Scrutable

Bird on a Fire wrote: ↑

Mon Nov 16, 2020 3:12 pm

I'm cautiously optimistic about this, which by 2020 standards probably means I'm about to have my heart broken.

I literally cannot wait to go back to huffing strangers' fomites all day, and will do the second we've been jabbed. f.ck this sh.t.

I know this might come across as selfish, but I'm really, really hoping they do people on the shielding list near the beginning*, because between shielding - a polite euphemism for isolation - and an unrelated disability that means I can't cope properly without outside help, I don't see myself surviving another year like this.


*Medical workers and care home staff/residents come first, I guess, but after that

Yeah, that's really f.cking selfish of you EAC. Don't you realise there are prime ministers who are unable to take basic precautions to keep themselves from being exposed who are in far greater need than you?

discovolante wrote: ↑

Mon Nov 16, 2020 5:05 pm

Hm that makes sense, thanks. Almost a bit too logical really.

I did include the disclaimer "in a rational world". How it will work in practice remains to be seen. I haven't heard anything about cost of different vaccines, for instance, and the Moderna guy was cagey about his stuff being manufactured outside their own sites in the US and EU. Those sorts of factors will obviously affect availability in different parts of the world, especially where any vaccines will be largely funded by foreign aid.

Sciolus wrote: ↑

Mon Nov 16, 2020 7:07 pm

discovolante wrote: ↑

Mon Nov 16, 2020 5:05 pm

Hm that makes sense, thanks. Almost a bit too logical really.

I did include the disclaimer "in a rational world". How it will work in practice remains to be seen. I haven't heard anything about cost of different vaccines, for instance, and the Moderna guy was cagey about his stuff being manufactured outside their own sites in the US and EU. Those sorts of factors will obviously affect availability in different parts of the world, especially where any vaccines will be largely funded by foreign aid.

The only thing I've read was this in the Guardian this morning (before the UK had bought a bunch):

At £38 to £45 for a course of two shots, Moderna’s vaccine is more expensive than the other frontrunners. AstraZeneca and Oxford University are aiming to sell their vaccine at about £3 a dose, while vaccines in trial with Johnson and Johnson and a collaboration between Sanofi and GSK are both expected to cost about £8 a dose. Pfizer is charging the US about £30 for a two-shot course. The UK has ordered 40m Pfizer shots but none of the Moderna vaccine.

clicky

EACLucifer wrote: ↑

Mon Nov 16, 2020 6:45 pm

Bird on a Fire wrote: ↑

Mon Nov 16, 2020 3:12 pm

I'm cautiously optimistic about this, which by 2020 standards probably means I'm about to have my heart broken.

I literally cannot wait to go back to huffing strangers' fomites all day, and will do the second we've been jabbed. f.ck this sh.t.

I know this might come across as selfish, but I'm really, really hoping they do people on the shielding list near the beginning*, because between shielding - a polite euphemism for isolation - and an unrelated disability that means I can't cope properly without outside help, I don't see myself surviving another year like this.


*Medical workers and care home staff/residents come first, I guess, but after that

Unfortunately, the serious answer seems to be f.ck you. "High-risk adults under 65 years of age" are number 6 on the list, below everyone over 65, even though under-70s and even under-80s are at low risk. Probably because deciding who's high-risk is too difficult to put in a simple list. Disability News Service article.

Have you got a friendly GP who could wangle a less tw.ttish approach?

EACLucifer wrote: ↑

Mon Nov 16, 2020 6:45 pm

Bird on a Fire wrote: ↑

Mon Nov 16, 2020 3:12 pm

I'm cautiously optimistic about this, which by 2020 standards probably means I'm about to have my heart broken.

I literally cannot wait to go back to huffing strangers' fomites all day, and will do the second we've been jabbed. f.ck this sh.t.

I know this might come across as selfish, but I'm really, really hoping they do people on the shielding list near the beginning*, because between shielding - a polite euphemism for isolation - and an unrelated disability that means I can't cope properly without outside help, I don't see myself surviving another year like this.


*Medical workers and care home staff/residents come first, I guess, but after that

Blimey, not selfish at all! I hope the same, that vaccines go out in order of need, which means the most medically vulnerable first, along with medical workers and carers.

I fully expect to be right at the back of the list, and I'm totally fine with that - a large part of the weight on my shoulders is the risk of spreading it to others, and society can't (or at least shouldn't) try to 'return to normal' until people are properly protected.

And yes, as sh.tty as I've found this year it's also made me aware that in almost every respect I'm relatively low-vulnerability and in fact pretty privileged in many ways, so if it's sucking this much for me the people nearer the top of the list have an extra reason to deserve their place there. Fingers crossed.

In America, the Biden administration is considering putting putting BAME and POC people at the head of the line.

Agency officials and the advisers are also considering what has become a contentious option: putting Black and Latino people, who have disproportionately fallen victim to Covid-19, ahead of others in the population.


In private meetings and a recent public session, the issue has provoked calls for racial justice. But some medical experts are not convinced there is a scientific basis for such an option, foresee court challenges or worry that prioritizing minority groups would erode public trust in vaccines at a time when immunization is seen as crucial to ending the pandemic.

https://www.nytimes.com/2020/07/09/us/c ... ccine.html

Sciolus wrote: ↑

Mon Nov 16, 2020 7:16 pm

EACLucifer wrote: ↑

Mon Nov 16, 2020 6:45 pm

Bird on a Fire wrote: ↑

Mon Nov 16, 2020 3:12 pm

I'm cautiously optimistic about this, which by 2020 standards probably means I'm about to have my heart broken.

I literally cannot wait to go back to huffing strangers' fomites all day, and will do the second we've been jabbed. f.ck this sh.t.

I know this might come across as selfish, but I'm really, really hoping they do people on the shielding list near the beginning*, because between shielding - a polite euphemism for isolation - and an unrelated disability that means I can't cope properly without outside help, I don't see myself surviving another year like this.


*Medical workers and care home staff/residents come first, I guess, but after that

Unfortunately, the serious answer seems to be f.ck you. "High-risk adults under 65 years of age" are number 6 on the list, below everyone over 65, even though under-70s and even under-80s are at low risk. Probably because deciding who's high-risk is too difficult to put in a simple list. Disability News Service article.

Have you got a friendly GP who could wangle a less tw.ttish approach?

I've not seen my GP in a while, but I'm due a consultant some point in the next couple of months. I can try making the case that my physical health is becoming untenable, I guess.

I do at least have paperwork showing the physical challenges I face, and general need for help, but this kind of thing does not help with the despair.

Adults over 65 is 'only' about 18% of the UK population, so vulnerable under-65s are still near the front, to be fair.

18% = 12 million people = 3 months at a massively optimistic 1 million per week. That's not near the front.

Seriously, that JCVI list is terrible. It is not at all consistent with my understanding of the risk profile, unless they have given *huge* weight to what they seem to think is the logistic simplicity of a simple age-based priority list (and I'm not knocking the importance of logistics). For example, Priority 1 is "older adults’ (sic) resident in a care home and care home workers", but there is good evidence that younger people in care homes are also extremely vulnerable, and the logistics are as easy as for older adults. Given the recent fuss about the importance of visitors, and the importance of vaccination in facilitating visits, this is an explicit f.ck you to younger people in care homes who are clearly not considered deserving.

The cost of vaccines and tests really shouldn't be relevant to any national-level decisionmaking. The impact on the economy is so huge that essentially any amount of money you can imagine spending would be cost effective, if it actually works.

In round numbers, UK GDP is £2 trillion and down about 10% since before Covid. So if you could wave a £200 billion magic wand to make Covid go away a year sooner, you'd be even. Or let's call it £500 million to speed things up by a single freaking day.

£3 per dose? £45 per dose? Who the hell cares?

Yes, this is approximated and oversimplified in order to fit on the back of an envelope. Feel free to imagine your own caveats.

Sciolus wrote: ↑

Mon Nov 16, 2020 8:00 pm

18% = 12 million people = 3 months at a massively optimistic 1 million per week. That's not near the front.

Seriously, that JCVI list is terrible. It is not at all consistent with my understanding of the risk profile, unless they have given *huge* weight to what they seem to think is the logistic simplicity of a simple age-based priority list (and I'm not knocking the importance of logistics). For example, Priority 1 is "older adults’ (sic) resident in a care home and care home workers", but there is good evidence that younger people in care homes are also extremely vulnerable, and the logistics are as easy as for older adults. Given the recent fuss about the importance of visitors, and the importance of vaccination in facilitating visits, this is an explicit f.ck you to younger people in care homes who are clearly not considered deserving.

Given the general Tory scapegoating of disabled people and the way they have handled this so far - cutting us off from support but in such a way that they can blame us if we do get infected - it could well be politics.

bolo wrote: ↑

Mon Nov 16, 2020 8:19 pm

The cost of vaccines and tests really shouldn't be relevant to any national-level decisionmaking. The impact on the economy is so huge that essentially any amount of money you can imagine spending would be cost effective, if it actually works.

In round numbers, UK GDP is £2 trillion and down about 10% since before Covid. So if you could wave a £200 billion magic wand to make Covid go away a year sooner, you'd be even. Or let's call it £500 million to speed things up by a single freaking day.

£3 per dose? £45 per dose? Who the hell cares?

Yes, this is approximated and oversimplified in order to fit on the back of an envelope. Feel free to imagine your own caveats.

The UK might not have to care, but the poorer countries of the world might.

Yes, fair enough.

bolo wrote: ↑

Mon Nov 16, 2020 8:19 pm

The cost of vaccines and tests really shouldn't be relevant to any national-level decisionmaking. The impact on the economy is so huge that essentially any amount of money you can imagine spending would be cost effective, if it actually works.

In round numbers, UK GDP is £2 trillion and down about 10% since before Covid. So if you could wave a £200 billion magic wand to make Covid go away a year sooner, you'd be even. Or let's call it £500 million to speed things up by a single freaking day.

£3 per dose? £45 per dose? Who the hell cares?

Yes, this is approximated and oversimplified in order to fit on the back of an envelope. Feel free to imagine your own caveats.

£45 a dose (is that for both required, or just one?), plus maybe £100* to distribute, organize and administer the two shots (two office visits, with follow-up to make sure people get the second dose, visits under current CoVID precautions because there's a pandemic on, and you can still catch and spread CoVID on the day you get the vaccine) is around £10 billion to vaccinate the whole UK. So it's not _that_ close, but close enough that you do have to think about how long the vaccine is effective for (currently not enough data) and how long it will take to process enough people through the system.

*Wild-Ass Guess. But not completely crazy, I think.

dyqik wrote: ↑

Mon Nov 16, 2020 10:31 pm

bolo wrote: ↑

Mon Nov 16, 2020 8:19 pm

The cost of vaccines and tests really shouldn't be relevant to any national-level decisionmaking. The impact on the economy is so huge that essentially any amount of money you can imagine spending would be cost effective, if it actually works.

In round numbers, UK GDP is £2 trillion and down about 10% since before Covid. So if you could wave a £200 billion magic wand to make Covid go away a year sooner, you'd be even. Or let's call it £500 million to speed things up by a single freaking day.

£3 per dose? £45 per dose? Who the hell cares?

Yes, this is approximated and oversimplified in order to fit on the back of an envelope. Feel free to imagine your own caveats.

£45 a dose (is that for both required, or just one?), plus maybe £100* to distribute, organize and administer the two shots (two office visits, with follow-up to make sure people get the second dose, visits under current CoVID precautions because there's a pandemic on, and you can still catch and spread CoVID on the day you get the vaccine) is around £10 billion to vaccinate the whole UK. So it's not _that_ close, but close enough that you do have to think about how long the vaccine is effective for (currently not enough data) and how long it will take to process enough people through the system.

*Wild-Ass Guess. But not completely crazy, I think.

The quote from the Guardian I posted above said both. It didn't say if it included distribution costs, but I assumed not.

I've been thinking about the GDP comparison Bolo made. I'm not sure it's the massive 10-15% drop you need to worry about, but how much you don't recover when everything gets turned back on, which will be more the longer the economy is paused for, but a much smaller amount. Plus the costs of supporting people during the pause too, of course.

ETA: Maybe put Covid economics in another thread?

No need for a separate thread. The answer is too easy. At £10 billion it's "who the hell cares".

Annual vaccinations would then be similar cost to flu. A significant ongoing resource requirement but not a problem for wealthy EU countries and probably not even for Former UK post the Brexit disintegration.

lpm wrote: ↑

Mon Nov 16, 2020 11:20 pm

No need for a separate thread. The answer is too easy. At £10 billion it's "who the hell cares".

Annual vaccinations would then be similar cost to flu. A significant ongoing resource requirement but not a problem for wealthy EU countries and probably not even for Former UK post the Brexit disintegration.

And given that coronaviruses mutate slower than influenza viruses, annual may not be needed. Obviously data on longer term immunity, natural or vaccine induced, is lacking at this point, so we don't know how long protection lasts.

EACLucifer wrote: ↑

Mon Nov 16, 2020 8:33 pm

Given the general Tory scapegoating of disabled people and the way they have handled this so far - cutting us off from support but in such a way that they can blame us if we do get infected - it could well be politics.

I just think that list was written by someone fantastically stupid. Another example is that they've put superspreaders as absolute bottom priority, or according to the footnote (and this is extraordinary) maybe not at all. Once you've done the 70+/vulnerable people, the next priority should be 18-25s followed by 11-17s, unless you've got good evidence that your particular vaccine doesn't slow transmission. Far, far better to stamp out the virus in the general population than to protect a small band of low-risk people.

Sciolus wrote: ↑

Mon Nov 16, 2020 11:55 pm

EACLucifer wrote: ↑

Mon Nov 16, 2020 8:33 pm

Given the general Tory scapegoating of disabled people and the way they have handled this so far - cutting us off from support but in such a way that they can blame us if we do get infected - it could well be politics.

I just think that list was written by someone fantastically stupid. Another example is that they've put superspreaders as absolute bottom priority, or according to the footnote (and this is extraordinary) maybe not at all. Once you've done the 70+/vulnerable people, the next priority should be 18-25s followed by 11-17s, unless you've got good evidence that your particular vaccine doesn't slow transmission. Far, far better to stamp out the virus in the general population than to protect a small band of low-risk people.

A lot of the earlier reports on vaccines were suggesting most did not stop transmission, and I guess it's too early to call now we have more data. Leaving the young until last would make sense with a vaccine that did not stop transmission, but I fear that a decision taken on that basis would remain in place even if we had a vaccine that did, given this government's track record with reacting to new information - ie the late lockdown, lack of mask mandate, rumours that eat-out-to-help-spread-the-virus will return, and so on.

I'm going to do what I can. There's no point trying until I've over this latest spasm/diazepam+withdrawal, so that's probably the end of the week at the earliest, but I'm going to start chasing this.

Anyone else wants to chase this, then please, please help. This isn't so much for me, there's others that are going to have it worse, like, say, those who are high risk but also need regular hospital treatment and need to travel to get it, or people where the choice isn't "scale back care and suffer a serious, possibly non-reversible function decline or face exposure" but "face exposure from a care industry that doesn't give a sh.t or immediately starve from lack of care", both of whom need the vaccine way more than a healthy 66yo does.

Logically it should not be prioritised for those at greatest risk, but at those whose essential job brings then into contact with the most people? Those are the people who are going to make the greatest difference to the R value and bring the epidemic under control?

What I heard was that it would be 6 months or so before we had decent info on transmission even for the most advanced vaccines, so hopefully we would be well into the rollout programme by then. Clearly we will need to be flexible (and yeah, that's not been a great characteristic of the government so far) and my comments should be taken with the obvious caveat.

I will say that there is also a strong social equity argument for prioritising 11-25s. These people, as a generation, have made a huge sacrifice at a critical stage in their lives, for no benefit to themselves, and we owe it to them to make it possible for them to get back to normal as soon as possible, and if jabbing them makes that possible, we should do it.

But yeah, all highly vulnerable people need to be top priority.

Don: That's essentially my argument but I reduced it to age bands for simplicity. I've previously mentioned bus drivers and the like, but there are probably few enough of these that they can be slotted in without much difficulty if TPTB actually make the effort.

I might be clutching at straws here but the JCVI advice is from September and labelled "interim". In this October FT piece (which I think Disco linked to in this or another thread) there's comments from the health dept, JCVI and Bingham that may be relevant: https://www.ft.com/content/d2e00128-788 ... e51355a751

The JCVI said there had not been a decision on who would be eligible for the vaccine.

The health department said it was looking at advice from the JCVI, adding that it wanted “as many people as possible to access a Covid-19 vaccine”.

Ms Bingham, who is also managing partner at fund manager SV Health Investors, said that if any vaccine proved to be 95 per cent effective, which is thought to be unlikely, then it may make sense to vaccinate more widely but any decision on this would be taken later.

Woodchopper wrote: ↑

Mon Nov 16, 2020 8:29 am

Russian Phase 3 trial results announced as 92% effective, amid some skepticism.
https://www.nature.com/articles/d41586-020-03209-0

That leads to the press release at https://sputnikvaccine.com/newsroom/pre ... l-trials-/ which says that the analysis was of 20 infections. How can that give you 92%? If no vaccinated people were infected (0:20) it would be 100%, 1:19 is 94.7%, 2:18 is 88.9%, etc down to 10:10 which would be 0%. Am I missing something here?

Putin has asked Macron for French help in producing the Russian vaccine.
https://www.challenges.fr/entreprise/sa ... ron_736652

From news reports earlier in the year I get the impression that quite a few vaccines under development are already being stockpiled as it was obvious that manufacturing capacity would be totally overwhelmed if they had to be produced after approval, so I'd be surprised if anyone had spare capacity available. Unlesss, of course, He was asking for advice rather than manufacturing capacity.

lpm wrote: ↑

Mon Nov 16, 2020 12:57 pm

The nice thing about having a huge surge of cases in the US is that it speeds up the trial. Whereas ordinary countries would need an age to get 95 cases, in the US you can reach that in five minutes by running the trial in a small town in South Dakota.

Unfortunately, it may not make much difference. If you look at the infection rate from the three vaccines that have released figures you get:

• Pfizer/BioNTech, 43538 participants, 86 placebo infections = 0.4%
• Moderna, 30000 participants, 89 placebo infections = 0.6%
• Sputnik V, 16000 participants, 19 placebo infections = 0.24%

assuming 50% of participants were on placebo. This is hugely lower than the rate in the general population, suggesting that the people in the study are different in some way. I'd guess that the way they differ is that they consider the disease to be very serious and worth a lot of effort. And cases in a rise a lot in a particular area because that area contains a large proportion of people who don't take the disease seriously. So, while the latter group might have a greater chance of infecting the former, I expect that the former group will not show anything like a proportionate rise in infections as they'll just be more careful in a hotspot to keep away from all the careless people.