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Covid vaccination linked to 'substantial reduction' in hospital admissions

heraldscotland.com

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Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#81

Until we have challenge trials, how do we know whether or not other variables, such as natural herd immunity and seasonality are not also significant contributing factors to the 'substantial reduction'?

This WSJ article mention herd immunity. Covid spread really fast, so herd immunity through a combination of the large amount of people that already had covid and vaccination of the vulnerable should make a big difference.

https://www.wsj.com/articles/well-have-herd-immunity-by-apri...

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#82
post #27

Earlier quoted context omitted.

there's no race. If this virus can mutate into something that renders the vaccine ineffective it will. Brazil and Mexico and the rest of the developing world will give it ample opportunity no matter how quickly we roll out the current drugs. It took decades to hunt down smallpox.

There certainly is a race. The slower we go the more spread. The more spread, the more variation. The more variation, the more likelihood of a vaccine-resistant strain taking hold. Even if it’s a long-term certainty, much better to be well-equipped to respond to it, which we simply are not at the moment.

My point is that this virus spreads unbelievably fast and even with the most optimistic vaccine scenarios it has literally billions of hosts in the developing world to infect who have 0 zero chance of getting a shot anytime in the next few years.

Of course the vaccines might be good enough to ward off infection from all future variants but that's just luck.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#83
post #75

The UKs adoption of First Dose First is amazing and inspiring in a time when governments worldwide seem unable to operate effectively. There are 2 things every country can do to save lives that have effectively zero cost and zero negative externalities: - lifting lingering vaccine bans (the US's ban of AZ is most glaring) - first dose first - the evidence is overwhelming at this point. These two things, which could b…

What is first dose first?

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#84
post #75

The UKs adoption of First Dose First is amazing and inspiring in a time when governments worldwide seem unable to operate effectively. There are 2 things every country can do to save lives that have effectively zero cost and zero negative externalities: - lifting lingering vaccine bans (the US's ban of AZ is most glaring) - first dose first - the evidence is overwhelming at this point. These two things, which could b…

While those 2 things would help, I haven't seen any projections that could possibly put supply or distribution availability at ~400M doses in the next 5 weeks.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#85
post #75

The UKs adoption of First Dose First is amazing and inspiring in a time when governments worldwide seem unable to operate effectively. There are 2 things every country can do to save lives that have effectively zero cost and zero negative externalities: - lifting lingering vaccine bans (the US's ban of AZ is most glaring) - first dose first - the evidence is overwhelming at this point. These two things, which could b…

> the US's ban of AZ is most glaring

People said the same thing about the US's ban on thalidomide until it turned out they were right.

In this case I'm ok with a little conservatism on the part of the FDA. The US is already in 4th place on vaccinations per capita, just barely behind the UK, without either of those policies.

Copying from my comment below, a bunch of other examples of times when the FDA was right and European regulators were wrong:

https://en.wikipedia.org/wiki/Lumiracoxib -- Approved in Europe, not the USA. Withdrawn from sales due to side effects.

https://en.wikipedia.org/wiki/Zimelidine -- Same.

https://en.wikipedia.org/wiki/Tolrestat -- Approved in Europe, failed stage 3 clinical in the USA

https://en.wikipedia.org/wiki/Rimonabant -- Approved in Europe, failed in the USA, withdrawn worldwide because the side effects were so bad.

Thalidomide is just the most famous because it was the most disastrous, but there are plenty of others.

The FDA has a strong many decades track record.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#86
post #42

Earlier quoted context omitted.

I don't mean to imply that this is your intention at all, but it's a false choice. Both questions are interesting; no need to set them up as if they were in tension with one another.

I meant less interesting as in all the studies/trials have already confirmed that the vaccines significantly reduce severe symptoms...the effect on transmission is still an open question from what I understand.

Preliminary results look good

https://www.reuters.com/article/health-coronavirus-israel-va...

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#87
post #83
post #75

The UKs adoption of First Dose First is amazing and inspiring in a time when governments worldwide seem unable to operate effectively. There are 2 things every country can do to save lives that have effectively zero cost and zero negative externalities: - lifting lingering vaccine bans (the US's ban of AZ is most glaring) - first dose first - the evidence is overwhelming at this point. These two things, which could b…

What is first dose first?

The UK's policy of making sure everyone gets their first dose of the two dose vaccines before most everyone gets their second, setting the second dose at 3 months instead of 3-4 weeks.

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#88

Until we have challenge trials, how do we know whether or not other variables, such as natural herd immunity and seasonality are not also significant contributing factors to the 'substantial reduction'?

At the very least it would be easy to measure the vaccines effect on severity by comparing the rate of hospitalisations to the rate of infection

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#89
post #19

Data is very encouraging. Presently this battle is essentially a race between the current vaccines (which data indicates are very effective against current strains) and eventual variants that will make the current vaccines less effective (or in the worst case ineffective). The mutations aren’t really a question of if just when. Vaccine data on some new strains is concerning and potentially an early warning of things…

Concurring with you, and here's some entertaining food for thought. It seems to me that every virus must have a minimum host population that it needs to persist.

The way I think about it is like a tabletop game. You, the player, are a virus. You draw a strain card and roll a stat sheet. Then you pick a human to infect. They draw an immunity card. After that you roll a set of dice that determine if you get to "evolve". If you evolve you get to draw a new strain card, replacing your old strain card, roll new stats, and all players discard their immunity cards. Whether you evolve or not, you start a new round by picking a new human to infect and repeat. The big caveat: you can't pick a human with an immunity card.

Now, if the number of players in this game is low enough and the likelihood of you rolling an evolve action is low enough, then it's easy to see that in all probability you'll lose the game. Every human will get an immunity card before you roll an evolve.

So there are two variables: host population and likelihood of evolution.

Our goal with vaccination is to decrease the former as much as possible. If we get it low enough, the virus will lose the "game". Every other non-vaccinated human will gain herd immunity naturally before it has the chance to evolve. It will die out, and never be given a chance again.

Now, I'm not addressing herd immunity. That's about whether a virus can spread in a given population. This tabletop game doesn't incorporate a virulence mechanic. This is about whether a virus can mutate before the _globe_ achieves herd immunity. The point I'm addressing is this idea lurking in the back of people's minds: third world countries. Won't the virus just "fester" in countries with low vaccination rates until it mutants enough that it can become a new pandemic?

My suggestion is that it's not a given that that's the case, as long as whatever remaining non-immune population is small enough.

What is low enough? An actual virologist could probably guesstimate for some given probability threshold.

But the good news is that SARS-CoV-2 has really bad evolution stats. Many viruses have a "checksum" protein in their genome, just like most other organisms do, that actually work to prevent mutations. Some viruses have this protein "tuned" lower so that they mutate faster, but it's a trade off because that often results in more production of impotent viral particles. SARS-CoV-2, from what I've read in studies, has its "checksum" protein tweaked higher, so it just doesn't evolve as quickly as something like the common cold strains.

In other words, I completely agree with your point. Get vaccinated as quickly as possible and keep up masks and social distance for now. That will give us the highest possibility of winning this "game".

Re: Covid vaccination linked to 'substantial reduction' in hospital admissions

#90
post #59

Earlier quoted context omitted.

I think it has been shown that standard corona seasonality shows the same shape of all case loads we have seen? That is, most of the recovery we saw last year going into summer could potentially be explained by regular cycles of similar viruses in the areas. The impression being that that could also explain or current recovery. It is not an argument against vaccination. And I haven't seen people pushing we have heard…

"the stark drops we are seeing do seen surprisingly sharp" Surely that suggests an unnatural cause, such as millions of vaccine doses being rolled out, specifically targeting the most vulnerable (LTC residents) and those most likely to catch/spread the virus (medical profession, first responders, front line workers)?

Where are we at in mapping genotypes of the most affected and the superspreaders?

Perhaps exposure has reached saturation among certain populations.

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