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Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

blogs.sciencemag.org

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Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#141

Post by tomtheelder »

the_af wrote: post #85
chrisco255 wrote: post #79

Earlier quoted context omitted.

It's 1-2 orders of magnitude more deadly than the flu. Some estimates are between 2 and 4% fatality rate for the Covid-19. Flu is 0.1%. That fatality rate average masks that it is far deadlier for the elderly and high risk patients, with as much as 10-20% fatality rate for that demographic.

Thanks for the reply. What is the fatality rate among the elderly and high risk patients for seasonal flu? (say, in the US if there are no worldwide statistics). I understand the real problem with any flu-like disease is precisely with the elderly and high risk patients. Usually, of course there are always cases of healthy people who die from a flu.

Somewhere around 1%. The 10x multiplier on fatality rate seems to be fairly consistent across age groups. Note that the CFR for this virus is still largely unknown, and is vastly different in different regions.

https://www.cdc.gov/flu/about/burden/2018-2019.html

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#142

Post by owlninja »

aazaa wrote: post #82

For those suggesting that a COVID-19 vaccine can somehow be fast tracked, consider what happens if something goes wrong during deployment to the population. The US has an active, very vocal anti-vax community. They've been growing and gaining ground for decades. The first sign of trouble of any kind with a new COVID-19 vaccine would result in a backlash of biblical proportions. It could be so strong as to derail any…

I hear more people talking about anti-vaxxers than I do from any actual anti-vaxxers. I don't think they are all that powerful.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#143

Post by Slartie »

the_af wrote: post #74

I see a lot of panicky comments, both in real life and in this very thread. I know COVID19 is different from a regular flu, but is it more serious? "Regular" flu is very contagious and kills lots of people every year. It's ok to study coronavirus and to try to find ways to effectively manage it, combat it or prevent the disease -- but why are we panicking? Nobody panics about the flu and it's proven to be fatal for a…

Something to consider: even if it was "just like a flu" (which it isn't, enough commenters already pointed out the differences, but let's just for the sake of my argument assume that it was), it is a matter of fact that this would then be a "second flu" going around at a time at which doctors and hospitals are already well-loaded with caring for patients that have more serious trouble with the "real flu" that happens to be at the peak of its activity just at the same time.

The "real flu" is relatively non-deadly for most people (even though it still kills a lot of people in absolute numbers) precisely because the healthcare system is capable of providing care to those requiring it because of the flu. It can do this because the flu is a relatively well-understood phenomenon, it comes every year, and although the exact mutations of the virus differ between the years, the overall characteristics of the outbreak are relatively well-known in advance. There are also vaccines against the flu (these are a big thing in allowing the personnel in the healthcare sector to do their work, which of course exposes them to flu patients) and there is medication available that's able to quicken the recovery. Nevertheless, the flu still puts a lot of strain on the system, and having a "second flu" of entirely unknown characteristics going around, possibly even infecting the same patients, for which there is no vaccination and no medication at all is not exactly a thing to take light-hearted.

I would not be surprised at all if the "real flu" would later be found to be much more deadly this year than in the years before, not because the virus was any different than before, but because the additional strain due to COVID-19 negatively impacted care for flu patients.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#144

Post by theseadroid »

cryoshon wrote: post #55

a vaccine might be 18 months away, if we're lucky and divert resources to the effort. if we're unlucky, it could be four to five years or even longer. remember, there's no guarantee that we can even make a vaccine for any arbitrary viral disease. we can't do nothing while we wait for a vaccine. placeholder antiviral therapies are also a non-starter. we can't manufacture the drugs at the scale we need them unless we m…

I totally agree with you.

>china and south korea both explicitly stated that they were transitioning to wartime footing to combat the virus. we need to follow in their footsteps. we need billions of dollars in spending, suspension of normal daily life, and requisitioning of the necessary resources from private entities if needed. and we need to do this today. now. this afternoon. preferably before 5 PM. this isn't a problem to be left until tomorrow.

This won't happen in North America. As a Chinese who reads Chinese and English news sources everyday, it appears while China is very heavy handed in censorship for anything coronavirus related, in NA there is too much misinformation floating around, to the point that people cannot agree on anything. Specifically western media have been producing outrage porn for clicks around Covid 19 for a while, resulting in much misinformation on how China's measurements in combatting the virus are inhumane and in violation of human rights, that even talking about those options will bring so much negativity into the discussion. Apparently inaction and incapability of the government and every one only takes care of themselves are not human right violation.

Even we don't have a cure, slowing down the spread is a huge win in for the healthcare system as a whole.[1]

1. https://www.vox.com/2020/3/2/21161067/coronavirus-covid19-ch...

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#145

Post by jefftk »

WaltPurvis wrote: post #139
jefftk wrote: post #62

Earlier quoted context omitted.

You can speed up clinical trials by running larger ones at earlier stages. This risks more deaths from bad medicines, which may still be worth it in a pandemic.

Large clinical trials require large numbers of patients, which thankfully we don't have, and also what we're trying to avoid.

If things get bad enough that this is worth the risk, we will have large numbers of patients

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#146

Post by AlexandrB »

gdsimoes wrote: post #128
Someone1234 wrote: post #120

Earlier quoted context omitted.

We should risk people's lives because doing otherwise may harm the economy..?

Harming the economy is also a risk to people’s lives, though.

So you’re in favor of policies that aggressively redistribute wealth to help mitigate such risks for the most vulnerable (the poor)?

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#147

Post by mellavora »

bluGill wrote: post #134
dekhn wrote: post #114

Earlier quoted context omitted.

The obvious risk here is that you're combining a rush job with limited oversight, and large-scale distribution. So any mistake that would have been caught by the existing process will instead have the potential to roll into a global disaster.

Compared to 2% chance of death from the virus? I'll take a 2% chance of blindness over 2% chance of death for example. Of course we don't know what the odds are for the negative side effects.

like, for example, if the vaccine is made from chicken eggs and a non-sterile batch gets through because we scaled up the pipelines faster than what was safe...

BTW, your 2% chance of death is assuming you catch the bug (and that the 2% figure is accurate). vs a much higher chance that you take the vaccine.

Do you prefer a 0.02 * 0.8 == 0.16 chance of blindness over a 0.02 * 0.05 == 0.001 chance of death?

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#148

Post by mellavora »

dnautics wrote: post #121
xiphias2 wrote: post #98

Earlier quoted context omitted.

Dearh rate for sever cases is huge. We'll get the first test results at end of march/start of april. If I have 30% chance of dying I take anything that lowers the chance significantly.

That's arbitrary. What's the death rate for severe flu? If I define severe to be "throwing a fever of greater than 42 C" it'll be really high.

flu mortality is about 0.1% though, like Covid, varies by age group/pre-existing. Also varies by strain/year

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#149

Post by mellavora »

HelloNurse wrote: post #60
RcouF1uZ4gsC wrote: post #29

I know Derek Lowe is an expert. However, sometimes, experts think that because things have always been a certain way throughout their career, they will always be like that. Drug development has been very conservative especially in the US for the past several decades. The FDA is all about making sure they never have a thalidomide incident and would rather lose a lot of good drugs than approve a bad drug. This is the s…

Production of pharmaceuticals (such as a vaccine, when it's ready) and medical equipment (such as ventilators) can be ramped up by commissioning and requisitioning an arbitrary number of factories, but developing a vaccine is inherently a sequence of trials that can only be "multithreaded" between relatively few research teams trying different approaches semi-independently.

Ummm, not quickly. Vaccine production requires very sterile facilities which take time to build.

You do not want to be taking vaccines produced under non-sterile conditions.

Also, are you assuming that supply chains are intact? How are you getting the raw and the finished materials to build the factories?

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#150

Post by bluGill »

HelloNurse wrote: post #60
RcouF1uZ4gsC wrote: post #29

I know Derek Lowe is an expert. However, sometimes, experts think that because things have always been a certain way throughout their career, they will always be like that. Drug development has been very conservative especially in the US for the past several decades. The FDA is all about making sure they never have a thalidomide incident and would rather lose a lot of good drugs than approve a bad drug. This is the s…

Production of pharmaceuticals (such as a vaccine, when it's ready) and medical equipment (such as ventilators) can be ramped up by commissioning and requisitioning an arbitrary number of factories, but developing a vaccine is inherently a sequence of trials that can only be "multithreaded" between relatively few research teams trying different approaches semi-independently.

True, but we can speed it up a lot. There are a lot of researchers currently looking something else that be a great research assistant (I know you are a great cancer researcher - that means you have the biology background to be a lab assistant). Even those who don't have a medical background can do menial data entry tasks, or clean up tasks.
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