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

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

#191

Post by thebruce87m »

xkbarkar wrote: post #190
thebruce87m wrote: post #187

Earlier quoted context omitted.

Countries like Norway show no significant excess mortality for the year despite lockdowns. Suicides also seem unaffected in the UK: https://twitter.com/samaritans/status/1326184288958746625?s=... Happy to see evidence otherwise.

Did you read the report you linked to ? - The post-lockdown figures were higher than in the equivalent period in 2019 - The higher figures in 2020 should be seen in the context of a rising national rate and maturing real-time surveillance systems; They say , Yes there were more suicides in 2020 than 2019 but that is because suicide rates were rising anyway. and we now monitor them better than we have before. AND the…

Yes? I think you covered the main points which don’t seem to disagree with what I was saying although from your response it seems like you think they do?

The caveat about the sample size and area is valid, but it did cover 9 million people which is a significant proportion of the population.

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

#192

Post by est31 »

toast0 wrote: post #167
est31 wrote: post #133

Earlier quoted context omitted.

> The last year has been supply chain disruption after supply chain disruption. Indeed, but even if 20% of people don't get their second shot on time and the impact of that is equal to them not being vaccinated at all (we don't know but likely the impact is smaller), even then the impact would be lower than stockpiling vaccines which increases the number of symptomatic infections by 34 to 42 percent. > If the vial ma…

> Indeed, but even if 20% of people don't get their second shot on time I think my worst case expectation is much worse than yours. With a two week production shut down, I expect my corner of the world would not get new shipments for more than two weeks; higher priority places would be getting their previous orders filled before us, and we'd only get more once the backlog was filled. Also, I fully expect any producti…

> higher priority places would be getting their previous orders filled before us

Hmm yeah that's a problem with the vaccine manufacturer. Ideally in such a scenario, the second doses get served first, after which the higher priority first doses get served.

> How do antibiotics help for covid?

Urgh my fault sorry, I meant antibodies not antibiotics. I tried to use them as example for something that has limited availability but allows to shorten disease durations.

> How do daily tests help avert a shutdown when you can spread the disease while testing negative?

Of course a shutdown is most effective and if done on a population scale it's bad for the pandemic. But daily tests do help to curb the spread.

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

#193

Post by xkbarkar »

thebruce87m wrote: post #191
xkbarkar wrote: post #190

Earlier quoted context omitted.

Did you read the report you linked to ? - The post-lockdown figures were higher than in the equivalent period in 2019 - The higher figures in 2020 should be seen in the context of a rising national rate and maturing real-time surveillance systems; They say , Yes there were more suicides in 2020 than 2019 but that is because suicide rates were rising anyway. and we now monitor them better than we have before. AND the…

Yes? I think you covered the main points which don’t seem to disagree with what I was saying although from your response it seems like you think they do? The caveat about the sample size and area is valid, but it did cover 9 million people which is a significant proportion of the population.

You claimed that suicide rates are unaffected. They are not. They have increased.

We don't know why they have increased, we don't even know if the current numbers are accurate.

It may very well be due to lockdown.

Suicide rates may well be higher than has currently been reported.

This report acknowledges that.

You however did not. You pretty much trivialized the severity of the truth behind these horrible numbers. I think you never read the report and just copied the twitter statement, and are now irritated because you got called on it.

For arguments sake

If I state that medical doctors have the highest suicide rates among all the professions (which is true).

Would you still trivialize the 2020 increase in suicide rates if I could show you that more oncologists took their own lives in 2020 than in 2019?

What if I could show you that the increase comes from unemployed, physically healthy men under the age of 35?

What if there is a steep increase in suicides among the elderly who have sheltered in place since march ?

Context is everything. This report acknowledges that proper context is still missing, and it's preliminary to draw conclusions other than that it looks like the increase was to be expected.

Which in itself is (pardon my french) fucking abysmal and should not go ignored.

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

#194

Post by handmodel »

hcknwscommenter wrote: post #157
handmodel wrote: post #141

Earlier quoted context omitted.

I think it is clear the regulatory framework wasn't ideal. The last stage of the trial (which took three months) was not about if they were safe - but simply if they worked. Meaning, they were cleared to have minimal side effects, just unclear if it worked. If you had approved people to choose to take the vaccine in August we could have had 50M people with shots already. A lot of people have my skepticism that the ma…

I think you misunderstand the clinical trial approval process. Yes, phase 2 is primarily about safety, but these are much smaller trials than phase 3, which in turn is much smaller than the post-marketing patient population (cohort). Safety issues routinely arise in phase 3, or even after, due to the much larger cohort sizes. Good phase 2 results are not proof of safety, rather an indication of safety. It is borderin…

Whether or not it would have been a full three months I stand by my belief the current system was not designed for the cost-benefit of a raging pandemic.

The three month time of phase III had nothing to do with safety. That long period was only used because it took that long time for enough people to catch Covid naturally for them to prove statistical effectiveness. In the current system, if Covid had been raging at an extreme rate they would have had enough positives in the control group after a month and ended the trial then. If it had been under control, it actually would have taken many more months to declare effectiveness even though the extra wait time would have shown no more data on safety.

Whether or not phase II was sufficient on its own they could have declared the vaccine probably safe a month after phase III began instead of after three months. This would have still saved 50,000 lives in the US at minimum.

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

#195

Post by handmodel »

vvillena wrote: post #155
handmodel wrote: post #141

Earlier quoted context omitted.

I think it is clear the regulatory framework wasn't ideal. The last stage of the trial (which took three months) was not about if they were safe - but simply if they worked. Meaning, they were cleared to have minimal side effects, just unclear if it worked. If you had approved people to choose to take the vaccine in August we could have had 50M people with shots already. A lot of people have my skepticism that the ma…

50M doses isn't something that gets suddenly summoned. It's a big logistics problem. Your assumption is valid only if the pharmas have capacity to make a extremely big amount of vaccine doses. That costs money and (I guess) materials, and both of those things could go towards a vaccine that is proven to be effective.

They had the vaccines in storage in October. Not as many as they had in December but they were just awaiting approval. The rollout would have been slower then with less to go around - but a headstart on the vulnerable population or potential spreaders would have been significant.

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

#196

Post by CyberDildonics »

BurningFrog wrote: post #189
iso1210 wrote: post #147

Earlier quoted context omitted.

Not aware of evidence that vaccination stops or reduces spread. Given that asymptomatic and presymptomatic people are the main spreaders, it's certainly not a given. Vaccinating front line health and care workers does make sense for two reasons 1) Far more likely to catch it 2) Far more problematic if they catch it and are off ill because of it Other front line workers like police probably less important -- less like…

There is no evidence the sun will rise tomorrow either. But it is still rational to use logic and experience and assume that sunrise will probably happen as usual tomorrow, and these vaccines probably behave like other vaccines.

You think there is no evidence the sun will rise tomorrow?

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

#197

Post by wbl »

rsync wrote: post #131
hombre_fatal wrote: post #123

Earlier quoted context omitted.

> 10٪ FWIW, that "Arabic percent sign" is barely visible on my 13" laptop while ASCII's "%" is impossible to miss.

Yeah ... genuinely interested: What typing tool, or mechanism, were you using that your '1' '0' and '%' typed out in a different character set than the rest of your comment ? Or was it manually inserted ? If so, why ?

I just used my phone keyboard. No idea it mapped to that character!

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

#198

Post by jpdus »

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.

That is not correct (I think that number comes from the Oxford/AZ vaccine?).

If you look at the cumulative incidence curves (for Moderna see [1] page 28), you can see that COVID-19 occurences drop approx. 14 days after the first dose with no measurable effect of the second dose after 28 days. This pattern is exactly the same for both vaccines.

[1] https://www.fda.gov/media/144434/download

PS: My parent comment was downvoted more often than any other HN comment I ever made, but nobody cared to elaborate why my line of thinking is unethical or why i am reading the data wrong. That's slightly disappointing.

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

#199

Post by triceratops »

helge9210 wrote: post #115
wbl wrote: post #81

Earlier quoted context omitted.

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?

If we're doing second-order effects, did you account for the lives saved by less driving around due to lockdowns? The lives saved by less air pollution? The lives saved by ensuring the healthcare systems weren't overloaded?

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

#200

Post by BurningFrog »

CyberDildonics wrote: post #196
BurningFrog wrote: post #189

Earlier quoted context omitted.

There is no evidence the sun will rise tomorrow either. But it is still rational to use logic and experience and assume that sunrise will probably happen as usual tomorrow, and these vaccines probably behave like other vaccines.

You think there is no evidence the sun will rise tomorrow?

I'm really trying to make the point that there is evidence that vaccination reduces spread, if you open your mind a little.

My use of sarcasm is maybe not the best way to convey that, but I am who I am.

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