Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

We should administer Covid-19 vaccines as fast as possible, not reserve doses

theglobeandmail.com

Post reply on HN
Print view View original

111–120 of 210 posts

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#111

Post by dan_hawkins »

Copenhagen hospitals vaccinating more people than scheduled [0]

> Hospitals in the Copenhagen area are ahead of their COVID-19 vaccination schedule, according to the Capital Region’s vaccine taskforce.

> According to the taskforce, 20 percent more people than calculated have been vaccinated because each vial contains at extra 1-2 doses.

> The reason for the extra doses is producer Pfizer/BioNTech adding a bit to account for potential spillage.

> And so to attain the excess doses, health personnel must handle the vaccine with care.

[0] https://cphpost.dk/?p=121536

Edit: formatting

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#112

Post by mlyle »

Lewton wrote: post #44
jewayne wrote: post #29

Earlier quoted context omitted.

The US is DEFINITELY doing this. Each time a first dose goes out of the Pfizer warehouse in Michigan, the second dose for it is set aside. Not only that, but they literally set aside ANOTHER 500,000 doses "just in case". They seem to be prioritizing smoothness of rollout and equity across states over immunizing the maximum number of people possible.

Whelp, guess I'm wrong on this one. That is extremely disappointing

Yup. It's stupid. You shouldn't hold back 0, but >50% is too much.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#113

Post by mlyle »

tehjoker wrote: post #86
jpdus wrote: post #50

I don't get why nobody seriously considers a one-dose regimen for the fastest possible vaccine rollout. All available data for both, Biontech/Pfizer and Moderna's vaccines suggests that one dose is enough for >90% efficacy which would be sufficient to reach herd immunity. There was a very good opinion article in the NY Times [1] about that, but not much more. The problem here is that a one-dose regimen was not studie…

That's not what the Pfizer paper showed. There was a confidence interval from between 20-70% iirc for the first shot. Maybe if we're lucky it's on the higher end, but I would stick to proven science if we're going to combat this thing effectively.

Wargame the scenarios. You wouldn't want to give one dose on purpose, but reserving a whole bunch of doses to prevent some people from getting only 1 in a worst case scenario is silly.

That 20-70% efficacy number includes the entire period between dose 1 and 2. It looks way better 10 days after dose 1, btw-- MLE around 80%.

e.g. single dose -- 50% efficacy (to be pessimistic); double dose -- 95% efficacy. 10M doses "in flight" monthly. 100 deaths/million/month. Ignore all effects on transmission (to be more pessimistic).

Scenario 1 (no logistics disruption, half held back): 5M dosed with 1 dose at day 0, 5M dosed with 2 doses at 1 month and 5M dosed with 1 dose at 1 month. 250 saved in first month, 725 saved in second month.

Scenario 2 (no logistics disruption, 25% held back): 7.5M dosed with 1 dose at day 0, 7.5M dosed with 2 doses at 1 month and 2.5M dosed with 1 dose at 1 month. 375 saved in first month, 837 saved in second month.

Scenario 3: (100% production disruption, half held back): 5M dosed with 1 dose at day 0; 5M dosed with 2 doses at 1 month. 250 saved in first month, 475 saved in second month.

Scenario 4: (100% production disruption, 25% held back): 7.5M dosed with 1 dose at day 0; 2.5M dosed with 2 doses at 1 month; (5M late for dose 2); 375 saved in first month, 612 saved in second month.

With a 25% reserve, you only get into the unexpected-only-1-dose regimen with a supply disruption of more than 50%... and even then it's still probably better than a 50% reserve.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#114

Post by capitainenemo »

burtonator wrote: post #101
inglor_cz wrote: post #8

Israelis give shots to medical workers and oldest citizens first. This should drive down the death rate pretty fast. If this approach works, Covid-related deaths in Israel should visibly drop by the end of January.

Sort of... there are still plenty of healthy people that only didn't die due to intubation. I'm curious to see the numbers there as well. If we vaccinate the old, then resume life as normal, we're going to overwhelm intubation machines.

I'd read medical studies and news articles over the summer that intubation was causing worse outcomes than things like proning in many cases, with dramatically improved survival rates in hospitals that avoided intubation. I'm wondering if advice on that has changed at this point. There was also an interesting piece on HN about jailbreaking CPAP machines to increase supply, although that might not be necessary now?

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#115

Post by helge9210 »

wbl wrote: post #81
breck wrote: post #79

Earlier quoted context omitted.

This comment was flagged so I vouched for it. You may disagree with it but it’s a reasonable position. Look at the official moderna data from the FDA. The placebo and vaccine groups of 15k have the exact same death rate. So according to the very dataset used to approve the vaccine, there is a strong case that COVID isn’t killing people, rather it’s their underlying conditions. And curing COVID will not save most of t…

Did you look at the death rate this year? We are on track for 10٪ excess deaths, most of those with at least a decade of life expectancy. The clinical trial for the vaccine was not going to see this with only a few hundred observed cases. That's only a handful of deaths.

Do you account for people who died from psychological effects of lockdown and job loss, and from not requesting medical assistance for other conditions because of fear of covid-19?

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#116

Post by ahelwer »

cmrdporcupine wrote: post #76
bluenose69 wrote: post #19

It seems reasonable for different provinces to take different approaches, since their disease patterns vary significantly. Ontario and Québec have endured many weeks of increasing numbers of diagnosed infections per day, whilst the other provinces have seen decreases. The absolute incidences also vary between provinces, letting some test-and-trace cases more easily than others.

I would take Alberta's latest numbers with a giant grain of salt. Testing rates are awful there right now. Too bad my family there used the numbers as an excuse to break quarantine. Enraging.

My sister lives there and knows multiple people her age (mid 20s) who've had the coronavirus. To my knowledge I only know a single person here in the US who has had it. Seems bad.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#117

Post by kyboren »

ubercore wrote: post #77
danarmak wrote: post #57

Earlier quoted context omitted.

Page 31, table row "mitigate health inequities" says: An upside (green) of vaccinating essential workers (non-healthcare) first: "Racial and ethnic minority groups disproportionately represented in many essential industries. ~1/4 of essential workers live in low-income families." A downside (red) of vaccinating adults age >65 first: "Racial and ethnic minority groups under-represented among adults >65". The next page…

They don't say ethics outweighs science, do they? They're just two axes on which to evaluate the model. You're coming to some interesting conclusions from those slides, unless I'm misreading something.

They do not say ethics outweighs science. Dooling simply ignores the science[0] (slide 23) and gives equal "maximize benefits and minimize harms" merit (3 pluses) to vaccinating 65+ and vaccinating essential workers, despite recognizing on slide 21 that with a disease-blocking vaccine, "Initially vaccinating age ≥65 in Phase 1b averts approximately 2–6.5% more deaths, compared to targeting high-risk adults or essential workers".

The tipping point then comes from the equal-weighted (why?) metric of "Mitigate health inequities", where she gives essential workers three pluses but 65+ only one plus. This gives "essential workers" 9 pluses total, greater than the 6 pluses for 65+.

It is frankly shocking that a person can recognize one course of action will clearly save the most lives, then assign an arbitrary score that puts that course of action as equally beneficial as the "woke" course of action--for no reason--and then invent another arbitrary category of equal importance that gives more weight to the "woke" course of action because there aren't enough brown people in the 65+ bucket.

It's even more shocking that this fundamentally irrational and (poorly) racially-motivated reasoning was unanimously approved[1] by the committee.

[0]: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-... [1]: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6950e2-H.pdf

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#118

Post by exabrial »

As many have been saying, optimizing to minimize case count has been where the entire handling of the pandemic has gone wrong. Let's not repeat this mistake yet again.

We need to optimize to minimize long term effects: death, disabilities, mental health, etc. These are things that actually matter.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#119

Post by sokoloff »

dragontamer wrote: post #91
outside1234 wrote: post #55

Earlier quoted context omitted.

Please stop. Having underlying health conditions that make you less likely to survive COVID-19 does not mean that you were not killed by COVID-19. We wouldn’t say that someone with peanut allergies was killed by the allergy — and not the peanut — so please just stop with this propaganda.

HIV / AIDS doesn't kill anyone. Its the NEXT disease that kills you: all HIV does is kill off your white-blood cells and prevent your body from fighting off the next disease. ------------- Colloquially: when someone dies of a typical flu / cold when they were infected by AIDS, we call that "dying because of AIDS", even though AIDS had very little to do with the ultimate death of that person.

If a patient would have likely survived that flu “but for” AIDS, it seems to me that AIDS had quite a bit to do with that untimely death.

Re: We should administer Covid-19 vaccines as fast as possible, not reserve doses

#120

Post by jpster »

rsynnott wrote: post #110
jpster wrote: post #88

Earlier quoted context omitted.

Wish I could find estimates showing “At current / projected vaccination rates it will take X years to vaccinate 90% of the population”, per country. I heard on TWiV (This Week in Virology podcast) for the US it was ~6.6 years and I believe it was based on < 90% of pop.

_Current_ rates are likely not worth worrying about, not this early on. Rates should be expected to increase fairly dramatically in the next weeks.

I hope so. But, frankly, most national and local responses to this outbreak have been subpar. I do not take it for granted that we (the US) can pull off this major logistical challenge smoothly or on an aggressive timeline.
Post reply on HN