Chat about Novel Coronavirus - 2019-nCoV - COVID-19

Who says estate agents are goulish cunts?

1 Attachment

Sage seem thing that increasing the vacine spacing is a bad idea https://www.independent.co.uk/news/health/covid-vaccine-uk-new-strain-sage-b1791438.html

Click bate headline, and your comment that "Sage think its a bad idea" is not borne out within the article.

Within papers from sage is discussion of the risk that delaying the second dose may increase the likelihood of vaccine escape mutations. It goes on to suggest "Is such an increased risk material? It's not possible to quantify this, but it is likely to be small".

Nowhere does it say "Sage think spreading the dose is a bad idea" They say it is a balancing act of risks.

The BMJ article bugged me too. It prominently quotes Pfizer as saying "There is no data to demonstrate that protection after the first dose is sustained after 21 days". This may be true, but only because everyone in the trial had had a second dose by then.

As pointed out in Van Tulleken thread, the main reason doses were tightly spaced in the studies, and no analysis of the merits of dose spacing was undertaken was so the studies could be completed as quickly as possible.

The thing that could be really useful here is the data coming out of Israel. There was some concern that early data there was not looking great on single dosing, but again, a key thing is what does protection look like from 20 days plus after your first jab? It's clear the first few days you have no meaningful protection, until your body builds it's response mechanism.

At the moment, I'm willing to trust the Joint Committee on Vaccination and Immunisation. We only have so much vaccine, there is not much we can do about that, given the whole worlds needs it, so we need to be smart in how it's used. I was also reassured that they said over the weekend that if things start to point towards it being the wrong approach, they can quite quickly change tack and go back to giving people second doses closer spaced.

Most news about vaccine from Israel seems positive

from FT:

"At the Rambam Health Care Campus in northern Israel, 91 per cent of
the 1,800 doctors and nurses that received the two dose vaccine showed
a major presence of antibodies 21 days after their first shot, before
receiving the second dose, according to Michael Halberthal, chief
executive of the hospital. A further 2 per cent showed a moderate
presence of antibodies. "

Israel has also seen a 60% drop in hospitalisations in the over 60s after first dose

It's all ok, they've apologised.

https://www.manchestereveningnews.co.uk/news/greater-manchester-news/manchester-estate-agent-criticised-tone-19695332

#facepalm

Edit: their ROI on those flyers will have improved as so many others saw them regionally & nationally. You can't usually buy that distribution so easily.

Indeed, the Michael O'Leary school of marketing.

In today's bizarro-world Covid happenings. Thanks to @JWestland's cue for finding more info about the NI vaccine roll out (to try and get some intel for my parents), I found myself in email conversation with former newsreader and UUP leader Mike Nesbitt. He was welcomingly helpful and gave me more info than any amount of googling had given me to date.

The studies had quite alot of computer modelling, at a guess, as many other medicines and vaccines do. What does the medicine approval state about spacing?

Oh well it is is the wrong approach, how will that be decided? How many will die and will use they would have died anyway. The reality is the we did not obtain enough vaccines even after the press announcement. That is down to the governance.

Give the vaccine as directed. Or fuck it lets play with lives...remember the loved ones will die comment. Bonus is they are poor and on benefits.

Ratner?

Flurry of emails/messages from my CEO this morning: the office is closed because one of the team has been summoned to central quarantine. Turns out that two weeks ago they met with someone who stayed at a hotel in a medium-risk area. Now they're in government quarantine until they test negative, and we can't reopen the office until they're out. I guess contact tracing is pretty effective when the government has complete access to details of everywhere you've ever been...

I guess contact tracing is pretty effective when the government has complete access to details of everywhere you've ever been...

In the west we outsource that to Google...

It's far more egalitarian here, we split it evenly between Alipay and Tencent.

Incidentally, I went to the public hospital today which is always a wild ride - I needed four different health codes and a covid test to get in. My very first covid test! How exciting. It cost 120 rmb (about £13), which you have to pay for on top of your appointment/treatment fees. I imagine this puts people off going to hospital - this was central Shanghai so the clientele is presumably wealthier than elsewhere and there were still lots of elderly people trying to pay using small coins.

Joking aside New Zealand and Australia however haven’t given many inches and less miles have been taken.

HK is moving from a system of carting off individual families to one of ‘ambush lockdowns’ where they seal off buildings, streets or districts in the early hours with no notice and blanket test everyone inside. They did this to about 7,000 people in Jordan, Kowloon over the weekend in a successful operation which identified 13 new cases for which we are eternally grateful to the wise and conscientious leaders for. But there was disappointment that details got out about the lockdown which caused panic buying and allowed people to flee before the barriers went up for their protection. Those people are still subject to the mandatory testing order though and face spot checks in the area for a negative test wristband or sms so could still end up in jail for 6 months or get a £2.5K fine.

Give the vaccine as directed.

This is the point that the previous comments have been trying to make.

The recommendations from the manufacturers are based on the testing they did. The testing they did was constrained by the need to get the vaccine out ASAP.

The expectation is that if there wasn't such a rush to get the vaccine out they would have had more time to their testing and their recommendations would then be to have a longer gap between the doses.

But the manufacturer cannot make that claim without being able to back it up with testing. What the virologists are saying is that, in general, longer gaps between vaccines usually make them more effective in the long term, so that it isn't much of a gamble to extend the doses.

From the BMJ report:-

"
What do the manufacturers say?

In a joint statement Pfizer and BioNTech said, “The safety and efficacy of the vaccine has not been evaluated on different dosing schedules as the majority of trial participants received the second dose within the window specified in the study design . . . There is no data to demonstrate that protection after the first dose is sustained after 21 days.”

The European Medicines Agency has said that the gap between the first and second doses of the Pfizer-BioNTech vaccine should not exceed 42 days. “Any change to this would require a variation to the marketing authorisation as well as more clinical data to support such a change, otherwise it would be considered as ‘off-label use,’” the agency said.
"

People are taking "There is no data to demonstrate that protection after the first dose is sustained after 21 days." to mean "Protection is not sustained after 21 days." but it obviously doesn't mean that.

If I study a cat for 21 days and then say "There is no data to demonstrate that the cat stays alive after 21 days." does not mean the cat drops dead soon after 21 days, it just means I've no idea what happens after 21 days. Obviously the cat doesn't live forever, but I can't use this info to make a guess at how long cats live, it could be 3 months, 3 years, 30 years. If I want to do that then I need a study that is much longer than 21 days, but we couldn't wait longer for a longer vaccine trial, otherwise more people would be dying. (This is what they are going to be doing with the vaccine programme now, they will be studying the cases with the extended programme.)

Also, if a year ago people had said that a vaccine would have been available with 70% efficacy and we'd be getting ~2 million doses of it a week people would have been over the moon about it and amazed at the turnaround and scientific effort. However, throw in the chance that 92% (or whatever) is possible and now people focus on that higher number and feel they're being short changed.

The simple fact is that the JCVI believe that spacing out the dosing will save more lives as it allows some level of immunity to be conferred on more people rather than giving half those people a greater level of immunity.

If supply wasn't a problem they'd follow the manufacturers recommendation although there would still be a chance that this is not the path to greatest protection.

The reality is the we did not obtain enough vaccines even after the press announcement. That is down to the governance.

The UK has ordered enough vaccines, more than enough, the limit is due to the suppliers. They can't make it quick enough, especially as the suppliers will have contracts with hundreds of different countries. The Government can't magically force them to make more or make it quicker.

I would hope, also, that the Government is considering giving some of the vaccines they have purchased to other countries. If they have bought 360mm doses, and they only need ~130mm doses for the current population (and ~1mm doses per year ongoing) then a huge chunk of those extra doses should be going to other countries as a form of international aid. And yes, as a fit healthy person in their 40s with no underlying health conditions I'd be happy to wait even longer so that more vulnerable or aged people in other countries get a vaccine before me.

Excellent post, thanks @Greenbank

Yes, this. It's not 'playing with lives' to give as many people the vaccine as soon as possible, it would be playing with lives to focus on giving two doses while leaving millions of vulnerable people entirely unprotected.

And yes, as a fit healthy person in their 40s with no underlying health conditions I'd be happy to wait even longer so that more vulnerable or aged people in other countries get a vaccine before me.

This is laudable but given that even fit healthy people in their 40s with no underlying health conditions get long Covid, end up on a ventilator or even die.... and because the economy/country won't truly be able to reopen until mass vaccination has happened: I can't see the Government sharing until the UK is sorted.

Another point I think is important is that generally, longer spacing between doses does lead to better overall protection in other vaccines.

There is obvious uncertainty here, not least because the Pfizer and Moderna vaccines are different to traditional vaccines. However, the Moderna has shown evidence that longer spacing may be appropriate.

With the AZ vaccine, which is the more traditional approach, my understanding is that longer spacing is almost always preferable.

This also needs to be considered against the demographic of how the disease is spreading. Generally, it builds in the younger population, who are out and about more, and seeps into the older population.

If we give all the vaccine to the most vulnerable, who are more likely to be holed up indoors, we will do nothing about bringing down the transmission rates in the portion of the population driving transmission. This is a strong argument for trying to spread the vaccine as widely as possible, while also imploring those who have been vaccinated to maintain social distancing etc.

https://twitter.com/DoctorChrisVT/status/1346104040804016130

Also a good read.

If we give all the vaccine to the most vulnerable, who are more likely to be holed up indoors, we will do nothing about bringing down the transmission rates in the portion of the population driving transmission.

https://www.wired.com/story/covid-19-vaccine-super-spreaders/

(Not my opinion, but an opinion).

And if you want to talk odds ratios
https://www.youtube.com/watch?v=ixKhS0Silb4&feature=youtu.be

Unless I'm mistaken, we don't know if the vaccine stops transmission yet?

Hänselblatt reporting that the German Federal Government has decided that the AZ vaccine will only be 8% effective in over 65s:
https://www.handelsblatt.com/politik/deutschland/pandemie-bekaempfung-rueckschlag-bei-corona-impfstoff-astra-zeneca-vakzin-wirkt-bei-senioren-offenbar-kaum/26849788.html

Vaccine envy really is a thing isn't it?

Whitehall are 'livid' according to Politico and privately accusing the German Government of Russian-style disinformation.

Nope. Like I said, not my opinion, but there's some interesting ideas in there.