population until infections start to decline.
|
| REALITY: Assuming 75-90% efficacy vaccine, vaccination is
| non-random and population is heterogeneous. You want to
| vaccinate everyone who agrees to take it. Just like with
| children diseases, there will be clusters of anti-vaxxers,
| or people just don't bother and they are often clumped
| together, travel around the world and spread the disease.
| TheButlerian wrote:
| Yes. The goalposts with the lockdowns moved so much that
| now the only way of getting out of them is 100% vaccination
| + 100% effectiveness of the vaccine. As this is not
| possible - mask wearing in the shops and public transport
| will remain for the foreseeable future.
| prox wrote:
| There is no magic bullet, the vaccine is just the best
| chance of getting the virus under control, since it doesn't
| rely on our behavior.
|
| Look up "swiss cheese model covid-19"
| BurningFrog wrote:
| Depends what you mean by "need". Need for what?
|
| Each extra person getting vaccinated adds protection, both
| for that person and the larger society.
| nullsense wrote:
| Theoretically the % of people needed to reach herd immunity
| is a function of how infectious the virus is. They use a
| number R to represent for each person who gets infected how
| many people they go on to infect. This changes over time as
| different measures come into place like lockdowns, masks,
| and social distancing. The basic reproductive number R0
| (R-naught) is how infectious the virus is initially without
| any of those measures in place. The formula for the % of
| people needed to reach herd immunity is R0-1/R0. So if R0
| is 4 then you need 3/4 of the population. If R0 is 3 then
| you need 2/3.
| moultano wrote:
| The vaccine may itself not be perfectly protective, and the
| herd immunity threshold only works if the people vaccinated
| are random. Otherwise any unvaccinated population can have
| an outbreak.
| lifeisstillgood wrote:
| I think this is the apex of the HN effect - usually it's
| finding a world expert answering your question ... but we can
| beat that :-)
|
| And thank you for volunteering.
| qwertox wrote:
| It's really a special place in the internet.
| alfiedotwtf wrote:
| Anyone notice vaccine good news always drops when the Dow drops
| about 2%? Every time
| castis wrote:
| My understanding is that because stimulus packages are good for
| the stock market. When hopes are up about a vaccine, the
| possibility of a stimulus drops, hence the market comes down.
|
| I've only been following the market for about a year, but its a
| weird thing.
| ineedasername wrote:
| I'm concerned that, given both effectiveness & willingness to get
| a vaccine, we may only experience incremental improvements in
| transmission rates.
|
| The flu vaccine is generally about 50% effective, and only about
| 50% of (Americans) say they will definitely or probably get a
| vaccine. If that holds, then combined, that would only cover 25%
| of the population. Well below herd immunity.
|
| Yes, it would be an improvement, but we should really be
| embarking on a heavy public awareness campaign that, once
| available (and assuming a low risk profile) that vaccination is
| the responsible and safe thing to do.
| atourgates wrote:
| The challenge is that we don't really know where the number of
| immune or semi-immune individuals comes in order to achieve
| "herd immunity" from Covid.
|
| Nature has a good article that goes into depth a bit here:
| https://www.nature.com/articles/d41586-020-02948-4
|
| Basically, there are reasonable estimates that the range could
| be anywhere from 20% - 70%.
|
| The effect also greatly depends on which portion of the
| population gets vaccinated. If (in an imaginary world) the most
| at-risk 50% of the population got vaccinated, we could
| reasonably expect Covid to actually become something like the
| flu.
|
| Finally, I expect this is something that'll gain acceptance
| over time. There are some not unreasonable factors that could
| cause people to be nervous about a Covid vaccine initially,
| that will be softened over time. Things like it being developed
| under the supervision of politicians who could be motivated to
| rush it out, or just being developed faster than any vaccine
| ever.
|
| Or, on the flipside, continued travel restrictions for
| individuals who haven't been vaccinated. Americans traveling to
| certain tropical countries have been required to get specific
| vaccines for years, I wouldn't be surprised if over the next
| few, travel to Europe or even Canada requires a Covid vaccine.
| FailMore wrote:
| WHOOOOOOOOOOOOOOO HOOOOOOOOOOOOOOO
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