COVID-19

[lpm]

This is going to be the most notorious chart of England's pandemic story.

If you missed the Prime Minister's speech, Step 1 is now. Step 2 is 1 June and Step 3 is 1 July - conditional on success in the coming weeks.

The Y-axis wasn't specified, but is presumably average new infections per day. A bit confusing, but the red section would be from when R was >1, leading to the growth, then lockdown and R has been <1 in the blue zone.

The downwards slope would be consistent with R remaining steady at, say, 0.8. Still new cases every day, but declining.

Of course, Step 1, Step 2 and Step 3 will change R. The whole point of unlockdown is you open shops, schools, restaurants, cinemas and cafes, as shown by the pretty little icons.

Keeping R steady at 0.8 while unlocking things obviously isn't going to happen. The chart cannot possibly be true.

And it's an easy thing to compare against reality. "Prime Minister, you presented this graph with cases steadily declining. But here's the actual path. What went wrong?"

[Woodchopper]

Keeping R steady at 0.8 while unlocking things obviously isn't going to happen. The chart cannot possibly be true.

It could, if either they have very good data on exactly which activities have a significant effect, and which don't, or Britain starts systematically tracing and isolating people who are infected.

But I doubt that either will happen.

[tom p]

One interesting thing I learned recently, which seems bleeding obvious in hindsight, is that the biggest block to producing sufficient quantities of any vaccine is building the factories to produce it.
The drugs companies currently racing to produce a vaccine don't know who's going to win that race, so none of them are willing to risk sinking millions into a factory that may well stand completely idle, and they won't start construction until they are pretty sure that they will be (one of the) first ones to have a vaccine to produce.
This is something that an enterprising government in a rich country that needs some good PR should be doing: source the land, build the factory and promise that it will be sold at cost to a company that can produce a workable vaccine. Or even build it big enough to manufacture 2 different vaccines in the quantities needed (and then some, to allow for export too) and lease it out to rival firms or just be a manufacturer for them and completely staff it and everything, then if necessary it can be retained as a government-owned, arms-length run vaccine or other medicinal products manufacturing plant in the future.

Site it somewhere up north where there are 2 marginals very close to each other that the tories captured from labour last time, and then you have boosted britain's manufacturing output, taken positive steps to prepare for getting britain back to work & securing the heath of the public and shored-up drug supplies in the event of a no-deal brexit.

You get hi-viz visits, ground-breaking photo-ops and the chance to be seen with the first batch of the new vaccine manufactured here. It would be the gift that keeps on giving.

[bob sterman]

This is going to be the most notorious chart of England's pandemic story.

And this could be the most notorious equation of England's pandemic story.

WTAF?????

[Woodchopper]

One interesting thing I learned recently, which seems bleeding obvious in hindsight, is that the biggest block to producing sufficient quantities of any vaccine is building the factories to produce it.
The drugs companies currently racing to produce a vaccine don't know who's going to win that race, so none of them are willing to risk sinking millions into a factory that may well stand completely idle, and they won't start construction until they are pretty sure that they will be (one of the) first ones to have a vaccine to produce.
This is something that an enterprising government in a rich country that needs some good PR should be doing: source the land, build the factory and promise that it will be sold at cost to a company that can produce a workable vaccine. Or even build it big enough to manufacture 2 different vaccines in the quantities needed (and then some, to allow for export too) and lease it out to rival firms or just be a manufacturer for them and completely staff it and everything, then if necessary it can be retained as a government-owned, arms-length run vaccine or other medicinal products manufacturing plant in the future.

Site it somewhere up north where there are 2 marginals very close to each other that the tories captured from labour last time, and then you have boosted britain's manufacturing output, taken positive steps to prepare for getting britain back to work & securing the heath of the public and shored-up drug supplies in the event of a no-deal brexit.

You get hi-viz visits, ground-breaking photo-ops and the chance to be seen with the first batch of the new vaccine manufactured here. It would be the gift that keeps on giving.

Bill Gates has already been thinking about that:

Usually, only the vaccine that is going to be used is manufactured. That means a delay in the rollout between when a vaccine is chosen and when it is actually available at the necessary scale.

Gates’s proposal is to build seven factories, for all the leading vaccine candidates, and manufacture lots of each of them. It will mean some wasted money, but it’ll be worth it to get a vaccine to patients sooner. He estimates this will cost billions. Though the foundation hasn’t disclosed how much it will personally be spending, a project of this magnitude will require other stakeholders — as have most of Gates’s public health projects.

“The Gates Foundation is working with a range of national and multilateral stakeholders who are funding the development of vaccines for COVID-19. Enhancements of global manufacturing capacity are clearly required given the population-level scale at which a COVID-19 vaccine will need to be given,” the Gates Foundation told Vox in a statement. “Many of the current vaccine approaches are novel and have never been scaled for a commercialized product. In addition, governments need to continue to provide important vaccines for other diseases while scaling a successful COVID-19 vaccine.”

https://www.vox.com/future-perfect/2020 ... llionaires

Hopefully if he chucks in a few hundred million other governments might partner.

[veravista]

One interesting thing I learned recently, which seems bleeding obvious in hindsight, is that the biggest block to producing sufficient quantities of any vaccine is building the factories to produce it.
The drugs companies currently racing to produce a vaccine don't know who's going to win that race, so none of them are willing to risk sinking millions into a factory that may well stand completely idle, and they won't start construction until they are pretty sure that they will be (one of the) first ones to have a vaccine to produce.
This is something that an enterprising government in a rich country that needs some good PR should be doing: source the land, build the factory and promise that it will be sold at cost to a company that can produce a workable vaccine. Or even build it big enough to manufacture 2 different vaccines in the quantities needed (and then some, to allow for export too) and lease it out to rival firms or just be a manufacturer for them and completely staff it and everything, then if necessary it can be retained as a government-owned, arms-length run vaccine or other medicinal products manufacturing plant in the future.

Site it somewhere up north where there are 2 marginals very close to each other that the tories captured from labour last time, and then you have boosted britain's manufacturing output, taken positive steps to prepare for getting britain back to work & securing the heath of the public and shored-up drug supplies in the event of a no-deal brexit.

You get hi-viz visits, ground-breaking photo-ops and the chance to be seen with the first batch of the new vaccine manufactured here. It would be the gift that keeps on giving.

Hahahahahahaha

Smacks a bit of forward planning that. Go wash your mouth out

[tom p]

One interesting thing I learned recently, which seems bleeding obvious in hindsight, is that the biggest block to producing sufficient quantities of any vaccine is building the factories to produce it.
The drugs companies currently racing to produce a vaccine don't know who's going to win that race, so none of them are willing to risk sinking millions into a factory that may well stand completely idle, and they won't start construction until they are pretty sure that they will be (one of the) first ones to have a vaccine to produce.
This is something that an enterprising government in a rich country that needs some good PR should be doing: source the land, build the factory and promise that it will be sold at cost to a company that can produce a workable vaccine. Or even build it big enough to manufacture 2 different vaccines in the quantities needed (and then some, to allow for export too) and lease it out to rival firms or just be a manufacturer for them and completely staff it and everything, then if necessary it can be retained as a government-owned, arms-length run vaccine or other medicinal products manufacturing plant in the future.

Site it somewhere up north where there are 2 marginals very close to each other that the tories captured from labour last time, and then you have boosted britain's manufacturing output, taken positive steps to prepare for getting britain back to work & securing the heath of the public and shored-up drug supplies in the event of a no-deal brexit.

You get hi-viz visits, ground-breaking photo-ops and the chance to be seen with the first batch of the new vaccine manufactured here. It would be the gift that keeps on giving.

Bill Gates has already been thinking about that:

Usually, only the vaccine that is going to be used is manufactured. That means a delay in the rollout between when a vaccine is chosen and when it is actually available at the necessary scale.

Gates’s proposal is to build seven factories, for all the leading vaccine candidates, and manufacture lots of each of them. It will mean some wasted money, but it’ll be worth it to get a vaccine to patients sooner. He estimates this will cost billions. Though the foundation hasn’t disclosed how much it will personally be spending, a project of this magnitude will require other stakeholders — as have most of Gates’s public health projects.

“The Gates Foundation is working with a range of national and multilateral stakeholders who are funding the development of vaccines for COVID-19. Enhancements of global manufacturing capacity are clearly required given the population-level scale at which a COVID-19 vaccine will need to be given,” the Gates Foundation told Vox in a statement. “Many of the current vaccine approaches are novel and have never been scaled for a commercialized product. In addition, governments need to continue to provide important vaccines for other diseases while scaling a successful COVID-19 vaccine.”

https://www.vox.com/future-perfect/2020 ... llionaires

Hopefully if he chucks in a few hundred million other governments might partner.

That bastard Gates is always one step ahead of me.

[lpm]

Keeping R steady at 0.8 while unlocking things obviously isn't going to happen. The chart cannot possibly be true.

It could, if either they have very good data on exactly which activities have a significant effect, and which don't, or Britain starts systematically tracing and isolating people who are infected.

But I doubt that either will happen.

Germany has great testing and proper processes - yet even so has nudged over 1. If there's one thing certain in the whole of this, it's that in every aspect the UK will be a f.ckload worse than Germany.

Last night Johnson himself said R might only just be <1 and his little graphics shows it at 0.9. We are now unlocking a bit - before we have testing, masks on public transport, the app, PPE... There is no way the govt strategy can be fitted with a goal of reducing deaths.

[shpalman]

So is today's alert level 223,060.9 or 3,877.9?

It's not clear.

[FlammableFlower]

It depends on the light, which angle you look at it and whether you squint a bit or not.

[tom p]

So is today's alert level 223,060.9 or 3,877.9?

It's not clear.

Also, if the #infections was 3 fewer, but R was exactly 2 instead of .9, then the alert level would be lower.
Who the f.ck cooked up that cockamamie half-arsed nonsense?

[shpalman]

If you knew (roughly) the number of undetected but contagious infections in each region, and divided by the susceptible population, and multiplied by R divided by the average number of days an undetected case is contagious for, you'd get a number which was basically your probability of getting infected that day prior to any modifications you make in your behaviour to raise or lower your risk from the average.

Just multiplying R and the number of cases makes a bit more sense as long as you normalize against something.

But you would probably be better off just, I don't know, not doing that. Whatever.

[dyqik]

So is today's alert level 223,060.9 or 3,877.9?

It's not clear.

Also, if the #infections was 3 fewer, but R was exactly 2 instead of .9, then the alert level would be lower.
Who the f.ck cooked up that cockamamie half-arsed nonsense?

But only for a few days. Then it'd shoot right up, with the same number of infections and an R of 2 rather than .9...

[AMS]

One interesting thing I learned recently, which seems bleeding obvious in hindsight, is that the biggest block to producing sufficient quantities of any vaccine is building the factories to produce it.
The drugs companies currently racing to produce a vaccine don't know who's going to win that race, so none of them are willing to risk sinking millions into a factory that may well stand completely idle, and they won't start construction until they are pretty sure that they will be (one of the) first ones to have a vaccine to produce.
This is something that an enterprising government in a rich country that needs some good PR should be doing: source the land, build the factory and promise that it will be sold at cost to a company that can produce a workable vaccine. Or even build it big enough to manufacture 2 different vaccines in the quantities needed (and then some, to allow for export too) and lease it out to rival firms or just be a manufacturer for them and completely staff it and everything, then if necessary it can be retained as a government-owned, arms-length run vaccine or other medicinal products manufacturing plant in the future.

Site it somewhere up north where there are 2 marginals very close to each other that the tories captured from labour last time, and then you have boosted britain's manufacturing output, taken positive steps to prepare for getting britain back to work & securing the heath of the public and shored-up drug supplies in the event of a no-deal brexit.

You get hi-viz visits, ground-breaking photo-ops and the chance to be seen with the first batch of the new vaccine manufactured here. It would be the gift that keeps on giving.

The other alternative is you use the facilities that would normally be used to manufacture the seasonal flu vaccine.

So here's hoping it's a mild winter for flu. (Though I'd have the global lockdown should have affected the fly's ability to spread too.)

[tom p]

Those facilities are busy, I'm afraid.
I heard it from 3 of the biggest manufacturers of vaccines.

[sTeamTraen]

And this could be the most notorious equation of England's pandemic story.

I think all y'all sciencey types are overthinking this. It just means "The alert level [is a combination of] R [and] the number of infections".

Have you never seen something like "Happiness = tea + biscuits"? Normal people have zero problem with that. If someone like me then says "Well acksherly a simple dimensional analysis shows that this requires the units of happiness, tea, and biscuits to all be the same", we get punched in the mouth, and quite rightly.

[Martin_B]

One interesting thing I learned recently, which seems bleeding obvious in hindsight, is that the biggest block to producing sufficient quantities of any vaccine is building the factories to produce it.
The drugs companies currently racing to produce a vaccine don't know who's going to win that race, so none of them are willing to risk sinking millions into a factory that may well stand completely idle, and they won't start construction until they are pretty sure that they will be (one of the) first ones to have a vaccine to produce.
This is something that an enterprising government in a rich country that needs some good PR should be doing: source the land, build the factory and promise that it will be sold at cost to a company that can produce a workable vaccine. Or even build it big enough to manufacture 2 different vaccines in the quantities needed (and then some, to allow for export too) and lease it out to rival firms or just be a manufacturer for them and completely staff it and everything, then if necessary it can be retained as a government-owned, arms-length run vaccine or other medicinal products manufacturing plant in the future.

Site it somewhere up north where there are 2 marginals very close to each other that the tories captured from labour last time, and then you have boosted britain's manufacturing output, taken positive steps to prepare for getting britain back to work & securing the heath of the public and shored-up drug supplies in the event of a no-deal brexit.

You get hi-viz visits, ground-breaking photo-ops and the chance to be seen with the first batch of the new vaccine manufactured here. It would be the gift that keeps on giving.

Any factory built now would need an enormous amount of flexibility built into the design. We don't know anything about what the vaccine will look like, raw materials required, reaction kinetics, required conditions, required dosages, production rates, etc. So any facilities (even Bill Gates' 7 factories) will be unnecessarily complex and expensive.

[tom p]

One interesting thing I learned recently, which seems bleeding obvious in hindsight, is that the biggest block to producing sufficient quantities of any vaccine is building the factories to produce it.
The drugs companies currently racing to produce a vaccine don't know who's going to win that race, so none of them are willing to risk sinking millions into a factory that may well stand completely idle, and they won't start construction until they are pretty sure that they will be (one of the) first ones to have a vaccine to produce.
This is something that an enterprising government in a rich country that needs some good PR should be doing: source the land, build the factory and promise that it will be sold at cost to a company that can produce a workable vaccine. Or even build it big enough to manufacture 2 different vaccines in the quantities needed (and then some, to allow for export too) and lease it out to rival firms or just be a manufacturer for them and completely staff it and everything, then if necessary it can be retained as a government-owned, arms-length run vaccine or other medicinal products manufacturing plant in the future.

Site it somewhere up north where there are 2 marginals very close to each other that the tories captured from labour last time, and then you have boosted britain's manufacturing output, taken positive steps to prepare for getting britain back to work & securing the heath of the public and shored-up drug supplies in the event of a no-deal brexit.

You get hi-viz visits, ground-breaking photo-ops and the chance to be seen with the first batch of the new vaccine manufactured here. It would be the gift that keeps on giving.

Any factory built now would need an enormous amount of flexibility built into the design. We don't know anything about what the vaccine will look like, raw materials required, reaction kinetics, required conditions, required dosages, production rates, etc. So any facilities (even Bill Gates' 7 factories) will be unnecessarily complex and expensive.

I would be astonished if pharma companies' factories, in terms of walls, roof, electricity, water, offices for managers, and HR, toilets, changing rooms so staff can get into and out of their PPE before and after shift, canteen, etc. even staff, aren't basically interchangeable, with the only real differences being of scale. Filling it with appropriate machines for making the active component of the vaccine will need to be done afterwards, but that's a relatively small step.
We also actually already have a few ideas of what the vaccine will look like. The EMA has been working with pharma companies to pre-approve all the usual bits - solution, containers, packaging, adjuvants etc so that if it's a standard vaccine, the approval phase almost only needs to check safety and efficacy & most of the quality bits are done. Sure, it might be a vaccine that is best delivered as an intra-nasal spray, but it's most likely to be an IM injection that comes in individual pre-packed sterile doses or small vials for doctors/nurses to extract from.

[tom p]

And this could be the most notorious equation of England's pandemic story.

I think all y'all sciencey types are overthinking this. It just means "The alert level [is a combination of] R [and] the number of infections".

Have you never seen something like "Happiness = tea + biscuits"? Normal people have zero problem with that. If someone like me then says "Well acksherly a simple dimensional analysis shows that this requires the units of happiness, tea, and biscuits to all be the same", we get punched in the mouth, and quite rightly.

Except if I give someone 18,000 biscuits + 4/5ths of a cup of tea, they won't be very happy. Especially if it's a sh.t biscuit like rich tea or nice.

[lpm]

I think all y'all sciencey types are overthinking this. It just means "The alert level [is a combination of] R [and] the number of infections".

Have you never seen something like "Happiness = tea + biscuits"? Normal people have zero problem with that. If someone like me then says "Well acksherly a simple dimensional analysis shows that this requires the units of happiness, tea, and biscuits to all be the same", we get punched in the mouth, and quite rightly.

It's pretend sciency, they should get punched in the mouth for it.

[Gentleman Jim]

I would be astonished if pharma companies' factories, in terms of walls, roof, electricity, water, offices for managers, and HR, toilets, changing rooms so staff can get into and out of their PPE before and after shift, canteen, etc. even staff, aren't basically interchangeable, with the only real differences being of scale. Filling it with appropriate machines for making the active component of the vaccine will need to be done afterwards, but that's a relatively small step.
We also actually already have a few ideas of what the vaccine will look like. The EMA has been working with pharma companies to pre-approve all the usual bits - solution, containers, packaging, adjuvants etc so that if it's a standard vaccine, the approval phase almost only needs to check safety and efficacy & most of the quality bits are done. Sure, it might be a vaccine that is best delivered as an intra-nasal spray, but it's most likely to be an IM injection that comes in individual pre-packed sterile doses or small vials for doctors/nurses to extract from.

Might put a strain on the packaging etc pipeline as all supplies are "just in time" but I agree about the factory/machinery - any change from the normal type vaccine delivery would probably cause havoc in the health care system
The biggest problems would be if the new vaccine required substantially different manufacturing conditions. Virtually all are made in large steel tanks of various sizes depending on amount of vaccine required. Secondly, manufacturing schedules are set up months in advance and utilise the whole capacity of the plant. To suddenly switch to producing covid vaccine without new capital equipment would inevitably lead to shortages of other vaccines, at least in the short term

[TopBadger]

Hancock is really pleased that care home deaths have halved in the last 2-3 weeks... is that because care homes are doing a better job of protecting their people or because the most susceptible have already died and the rest recovered? In either case i don't think the government can claim much credit here.

[tom p]

I would be astonished if pharma companies' factories, in terms of walls, roof, electricity, water, offices for managers, and HR, toilets, changing rooms so staff can get into and out of their PPE before and after shift, canteen, etc. even staff, aren't basically interchangeable, with the only real differences being of scale. Filling it with appropriate machines for making the active component of the vaccine will need to be done afterwards, but that's a relatively small step.
We also actually already have a few ideas of what the vaccine will look like. The EMA has been working with pharma companies to pre-approve all the usual bits - solution, containers, packaging, adjuvants etc so that if it's a standard vaccine, the approval phase almost only needs to check safety and efficacy & most of the quality bits are done. Sure, it might be a vaccine that is best delivered as an intra-nasal spray, but it's most likely to be an IM injection that comes in individual pre-packed sterile doses or small vials for doctors/nurses to extract from.

Might put a strain on the packaging etc pipeline as all supplies are "just in time" but I agree about the factory/machinery - any change from the normal type vaccine delivery would probably cause havoc in the health care system
The biggest problems would be if the new vaccine required substantially different manufacturing conditions. Virtually all are made in large steel tanks of various sizes depending on amount of vaccine required. Secondly, manufacturing schedules are set up months in advance and utilise the whole capacity of the plant. To suddenly switch to producing covid vaccine without new capital equipment would inevitably lead to shortages of other vaccines, at least in the short term

I knew you'd know more about it than me!
Even though supplies are normally just in time, I presume there's nothing to stop an organisation sourcing and putting in an order for 6-12 months time to build up a stockpile in advance of a vaccine's anticipated approval if they wanted to, is there? After all, that's the timescale we're working on here, in the best case scenario.
With some sensible planning and goodwill all round, there's no reason why there should be any risk of money wasted (apart from the cost of transporting the goods). Buy the packaging materials, stockpile them and monitor when they will expire. Have agreements in place with some MAHs that if we get within 6 months of the expiry date of the packaging without a coronovirus vaccine in sight, they will buy them for seasonal flu or something else that is gonna get used shortly and we will take the JiT stocks they were gonna buy. That way we always have stocks ready and the packaging materials are never wasted. Might be a slight loss on shipping, but only slight. Make everything completely public so there's a strong incentive for the MAH not to renege and f.ck us over and then job's a good 'un. All the prep is in place.

[bob sterman]

Hancock is really pleased that care home deaths have halved in the last 2-3 weeks... is that because care homes are doing a better job of protecting their people or because the most susceptible have already died and the rest recovered? In either case i don't think the government can claim much credit here.

Well I fear that with the cessation of much routine medical care - and people's avoidance of A & E departments - the susceptible care home population will be replenished fairly soon.

[AMS]

Hancock is really pleased that care home deaths have halved in the last 2-3 weeks... is that because care homes are doing a better job of protecting their people or because the most susceptible have already died and the rest recovered? In either case i don't think the government can claim much credit here.

Transmission between care homes should be fairly rare, so it could well be that the virus has run its course through homes that got infected, while others have had zero cases. The big risk is the virus getting into homes that were previously untouched.