Developing the Covid-19 vaccine

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Re: Developing the Covid-19 vaccine

Post by PeteB » Tue Nov 10, 2020 5:20 pm


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Re: Developing the Covid-19 vaccine

Post by jdc » Tue Nov 10, 2020 8:17 pm

Arse. Looks like I need to re-read Lange's Medical Epidemiology. Again.

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Re: Developing the Covid-19 vaccine

Post by headshot » Wed Nov 11, 2020 9:42 am

I keep seeing people social media happily posting in response to this: https://metro.co.uk/2020/11/09/life-bac ... -13563931/
Life back to normal by spring after discovery of 90% effective vaccine’, expert says
Saying they can’t wait for all the usual things they do in spring/summer: holidays, theatre, cinema, orgies etc.

I’ve suggested that we should perhaps err on the side of caution with these headlines and that a return to normal is probably not possible with 4-5 months, given how long it’s likely to take to vaccinate an adequate percentage of the population.

I haven’t even mentioned how Brexit could interrupt supply chains yet.

I suppose spring goes all the way up to 20th June...but it seems like a stretch to me.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Wed Nov 11, 2020 7:03 pm

Brazil resumes trial of Sinovac Biotech covid vaccine.
On Monday, Anvisa said it had "ruled to interrupt the clinical trial of the CoronaVac vaccine after a serious adverse incident".

It did not reveal what had happened, nor where it had taken place.



Dimas Covas, head of the Butantan institute conducting the trials, told local media that the trial's suspension was related to a death, but insisted that the death was not linked to the vaccine.

This was backed up by Jean Gorinchteyn, health secretary for the state of São Paulo, who told a news conference that the death was an "external event" that was not related to the vaccine.

Mr Covas said that there had been no adverse reactions to the vaccine, and that the decision to suspend the trial had caused "indignation".

Media reports say police are investigating the death as a suicide.
https://news.yahoo.com/covid-brazil-all ... 26831.html
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Re: Developing the Covid-19 vaccine

Post by jdc » Wed Nov 11, 2020 7:54 pm

headshot wrote:
Wed Nov 11, 2020 9:42 am
I keep seeing people social media happily posting in response to this: https://metro.co.uk/2020/11/09/life-bac ... -13563931/
Life back to normal by spring after discovery of 90% effective vaccine’, expert says
Saying they can’t wait for all the usual things they do in spring/summer: holidays, theatre, cinema, orgies etc.

I’ve suggested that we should perhaps err on the side of caution with these headlines and that a return to normal is probably not possible with 4-5 months, given how long it’s likely to take to vaccinate an adequate percentage of the population.

I haven’t even mentioned how Brexit could interrupt supply chains yet.

I suppose spring goes all the way up to 20th June...but it seems like a stretch to me.
My predictions from 31 Oct: "I'll have 10p on spring and 5p on winter [for vaccines to be used outside a trial scenario]. I've another 5p that says Boots have it on offer by August 2021." I reckon I'm on the right lines for the 'use after emergency approval' betting but I worry I may have been slightly optimistic about its availability in Boots.

I'd interpret "by spring" as by the start rather than the end personally. I reckon the only way life is going "back to normal by spring" is if we (under-50s? under-70s?) all go back to normal once the vulnerable have been vaccinated and take our chances with the virus, and I'd be surprised if that were the case; this is how people felt about lifting the lockdown and going back to normal in May: https://uk.reuters.com/article/uk-healt ... KKBN22D4VS

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Re: Developing the Covid-19 vaccine

Post by shpalman » Wed Nov 11, 2020 8:48 pm

jdc wrote:
Wed Nov 11, 2020 7:54 pm
headshot wrote:
Wed Nov 11, 2020 9:42 am
I keep seeing people social media happily posting in response to this: https://metro.co.uk/2020/11/09/life-bac ... -13563931/
Life back to normal by spring after discovery of 90% effective vaccine’, expert says
Saying they can’t wait for all the usual things they do in spring/summer: holidays, theatre, cinema, orgies etc.

I’ve suggested that we should perhaps err on the side of caution with these headlines and that a return to normal is probably not possible with 4-5 months, given how long it’s likely to take to vaccinate an adequate percentage of the population.

I haven’t even mentioned how Brexit could interrupt supply chains yet.

I suppose spring goes all the way up to 20th June...but it seems like a stretch to me.
My predictions from 31 Oct: "I'll have 10p on spring and 5p on winter [for vaccines to be used outside a trial scenario]. I've another 5p that says Boots have it on offer by August 2021." I reckon I'm on the right lines for the 'use after emergency approval' betting but I worry I may have been slightly optimistic about its availability in Boots.

I'd interpret "by spring" as by the start rather than the end personally. I reckon the only way life is going "back to normal by spring" is if we (under-50s? under-70s?) all go back to normal once the vulnerable have been vaccinated and take our chances with the virus, and I'd be surprised if that were the case; this is how people felt about lifting the lockdown and going back to normal in May: https://uk.reuters.com/article/uk-healt ... KKBN22D4VS
People didn't need telling twice to "eat out to help out" over the summer though.
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Re: Developing the Covid-19 vaccine

Post by Herainestold » Thu Nov 12, 2020 2:50 am

Russia's Sputnik vaccine 92% effective.
MOSCOW (AP) — Developers of Sputnik V, Russia’s experimental COVID-19 vaccine, announced Wednesday that early, interim data from a large trial suggests the shot appears to be 92% effective.

The statement, which did not include detailed information about the trial, comes just two days after a similar one from Pfizer Inc., but is based on far fewer virus cases. Some experts suggest the data may have been rushed out in an effort to keep up with the worldwide race for a successful coronavirus vaccine.

Russia touted Sputnik V, a two-shot vaccine, as the world’s first to receive a government go-ahead after it was approved in early August without completing advanced testing. The move drew considerable criticism from experts who said data from tens of thousands of people were needed to ensure the safety and effectiveness of the vaccine before it is given widely.
https://apnews.com/article/russia-says- ... 9b3f5d4ad5
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Re: Developing the Covid-19 vaccine

Post by headshot » Thu Nov 12, 2020 7:35 am

Can anyone work out the actual figures they’re stating here??

Is it that there will be centres that vaccinate 5000 people per day, as well as converted sports stadiums that will vaccinate 2000 people per day AND 1560 community-based GP-run centres vaccinating 200-500 people EACH per day?

Or is 5000 people per day a headline figure for the entire vaccination programme??

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Re: Developing the Covid-19 vaccine

Post by shpalman » Thu Nov 12, 2020 8:17 am

headshot wrote:
Thu Nov 12, 2020 7:35 am
Can anyone work out the actual figures they’re stating here??

Is it that there will be centres that vaccinate 5000 people per day, as well as converted sports stadiums that will vaccinate 2000 people per day AND 1560 community-based GP-run centres vaccinating 200-500 people EACH per day?

Or is 5000 people per day a headline figure for the entire vaccination programme??


Image
f.ck knows. It might have made sense when the "NHS officials" said it but not after the helpful filter of the innumerate journalists.

The simplest thing to do is assume that the NHS wants to vaccinate about 500,000 people a day in total via 2000 a day in each football stadium, town hall, and conference centre and 200-500 a day in each of 1560 community-based centre.

500,000 per day seems like it would get through a reasonable amount of the population in a reasonable time frame (well, you could do ~10% of the population in a month bearing in mind two jabs each), so it's a big enough number to sound useful but not so big as to be ridiculous. I expect the NHS started from there and worked backwards.
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Re: Developing the Covid-19 vaccine

Post by shpalman » Thu Nov 12, 2020 10:34 am

A bit lower down in the article it says that
District nurses, health visitors and other health professionals who do not work in hospitals will also be drafted in to help, amid concerns that, while GPs are playing the lead role in the immunisation effort, there are too few of them to deliver the NHS target of vaccinating a million people a week.
So the order of magnitude is 150,000-200,000 per day.

975 people per week at 1260 mass vaccination centres is about 1.2 million per (7-day) week or 175500 per day. (About 140 per day per centre, one every 3-4 minutes or so.)

The article you mention may just be saying that the stadium-sized centres will instead aim for 2000 people per day each, but some of the bigger ones will do up to 5000 people per day.
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Re: Developing the Covid-19 vaccine

Post by AMS » Thu Nov 12, 2020 10:43 am

Does anyone else look at that and think "yes, I'm confident that this government can set up the logistics to vaccinate the whole population at a rate of 4/min at each of 1000+ centres?"

Or do you look at (for example) the contract tracing system, or maybe the post-Brexit HMRC systems for imports/exports, and think "hmmm...?

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Re: Developing the Covid-19 vaccine

Post by lpm » Thu Nov 12, 2020 10:57 am

If the pharmas can produce them, we can easily inject them. It's production that will be the bottleneck all next year.

A few thousand a day is pathetic - a football stadium has 50,000 people going in and out over a couple of hours. A drive thru could inject a hundred every minute.

My GP surgery got in a stock of flu vaccine and did 494 jabs in a single Saturday morning. Outside, two lanes with short queues, a handful of nurses/helpers, conveyor belt style. They've now done this 3 times - if they get the stock in they immediately send out notifications to their >65 list.

A week's production of vaccine can be injected into the arms of Brits in less than an hour.
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Re: Developing the Covid-19 vaccine

Post by bolo » Thu Nov 12, 2020 3:56 pm

A possibly stupid question: That Pfizer vaccine that has to be kept at -70C? Do they warm it up a bit before injecting it?

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Re: Developing the Covid-19 vaccine

Post by Gfamily » Thu Nov 12, 2020 4:10 pm

bolo wrote:
Thu Nov 12, 2020 3:56 pm
A possibly stupid question: That Pfizer vaccine that has to be kept at -70C? Do they warm it up a bit before injecting it?
I heard someone say it's removed from the dry ice* a couple of hours before use.

* or equivalent
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Re: Developing the Covid-19 vaccine

Post by Sciolus » Thu Nov 12, 2020 4:11 pm

That's part of the issue with distributing it. Batches of (I think) 100 samples have to be defrosted, diluted and injected within 48 hours. So there is a non-trivial process around administering it, as well as just trucking it around, finding enough freezer space, finding enough people to do the jabs, and herding the public into the right place at the right time, twice.

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Re: Developing the Covid-19 vaccine

Post by Herainestold » Thu Nov 12, 2020 4:27 pm

Sciolus wrote:
Thu Nov 12, 2020 4:11 pm
That's part of the issue with distributing it. Batches of (I think) 100 samples have to be defrosted, diluted and injected within 48 hours. So there is a non-trivial process around administering it, as well as just trucking it around, finding enough freezer space, finding enough people to do the jabs, and herding the public into the right place at the right time, twice.
In America the CDC was advising hospitals not to buy new freezer units, as they foresee more vaccines coming down the pipeline that dont require ultra cold storage. Obviously its a huge logistical challenge, but the thought seemed to be to administer the first round of vaccine in places that already had the facilities, and by round two there would be other alternatives that would be easier to distribute.
The Centers for Disease Control and Prevention has advised state health departments against purchasing ultra-cold freezers — which cost $10,000 to $15,000 each — saying other vaccines with less demanding storage requirements will be available soon. Hospitals with money to spare are flouting this guidance. Four major health care systems, from North Carolina to Ohio, North Dakota, and California, told STAT they had bought additional ultra-cold freezers, while Jefferson Health in Philadelphia said it has leased five units.
https://www.statnews.com/2020/11/11/rur ... 9-vaccine/
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Re: Developing the Covid-19 vaccine

Post by lpm » Thu Nov 12, 2020 4:33 pm

If we can do 300,000 Covid tests per day, why can't we do 300,000 vaccinations per day? It's easier. No need for lab resources. Just a queue, a gazebo with people stabbing arms, a post-jab resting place to check for allergic reactions.
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Re: Developing the Covid-19 vaccine

Post by headshot » Thu Nov 12, 2020 5:00 pm

shpalman wrote:
Thu Nov 12, 2020 10:34 am
A bit lower down in the article it says that
District nurses, health visitors and other health professionals who do not work in hospitals will also be drafted in to help, amid concerns that, while GPs are playing the lead role in the immunisation effort, there are too few of them to deliver the NHS target of vaccinating a million people a week.
So the order of magnitude is 150,000-200,000 per day.

975 people per week at 1260 mass vaccination centres is about 1.2 million per (7-day) week or 175500 per day. (About 140 per day per centre, one every 3-4 minutes or so.)

The article you mention may just be saying that the stadium-sized centres will instead aim for 2000 people per day each, but some of the bigger ones will do up to 5000 people per day.
Two doses needed though...

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Re: Developing the Covid-19 vaccine

Post by shpalman » Thu Nov 12, 2020 5:04 pm

headshot wrote:
Thu Nov 12, 2020 5:00 pm
shpalman wrote:
Thu Nov 12, 2020 10:34 am
A bit lower down in the article it says that
District nurses, health visitors and other health professionals who do not work in hospitals will also be drafted in to help, amid concerns that, while GPs are playing the lead role in the immunisation effort, there are too few of them to deliver the NHS target of vaccinating a million people a week.
So the order of magnitude is 150,000-200,000 per day.

975 people per week at 1260 mass vaccination centres is about 1.2 million per (7-day) week or 175500 per day. (About 140 per day per centre, one every 3-4 minutes or so.)

The article you mention may just be saying that the stadium-sized centres will instead aim for 2000 people per day each, but some of the bigger ones will do up to 5000 people per day.
Two doses needed though...
Which makes a factor of two difference, not an order of magnitude.

What happens if the second dose is a bit late? I mean, it's hard enough to organize in the first place without having to make sure everyone from one day comes back and gets seen to on the right other day.
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Re: Developing the Covid-19 vaccine

Post by headshot » Thu Nov 12, 2020 5:09 pm

The Guardian's graphic on the Pfizer vaccine show the cold distribution network. The vaccine can be kept in a normal refrigerator for up to five days.
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Re: Developing the Covid-19 vaccine

Post by shpalman » Thu Nov 12, 2020 5:13 pm

"At any point, the boxes can be recharged with dry ice"

Assuming you have some tanks/cylinders of liquid CO2 to hand.
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Re: Developing the Covid-19 vaccine

Post by bolo » Thu Nov 12, 2020 5:41 pm

Thanks. The actual injection being at 2-8 C sounds much less ... uncomfortable.

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Re: Developing the Covid-19 vaccine

Post by shpalman » Thu Nov 12, 2020 5:52 pm

Italy will probably want to have the Oxford/AstraZeneca one anyway, since there are Italians involved in making that, which means that it's obviously the best one despite that we don't know if it works yet.
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Re: Developing the Covid-19 vaccine

Post by AMS » Thu Nov 12, 2020 6:20 pm

shpalman wrote:
Thu Nov 12, 2020 5:13 pm
"At any point, the boxes can be recharged with dry ice"

Assuming you have some tanks/cylinders of liquid CO2 to hand.
Dry ice is a solid.

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Re: Developing the Covid-19 vaccine

Post by AMS » Thu Nov 12, 2020 6:23 pm

AMS wrote:
Thu Nov 12, 2020 6:20 pm
shpalman wrote:
Thu Nov 12, 2020 5:13 pm
"At any point, the boxes can be recharged with dry ice"

Assuming you have some tanks/cylinders of liquid CO2 to hand.
Dry ice is a solid.
Also, it's easy to handle. We routinely use it at work as the packing agent for frozen shipments, including international stuff. I bet there are some on nearly all Fedex transatlantic flights.

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