Prioritizing A Potential COVID-19 Vaccine
[guest post by Dana]
It feels like it’s been a long time since Anthony Fauci has delivered good news—but here it is. U.S. biotech firm Moderna announced Monday that preliminary analysis shows that its COVID-19 vaccine is nearly 95 percent effective at preventing the disease. It appears to be particularly effective at stopping people from falling severely ill, according to The Washington Post. “It’s extremely good news. If you look at the data, the numbers speak for themselves,” said Fauci, the director of the National Institute of Allergy and Infectious Diseases. Moderna’s vaccine was co-developed with Fauci’s institute and is being tested in 30,000 people. While Pfizer’s recently announced vaccine needs ultra-cold storage at around minus 75C, Moderna said its vaccine would be easier to store as it remains stable at minus 20 degrees Celsius for up to six months, and can be kept in a standard fridge for up to 30 days.
Now that we have a glimpse of an eventual end to the pandemic in our near future, Dr. Fauci cautioned this weekend that getting back to normal “won’t be like the flick of a switch.”
“If we get the overwhelming majority of people taking the vaccine and you have on the one hand, an effective vaccine, on the other hand, a high degree of uptake of the vaccine, we could start getting things back to relative normal as we get into the second and third quarter of the year”—meaning 2021—”where people can start thinking about doing things that were too dangerous just months ago, but we’ve got to put all those things together—we can’t just wish it happening. We’ve got to get the vaccine, it’s gotta be deployed and we can’t abandon fundamental public health measures. You can approach a degree of normality while still doing some fundamental public health things that synergize with the vaccine to get us back to normal.”
Fauci reiterated that normality wouldn’t come at the flick of a switch. “If we get most of the country vaccinated in the second, third quarter of the year and the vaccine continues to prove its efficacy and people adhere to those fundamental measures, I think we can start approaching the degree—[but it] is not going to be a light switch, we’re not going to turn it on and off going from where we are to completely normal. It’s going to be a gradual accrual of more normality as the weeks and the months go by as we get well into 2021.”
Of course, not everyone will want to take the vaccine: anti-vaxxers, young people who don’t see the need for it, the elderly who figure there is little reason for it at their advanced age, etc. And certainly, questions about any potential side effects (of both Moderna and Pfizer’s vaccines) will give Americans pause. Here is look at what scientists have seen thus far:
So far, both vaccines appear to be generally tolerable — but by no means painless. In its announcement Monday, Moderna said it observed a few short-lived severe side effects in volunteers, including fatigue, muscle pain, and headache. None required hospitalization. For its part, Pfizer said last week that its independent data monitors reported no serious safety concerns. In an earlier update from its Phase 1 clinical trial, Pfizer’s vaccine led to mild or moderate fever and pain at the site of injection, side effects that resolved over time, the company said.
But the most important safety data won’t come until patients have been followed for months and even years. Pfizer and Moderna have promised to collect and disclose that information in time.
I’m also interested in learning how the distribution of the vaccines will be prioritized. Clearly, frontline workers receiving the vaccines first makes sense. But what about after that?
Both Moderna and Pfizer have promised to file for emergency use authorizations in the coming weeks. If the FDA grants them, as it’s widely expected to do before the end of the year, the companies will ship doses to the federal government, which is in charge of allocating the limited supply to front-line workers and people at an elevated risk of severe Covid-19.
For everyone else, neither vaccine is likely to be available until spring at the earliest, in large part because of logistics. (By that time, Pfizer and Moderna are also likely to have generated enough supporting data to justify full FDA approvals.) Pfizer and Moderna expect to produce just 70 million doses of their vaccines by the end of 2020, enough for only 35 million people around the globe. In 2021, the companies could have as many as 2.3 billion doses between them, but in a pandemic-ravaged world of 7.5 billion people, that’s not going to be enough to satisfy demand. Unless more Covid-19 vaccines prove to work in the coming months, the world will be rationing doses well into next year.
One of President-elect Joe Biden’s coronavirus task force health advisors, Dr. Zeke Emanuel, has previously written about the path he would like to see taken with regard to vaccine distribution:
The model allows the country that produces the vaccine to hold onto enough of a supply to reach a threshold for herd immunity (“Rt below 1″). Beyond that, the model supports distributing the vaccine internationally, which means giving away or selling doses of the vaccine before it’s available to every citizen in that country, Emanuel explained to Scientific American.
“Reasonable national partiality does not permit retaining more vaccine than the amount needed to keep the rate of transmission (Rt) below 1, when that vaccine could instead mitigate substantial COVID-19–related harms in other countries that have been unable to keep Rt below 1 through ongoing public-health efforts,” the Science magazine article titled “An ethical framework for global vaccine allocation” argues.
“Associative ties only justify a government’s giving some priority to its own citizens, not absolute priority,” Emanuel wrote with his co-authors.
Contra to Emanuel’s ideas, the Trump administration’s stated plan differed considerably:
The Trump administration had said that the U.S. will share any coronavirus vaccine it develops with other countries after American needs are met and that the U.S. will not coordinate with the World Health Organization (WHO) on distribution.
“Our first priority of course is to develop and produce enough quantity of safe and effective FDA-approved vaccines and therapeutics for use in the United States,” Health and Human Services Secretary Alex Azar said during an August visit to Taiwan.
“But we anticipate having capacity that, once those needs are satisfied, those products would be available in the world community according to fair and equitable distributions that we would consult in the international community on,” Azar said.
Here is the Mayo Clinic’s estimate for herd immunity in the U.S.:
Even if infection with the COVID-19 virus creates long-lasting immunity, a large number of people would have to become infected to reach the herd immunity threshold. Experts estimate that in the U.S., 70% of the population — more than 200 million people — would have to recover from COVID-19 to halt the epidemic.
As the vaccines get ready for mass production, the debate about distribution and prioritizing who gets it first is bound to increase.
Here is how the President and the President-elect reacted to today’s great news about the vaccine:
Another Vaccine just announced. This time by Moderna, 95% effective. For those great “historians”, please remember that these great discoveries, which will end the China Plague, all took place on my watch!
— Donald J. Trump (@realDonaldTrump) November 16, 2020
Once again, I congratulate the brilliant women and men who produced this breakthrough and have brought us one step closer to beating this virus. I am also thankful for the frontline workers who are still confronting the virus around the clock.
— Joe Biden (@JoeBiden) November 16, 2020
–Dana
It will be interesting to see whether the distribution will be ready during Trump’s tenure and thus he will direct it (or rather, someone in his administration since he doesn’t appear too interested in Covid these days), or if it will happen after Biden takes the helm. There’s a lot at stake and we have two very different scenarios.
Dana (6995e0) — 11/16/2020 @ 12:19 pmTwo viable vaccines now.
‘Once again, I congratulate the brilliant women and men who produced this breakthrough and have brought us one step closer to beating this virus. I am also thankful for the frontline workers who are still confronting the virus around the clock.’- Idiot Elect
Really Joe? “No miracle is coming.” – Joe Biden.
You’ve been Trumped.
DCSCA (797bc0) — 11/16/2020 @ 1:05 pmIt’s wonderful to see a Democrat like Joe Biden congratulate Big Pharma at a time when most Democrats hate Big Pharma. It’s almost like Biden gets lots of money from Big Pharma, hence the nice tweet.
https://www.newsweek.com/big-pharma-joe-biden-fix-drug-pricing-1534809
Hoi Polloi (7cefeb) — 11/16/2020 @ 1:12 pm@3. It’s ‘a miracle.’ 😉
DCSCA (797bc0) — 11/16/2020 @ 1:29 pmI Was a Military COVID Planner. The Vaccine Rollout Is Going to Be a Nightmare
….
The incoming administration will inherit one of the most daunting challenges any president has ever faced: planning and executing a national mass-vaccination campaign in the middle of a global pandemic.
Before I retired from the Army, I served as a COVID crisis planner at NORTHCOM, where we were terrified of a potential “COVICANE.” Luckily, a major hurricane did not deliver a Katrina- or Harvey-like hit to a big city facing a coronavirus outbreak this year, at least on the scale we feared.
But our next biggest concern was what the virus might do to rural America. And it’s playing out in harrowing fashion right now.
…..
With cases spiking to over 10 million, the virus is everywhere, and spreading deeply into every corner of the country. This is where the Biden administration will face its biggest challenge, especially as it pertains to rolling out a potential vaccine.
…….
….[T]he vaccines themselves present a logistical challenge alone that borders on the impossible for rural America. The Pfizer vaccine, now the leading contender, will require ultra-cold storage of at least -94 degrees Fahrenheit and two rounds of shots. Another leading vaccine candidate from Moderna also requires cold storage, albeit not to the same extent, according to the company. Typically, hospitals and large clinics have this capability. Small towns lacking even the most basic health clinics do not.
To deploy the Pfizer vaccine or any other one, health planners will have to figure out a way to deliver it to rural areas while maintaining its required temperature long enough to ensure that the population receives both doses. This scene will be repeated all across small-town America. This presents a big risk: An uncoordinated federal roll out of vaccines requiring ultra-cold storage could leave state and local governments competing for resources much like they were competing for PPE earlier in the pandemic.
…….
At NORTHCOM, we were the military’s lead for the Defense Support to Civil Authorities (DSCA) mission, and we had only one dedicated pandemic expert on the staff at the start of the crisis. Afterwards, we surged a lot of resources at the problem, but it just isn’t realistic to think the military can replicate the hard work of state and local health-care planners.
Instead of a military miracle, it will take nearly flawless coordination between local, state, and the federal government to execute the plan. Our long winter with COVID could turn into a slog through the spring and summer even with an effective vaccine. Pockets of the virus could linger with us for months as we try to reach Americans in every isolated place….
Getting this right is going to be hard, and given the our climate of disinformation and vaccine scepticism, we may never get to the point where we are completely free from COVID. ……
Rip Murdock (d2a2a8) — 11/16/2020 @ 1:47 pm…….
@5 Properly incentivized, the private sector will distribute the vaccine much more quickly than the government. The free market is always more efficient than central planning. It’s like a law of economics or something.
norcal (a5428a) — 11/16/2020 @ 2:16 pmRegarding government distribution, Hayek would like a word:
F.A. Hayek
norcal (a5428a) — 11/16/2020 @ 2:20 pm1) Anyone who refuses a vaccine when offered is not offered it again until everyone else has been served.
2) After hospital workers, EMTs, police, and other emergency personnel who cannot avoid exposure:
a) assisted living facility occupants and staff.
b) other elderly
c) Other people with compromised immune systems (e.g. transplant patients, chemo/radiation patients, HIV+, and similar)
d) Persons with chronic pulmonary illness or conditions (COPD, asthma, emphysema, cystic fibrosis, etc).
e) Persons with other chronic conditions known to create risk.
Not sure what the statistics are about race, but if as it seems, that blacks are more susceptible, maybe they go up on the list. If Asians are less susceptible, maybe they go to the bottom. Data seems confused though, and other factors may apply.
Kevin M (ab1c11) — 11/16/2020 @ 2:53 pmProperly incentivized, the private sector will distribute the vaccine much more quickly than the government.
There is no benefit to distributing it faster than it can be manufactured. I think that is the place to focus efforts.
Kevin M (ab1c11) — 11/16/2020 @ 2:55 pmTrump always claimed that the favorable vaccine news was being suppressed until after the election. Just because he’s paranoid does not mean that people were not out to screw him.
Kevin M (ab1c11) — 11/16/2020 @ 2:57 pmUnless I missed it, the post didn’t mention Moderna’s connection with Operation Warp Speed.
beer ‘n pretzels (042d67) — 11/16/2020 @ 3:06 pm@11: True. Which is why their vaccine production is owned by the US government.
Kevin M (ab1c11) — 11/16/2020 @ 3:12 pmAs for immunizing people outside the USA, it would make sense to share some with Canada and northern Mexico. It would also make sense to close our borders entirely to the unvaccinated. Probably schools, too.
Kevin M (ab1c11) — 11/16/2020 @ 3:14 pmIt would also make sense to close our borders entirely to the unvaccinated.
Great idea. I’m sure Biden will follow the science on this. LOL
beer ‘n pretzels (042d67) — 11/16/2020 @ 3:17 pmAll that screaming, four miles of new wall, total failure on immigration, and you’re still convinced Biden was the problem.
Give the guy a chance. Don’t be a sore loser.
Dustin (4237e0) — 11/16/2020 @ 3:26 pmThe model allows the country that produces the vaccine to hold onto enough of a supply to reach a threshold for herd immunity (“Rt below 1″). Beyond that, the model supports distributing the vaccine internationally, which means giving away or selling doses of the vaccine before it’s available to every citizen in that country, Emanuel explained to Scientific American.
I just love it when scientists start making ethical pronouncements. Sorry, Charlie, but I’m just as qualified to make value judgements as you are. Screw you and your model, Zeke Emanuel. Another of your models suggests that Joe Biden should not take significant medical measures to extend his life, because he’s over 75.
Here’s a value judgement for you, Dr. Emanuel. Country A doesn’t have a claim on a vaccine developed by Country B. It’s okay for Country B to close its borders to Country A until each and every citizen of Country B has a chance to be vaccinated. To argue the contrary is akin to supporting Communism, e.g., “From each according to his ability. To each according to his need.”
Now, there may be a geopolitical calculation where it is in the national interest of the U.S. to provide a vaccine to some countries sooner rather than later, but that is a different argument.
norcal (a5428a) — 11/16/2020 @ 3:57 pmDCSCA:
#2
Did Biden steal your girlfriend? Push your sister off the Acela? Rip off your best speech?
Appalled (1a17de) — 11/16/2020 @ 4:20 pm@19. No. He did nothing. For 47 years.
You bought him; you own him.
DCSCA (797bc0) — 11/16/2020 @ 4:45 pmThe orange buffoon with the unsuccessful hair transplants wants credit for the vaccine that other people invented, while “it is what it is” and he “takes no responsibility” for the hundreds of thousands of dead Americans and the millions of sick ones.
On the other side, the public servant of 47 years with the successful hair transplants congratulates the people who actually invented the vaccine and thanks the ones who have been fighting the coronavirus without it for most of the past year.
There’s something to see there for people who want to see it.
nk (1d9030) — 11/16/2020 @ 5:03 pm@21. Congratulations: “No miracle coming.”
DCSCA (797bc0) — 11/16/2020 @ 5:14 pmThe orange buffoon with the unsuccessful hair transplants wants credit for the vaccine that other people invented
The Orange buffoon had heard “on his watch” for the past nine months and fittingly threw that dookie back in your face. There is certainly now something to see there.
beer ‘n pretzels (042d67) — 11/16/2020 @ 5:18 pmSo you’re blaming Trump for 250,000-300,000 dead Americans?
You want to have it both ways right? Trump is both innocent of all that’s wrong and responsible for all that’s good?
Why? He already lost. What’s it to you that people adore this guy?
Dustin (4237e0) — 11/16/2020 @ 5:32 pmNope. Just hard work. Science. Vaccines and sacrifice.
If Trump had believed in hard work we’d be doing a lot better, he would be too, and we could mock Biden for losing the election he had no chance at. But Trump took the lazy path of pretend and fantasy.
Dustin (4237e0) — 11/16/2020 @ 5:33 pmOh, no, no, no, Mr. beer ‘n pretzels! Do not put words in my mouth praising the corrupt criminal traitor with faint damns.
The coronavirus did not merely happen on Trump’s watch. The decimation and desolation it has caused America is due to Trump’s malignant indifference and hopeless incompetence.
nk (1d9030) — 11/16/2020 @ 5:46 pmIf the first shot is given at least something like six weeks in advance of infection.
Like the Pfizer vaccine, it is two step vaccine. Unlike the Pfizer vaccine, (rated 90% effective) the Moderna vacciine (rated 94.5% effective) it only has to be stored at below 25 degrees Fahrenheit. (I also read minus 4 degrees F) The Pfizer vaccine has to be stored at minus 80 degrees Fahrenheit but comes packed in dry ice, creating a hazardous transportation problem, and can keep that way for maybe 10 days but can last a bit longer in an ordinary freezer.
The Pfizer vaccine’s two doses come 21 days apart; the Moderna vaccine 28 days apart.
Patients given one dose will get a slip with an appointment for the booster shot – they recommend that people take a picture of the piece of paper – so many people have cameras or cell phone cameras nowadays and can upload them. They could also mark it on a calendar or appointment book but might lose it before they get home. So they say take a picture if you can.
The vaccine (I’m not sure which one) can give people what feels like a mild case of Covid. A fever of 100.3 and tiredness for about one day.
Joe Bideb: What was true with the first vaccine remains true with the second: we are still months away. Until then, Americans need to continue to practice social-distancing and mask-wearing to get the virus under control.
Note that Dr. Anthony Fauci did not say “until then” but well past that time. Especially if Joe Biden decides that all he needs to do is get R0 below 1.0 and then ship it off to other countries that have an R0 above 1.0.
Sammy Finkelman (f6c6ee) — 11/16/2020 @ 5:58 pmDCSCA (797bc0) — 11/16/2020 @ 1:05 pm
The UK also has
onesix in the pipeline.https://pressofatlanticcity.com/news/world/uk-to-run-final-stage-trials-of-janssen-covid-vaccine/article_42b504db-6adc-5843-9866-8be5efff32b8.html
I think they tested it out by deliberately infecting people who agreed.
China also has a vaccine which they have used on the military, for important people, and for people traveling outside of China.
https://www.npr.org/sections/goatsandsoda/2020/11/12/933956247/china-is-inoculating-thousands-with-unapproved-covid-19-vaccines-why
China has four vaccines in development by three companies (one has two)
More:
Sammy Finkelman (f6c6ee) — 11/16/2020 @ 6:18 pmI know this is more for the Trump fans to say, but if I learned China had a vaccine for COVID 19 two years ago I wouldn’t be that surprised.
Dustin (4237e0) — 11/16/2020 @ 6:23 pm8.
These people can’t be vaccinated. Not only will it not tend to work, it can cause disease.
They need antibodies, not vaccines.
They might actually be, apart from sociological causes, because of lower Vitamin D levels in the blood. Of course, that can be cured with a pill. The CDC probably won’t recommend anything like that for a long, long time
R0 <1.0 is not the metric to use for when you can slow down and distribute some of it abroad. It's when the level of weekly infections per thousand has dropped.
But again, this is not a cure. It's preventative. The Regeneron and Eli Lilly antibodies are a cure. Vaccines are for when there is no epidemic.
Sammy Finkelman (f6c6ee) — 11/16/2020 @ 6:33 pm29. Dustin (4237e0) — 11/16/2020 @ 6:23 pm
No, I think they’ve just been studying coronaviruses for longer. They developed a vaccine against SARS which turned out to be no good.
Now I think the virus probably escaped from the Wuhan Center for Disease Control and Prevention, located about 300 yards from the seafood/eyeglasses market that was scapegoated as the source (not to be confused with the Wuhan Institute of Virology, eight miles away.)
The Wuhan Institute of Virology had links with the outside world. The Wuhan Center for Disease Control and Prevention, not so much.
Sammy Finkelman (f6c6ee) — 11/16/2020 @ 6:44 pmThat’s what struck me when I read the post. Biden’s tweets are not remarkable or especially profound, but my God do they look like the words of an adult when placed next to the mewling of the self-obsessed infant.
Patterico (115b1f) — 11/16/2020 @ 6:45 pm‘Just hard work. Science. Vaccines and sacrifice.’
On Donald’s watch.
‘There’s a dark winter ahead.’ – Idiot-elect.
Because, you know, if you ain’t for him then you ain’t black.
DCSCA (797bc0) — 11/16/2020 @ 7:00 pmThis:
Half of America just want a normal adult in office. Let him be old and boring and not particularly bright. Just normal. Trump’s hissy fits, erratic behavior and irrational thinking have successfully exhausted America. We just want normal. That’s how low the bar is now.
Dana (6995e0) — 11/16/2020 @ 7:03 pm34. Are you saying that a man displaying signs of dementia occupying the highest office in the land and possessing the ability to order a nuclear strike is what passes for “normal?” I wholly reject your premise that is somehow “better” than Trump.
Gryph (f63000) — 11/16/2020 @ 7:14 pmNormal…
https://www.youtube.com/watch?v=fNQAbF33gFM
You bought him; you own him.
DCSCA (797bc0) — 11/16/2020 @ 7:16 pmThe Regeneron antibodies look better than the Eli Lilly antibodies, so naturally, the FDA approved the li Lilly antibodies first.
https://blogs.sciencemag.org/pipeline/archives/2020/10/29/the-latest-antibody-data-from-lilly-and-from-regeneron
They may not have made enough of it.
the discussion, some sayit does amount to something.
One problem is that this duplicates only one element of the body’s immune response. The discussion also goes into vaccines.
Sammy Finkelman (f6c6ee) — 11/16/2020 @ 7:21 pmOT- CSPAN-1 carrying live coverage now of Dragon approach and docking w/t ISS.
Truly wonderous and majestic imagery of our Earth, our ISS and humans at work in space.
It never grows old.
DCSCA (797bc0) — 11/16/2020 @ 7:26 pmPostscript. Science fiction becomes reality; what a waltz: this television imagery is incredible- from the space station to Dragon to the astronauts working their controls and displays- it looks exactly like a segment from ‘2001: A Space Odyssey.’ All that’s missing is a little classical music.
DCSCA (797bc0) — 11/16/2020 @ 7:44 pmYouTube, too.
262 miles above Idaho gives new meaning to “flyover country”.
nk (1d9030) — 11/16/2020 @ 8:05 pmIn a 1959 “Peanuts” comic strip*, the kids wonder whether a light in the sky is “a sputnik”, lowercase, common noun, connoting more than one up there. When did they become “satellites”?
*(Yes, a 1959 “Peanuts” comic strip, who are you to judge me?)
nk (1d9030) — 11/16/2020 @ 8:09 pm37.
SF: The Regeneron antibodies look better than the Eli Lilly antibodies, so naturally, the FDA approved the Eli Lilly antibodies first.
The situation is even worse:
https://blogs.sciencemag.org/pipeline/archives/2020/11/13/lillys-monoclonal-eua
One person says they used the wrong endpoint (nasopharyngeal loa, or day 11 viral load – and after all neutralizing antibodies don’t clear viral particles from the system but rather block the binding of the virus to the receptor.)
But Eli Lilly may have a marketing strategy to be very careful not to compete with a vaccine, and have only a high cost treatment with marginal utility, since that is what will most easily get approved.
Sammy Finkelman (f6c6ee) — 11/16/2020 @ 8:16 pmHalf forgotten:
https://www.biocentury.com/article/631024
https://www.biocentury.com/article/631812
Sammy Finkelman (f6c6ee) — 11/16/2020 @ 8:27 pm@41. Snoopy and Charlie Brown are very NASA, nk. For starters, see Apollo 10 for details. 😉
DCSCA (797bc0) — 11/16/2020 @ 8:48 pm@32: Biden’s tweets are not remarkable or especially profound, but my God do they look like the words of an adult when placed next to the mewling of the self-obsessed infant.
An adult doesn’t require others to write tweets for him.
beer ‘n pretzels (042d67) — 11/16/2020 @ 10:03 pmI can think of one putative “adult” who would benefit very strongly — so strongly! — from such a service.
Patterico (115b1f) — 11/16/2020 @ 10:30 pmPerhaps you prefer your tweets written in crayon. To each his own.
Patterico (115b1f) — 11/16/2020 @ 10:32 pmI’m trying to imagine what it’s like to be impressed by tweets. Failing at it, but I’ll try harder tomorrow.
beer ‘n pretzels (042d67) — 11/16/2020 @ 11:00 pm@ 48 — Is it too hard to imagine that a regular tweeting pattern might actually tell us something important about the person who chooses to express his thoughts in that medium?
Radegunda (20775b) — 11/16/2020 @ 11:20 pmTrump’s superfans have said that Twitter is his very important way of reaching the American people directly.
Radegunda (20775b) — 11/16/2020 @ 11:24 pmBut sometimes they find it more useful to scoff at anyone so naive as to think his tweets have any importance whatsoever.
I’m trying to imagine what it’s like to be impressed by tweets. Failing at it, but I’ll try harder tomorrow.
Radegunda beat me to it, but this is exactly what so many of us have been saying for the past four years.
JVW (ee64e4) — 11/16/2020 @ 11:53 pmDana,
I’m not sure i see much difference between the proposal outlined by Biden’s team and the one outlined by Trump’s. Azar said “After American needs are met.” I didn’t see where they defined what that was. It’s very possible that other then the chest puffing Trump and Biden want to do very similar things.
It is funny, in a sad way, that Trump prioritized that he get credit for the good thing that happened, and Biden’s statement focused on praising the people more directly responsible for the work.
Time123 (441f53) — 11/17/2020 @ 4:46 ambut mr time only a super genius like president donald who really gets this stuff and was totally joking about the whole bleach thing could have come up with the idea of developing a vaccine in response to a raging pandemic
its obvious to anyone willing to do the analysis
Dave (1bb933) — 11/17/2020 @ 5:11 amHe did call it the Wuhan Flu.
nk (1d9030) — 11/17/2020 @ 5:38 amAnd then the China Virus.
And now he administered the coup de grace with the China Plague.
And the sad thing is that to him and his followers that’s not a joke. To them, that’s fighting and winning.
@49: Absolutely! It tells us that Joe needs a ghost writer for his own thoughts.
beer ‘n pretzels (042d67) — 11/17/2020 @ 6:14 amTrump superfans feel powerless, picked on and disrespected. When trump says dumb Sh*t on twitter they feel better because someone is giving voice to their sense of persecution in a way that demands the attention they don’t think their issues usually get.
When someone else says something on twitter they don’t understand why anyone would pat attention to such a silly platform.
Time123 (b4d075) — 11/17/2020 @ 6:14 am@55, you mean he took the time to put out a thoughtful statement instead of what the guy at the end of the bar would say after his 4th beer?
Time123 (b4d075) — 11/17/2020 @ 6:19 amSome people are trying to tell Governors not to promote distrust of a vaccine:
https://www.nytimes.com/2020/11/16/us/coronavirus-vaccine-states-trump.html
They talk as if the only problem could be that approvals are too fast, and they say it wasn’t.
I guess these people are trying to enhance the authority of the FDA. When they say yes, it should be a yes. hey are focusing on salesmanship.
The Governors of California, Oregon. Washington, Nevada, Connecticut, West Virginia and New York, plus the local D.C. government want to uphold their suspicions of Trump. They, or others, got Trump not to interfere, and they delayed approval of the vaccine past Election Day. (the interference was insidious, done by setting conditions and warning of possible interference to go too fast – they had no evidence of Trump doing anything wrong – the Senate should hold hearings on political pressure from all sides.)
They want blind faith – both ways. Particularly, now that we have Biden’s hand selected experts.
I think the main goal is to assure the public (falsely) that Democrats were not guilty of political interference and that the concerns were justified.
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 7:22 amFor alll that, it’s possible for bad, or dangerous for certain people, vaccine to be approved:
https://www.npr.org/sections/goatsandsoda/2019/05/03/719037789/botched-vaccine-launch-has-deadly-repercussions This was eventually approved in the USA with warnings.
You can get the science wrong and a set of rules will not avoid it.
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 7:25 amBack to today’s New York Times story:
Trust just happened to break down? Sure. [NOT!]
These reviews are designed to justify the distrust.
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 7:36 amThe more common problem is too slow approval, or even the company giving up
https://www.wsj.com/articles/trump-biden-and-covid-vaccines-11605568709
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 7:40 amSammy —
Trump fostered the mistrust by his behavior throughout the pandemic. No amount of closely reasoned paragraphs can conceal that basic and profound failure of leadership.
Appalled (1a17de) — 11/17/2020 @ 7:43 amI thought Obama’s head of the FDA, Scott Gottlieb, was a goniff, too. But nobody trusts any part of Trump’s health care alphabet soup now.
nk (1d9030) — 11/17/2020 @ 7:48 am62. Appalled (1a17de) — 11/17/2020 @ 7:43 am
In general, yes. He was constantly predicting it would all be over soon, that we would open up soon/
On closer inspection, no. There was pushback, so that Trump knew that if something was done wrong it would become known, and there was knowledge of what was actually happening. Trump argued, but he didn’t order anything approved.. And they knew it.
Trump did not attempt to tell the pharmaceutical companies what to do. He talked to them and maybe asked what help they needed. (and the pharmaceutical companies weren’t about to put out a disaster.)
And Trump tended to cave when the accusations got too strong.
Hee evn gave in whe
No amount of closely reasoned paragraphs can conceal that basic and profound failure of leadership.
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 8:02 amTrump even gave in when the pressure got too much, or when the pharmaceutical companies gave in (mostly the latter, which they did even when the medical science didn’t require them too.)
When the pharmaceutical companies surrendered on something that was it. He couldnn;t be more Catholic than the Pope.
https://www.nytimes.com/2020/10/20/health/covid-vaccines-fda-trump.html
The antibodies probably matter most when someone’s condition is rapidly or semi-rapidly deteriorating relatively early in the course of the disease, indicating that body’s immune response isn’t ramping up fast enough or they just got exposed to too much virus. Late in the disease, either there already is a strong, maybe too strong immune response, or it’s too little to help. Before the disease gets going it would probably confer temporary immunity but that might be difficult to prove, especially if you are looking for the lowest effective dose first.
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 8:36 amThere was a lack of intelligent understanding. So even when he was onto something, and, of course, looking at all sorts of things, he sometimes was, he gave up.
The distrust was promoted, or reacted to, by people within the FDA
https://www.usatoday.com/story/opinion/2020/09/10/sound-science-to-meet-covid-challenges-fda-career-officials-column/5756948002
Trump also did not know how to answer his critics. But he was still better than someone who would just go along with the bad status quo.
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 8:37 amWith the antibodies, there is also an issue of quality manufacturing standards, but if watched, that should be no problem. That’s an issue with any drug.
About Dr. Gottlieb: What I have noticed that he seems to be careful, like Pfizer, not to challenge the FDA and he says some things only when questioned. He also is kind to Donald Trump, and interprets what he does as most favorably as he legitimately can (it helps that Trump does usually base what he says on something – except Trump’s judgement is probably better than he makes it appear.)
Dr. Scott Gottlieb always talks about the antibodies as a bridge to vaccine, (like he’s afraid someone might say they would supersede a vaccine, and that’s a no-no with the FDA or maybe Pfizer)
He’s lately not volunteered a mention of it, only referring to that sort of thing when prompted.
And of course, manufacturing was not ramped up, as he wanted it to be, so that’s a reason.
The antibodies are better, more immediate and more universal, than a vaccine. It should be possible to prove it, but they may have to be careful in selecting a metric because some won’t get to the heart of it. It’s been proven for Vitamin D, so it should be for the neutralizing antibodies as well.
https://www.hackensackmeridianhealth.org/HealthU/2020/11/03/should-you-take-vitamin-d-for-covid-prevention
Of course, there, with Vitamin D, you know who’s deficient. How do you determine who’s deficient in antibody response? Well, for someone already testing positive, two blood tests for immune response, a specific number of hours apart, maybe could do it. A clinician, of course, could just watch how the patient is doing over 8 to 12 hours. And maybe judge by age and other things who is likely to be deficient.
Pharmacuetical companies will pick the mot rovable indication when asking for approval, nit the most useful one, though. By now, they’ve become experts at gaming the system (while usually avoiding fraudulant claims. Oxycontin did not, because its big claim was that it was non-addictive.)
Sammy Finkelman (f6c6ee) — 11/17/2020 @ 10:52 am