Pfizer Covid vaccine approved for use next week in UK • Hacker News Board

Re: Pfizer Covid vaccine approved for use next week in UK

#241

Post by Wintamute » Wed, Dec 02, 2020, 10:50 AM UTC

ksec wrote: post #179

DanBC wrote: post #143

Earlier quoted context omitted.

We had excellent Public Health test and trace departments who had a wealth of experience of tracing people for sexual health purposes. But we still chose to give the contract to Dido Harding despite her poor record at NHS Improvement. And I saw what happened to NHS Logistics, which was one bit of the NHS that wasn't losing money. It was running well. It was privatised to DHL in 2006 for purely ideological reasons, an…

From a high level overview and global perspective, what the OP is saying, or meant , is that comparatively speaking UK is much better than possibly 80% of developed countries. Not to say NHS is without flaws, far from it. But if you step outside and look around the world many are surprised how awful public health services and logistics can be. So to put it another way, It is not that NHS is good, it is just the other…

What you're missing is that amongst a certain class of Brit, and across much of the West, relentless and savage cultural self-criticism has become the norm, and a currency used for in-group signalling. Even when people in the UK should be celebrating, as literally the first country in the world to develop an approved C19 vaccine in record breaking time, and enjoy the privilege of a free health system that can roll it out within _weeks_ they still find a way to twist it. Asking them to truly recognise the fact that there indeed exists big differences between the UK and much of the world in this respect will fall on deaf ears - it doesn't serve their purpose - which to be clear, isn't truth-telling or (heaven forbid expressing pride in their national achievements) it's a habit of personal advancement at the expense of others and dissolving their own culture in an acid bath of manifold criticism. It's only where this sort of criticism is expressed in forums with international readers, many in far less fortunate positions, does it begin to reveal itself for the pathology that it is.

Re: Pfizer Covid vaccine approved for use next week in UK

#242

Post by jfoster » Wed, Dec 02, 2020, 10:51 AM UTC

sideshowb wrote: post #202

shusson wrote: post #71

Out of curiosity, how do people on HN rate the risk of long term side-effects?

I'd also be interested to know whether mRNA vaccine, in hijacking the body's own cells then training the immune system to attack them, carries extra risk for those with autoimmune disorders i.e. people whose immune systems already have an unfortunate tendency to attack themselves. I'm sure this has all been thought about by relevant experts but I'd like to see the published research.

From what I understand, people unlucky enough to have certain conditions haven't been included in the studies, and therefore won't be taking the vaccine. That includes pregnant women, and (I think?) people with autoimmune disorders.

Re: Pfizer Covid vaccine approved for use next week in UK

#243

Post by thu2111 » Wed, Dec 02, 2020, 10:54 AM UTC

DanBC wrote: post #143

apsec112 wrote: post #107

Earlier quoted context omitted.

I'm sure the UK is in the top twenty countries in the world for logistics infrastructure. It's easy to read news stories about your country messing things up, and quietly not read foreign-language media about poorer countries messing things up a lot more by comparison, and get a biased perspective.

We had excellent Public Health test and trace departments who had a wealth of experience of tracing people for sexual health purposes. But we still chose to give the contract to Dido Harding despite her poor record at NHS Improvement. And I saw what happened to NHS Logistics, which was one bit of the NHS that wasn't losing money. It was running well. It was privatised to DHL in 2006 for purely ideological reasons, an…

That story can easily be told in reverse.

NHS Logistics didn't run well. As is consistently true of government run organisations it was run so badly that most of the NHS didn't even try to use its services. At the time of the privatisation the NHS sourced around half a million products but only acquired 50,000 of them via NHS Logistics. The entire purpose of privatising it was to try and make it work better and thus to encourage the NHS to buy more centrally to get bulk discounts, something that wasn't going to happen for as long as doing so required them to work with a small, sclerotic socialised bureaucracy.

Why would anyone think that an organisation which had no economies of scale, nor any demonstrated expertise in logistics in a competitive environment, be better at delivering things than DHL, a world famous delivery and logistics company that the NHS frequently chose to use anyway in preference to its own operation? That's ideology.

How much did NHS Logistics workers care about the health of the citizens who paid their salaries? Not at all: even though many of them were going to keep their jobs anyway they reacted to privatisation by going on strike and picketing trucks to stop them delivering supplies to hospitals. That's ideology. Fortunately it didn't kill anyone, but only because hospitals were already mostly bypassing the striking workers already due to aforementioned poor performance.

The NHS had its limits thrown into sharp focus this year. Mass testing is a bad idea, but putting that to one side for a moment, Germany and indeed most other places were able to ramp up test volumes far faster than the UK did, because Germany used private labs from the start when the NHS insisted on only using NHS labs, despite being given direct commands to scale up testing as fast as possible. That's ideology.

Finally, the supply chain hasn't been effectively renationalised. The contract changed from DHL to Unipart:

https://spendmatters.com/uk/dhl-challenges-loss-of-nhs-logis...

Supply Chain Coordination Ltd is what the name suggests: a relatively small coordinating body that manages contracts for various services, including contracts for logistics provisioning.

The brutal reality about the NHS is that not a single country in the world has copied this model. If it was good we'd see other countries adopt it but they don't. They don't adopt it because it's not good: this model is a relic of a time when the British public had just won a world war and as such had been exposed to years of war propaganda that made the government look artificially competent. In countries where that didn't happen the idea you'd want a single, centralised government agency to run every aspect of something as vital as healthcare was seen as insane: after all, if you go down that route why not have the government supply all food too? All entertainment? Why not run a fully USSR-style economy? Well because we know it doesn't work, that's why. There's nothing magical about the NHS that renders all those experiences irrelevant.

Re: Pfizer Covid vaccine approved for use next week in UK

#244

Post by makomk » Wed, Dec 02, 2020, 10:54 AM UTC

apsec112 wrote: post #107

DanBC wrote: post #101

Earlier quoted context omitted.

> Developed country with great logistics. Please don't under-estimate our ability to fuck this up, probably by giving the distribution contracts to a crony.

I'm sure the UK is in the top twenty countries in the world for logistics infrastructure. It's easy to read news stories about your country messing things up, and quietly not read foreign-language media about poorer countries messing things up a lot more by comparison, and get a biased perspective.

Even success story South Korea has been doing a lot worse than you'd think from the BBC coverage. For example, they ran this article about Europe struggling with Covid that made it sound like South Korea's test and trace is working so well, they can even reopen pubs and nightclubs: https://www.bbc.co.uk/news/world-54482905 In reality, pub closures and social distancing measures had only been lifted the day before the article, every time they've lifted them before cases have gone up and they've had to reimpose them, and this time was no exception. You wouldn't know that from the BBC coverage, at all. If the UK was doing the same thing, there'd be endless headlines about U-turns, arbitrary and unpredictable measures that change for no reason, the cost to businesses of both the closures and the uncertainty - but because it's happening in South Korea readers are given the false impression that it isn't happening at all.

A huge part of the perception that the UK is failing at dealing with Covid-19 due to awarding contracts to cronies comes from exactly this comparison with a South Korean success story that is a complete and utter media illusion. (They're also testing at something like a twentieth the rate of the UK - not enough to offer free testing to everyone with potential symptoms like we do, let alone do regular testing of all medical staff or any of the other things our press says our government is incompetent for not achieving - but you wouldn't know that from the UK media coverage either. Judging from their media reporting on the number of people awaiting results, they're probably not even doing any better at returning the results to people fast either.)

Sometimes they even just outright lie. When the UK hit 100,000 Covid tests in a day, the BBC ran a completely false claim that Germany reached that level of testing a month before the UK when in reality they didn't until several months after us. The BBC kept that claim in an article that was prominently featured on their news front page for a month after they were aware it was false meaning a substantial proportion of the entire UK population probably saw it. I still see it popping up everywhere. (They also claimed that meeting the 100,000 a day goal was faked by counting tests when they were sent out rather than when they were completed. In reality, it was met either way, and one of the minsters involved even pointed this out in a BBC interview - but people who followed the BBC coverage wouldn't know about it.)

Re: Pfizer Covid vaccine approved for use next week in UK

#245

Post by rebuilder » Wed, Dec 02, 2020, 10:54 AM UTC

Do we have any more data on what the wider effectiveness of these vaccines is likely to be?

Duration of immunity? I've heard a minimum of 3-4 months reported, possibly longer, but do we know more now?

Am I right that we don't yet know if they reduce transmission or simply prevent the disease?

If the duration of immunity turns out to only be a few months, I wonder how this is going to play out. Will we periodically vaccinate 25-60% of the population, indefinitely? (I've seen varying estimates on what kind of coverage is needed to keep the pandemic in check.)

Short of eradication, if immunity is not permanent, what options do we have apart from a perpetual vaccination program or just accepting an increased rate of mortality going forward?

Re: Pfizer Covid vaccine approved for use next week in UK

#246

Post by kmlx » Wed, Dec 02, 2020, 10:55 AM UTC

samdamsamma wrote: post #186

VBprogrammer wrote: post #131

Earlier quoted context omitted.

It's a fairly stereotypical British trait to be self deprecating. If we were singlehandedly saving the world from a rogue asteroid the general sentiment would probably be "let's hope we don't mess this up".

Actually the UK government is an absolute wreck.

it really depends.

they're pushing for more cycling, more climate measures, more taxes on IT giants etc

and these are Conservatives, the opposite of left-leaning.

on the other hand, their Covid response was the same as Spain, Italy, France etc i.e. pretty bad. but they also approved the vaccine really quick, and we're getting that next week.

so overall, a meh, like most other countries where I lived.

as a point of reference, from the countries I lived in, I consider Singapore and Tokyo to be a notch above the rest of the world when it comes to governance.

but most government of the countries i've lived in were the same as the UKs: they only react, they're politicians, they're detached from the real world etc etc

Re: Pfizer Covid vaccine approved for use next week in UK

#247

Post by LandR » Wed, Dec 02, 2020, 10:56 AM UTC

fabian2k wrote: post #133

spaceman_2020 wrote: post #46

Serious question: if you're a young person with no health issues, should you even get the vaccine?

Assuming you're somewhere between 20 and 30, your risk of dying when contracting COVID-19 is somewhere around 0.01%, so 1 in 10,000. I'm not including the chance for severe side effects, hospitalization here (I don't know a good data source for those that is age-specific). That's a lot lower than the risk for older people, but it's still a somewhat high absolute risk. Personally, I'd get vaccinated. The risk even for…

> I'm not including the chance for severe side effects, hospitalization here (I don't know a good data source for those that is age-specific).

From the Scottish Government figures.The hospitalization to confirmed cases breaks down like this for age:

    Age      Cases     Hospitilizations
    0-4      1417       77   (5.4%)
    5-14     3933       44   (1.1%)
    15-19    7766       46   (0.5%)
    20-24    9035       79   (0.8%)
    25-44    28690      867  (3.0%)

Everyone should get the vaccine.

Re: Pfizer Covid vaccine approved for use next week in UK

#248

Post by OneGuy123 » Wed, Dec 02, 2020, 10:57 AM UTC

spaceman_2020 wrote: post #46

Serious question: if you're a young person with no health issues, should you even get the vaccine?

No. You cannot seriously belive such a rushed vaccine has been tested properly.

If you're young you will get natural immunity from it sooner or later.

No young person had any issues.

More young people will be hurt by the vaccine than COVID.

Re: Pfizer Covid vaccine approved for use next week in UK

#249

Post by DanBC » Wed, Dec 02, 2020, 10:57 AM UTC

shellac wrote: post #177

DanBC wrote: post #103

Earlier quoted context omitted.

Hospital workers are likely to be first. https://twitter.com/HSJEditor/status/1334042232182235139?s=2...

That seems to be a (minor) alteration in the original plan, possible due to the storage requirements for the vaccine.

I think it's mostly because NHS organisations are already well organised for distribution of vaccines to staff. They're large organisations with thousands of employees.

Care homes are all mostly small, with a handful of employees.

EDIT: Wales has just said it's going to be really hard getting the Pfizer vaccine out to care homes: https://www.pulsetoday.co.uk/news/clinical-areas/immunology-...

Re: Pfizer Covid vaccine approved for use next week in UK

#250

Post by garmaine » Wed, Dec 02, 2020, 10:59 AM UTC

polytely wrote: post #88

modeless wrote: post #54

Earlier quoted context omitted.

Pfizer concluded their trial and filed for approval with the FDA almost two weeks ago. People are dying. Why is it not approved yet?

It is of vital importance that the majority of people feel safe taking the vaccine, because you need herd immunity. If people have doubts that it has been correctly vetted they will be reluctant to get vaccinated which makes the whole investment in the vaccines pointless.

Safety tests were already completed and approved by regulators months ago. The Phase 3 trials are efficacy trials to show that the vaccine gives immunity. Certainly we learned more about the safety of the vaccines from Phase 3 data, but we already knew that adverse immediate reactions would be very rare.

What's ridiculous about this situation is that the regulatory authorities are not willing to weigh against the benefit which would come from an early emergency-use authorization (which could have happened as early as August). It's like CPU branch prediction: approve the vaccine for early distribution as fast as it can be made--which would only have been a few hundred million doses globally so far--while the phase 3 studies are going on. The early distribution would be watched as observational studies, of course. If it fails Phase 3, stop distribution and move on to the next vaccine.

If the vaccine works, this strategy would have directly saved tens or hundreds of thousands of lives, and potentially millions from getting sick and whatever long-term complications come from COVID-19. Indirectly, early vaccination of essential workers would work to decrease R0 and therefore cause fewer people to get sick through normal means.

If the vaccine doesn't work, there isn't much money wasted since the manufacturing is already being done pre-approval anyway.

In the worst case if the vaccine primes and adverse immune reaction, that is bad and an argument against early approval. However you have to weigh the added risk (that early vaccinated people have a higher CFR) vs the probability of that happening, which is low.

High likelihood of highly beneficial outcome if it works. Lower possibility of a relatively moderate bad outcome to a smaller population if it doesn't. Certainty of many added deaths if you wait. I don't have the data the regulators have that is necessary to quantify this and make the call.

But for dumb political reasons, this option is off the table. Only Russia and China went ahead with early vaccination; all the other national agencies decided not to even think about early distribution. It was not even an option on the table.