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What we learned doing Fast Grants

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Re: What we learned doing Fast Grants

#51

Post by dalbasal »

ALittleLight wrote: post #38

"This is an instance of a broader theme: we were surprised that many entities continued with something close to “business as usual” rather than switching to emergency pandemic mode" I think we need to codify what "emergency mode" is and when we switch to it. Bureaucracies, and those working in them, need to understand when the situation is not "business as usual" and get out of the way! Implicit in that is, when we a…

>> We can't just expect systems designed to be slow and cautious to instantly flip to aggressive explorers without defining what we expect and when to do it.

This is precisely the problem. Who is "we," and how are they going to define these new protocols?

The "systems" are not (exclusively) designed. They're evolved. They're impenetrable, or at least difficult to penetrate. They're autonomous. Only insiders have the requisite knowledge to figure out what emergency mode is.

The whole point is not to wait for "orders" to drop down.

Re: What we learned doing Fast Grants

#52

Post by dalbasal »

buu700 wrote: post #24
nickthemagicman wrote: post #17

Earlier quoted context omitted.

How about we quit treating people like children and make all drugs legal? The FDA stamp will just be a stamp of quality to help guide people to a known quality product. No enforcement of drug laws at the barrel of an authorities gun. But if people want to do some experimental off brand use that their doctor recommends then they can. If people do their own research and want to self prescribe they can. Getting the mono…

I've thought the same thing and generally agree with it. Why shouldn't I be able to walk to CVS and pick up a bottle of heroin and various prescription drugs? I'm an adult; I shouldn't even owe anyone an explanation. At the same time, I think we would need to concurrently ban drug advertisements as other countries have. To me, that seems like a better balance between treating individuals as adults with autonomy and m…

IMO, it's a mistake to approach these kinds of questions from first principles perspective, at least exclusively. We have a history, and a lot of where we are is a response to past problems. That doesn't mean where we are is optimal, just that it's not simple.

Snake oil is a major problem, always has been. Drugs of abuse are a problem, like the oxi crisis. Antibiotic resistance. Etc. There are lots of reasons to have controls in place that don't have a first principles logic to them... just an empirical one.

Re: What we learned doing Fast Grants

#53

Post by buu700 »

dalbasal wrote: post #52
buu700 wrote: post #24

Earlier quoted context omitted.

I've thought the same thing and generally agree with it. Why shouldn't I be able to walk to CVS and pick up a bottle of heroin and various prescription drugs? I'm an adult; I shouldn't even owe anyone an explanation. At the same time, I think we would need to concurrently ban drug advertisements as other countries have. To me, that seems like a better balance between treating individuals as adults with autonomy and m…

IMO, it's a mistake to approach these kinds of questions from first principles perspective, at least exclusively. We have a history, and a lot of where we are is a response to past problems. That doesn't mean where we are is optimal, just that it's not simple. Snake oil is a major problem, always has been. Drugs of abuse are a problem, like the oxi crisis. Antibiotic resistance. Etc. There are lots of reasons to have…

Makes sense. There's definitely room for disagreement without either side being malicious. On one hand there are the problems we see in front of us today of a lot of people having their lives unfairly destroyed by the state and billions of dollars being arguably wasted; on the other hand, we have to consider the problems that led to our current situation, and ensure that any solution we implement today doesn't excessively regress in those areas.

I'm still pro-full-legalization for the moment, but wouldn't just sign a bill if presented to me today without first ensuring that my administration had a firm understanding of all the historical issues, and felt comfortable that the bill reasonably addressed them (or, if not, that the cure at least wasn't worse than the disease). I know there's a pop culture narrative that drug prohibition was primarily motivated by malicious suppression of anyone Nixon considered undesirables, but from what I understand the real history is much more complicated.

Perhaps simple decriminalization would be a better first step, if not ultimately a better long-term solution as well. And, oh hey, it looks like that may soon be on the table: https://news.ycombinator.com/item?id=27522843

Re: What we learned doing Fast Grants

#54

Post by jvanderbot »

eganp wrote: post #46
jvanderbot wrote: post #7

The US went all in on vaccines. I'm disappointed but not surprised that the US didn't fund more academic R&D; that's the MO I expected during that administration.

I'm glad we did. Vaccines were a home-run solution. In a crisis, what does academic R+D get you on the margin? Better testing for sure, but that wouldn't solve the crisis like vaccines would. I will say the drug repurposing landscape was an absolute fiasco last year. Every funding opportunity wanted reams of data supporting use in COVID19 which takes time to generate. Yet, somehow on-patent anti-IL-6 drugs were tried…

You are framing as a dichotomy when perhaps it is not. But, so did I! ( "all in" ).

Re: What we learned doing Fast Grants

#56

Post by bjt »

cbsmith wrote: post #31
unchocked wrote: post #8

> Making human clinical trials cheaper and quicker is probably one of the biggest opportunities for improving U.S. healthcare both during and beyond pandemics. The failure to accelerate vaccine development through challenge testing is a black mark on our ethical and regulatory system. the Moderna vaccine mRNA was developed two days after COVID-19 was identified, yet it took over a year to get through human testing. A…

Keep in mind that vaccines solve a systemic problem, and a bad vaccine can exacerbate a pandemic. Yes, vaccines can be made in a day or two, but it takes a long time to know if they are effective .

That's not addressing the parent's point about a challenge trial though. A challenge trial could greatly accelerate measuring that effectiveness.

Re: What we learned doing Fast Grants

#57

Post by cbsmith »

nickthemagicman wrote: post #45
cbsmith wrote: post #30

Earlier quoted context omitted.

> There's a difference between people who don't think vaccines are good as a whole...and people who question a rushed vaccine developed with no FDA oversight or testing by companies who have absolutely no liability if things go wrong for a disease that has 99.99% survival rate for most people. > > And then there are questions about it even WORKING fully and one still has to wear a mask and you can still be contagious…

> Covid chance of death in general population (Deaths / US population): 100 - (600000/350 million) = 99.9982857143% survival rate > "Currently, no coronavirus vaccine is fully approved by the FDA, but three were given emergency use authorization by the agency" https://www.nbcchicago.com/news/coronavirus/are-covid-vaccin... > The demand on our healthcare infrastructure is potentially crippling, as we've seen Completel…

[flagged]

Re: What we learned doing Fast Grants

#58

Post by mchusma »

cbsmith wrote: post #31
unchocked wrote: post #8

> Making human clinical trials cheaper and quicker is probably one of the biggest opportunities for improving U.S. healthcare both during and beyond pandemics. The failure to accelerate vaccine development through challenge testing is a black mark on our ethical and regulatory system. the Moderna vaccine mRNA was developed two days after COVID-19 was identified, yet it took over a year to get through human testing. A…

Keep in mind that vaccines solve a systemic problem, and a bad vaccine can exacerbate a pandemic. Yes, vaccines can be made in a day or two, but it takes a long time to know if they are effective .

It actually doesn't take long to have high confidence vaccines work. Roughly 30 days. Day 1- inject vaccine. Day 15 - infect virus. Day 30 - know it works.

Human challenge studies were a ethical no brainer.

Even other studies if we gradually increased the number of people allowed to take them would mitigate almost any real risk. So you let up to 1k people take it month 1, 10k month 2, 100k month 3, and so on. Basically no meaningful extra risk but faster results.

Vaccines have a very good safety record and efficacy record, this isn't like cancer which is much more speculative.

Banning vaccines is not the answer. Most US deaths were completely preventable.

Re: What we learned doing Fast Grants

#59

Post by eloff »

eloff wrote: post #12
an_opabinia wrote: post #6

> Most importantly, Fast Grants didn’t change the vaccine timeline, and vaccines were clearly the most important component of the response. They are being really intellectually honest here. One thing you couldn't apply for for Fast Grants was a media effort to convince people to take the vaccine. And speaking of the power of individuals, Robert De Niro ( https://www.latimes.com/entertainment/movies/moviesnow/la-et...…

What's disturbing is people taking health advice from celebrities instead of medical experts.

Did I actually get down voted by someone who believes the contrary? Is that possible for a rational individual to take that position?
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