On Deciding Who Gets The Coronavirus Vaccine First
[guest post by Dana]
When a coronavirus vaccine becomes available, there will be a limited supply at first, so who should go to the front of the line?
A preliminary plan devised by the Centers for Disease Control and Prevention this spring gives priority to health care workers, then to people with underlying medical conditions and older people. The C.D.C. has not yet decided whether the next in line should be Blacks and Latinos, groups disproportionately affected by the coronavirus.
But let’s suppose that health care workers and people with underlying medical conditions use up the first doses of the available vaccine. Should some be held in reserve for Black and Latino people? What about bus drivers and train conductors? Perhaps teachers or schoolchildren should get it so they can return to classrooms with peace of mind.
If shortages happen, most of the nation will have no chance to get the initial lots of a vaccine under the C.D.C.’s plan. And as the United States combats a soaring number of coronavirus cases, rising demand for drugs and maybe ventilators is expected. They, too, will need a fair system of distribution.
One option that is gaining traction is a “weighted lottery”:
One solution that is starting to attract the attention of public health experts is a so-called weighted lottery, which gives everyone a chance at access, although some get a better shot than others.
Doctors and ethicists rank patients, deciding which groups should be given preference and how much. First-responders, for example, may be weighted more heavily than, say, very sick patients who are unlikely to recover.
The goal is to prevent haphazard or inequitable distribution of a treatment or vaccine when there isn’t enough to go around. Such a system has already been used in allocations of remdesivir, the first drug shown to be effective against the coronavirus…
They also noted another advantage: Weighted lotteries can allow researchers to find out, in a rigorous way, which subgroups of patients do best with a new drug or vaccine.
That is because allocation within a group is random. The distribution is, in effect, a randomized, controlled clinical trial. The only difference between, say, people over age 60 who got the drug and those who did not is the toss of a coin in the lottery.
While it’s certain that every American is not going to want a new vaccine, hard decisions will nonetheless have to be made about prioritizing those who do. As one doctor put it:
We would like to get people to think ahead about how vaccines are allocated. There is no way we can vaccinate everybody, so we have to think about what’s fair and what’s just.
–Dana
Good morning.
Dana (25e0dc) — 7/24/2020 @ 8:00 amJust to be devilishly advocating here, shouldn’t the people who get the vaccine be the folks who are most likely to spread it far and wide? Get the likely superspreaders first? Like, set up vaccination booth at the local bar on mask free day?
Appalled (1a17de) — 7/24/2020 @ 8:05 amAs a non-essential person in Los Angeles, who cares.
Too many of us the government has no need for.
The government pocked winners and losers and musicians are the obvious losers.
BillPasadena (e482e2) — 7/24/2020 @ 8:06 ama vaccine only works before you get it, that’s why they don’t give one when you have a cold,
narciso (7404b5) — 7/24/2020 @ 8:10 amGiven that these people are definitionally irresponsible, what is the likelihood of their interest in a vaccine even if prioritized?
(Not That) Bill O'Reilly (6bb12a) — 7/24/2020 @ 8:14 amObviously the vaccine should go to President Trump’s campaign donors first, ranked by the size of their contributions.
Dave (1bb933) — 7/24/2020 @ 8:14 amwe’re about 4% of the world’s population, so I’m gathering we’re way down on the list, after China and India,
narciso (7404b5) — 7/24/2020 @ 8:20 amWhy are teachers considered too high risk and their jobs so unimportant that they don’t have to go to work, but still get paid, yet grocery clerks are “necessary” yet never get mentioned in any scenario about risk?
NJRob (eb56c3) — 7/24/2020 @ 8:24 am#4 —
If I vaccinate Mr. Stupid at the bar, I don’t protect him that day. I protect him a few weeks down the line, when he does Stupid again and again and again. More to the point, I keep him from spreading to all the other stupids.
Appalled (1a17de) — 7/24/2020 @ 8:27 amGenerally, the people who should get vaccinated for viruses are healthy people who are unlikely to have antibodies or T Cell immunity to the virus. First, they are more likely to help the community get herd immunity. Second, they are less likely to have adverse reactions.
DRJ (aede82) — 7/24/2020 @ 8:28 amThere is a question in the comedy — is society better served by targeting the vulnerable, or targeting the likely spreaders?
Appalled (1a17de) — 7/24/2020 @ 8:28 amGive it to the university asst. professors, as they are essential in the effort to decimate the USA and brainwash our young.
Colonel Haiku (5b7649) — 7/24/2020 @ 8:29 amno give them the placebo,
narciso (7404b5) — 7/24/2020 @ 8:30 amPeople who need to be out and around with other people who cannot do without them. Police, firemen, paramamedics, nurses, doctors, food workers. Trump the very last.
nk (1d9030) — 7/24/2020 @ 8:32 amBut who will actually get it first will be federal law enforcement and the active duty military.
nk (1d9030) — 7/24/2020 @ 8:34 amGood points, nk.
DRJ (aede82) — 7/24/2020 @ 8:36 am#8
Because a grocery worker who doesn’t work doesn’t get paid. The teacher working remotely will get her paycheck.
Appalled (1a17de) — 7/24/2020 @ 8:36 amNewton’s Third Law, with its egalitarian undertones, is definitely a commie plot.
Dave (1bb933) — 7/24/2020 @ 8:40 am‘While it’s certain that every American is not going to want a new vaccine, hard decisions will nonetheless have to be made about prioritizing those who do. As one doctor put it: We would like to get people to think ahead about how vaccines are allocated. There is no way we can vaccinate everybody, so we have to think about what’s fair and what’s just.’
Past Is Prologue; it’s a workable problem:
http://www.pwencycl.kgbudge.com/U/n/Unit_Of_Fire.htm
‘There are some military concepts from the time of the Pacific War that crop up frequently in contemporaneous accounts, yet remain sources of confusion into the 21st century. One such concept is the ‘unit of fire.’ The ‘unit of fire’ was defined by the U.S. Army as follows (Army Field Manual 9-6, “Ammunition Supply”, 15 June 1944): A unit of measure for ammunition supply within a theater from a tactical point of view, based upon experience in the theater. It represents a specified number of rounds per weapon, which varies with the types and calibers of the weapons. The unit of fire is not synonymous with the term “day of supply”…. In general, it represents a balanced expenditure by the various weapons under conditions of normal action. The unit of fire prescribed by the War Department may be modified by theater commanders as necessary for each individual theater.
It differed from the ‘day of supply,’ defined as follows (ibid.): Estimated average expenditure of various items of supply per day in campaign, expressed in quantities of specific items or in pounds per man per day. A day of supply for ammunition is expressed in rounds per weapon per day.’
DCSCA (797bc0) — 7/24/2020 @ 8:41 amNursing home and Assisted living residents/staffs ought to be pretty high in priority.
whembly (c30c83) — 7/24/2020 @ 8:57 amPolling over whether Americans are even willing to receive a vaccine (assuming it’s voluntary) is all over the map.
(June 2020) 7 in 10 Americans would be likely to get a coronavirus vaccine, Post-ABC poll finds
About 7 in 10 Americans say they would get a vaccine to protect against the novel coronavirus if immunizations were free and available to everyone, according to a Washington Post-ABC News poll.
…..
(May 2020) AP-NORC poll: Half of Americans would get a COVID-19 vaccine
Only about half of Americans say they would get a COVID-19 vaccine if the scientists working furiously to create one succeed, a number that’s surprisingly low considering the effort going into the global race for a vaccine.
But more people might eventually roll up their sleeves: The new poll from The Associated Press-NORC Center for Public Affairs Research found 31% simply weren’t sure if they’d get vaccinated. Another 1 in 5 said they’d refuse.
RipMurdock (d2a2a8) — 7/24/2020 @ 8:59 am……
And this doesn’t take into account the anti-vaxxers. Considering the billions of dollars being invested, these numbers are pretty low.
Which law is “when two objects of different masses collide, the object with the greater mass will undergo the smaller change in direction and velocity”?
nk (1d9030) — 7/24/2020 @ 8:59 amThe line is forming for a COVID-19 vaccine. Who should be at the front?.
RipMurdock (d2a2a8) — 7/24/2020 @ 9:05 am@22
That’s the Third Law, combined with the Second.
When two objects interact, the Third Law says the forces on the objects are equal in magnitude.
And the Second Law says that for a given force, the acceleration of an object will be inversely proportional to its mass (an object twice as massive will have an acceleration – a change in direction and velocity – half as large).
Dave (1bb933) — 7/24/2020 @ 9:06 amI think that’s a fair estimate, whembly
narciso (7404b5) — 7/24/2020 @ 9:06 amTwerkin’ for Justice, deep dish Chicago style…
https://twitter.com/vashon_photo/status/1286487094291030016?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1286487094291030016%7Ctwgr%5E&ref_url=http%3A%2F%2Fwww.ace.mu.nu%2F
Colonel Haiku (5b7649) — 7/24/2020 @ 9:08 amThe C.D.C. has not yet decided whether the next in line should be Blacks and Latinos, groups disproportionately affected by the coronavirus.
There’s a lawsuit waiting to happen!
Bored Lawyer (56c962) — 7/24/2020 @ 9:15 amThat a random “slice”, Col… or is that Vashon dude trying to be the next Jason Whitlock? Us locals eat the thin Tavern style (altitude wise, not even 2x the height of NY style).
urbanleftbehind (06b554) — 7/24/2020 @ 9:17 amin other ranch news,
https://legalinsurrection.com/2020/07/nicholas-sandmann-settles-lawsuit-against-the-washington-post/
narciso (7404b5) — 7/24/2020 @ 9:18 amSome Vaccine Makers Say They Plan to Profit From Coronavirus Vaccine
Executives from four companies in the race to produce a coronavirus vaccine — AstraZeneca, Johnson & Johnson, Moderna Therapeutics and Pfizer — told lawmakers on Tuesday that they are optimistic their products could be ready by the end of 2020 or the beginning of 2021. All four companies are testing vaccines in human clinical trials.
Three of the firms — AstraZeneca, Johnson & Johnson and Moderna — are getting federal funds for their vaccine development efforts. AstraZeneca and Johnson & Johnson pledged to the lawmakers that they would produce hundreds of millions of doses of their vaccines at no profit to themselves. Moderna, however, which has been granted $483 million from the government to develop its product, made no such promise.
“We will not sell it at cost,” said Dr. Stephen Hoge, the president of Moderna.
……
In a statement released on June 30, the Food and Drug Administration noted that any vaccine candidate vying for approval would need to prevent or ameliorate disease in at least 50 percent of the people who received it. Manufacturers won’t have a good sense of these metrics until the completion of so-called Phase 3 clinical trials, which enroll thousands of participants — some of whom are vaccinated, some of whom aren’t — and track their infection status over the course of multiple months.
Federal approval isn’t the only goal of vaccine development, the executives said. Once this milestone is met, the vaccines will still need to be administered widely and also be accessible to a range of populations particularly those that have been disproportionately affected by the virus. Those would include the elderly, people with underlying medical conditions and Black, Latino and Native Americans.
RipMurdock (d2a2a8) — 7/24/2020 @ 9:20 am…….
Moderna is really placing the cart before the horse. They have never successfully brought a drug to market. Indeed, they just lost an attempt to invalidate another company’s patent that possibly impacts their vaccine development.
Ya’ll won’t think I’m some kind of Trump supporter or something, if I respectfully suggest that the reason Blacks and Latinos are disproportionately affected by the coronavirus is the same reason that they are disproportionately affected by prison, will you?
nk (1d9030) — 7/24/2020 @ 9:21 amhey lets trust them to get it right, shirley,
https://chicago.cbslocal.com/2020/07/22/health-care-worker-tests-positive-for-covid-19-quarantines-and-loses-job-only-to-find-out-test-was-wrong/
narciso (7404b5) — 7/24/2020 @ 9:22 amComrade nk’s right-deviationist tendencies should come as no surprise to anyone.
Dave (1bb933) — 7/24/2020 @ 9:26 amWe all want to protect those most at risk but it is possible the elderly do not respond well or consistently to immunizations:
The same is true for the ill, immunocompromised, and infants. All these groups have weaker or altered immune systems that can respond to immunizations in unusual ways. After all, immunizations are designed to alter our immune systems, and people whose immune systems are weak may not respond well.
IMO the best protection for our at risk communities is herd immunity for the healthy.
DRJ (aede82) — 7/24/2020 @ 9:34 amIf so, the first people immunized should be the essential workers who come in contact with the public because they have to work.
DRJ (aede82) — 7/24/2020 @ 9:40 amAs a practical matter, it’s hard to see how they can manage distribution of the vaccine based on complicated criteria like job duties or immunological risk factors.
If herd immunity is all that matters, a draft-style lottery based on birthday would probably be nearly as effective as a targeted (and far more difficult to administer) system.
Dave (1bb933) — 7/24/2020 @ 9:45 amnk (1d9030) — 7/24/2020 @ 9:21 am
No way that you are “some kind of Trump supporter.” Now, you may be “something”…else.
One’s personal decisions do contribute to the state of one’s health. Even the one who is genetically gifted will succumb, eventually, to obstinate foolishness. Besides, no one gets out of here alive.
felipe (023cc9) — 7/24/2020 @ 9:45 amI also haven’t seen any discussion about the interactions between a COVID-19 vaccine and a flu vaccine.
RipMurdock (d2a2a8) — 7/24/2020 @ 9:46 amImmunizing the healthy should also reduce the strain on health care, making it easier to care for the elderly, ill, immunocompromised, pregnant, and young that get sick.
DRJ (aede82) — 7/24/2020 @ 9:47 amWe already do it, Dave. We also are doing it now with Covid testing.
DRJ (aede82) — 7/24/2020 @ 9:48 amAnother factor is whether this will be a live vaccine, deactivated vaccine, or a blend. The at risk groups should avoid live/blend vaccines.
DRJ (aede82) — 7/24/2020 @ 9:50 amIf the fight against the Chinese flu is like war, then the proper method to use is triage, not a lottery. If you make it a “game” it will be gamed.
felipe (023cc9) — 7/24/2020 @ 9:52 amDoctors will probably screen who to give these vaccines. (Walgreens, CVS, etc., can do it the way they give flu shots but I doubt that will happen for awhile because there will be limited quantities.) I think doctors will vary in how they distribute vaccines but whoever delivers it, there will be limited quantities at first and there will be adverse reactions. Directing the initial vaccines solely to underprivileged neighborhoods opens the door to claims we are using them as guinea pigs.
DRJ (aede82) — 7/24/2020 @ 9:57 amThose vaccines that have entered Phase 3 trials are being speculatively mass produced. Similarly with treatment drugs. One thing government is REALLY good at is throwing money at a problem.
So, when the vaccines or drugs succeed at the trials, there should be substantial quantities available. AIUI, the British vaccine reported last week in The Lancet has a US government order of 300 million doses, hopefully by October.
I will leave connecting that dot to others.
Kevin M (ab1c11) — 7/24/2020 @ 10:06 amOne option that is gaining traction is a “weighted lottery”
What weight do you suppose will be allotted to Presidents, cabinet secretaries, Supreme Court justices, Senators and Congressfolk?
Kevin M (ab1c11) — 7/24/2020 @ 10:08 amshouldn’t the people who get the vaccine be the folks who are most likely to spread it far and wide?
Why interfere with evolution in action?
Kevin M (ab1c11) — 7/24/2020 @ 10:09 amRules:
1. No one is offered the vaccine twice, after refusing once, until all willing recipients have been vaccinated.
2. Jenny McCarthy and RFK, Jr are not offered it even once, lest they be offended.
But in reality, those at highest risk should get it first, because
1. They are most likely to accept the vaccine
Kevin M (ab1c11) — 7/24/2020 @ 10:19 am2. Immunizing them first reduces the burden of protection on everyone.
3. Any other order (e.g. reward*risk) involves assigning values to people.
If there are that many doses available from the start, we may only need half.
DRJ (aede82) — 7/24/2020 @ 10:25 amOne thing to remember: vaccines do not generally confer immunity. They confer resistance; they harden the target. If you reduce the likelihood of disease given a level of contagion, you exponentially reduce the rate of spread, which is the key to ending the pandemic.
Having gotten the vaccine does not mean you can go maskless in a Covid ward. But you might not worry so much about dining out.
Kevin M (ab1c11) — 7/24/2020 @ 10:26 amDRJ, maybe, but we also may need multiple doses.
Kevin M (ab1c11) — 7/24/2020 @ 10:27 amWith AstraZeneca and it’s affiliates committed to supplying 2B doses a year for AZD1222, that sounds great. Pilot manufacturing will be availble in 2020 for up to 20k doses per week somewhere in Sept/Oct. Starting in January 2 manufacturing facilities will be available, raising it to about 500K a week, pushing it up to over 100M a week mid year.
Logistics being what they are, the VAST majority of people will not be getting a vaccine until fall of 2021, and unless you’re on the Phase 3 trial, probably zero people in 2020. That’s just reality.
Of course, that assumes AZD1222 actually works, if it’s any one of the others, back all of that up by 3 months to 1,000 years.
Colonel Klink (Ret) (305827) — 7/24/2020 @ 10:27 amWell, if it gives strong immunity (which may be a problem) they should try to get them (but not force) them to give plasma to cure people already sick in the hospital.
But that would be too daring for the drug regulatory people – and even the doctors and pharmaceutical they;re so used to the way things are.
They probably haven’t even thought of the idea.
They’ll let people die instead.
There’s not enough convalescent fluid to go around. This way it could be manufactured to order.
So I propose that healthy close family and friends of a sick person make this proposal, at the time when the vaccine is in Phase III trials.
Give the vaccine to family members or friends of people long term in the hospital with an informal agreement (not enforceable by law) that, if, as a result of getting the vaccine they produce copious amounts of of antibodies, they’ll donate it to sick people, with reference given to the person close to them, if useful and needed.
And it would be an excellent way to test out the practical value of the vaccine.
Too bold or out of the box?
Sammy Finkelman (db2a13) — 7/24/2020 @ 10:31 amAs for mandatory vaccinations: I am opposed to branding the unvaccinated with an “M” for “moron”, but I think that all those who are vaccinated should get some unforgeable ID stating such. Just in case some businesses demand such ID before allowing one on their premises or public conveyance.
Kevin M (ab1c11) — 7/24/2020 @ 10:32 amThe U.S.government is actually placing bets on two vaccines not made by Moderna.
Sammy Finkelman (db2a13) — 7/24/2020 @ 10:32 amThey probably haven’t even thought of the idea.
They really should check with you more often.
Kevin M (ab1c11) — 7/24/2020 @ 10:35 amNot everyone who gets vaccinated actually develops immunity.
And it might be pointless to give the vaccine to people who already have antibodies (depending on the way the vaccine works and the antigen it targets.)
And there is a danger of an overreaction.
If there still an epidemic raging at the time and not enough of or no cure, priority should be given to those who want to donate plasma after the vaccination takes effect.
Sammy Finkelman (db2a13) — 7/24/2020 @ 10:42 am38. RipMurdock (d2a2a8) — 7/24/2020 @ 9:46 am
It makes both vaccines less effective; makes a person more vulnerable to other diseases, including versions of the flu not being vaccinated for, and if increases of getting sick from the vaccination if it a live virus.
This can be mitigated by the right nutrition and vitamins. I am not sure what that would be. Vitamin C? Vitamin D? Vitamin A? Calcium? Folic acid? Co-enzyme Q? Zinc? Protein? Good sugar control – that means periods of low sugar and no periods of high blood levels of glucose? Good sleep?
Sammy Finkelman (db2a13) — 7/24/2020 @ 10:49 am34. DRJ (aede82) — 7/24/2020 @ 9:34 am
Sammy Finkelman (db2a13) — 7/24/2020 @ 11:09 am55. Kevin M (ab1c11) — 7/24/2020 @ 10:35 am
And also other people.
The wisdom of crowds, but also a way to escape from groupthink. Even Donald Trump sometimes might be right, or more accurately, relying on someone who was right.
Sammy Finkelman (db2a13) — 7/24/2020 @ 11:11 amThis can be mitigated by the right nutrition and vitamins. I am not sure what that would be. Vitamin C? Vitamin D? Vitamin A? Calcium? Folic acid? Co-enzyme Q? Zinc? Protein? Good sugar control – that means periods of low sugar and no periods of high blood levels of glucose? Good sleep?
HCQ?
RipMurdock (d2a2a8) — 7/24/2020 @ 12:12 pmbrainslugs deemed uncurable,
https://www.newsbusters.org/blogs/nb/nicholas-fondacaro/2020/07/22/dunces-cuomo-and-lemon-fail-accurately-id-animal-mental
narciso (7404b5) — 7/24/2020 @ 12:15 pm24. When two objects interact, the Third Law says the forces on the objects are equal in magnitude.
Which is why women ‘never’ fake an orgasm. 😉
DCSCA (797bc0) — 7/24/2020 @ 12:42 pmTrump explains decision to cancel Jacksonville part of GOP convention: ‘Setting an example’
RipMurdock (d2a2a8) — 7/24/2020 @ 1:20 pm…..
Citing the rising numbers of COVID-19 in the state, Trump told Sean Hannity that he is “setting an example” with the last-minute change, which he hopes will encourage citizens to practice social distancing.
…..
Bill Stepien, Trump’s reelection campaign manager, praised the move in a statement, writing: “Leading by example, President Trump has put the health and safety of the American people first with his decision on the Jacksonville convention.”
…..
Plagiarist. The Democratic convention was cancelled exactly month ago.
no one was going to be there,
https://legalinsurrection.com/2020/07/wall-street-journal-refuses-to-take-a-knee-to-internal-woke-mob/
narciso (7404b5) — 7/24/2020 @ 1:24 pmthe last two were about mind arson, this is another type
https://www.aier.org/article/the-models-were-wildly-wrong-about-reopening-too/
narciso (7404b5) — 7/24/2020 @ 1:30 pmI wonder if mass manufacture of the COVID vaccine would adversely impact the availability of the flu vaccine this coming fall.
JVW (ee64e4) — 7/24/2020 @ 1:43 pmA Vaccine Reality Check
……..
The CDC’s Advisory Committee on Immunization Practices is also normally responsible for recommendations on how to prioritize vaccines. The committee, which is composed of outside experts, last met in late June, when they discussed prioritizing vaccines for health-care workers, the elderly, and those with underlying conditions. They also considered prioritizing vaccination by race, given the racial disparities in COVID-19 cases. But now the National Academy of Medicine is convening a panel on the same topic, which is again causing confusion about who is responsible for making these decisions.
In 2009, (Kelly Moore, who was the director of the Tennessee Immunization Program in 2009) job was to put the CDC advisory committee’s recommendations into practice. Two or three times a week, she would get an email from the CDC’s vaccine distributor letting her know the number of doses available for her entire state. In practice, though, an initial shipment of vaccines might not be enough to cover everyone in even the highest priority group, such as health-care workers. It was up to people like Moore to decide which hospital got how many doses, with the promise of more on the way next week. Then individual hospitals administered the actual vaccines to their employees based on priority status.
This system is meant to be flexible and responsive to local conditions, but it also means the availability of a vaccine might seem to vary from place to place. For example, Emily Brunson, an anthropologist at Texas State University who studies vaccines, says that in 2009 there were cases in which one district interpreted recommendations strictly, giving the vaccine only to high-priority groups, and a neighboring district offered it to anyone who wanted it. The decision to distribute the vaccine through employee health centers in New York, which happened to include several Wall Street firms, also caused a big backlash. “There are many ways that things can be misinterpreted,” Brunson says. And during an initial shortage, these decisions can feel unfair—especially given tensions seeded earlier in the pandemic when the rich and the famous were getting COVID-19 tests while ordinary people were being turned away at clinics.
RipMurdock (d2a2a8) — 7/24/2020 @ 1:49 pm……
Rationing by another name.
28 and 66… good questions…
I must say, ulb, nothing this side of James Brown is funkier than when an extremely “sturdy” womens dances like dat!
Colonel Haiku (2601c0) — 7/24/2020 @ 1:49 pmNo vaccine for RipTaylor!
Colonel Haiku (2601c0) — 7/24/2020 @ 1:50 pmDRJ #35 seems to have it right — vaccinate the people who need it most because they come into contact with the public the most. Then make the elderly and nursing home residents the next priority, if (see #34) the trials for the eventual vaccine show it will benefit them.
I’m no anti-vaxxer (just got my first of two shingles shots) but may very well not get the covid vaccine if and when there is one. If I do, it will be so as not to become an asymptomatic spreader. If the decision involved only personal preference, I’d likely not get it whenever they get down to whatever priority level they put healthy mid-60s types at. I’ve never had a flu shot (yes, I know flu and covid aren’t the same, but still) and the only time in the last 20 years or so I got the flu was a couple of years ago when the bad stomach flu was going around; my wife had a bad case and I sat with her in Germ Central (the ER) for about five hours until they got her feeling better and we could go home, then was sick two days later. The key for me is to be a fanatical hand-washer, seems like there’s always a couple of dishes or glasses to wash in the sink instead of the dishwasher. Covid may fell me tomorrow but for years this approach has worked.
RL formerly in Glendale (750b62) — 7/24/2020 @ 1:55 pm60. HCQ seems to make it a little bit more difficult for the virus to infect cells. It is said to need zinc (either taken with it or already there from other sources) to work. HCQ is most important before the disease really gets going. Dr. Zelenko claims an almost 100% success rate is preventing death if used at the first possibility of illness. Note: Maybe 85% won’t get really sick in any case/
There are now 7 or 8 common drugs used to combat Covid-19 in some way at some point in the disease.
But of course best would be synthetic monoclonal antibodies, which is moving ahead, not so slowly, but production ins’t moving ahead at warp speed, according to Dr. Scott Gottlieb. So we’ll have an almost 100% cure by late September or early October, (although many doctors, and even more so authorities, will be slow in acknowledging it) but a limited supply.
Sammy Finkelman (db2a13) — 7/24/2020 @ 2:04 pmindeed sammeh, that’s what the lancet, nejm and u minnesota as well as imperial college studies left out of the story, it seems to be a catalytic agent,
narciso (7404b5) — 7/24/2020 @ 2:12 pmIt seems Florida, Texas and AZ are but pikers in the death sweepstakes…
https://pjmedia.com/instapundit/wp-content/uploads/2020/07/Screen-Shot-2020-07-24-at-9.24.26-AM.png
Full chart >>> https://www.statista.com/statistics/1109011/coronavirus-covid19-death-rates-us-by-state/
Colonel Haiku (2601c0) — 7/24/2020 @ 2:16 pmIn terms of vaccine priorities, I only ask that in the blog world the guest bloggers take precedence over the host blogger.
JVW (ee64e4) — 7/24/2020 @ 2:17 pmYes, that is a problem. The work around appears to be getting governments to fund expanded manufacturing capacity by “pre” buying Covid vaccines and companies shifting from other vaccine manufacturing to Covid, and leveraging whatever is in the channel of rubella, etc to hold on till the new plants/lines are done.
With the Moderna mRNA vaccine, so far that hasn’t been a way we make drugs at scale, so…who knows. There’s also a patent dispute that may cause an issue, although it could be the govs just throw money at the two until they settle it.
If it takes $10B or $100B or $1T to build the capacity, the world better get off its collective butt and just fund it, that’s like an hour to a week of lost GDP depending. What do we/they/them do with the factories afterword is a question, that at present I don’t care what the answer is.
Colonel Klink (Ret) (9878f6) — 7/24/2020 @ 2:18 pmThe golden rule will be followed. Those with the gold rule! In hidalgo co. texas hospitals are full rich are transported out older poor (hispanics) are told to go home to die!
asset (ca0c92) — 7/24/2020 @ 2:26 pmWill Trump have his signature engraved on the syringes, like he did the stimulus checks?
Dave (1bb933) — 7/24/2020 @ 2:35 pm49. You have no idea what you’re talking about, do you? SMDH
Gryph (08c844) — 7/24/2020 @ 2:38 pmWe already do it, Dave. We also are doing it now with Covid testing.
Boy, that’s working well. In some places the results come back more than 10 days later. As more and more businesses require all employees to be tested, not to mention airlines wanting a “recent” test from passengers, the entire system is overloaded. I had some mild symptoms and got a test out of caution. The results came back (negative) 8 days later, by which time the symptoms had abated. It was almost of no use.
Kevin M (ab1c11) — 7/24/2020 @ 2:50 pmWhat we need is an accurate home test, like pregnancy tests are. This bureaucratic laboratory system is incapable of handling large numbers. If pregnancy tests had to be done like this we’d have big problems.
Kevin M (ab1c11) — 7/24/2020 @ 2:52 pm80. Pregnancy home tests are horrendously inaccurate. They all have inserts that say if you think you might be pregnant, you should check with your doctor to be sure.
Gryph (08c844) — 7/24/2020 @ 2:58 pmSee also Tom Clancy’s novel Rainbow Six, where — after loosing a deadly virus on the world — Green extremists offer up a “vaccine” which is actually a long-incubation version of the same virus, with the intent of killing most of the human race. Except for the chosen few, of course.
Kevin M (ab1c11) — 7/24/2020 @ 3:00 pmPregnancy home tests are horrendously inaccurate.
The Mayo Clinic disagrees. Particularly regarding false positives (“rare”). False negatives do occur, usually in the first few days of pregnancy, or when the test is not done correctly.
Kevin M (ab1c11) — 7/24/2020 @ 3:04 pmI’m not sure what DRJ meant by this.
While heath professionals can be taken care of at their place of work, how does the bag-boy at the grocery store or diabetic old lady down the street get their place at the front of the line? There’s no database that contains everybody’s job description and heath history, and there’s no bureaucracy at the state or national level capable of handling hundreds of millions of inquiries from everyone who will be trying to get their Trumpshot at the same time.
Dave (1bb933) — 7/24/2020 @ 3:06 pmIf it takes $10B or $100B or $1T to build the capacity, the world better get off its collective butt and just fund it,
We do this kind of thing in wartime. $10B is a no-brainer, $1T needs an assurance that other opportunities aren’t being ignored.
Kevin M (ab1c11) — 7/24/2020 @ 3:07 pm74,
OK, but you go first. I’ll wait to see if you have any negative reactions. Just in case…
Dana (25e0dc) — 7/24/2020 @ 3:09 pmDave,
I think that we should aim at first-order approximations, government being poor at finesse. So, everyone on Medicare, everyone prescribed certain drugs (insulin, albuterol, chemo, interferon, etc). There are a lot of clear markers for those at risk. Medical workers are not hard for their system to identify.
The only thing I’m sure of is that the Government Inoculation Site is the wrong way to go about it.
Kevin M (ab1c11) — 7/24/2020 @ 3:13 pm83. Well, in the event of a false negative, I’m sure the lawyers want to cover their butts, so I guess there is that.
84. Maybe we can just depend on people to do right by themselves just like they currently do with flu shots.
Gryph (08c844) — 7/24/2020 @ 3:14 pmI’ll wait to see if you have any negative reactions. Just in case…
And this is another way to prioritize. Those who worry more about side effects than they do about Covid can wait.
Kevin M (ab1c11) — 7/24/2020 @ 3:14 pm72. narciso (7404b5) — 7/24/2020 @ 2:12 pm
It changes the pH of the blood, and maybe some other things.
They seem too often to leave out the matter of the zinc – also the point in the disease when it helps or might help. They were testing to see if helped at the end of the disease. A theory like that had been floated, but the main thinking of the proponents of HCQ was that it cold help right at the stat of the disease.
I think we stll don;t have any statistics on the relative safety from Covid of people taking HCQ all the time (but that would be without special zinc)
I agree with you, the real reason Trump cancelled the convention in Jacksonville now was that too many people were not going to attend.
Sammy Finkelman (db2a13) — 7/24/2020 @ 3:15 pm74. Dana (25e0dc) — 7/24/2020 @ 3:09 pm
That’s what my doctor, (well my parent’s doctor he was a GP) Dr. Julius Turkewitz, did with the polio vaccine when it first came out in the 1950s. His policy was to wait two years.
Sammy Finkelman (db2a13) — 7/24/2020 @ 3:19 pmBasic rule of coveting: It has to exist before you squabble over it.
Kevin M (ab1c11) — 7/24/2020 @ 3:22 pmHis policy was to wait two years.
How many of his patients’ children contracted polio in those two years?
Kevin M (ab1c11) — 7/24/2020 @ 3:23 pm90. Sammy, the safety of HCQ is established. It’s been used decades as a prophylactic for malaria. The only salient question is its effectiveness for use in cases of CoViD, but if its safety was being legitimately questioned it wouldn’t remain available for purchase.
Gryph (08c844) — 7/24/2020 @ 3:24 pmDrinking hemlock both prevents Covid and cures all its symptoms.
Kevin M (ab1c11) — 7/24/2020 @ 3:25 pm95. That’s funny. I heard the same thing about using hemlock to prevent malaria.
Gryph (08c844) — 7/24/2020 @ 3:27 pmSpoken like a man who’s never been Co-PI on a grant proposal…
;p
Dave (1bb933) — 7/24/2020 @ 3:28 pm91. And he also did NOT take out my tonsils, unlike so many other doctors of the time.
But in 1969, he diagnosed my father’s colon “cancer” as hemmoroids. But then he died. So my father went somewhere else and had an operation. I put cancer in quotes because there is a range.
Sammy Finkelman (db2a13) — 7/24/2020 @ 3:29 pmSpoken like a man who’s never been Co-PI on a grant proposal
Actually, I’m in a similar situation right now.
Kevin M (ab1c11) — 7/24/2020 @ 3:29 pm94. Gryph (08c844) — 7/24/2020 @ 3:24 pm
I know, there is, or was, a big slander campaign going on against HCQ. It went to the extent of organizing a giant hoax study that was published in the Lancet.
Sammy Finkelman (db2a13) — 7/24/2020 @ 3:31 pmMeanwhile the CDC warns people NOT to drink had sanitizer. Even though the label may say “ethanol” most generic hand sanitizers contain methanol as well, even though that is not listed.
Kevin M (ab1c11) — 7/24/2020 @ 3:32 pmbut if its safety was being legitimately questioned it wouldn’t remain available for purchase.
Bollocks. It is safer than having untreated malaria. Not that it is as safe as distilled water.
Kevin M (ab1c11) — 7/24/2020 @ 3:33 pm102. Safety is a binary proposition in drug testing, Kevin. That’s precisely how I know you have no idea what you’re talking about. Either a drug IS safe and moves on to efficacy testing, or it is NOT and the rest is moot. There is no “safe” for some use” and “unsafe” for others. That’s not how this works.
Gryph (08c844) — 7/24/2020 @ 3:36 pmThat’s exactly how it works.
Prescription drugs are only available with a prescription because there are risks associated with ingesting them.
And even non-prescription medications, taken in recommended doses, have dangerous side effects for a small fraction of people.
Dave (1bb933) — 7/24/2020 @ 3:44 pm104. Duh. But, either a drug is considered safe enough, or not safe enough. If a drug is safe, it is safe, though not approved as effective for all possible uses.
Do you guys honestly think that HCQ was given as an anti-malarial to our boys in ‘Nam even if its side effects would be dangerous enough to kill them? Or is it possible that someone is blowing smoke up your a$$ because HCQ is cheap and off-patent?
Gryph (08c844) — 7/24/2020 @ 4:02 pmAh, the good old days, when a free American could just walk into a drug store, buy opium dissolved in alcohol, and give it to the baby for teething pain.
nk (1d9030) — 7/24/2020 @ 7:01 pmNo, I don’t believe the entire medical community is complicit in your nefarious conspiracy.
I also don’t believe we’re facing a malaria pandemic.
The doses of HCQ given for malaria are much lower (400 mg per week to young men in generally good health) than the doses that were being tried for COVID (450+ mg once or twice daily to people with a potentially fatal disease). In its other uses, e.g. for Lupus, the doses are lower still.
Dave (1bb933) — 7/24/2020 @ 10:30 pm107. It doesn’t have to be the entire medical community, only the people in charge of deciding who gets what and for what. You happen to believe what you’re told. I don’t. And I would think that given the fear over this “potentially fatal disease,” people would be willing to risk the side effects of HCQ *if* that disease is really as deadly as it’s claimed to be.
Gryph (08c844) — 7/25/2020 @ 4:39 amAnd just who are these “people in charge of deciding who gets what and for what”? List their names.
I happen to believe evidence. You don’t.
Dave (1bb933) — 7/25/2020 @ 5:15 amI find this story heart-warming, but you will never guess why. https://www.chicagotribune.com/coronavirus/ct-coronavirus-illinois-covid-19-friday-numbers-20200724-cvhkt6hl4rhpbbrpm2ghneax2m-story.html
nk (1d9030) — 7/25/2020 @ 5:53 am109. Evidence of what? HCQ has been used safely for decades in long-term prophylactic applications. You see what you want to see in the “evidence.”
And the people in charge of deciding who gets what and for what are the people in charge of approving drugs at the FDA, Dave. It’s the same way we’ve been doing things for 114 years and in 65 years of using HCQ we’ve never questioned it’s safety once — until now. HCQ is on the WHO’s list of essential medicines. It’s safe enough to be indicated for use during pregnancy. I call baloney and you’re no more qualified to disagree with me than I am to disagree with you. So here we are.
Gryph (08c844) — 7/25/2020 @ 6:03 amWere talking to nick riviera, gryph, splitting atoms with his mind.
Narciso (7404b5) — 7/25/2020 @ 6:07 amI was initially hopeful but skeptical about hydroxychloroquine. This is anecdotal and people will have to trust me that I am telling the truth, but what I am saying will be reported in a pending paper.
I have seen our local infectious disease doctor regularly during this pandemic. He consults in treating all the Covid patients in our town. He successfully used limited (a few days) low doses of Hydroxychloroquine on his first Covid patients with excellent results, despite the fact that most patients were from a nursing home so they were older and sick. He quit using Hydroxychloroquine when the guidelines said not to use it, and the mortality rate has more than doubled even though his current patients are younger and healthier.
DRJ (aede82) — 7/25/2020 @ 6:18 amAs for safe vs unsafe, I am with Dave on that. Prescription drugs are designed to alter the way the body works — they stop pain, lower blood pressure, etc. They can work exactly as designed but still be unsafe for some. And then there are drugs that have long-term or rare adverse consequences not discovered in testing, such as the black box warnings added to the fluoroquinolone antibiotics.
DRJ (aede82) — 7/25/2020 @ 6:27 amSo why did surgisphere lie so blatantly
https://mobile.twitter.com/AlexBerenson/status/1286775817436114945
Narciso (7404b5) — 7/25/2020 @ 6:51 amOh
https://mobile.twitter.com/maciverwisc/status/1287005519736176640?s=21
Narciso (7404b5) — 7/25/2020 @ 6:59 amThere is no absolute way to do it but in my community, the initial testing was done only with doctors’ orders and I expect the initial vaccines will, too. Doctors have lots of information about us in their files including employment. Folks could circumvent this by going to clinics and lying about their jobs but it would be harder to fake pre-existing conditions.
DRJ (aede82) — 7/25/2020 @ 7:02 amBy the way, there were stages of testing in my town. At first, only health care workers. Then they added law enforcement, firefighters and paramedics. Then the grocery store workers and at risk population. Maybe small towns are more compliant in these things but we managed it.
DRJ (aede82) — 7/25/2020 @ 7:04 amwhat do we really know about this virus,
https://retractionwatch.com/retracted-coronavirus-covid-19-papers/
narciso (7404b5) — 7/25/2020 @ 7:41 amChicken soup.
nk (1d9030) — 7/25/2020 @ 7:56 am113… yes, and there have been other reports of its effectiveness elsewhere.
It’s a shame so many of the KARENs with petrified personalities were so vociferous in their hatred of all things Trump that they let it color their constant yipping. And they know who they are.
Colonel Haiku (2601c0) — 7/25/2020 @ 8:29 amApparently, the US is going to test the vaccine candidates with all deliberate bureaucratic speed.
https://apnews.com/d9150647d677cd036c03b8d0ab52358b
Kevin M (ab1c11) — 7/27/2020 @ 9:54 am4. narciso (7404b5) — 7/24/2020 @ 8:10 am
I don’t think the reason is becayse they suspect you might have the disease you are being vaccinated against.
It’s because, if someone has a cold, it would be creating too much work for the immune system, and you might get really sick, either from the cold or unrelated infection, or from what you are getting the vaccine for if it is a live vaccine.
Sammy Finkelman (db2a13) — 7/27/2020 @ 4:27 pmnarciso @119. Some of the retractions, of papers that were published in China maybe shouldn’t have been retracted. You can;t even find out why they were retracted, not can you obtain a copy..
Which gives me the idea that it might be because of some incidental mention related to the timeline of the virus. But there could be different reasons for different retractions in China.
Sammy Finkelman (db2a13) — 7/27/2020 @ 4:34 pmnarciso @115.
A conspiracy of course. And the people involved need to be indicted if they knew they were participating in a fraud and we need to find out why.
Sammy Finkelman (db2a13) — 7/27/2020 @ 4:36 pmHmm
https://coronavirus.jhu.edu/data/new-cases-50-states/:stateId
Narciso (7404b5) — 7/27/2020 @ 4:42 pm111. Gryph (08c844) — 7/25/2020 @ 6:03 am
That said, I heard Saturday afternoon from someone who was in the hospital for coronavirus during the height of the epidemic in New York City, around late March or April during which his blood oxygen level dropped to 84 but he never was on a ventilator, that Hydroxychlorquine is something to be careful about and has side effects.
I asked if the doctors noticed. He said they didn’t, but he did.
No. Only since 1962 and it’s gotten worse and worse with time even after that. Safety needed to be proven since about 1938. There are pros and cons to the safety system but in the long run it’s bad. It slows down medial progress tremendously.
A set of rules is no substitute for judgement.
Sammy Finkelman (db2a13) — 7/27/2020 @ 4:43 pmNew York Times article, published in the Saturday paper, about the idea of weighted lottery (like used for charter school admissions)
https://www.nytimes.com/2020/07/23/health/coronavirus-vaccine-allocation.html
Ut first came up with regard to ventilators, which never actually needed to have an organized rationing system and then was used for remdesivir. And now someone proposes this for vaccine.
The weighted lottery the University of Pittsburg used for remdesivir avoided race and ethnicity, and also quality of life and whether or not the patient had a disability and even age and also disregarded ability to pay but it did use limited life span and other illnesses. It also gave preference to people from economically disadvantages areas, in order words, zip code – but not any form of ancestry.
It gave preference to health care and EMS workers. Nobody got a 100% chance. Nobody had a 0% chance.
The article jumbles the chronology quite a bit, and I’ll try to reorganize this here later.
Sammy Finkelman (db2a13) — 7/27/2020 @ 4:56 pm