covid-19

[Timbuk2]

Do you foresee that by say April the UK's vaccine decisions will be leading to the UK having comparatively better, worse or indifferent results?

I don't think that is what anyone on this forum is saying - specifically that the decisions being made by the UK govt re: prioritising first doses and delaying second doses will lead to better or worse results.

What I gather is being said is that it is dangerous simply to make those decisions based purely on non-clinical evidence. There are too many complexities, variables, moving parts, to make any informed decisions without clinical trials, and all the scientific scrutiny and vigour therein. In that, the only reliable information we have is that provided by ASZ and Pfizer. Outside of clinical trial, and simply throwing it out there into the public to see if it works where there is nothing but complexity, variety, and said moving parts without any of the scientific scrutiny brought by controlled clinical trial, is dangerous.

If it makes things better, then that will be largely by dint of vaguely back-of-the-envelope (nod, wiggin) guesstimated luck. And in an emergency as we have, that is the worst thing to do.

Stick to what we know - ie what is proven.

[wiggin]

There's some early indications that its already working. Considering the new variant there was some concern that the lockdown would be insufficient to cut cases but they're falling fast and the fall is accelerating rather than declining with some limited evidence that the earliest vaccinations especially of NHS staff may already be reducing acquired infections. Be another couple of weeks before concrete data is available but *fingers crossed*.

That is evidence of improvement, which is expected given a vaccination campaign and lockdown. The question will be how it performs long term against a counterfactual. Tens of thousands of lives are at stake, but I'm afraid we may never know.

[RandBlade]

Fantastic news Gogo, very glad you've got your shot.

I hate to belabour the point but Gogo as Priority Group 4 has only gotten his shot now because of the twelve week policy. Had there been only 7 million given booster shots first instead then priority group 4 wouldn't have begun yet. Gogo and millions of real people are the ones whose shot would be delayed if we stuck religiously to the 3 week rule.

Sorry Tim but I couldn't disagree more, doing what is "proven" is waiting far too late for proof. You have to go off best evidence and adjust course if need be. Covid "sceptics" are demanding the "proof" that lockdowns work well past the point we have enough evidence they do. Denying vaccine rollouts is no better than Toby Young's "sceptics".

The evidence from the trials is not the only evidence that exists, it is significant evidence but far more evidence than that (including an understanding of how vaccines and immunity work and wane etc) is also evidence. Plus the evidence from the trials is a key part of the JCVI's considerations.

As a reductio ad absurdum extreme counterexample lets say that the first dose showed an immediate 100% prevention of any further infections from just one dose being given until the second was given then based on that evidence would you say that was sufficient evidence to show that the first dose was sufficient to give twice as many first doses and do second ones later? Or would you still do the second despite that?

[gogobongopop]

Fantastic news Gogo, very glad you've got your shot.

I hate to belabour the point but Gogo as Priority Group 4 has only gotten his shot now because of the twelve week policy. Had there been only 7 million given booster shots first instead then priority group 4 wouldn't have begun yet. Gogo and millions of real people are the ones whose shot would be delayed if we stuck religiously to the 3 week rule.

Thanks. Given the choice I would have been happy to wait longer and receive the vaccine as per the tested trials and manufacturer instructions.

[RandBlade]

AZN at least agree with the 12 week delay and say its the right thing to do.

Do you know whether you got the AZN or Pfizer jab or did they not tell you that?

[Aimless]

Just had my first covid vaccine

No side effects so far. Expecting some aches and a touch of fever in a few hours time, which I normally get with the flu jab (lower backache, mostly), but we'll see.

Congrats mate, if you grow a second head you must post pix

UK cases plummeting, as new national lockdown takes effect finally.

Extremely good news, and, yet, difficult not to be saddened by the knowledge that the UK could've stayed out of this particular circle of hell by making better decisions in Autumn and early Winter. Lockdowns have worked for the UK—when they've been allowed to work. Hopefully, enough people will have been vaccinated to mitigate a future surge when restrictions are lifted.

I don't think that is what anyone on this forum is saying - specifically that the decisions being made by the UK govt re: prioritising first doses and delaying second doses will lead to better or worse results.

What I gather is being said is that it is dangerous simply to make those decisions based purely on non-clinical evidence. There are too many complexities, variables, moving parts, to make any informed decisions without clinical trials, and all the scientific scrutiny and vigour therein. In that, the only reliable information we have is that provided by ASZ and Pfizer. Outside of clinical trial, and simply throwing it out there into the public to see if it works where there is nothing but complexity, variety, and said moving parts without any of the scientific scrutiny brought by controlled clinical trial, is dangerous.

If it makes things better, then that will be largely by dint of vaguely back-of-the-envelope (nod, wiggin) guesstimated luck. And in an emergency as we have, that is the worst thing to do.

Stick to what we know - ie what is proven.

It can be difficult to stick to what we know and what is proven in an incredibly urgent emergency such as the pandemic.

Somewhere back between p54 and p58 I explained that, because this is uncharted territory, and because these decisions about epidemic control strategies are so momentous, I believe they should be supported by certain kinds of data and analyses that can help us get a better idea of how risky our chosen course really is compared to the alternatives, under a wide range of plausible circumstances and assumptions. If you see that a particular strategy should be expected to result in a lower overall attack rate and death toll than other strategies, across a range of assumptions about key parameters (eg. vaccine efficacy in specific groups over time, risk of exposure and death, etc), that would be reassuring—and, if your circumstances were to go beyond that safe range, you would be able to respond quickly. It would probably improve the quality of the decision-making process, make it easier to evaluate performance (and hold people accountable ofc), facilitate course-corrections if necessary, help other countries—and, of course, increase our knowledge.

The AZN data is honestly not of very high quality if you're trying to answer these questions, but that vaccine is nevertheless somewhat easier to justify stretching in this manner in order to facilitate a breadth-first strategy (if you take off the immunology hat for a moment). I think it's interesting and useful to subject the careless reasoning about immunological concerns to scrutiny, but, pragmatically, we can focus on the epidemiological aspects of these questions. My gut feeling is that the primary benefit of a breadth-first strategy will be to mitigate the fallout from the govt's monumental fuckups in Autumn and early Winter, and to mitigate the potential negative impact of a premature easing of lockdown restrictions—but I think the overall attack rate may indeed be a little lower as well. I hope that the breadth-first strategy will also hasten the fall in case numbers to the point where the risk of exposure will be very low for any frail elderly institutionalized people that may have lost the protection conferred by the first dose of whatever vaccine they received.

Fantastic news Gogo, very glad you've got your shot.

I hate to belabour the point but Gogo as Priority Group 4 has only gotten his shot now because of the twelve week policy. Had there been only 7 million given booster shots first instead then priority group 4 wouldn't have begun yet. Gogo and millions of real people are the ones whose shot would be delayed if we stuck religiously to the 3 week rule.

Sure, or many people in priority group 4 would nevertheless have gotten their shots in a reasonable time-frame by being placed in a higher priority group.

[gogobongopop]

AZN at least agree with the 12 week delay and say its the right thing to do.

Do you know whether you got the AZN or Pfizer jab or did they not tell you that?

It was AZN. Big posters all over the wall stating so.

Got a little leaflet with info about the vaccine, as you normally do with medicine. It states the second jab needs to be given between 4 and 12 weeks. That's reassured me a bit, although I'm still keen to understand the efficacy of one shot only at 4 weeks, 12 and then 13.

Feeling a bit shit now. Chills and got flushes starting. Arm beginning to ache. Think I'll skip my afternoon walk today!

[RandBlade]

It was AZN. Big posters all over the wall stating so.

Got a little leaflet with info about the vaccine, as you normally do with medicine. It states the second jab needs to be given between 4 and 12 weeks. That's reassured me a bit, although I'm still keen to understand the efficacy of one shot only at 4 weeks, 12 and then 13.

Feeling a bit shit now. Chills and got flushes starting. Arm beginning to ache. Think I'll skip my afternoon walk today!

Hope the side effects don't get too bad.

The AZN data showed you get a better response be spacing out the 2 doses further apart than if you do them too close to each other. Due to the vector of how the vaccine works, not the same vector as Pfizer.

More countries now approving it

Twitter Link

[Timbuk2]

Paris police accused of breaking curfew after Macarena at party

Officials are investigating claims Paris police broke Covid-19 and curfew rules by staging a leaving party for a colleague at which they danced the Macarena inside a police station.

Videos of the event appear to show police officers and other station staff celebrating and dancing until 3am. None was wearing a mask, there was little social distancing and the party broke the 6pm to 6am nationwide curfew.

Officers are seen singing and dancing the Macarena inside the police station at Aubervilliers in the Seine-Saint-Denis suburb. The regional police authority has launched an investigation.

[gogobongopop]

Twitter Link
The plot thickens

[wiggin]

AZN at least agree with the 12 week delay and say its the right thing to do.

Do you know whether you got the AZN or Pfizer jab or did they not tell you that?

As an aside, I think it's unethical and possibly illegal for AZN to promote the use of their product in such a manner.

[RandBlade]

Twitter Link
The plot thickens

Absolute idiocy.

Because the subsample of over 65s in the Phase III was small so the confidence interval is massive.

Same issue applied to Pfizer. The subsample of over 65s in Pfizer's Phase III was small and the confidence interval went down to -13% . . . ie that worst-case you're 13% more likely to catch Covid if you have Pfizer than if you don't.

[RandBlade]

As an aside, I think it's unethical and possibly illegal for AZN to promote the use of their product in such a manner.

Why would it be either unethical or illegal for a product they're not making a profit on being promoted to be used in a way its been authorised to be used?

[Aimless]

At least they're doing something stupid with style... in the past week, bosses in various positions in local councils have allowed their relatives to jump the vaccination queues, our public health agency has decided not to pay Pfizer's invoices over a stupid dispute (about the number of doses per vial), and the agency's head has been seen riding the bus during rush hour without wearing a mask.

[wiggin]

Why would it be either unethical or illegal for a product they're not making a profit on being promoted to be used in a way its been authorised to be used?

Because when a manufacturer makes recommendations about the use of their product there is an implied imprimatur associated with their recommendations. When they make the recommendation in a way it IS NOT authorized for use by a regulatory body (and to my knowledge the neither the MHRA nor any other regulatory agency in the world has authorized a different dosing schedule) people think that the approval covers this unapproved method of use. Many pharma and device manufacturers in the US have been fined huge sums of money and put under intense regulatory scrutiny when they market their products for off-label uses.

It doesn't matter if they're making a profit or not.

[Flixy]

Absolute idiocy.

Because the subsample of over 65s in the Phase III was small so the confidence interval is massive.

Same issue applied to Pfizer. The subsample of over 65s in Pfizer's Phase III was small and the confidence interval went down to -13% . . . ie that worst-case you're 13% more likely to catch Covid if you have Pfizer than if you don't.

Isn't the problem with them that their data is messy and the study was poorly set up/ executed on top of that?

[Aimless]

Isn't the problem with them that their data is messy and the study was poorly set up/ executed on top of that?

Biggest problem is that there was, like, one (1) case in the control group in that age category. It makes it very difficult to estimate efficacy. You can (but shouldn't ) try to infer the true efficacy through various methods, and I suspect they will be consistent with low or intermediate or high efficacy—ie. useless.

[gogobongopop]

Vaccine update.

In bed. Temperature. Can't move. Cold. Everything hurts. Nausea. Properly feels like flu.

Feel conscious and with it though.

I last had chemo two weeks ago today. Bloods were top notch this morning. Felt fighting fit.

On the plus side it's more comfortable than chemotherapy. Give me the flu anytime.

Hoping it'll pass soon.

[Aimless]

Take care gogo... good night to treat yourself to something nice

[gogobongopop]

Thanks. Think it might be easing. Chills have stopped and I'm sitting up. Very high fever though.

Papa John's as soon as poss. Stuffed crust. Onions. Double Mushrooms. Pepperoni.

[Steely Glint]

Onions

too far

[RandBlade]

Sounds good, enjoy, you deserve it!

[Aimless]

Thanks. Think it might be easing. Chills have stopped and I'm sitting up. Very high fever though.

Papa John's as soon as poss. Stuffed crust. Onions. Double Mushrooms. Pepperoni.

damn you i had just managed to kick the pizza addiction

[RandBlade]

Twitter Link

BOOM! Another successful vaccine Phase III!

89% efficiency.

Tested on Kent supercovid mutation.

Manufactured in Teeside.

60 million doses on order. First doses reserved.

27% of people in the trial were over 65.

Another one in the back of the net. Fantastic! We're going to have more doses than we need and able to send them to Covax to aid the third world soon.

UK reserved first Novavax doses last August. EU are still in talks with Novavax - might want to get a move on . . .

EDIT: Rolling review process for this too so MHRA should be able to grant emergency authorisation quite quickly so long as everything is good.

The company initiated a rolling submission to the United Kingdom’s regulatory agency, the MHRA, in mid-January.

August 14th: Under the terms of the agreement, Novavax will supply 60 million doses of NVX-CoV2373 to the UK beginning as early as the first quarter of 2021. Excess supply of antigen manufactured at the FUJIFILM Diosynth Biotechnologies site in Billingham, Stockton-on-Tees may be available for Novavax to sell to additional markets outside the UK.

https://ir.novavax.com/node/15506/pdf

[RandBlade]

Novavax only 50% effective against Saffers Covid variant though. Concerning that others could be similarly effected. We need to enforce hotel quarantine with all countries that aren't zero Covid.

[Lewkowski]

https://www.npr.org/sections/coronav...ng-home-deaths

"When the first coronavirus wave hit New York state last spring, nursing homes and assisted living facilities were devastated.

An investigation by the office of state Attorney General Letitia James issued Thursday found the death toll was far worse than officials disclosed.

"A larger number of nursing home residents died from COVID-19 than [New York Department of Health] data reflected," the preliminary report concluded.

N.Y. officials had estimated nursing home deaths during the pandemic totaled roughly 8,700.

But the probe by James' office found those reports "undercounted by as much as 50%" the number of seniors who died.

Investigators surveyed more than 60 nursing homes and found discrepancies between the number of deaths recorded and numbers previously reported by state officials.

The AG's office says it is still "investigating those circumstances where the discrepancies cannot reasonably be accounted for," according to a statement in the report.

Cuomo himself hasn't responded to the report. But state Health Commissioner Dr. Howard Zucker issued a lengthy statement Thursday afternoon downplaying the significance of the findings.

Zucker said N.Y. reported coronavirus fatalities by the location where they occurred. Which means if an elderly patient died after being transported to a hospital, they wouldn't be included in the tally of nursing home deaths.

"DOH does not disagree that the number of people transferred from a nursing home to a hospital is an important data point, and is in the midst of auditing this data from nursing homes," Zucker added.

During the pandemic, Cuomo, a Democrat, gained a national profile for his hands-on approach to promoting public health policies and reducing infection rates.

For a time, his daily briefings drew a national audience, serving as a kind of counterpoint to coronavirus briefings held by then-President Donald Trump.

But questions about Cuomo's handling of nursing home safety have haunted his administration.

Cuomo has drawn particular fire for an executive order issued in March requiring nursing homes to re-admit residents still recovering from COVID-19.

His administration later rescinded the controversial order.

Last summer, a report by state health officials concluded high rates of coronavirus death in nursing homes were caused by infected staff, not returning residents.

But Cuomo's team has refused to make public the data used to compile that report.

Earlier this week, a top Democrat in the state legislature, Sen. James Skoufis, threatened to file subpoenas to "compel" Health Department officials to release more information.

This new report adds to the pressure on Cuomo's team to offer a full accounting of nursing home mortality.

In a statement, James, also a Democrat, said "it is imperative that we understand why the residents of nursing homes in New York unnecessarily suffered at such an alarming rate."

While much of the scrutiny of Cuomo's nursing home policy has come from fellow Democrats and the media, the issue has increasingly become a political liability for the governor.

Shortly after James' report was made public, New York's Republican Party issued a statement condemning Cuomo's handling of the pandemic and accusing him of a "cover-up."

"These findings will have implications across New York state and they cannot be dismissed as political attacks," the statement read.

James' report also found many nursing homes in New York failed to comply with infection control protocols and lacked sufficient personal protective equipment needed to keep residents safe."

New York fucked up.

[RandBlade]

Who has bought Novavax:

https://www.bloomberg.com/graphics/c...ion-purchasing


Big list already there, close to 1.4 billion doses already on order, should be a massive boost to the globe to get this approved.

[Timbuk2]

Twitter Link

89% efficiency.

Tested on Kent supercovid mutation.

Manufactured in Teeside.

60 million doses on order. First doses reserved.

27% of people in the trial were over 65.

[Timbuk2]

India, 1bn orders

[RandBlade]

The Indians aren't pissing about

That's on top of the billion orders of AZN they're getting this year.