COVID-19 Coronavirus Containment Efforts

[PeroK]

I heard in the news last year that the flu killed millions a year in the US alone and tens of millions worldwide. Why didn't we have lockdown for flu? Is it due to the Covid being new so people were more afraid or excited? Does it mean when people get used to Covid and it kills millions a year in the US, it would be as common as the flu and people would accept it, and slowly we won't keep hearing it at headlines like the flu and get used to it?

How could millions of people in the US die from flu every year? There are about 3 million deaths per year in the US total - from all causes. And about 60 million deaths worldwide - from all causes.

Do you think that in a typical year the hospital intensive care units are full to capacity with flu patients and that surgery and other medical treatments are canceled because of an annual flu epidemic?

You must try to learn how to distinguish fact from fantasy. This sort of misinformation - and the general inability to identify misinformation - is killing our societies.

Here's a webpage with world population, birth and death rates:

https://www.worldometers.info/world-population/

 

[mfb]

"Distributed" means shipments, not deliveries. The start of the distribution pipeline, not the end (when I used the word "deliver" earlier, I meant delivery to the final destination: an arm).

I meant delivered as the in Pfizer -> US delivery. If that's not what "distributed" (by Pfizer) means, then how can we tell anything about the supply?

 

[Astronuc]

Larry King, legendary TV host and radio personality, died Saturday morning at the age of 87 after a weekslong battle with COVID-19. He was hospitalized with the disease in late December. He had several health scares in recent years, including multiple heart attacks, a lung cancer diagnosis and a stroke, i.e., he had several comorbities.

 

[StevieTNZ]

Well the circle of lockdowns may well begin soon, with a suspected case of community transmission of Covid-19 in NZ : https://www.stuff.co.nz/national/he...n-northland-ministry-of-health-to-give-update

Noting that the virus may still be detected two weeks after the person has become infected.

 

[bhobba]

Well the circle of lockdowns may well begin soon, with a suspected case of community transmission of Covid-19 in NZ : https://www.stuff.co.nz/national/he...n-northland-ministry-of-health-to-give-update

It's exactly the same as here in Aus. Even one case was enough to send Brissy into lockdown and stronger than usual precautions till last Friday at 1 am. 3 days hard lockdown to conduct a thorough tracing, a partial lock down for a further 2 weeks, then a week of what I would call just strong precautions like mandatory mask wearing and restrictions on gatherings. It's lifted now - we are back to Covid normal eg stadiums, restaurants etc only half full, no need to wear a mask unless you want (although I do) ie mostly normal. IMHO they have got to stop this lockdown madness. We have people saying it doesn't work - it works all right at suppressing the virus but has some horrid side issues eg it has been reported during a hard lockdown nearly 50% of people have contemplated suicide. Aus and NZ, and likely everyone else as well, should look at what Taiwan does:
https://www.wired.co.uk/article/taiwan-coronavirus-covid-response

A big factor seems to be use of high tech data analytics and tracing, actively identifying and suppressing misinformation, basically as the article says 'Taiwan has been smart about changing the institutions and structure of government and they have transformed citizens expectations of what the government does.' Here in Aus we still have conspiracy theory rubbish people actually believe (eg this is just another flu blown out of proportion by big pharma and Bill Gates to make money ). We even have politicians calling other politicians conspiracy theorists because they post and discuss peer reviewed scientific literature on their facebook pages. How a peer reviewed scientific paper can be a conspiracy theory beats me. You might not agree with it and explain why - but a conspiracy theory? The answer given is it is against the medical advice of our bureaucrats. And that seems to be the sad reality - we did not transform, as Taiwan did, the structure of government and people's expectations. The bureaucrats here in Aus have proven hopeless - eg the Schultz act they collectively gave into the enquiry about the failure of hotel quarantine in Victoria, and the constant bickering between states. But for some reason Taiwan has had cultural change and the bureaucrats are in 'tune' with best practice.

I am starting to believe this is as much a people issue as it is about a virus.

Thanks
Bill

 

[nsaspook]

Well the circle of lockdowns may well begin soon, with a suspected case of community transmission of Covid-19 in NZ : https://www.stuff.co.nz/national/he...n-northland-ministry-of-health-to-give-update

Noting that the virus may still be detected two weeks after the person has become infected.

https://www.stuff.co.nz/national/po...ne-rollout-is-top-risk-for-arderns-government

Much of the developed world (with larger populations) has already begun to administer vaccines to frontline workers and the vulnerable, while New Zealand is yet to even approve the inoculation.

Over the holiday period, the Government’s messaging on the roll-out has been confused and inconsistent. Whereas we were at the front of the international queue for doses in November, Covid recovery minister Chris Hipkins now says citizens must wait our turn and the vaccine won’t arrive at these shores until March.

A few weeks ago, it was stated that the general public won’t start getting jabs until September, an inexplicably long wait given ministers and officials have had months to prepare. Now Hipkins says it is mid-year.

The stealth destroyers are getting closer with the new strains. I really hope NZ can maintain isolation that long.

 

[bhobba]

I heard in the news last year that the flu killed millions a year in the US alone and tens of millions worldwide. Why didn't we have lockdown for flu?

It is more deadly than the flu especially for people with comorbidities eg:
https://www.mcknights.com/news/clinical-news/covid-mortality-rate-30-percent-in-diabetes-parkinsons/
https://care.diabetesjournals.org/content/43/7/1378

Just take diabetes. People with diabeties are 10% of the population. At a 7.2% death rate if you have it then there's at least a .72% death rate from diabeties alone (unless those with diabeties take greater precautions such as Vitamin D mentioned below - which of course they should). Then we have pre-diabetes which is not as deadly a comorbidity - but still significantly increases your risk. A whopping 1/3 of the population has pre-diabetes of which 80% do not know it. So one thing everyone should do is a simple blood sugar test that here in Aus any chemist will do for free. Then you have heart disease, high blood pressure etc - all of which significantly increase risk. They are risk factors for dying from the flu as well - but it is much less eg about .3% if you have diabeties. We also have a vaccine for the flu - it is usually only about 40-60% effective - one year it was as low as 10%. But here is the interesting thing - if you get the flu and are vaccinated it generally is a lot less severe and death rates I have read are about 90% lower. The same is true of the Oxford Covid vaccine - it is only 60-70% effective but so far is 100% effective if you do manage to get it at preventing severe cases. It is now being rolled out in the millions in India and England (soon where I am in Aus as well - but since it is well controlled here our authorities are waiting to see what happens in other countries) and we will see how well that 100% holds up. The Pfizer vaccine is more effective at preventing you getting it, but the information at the moment is it may not be as effective at preventing severe cases if you do get it as the Oxford vaccine - again as vaccinations progress we will get more exact numbers. So far nobody died from Covid after either vaccine.

If we just protected people with comorbidities and gave everyone a simple physical to determine what comorbidities they do have, we could make a big dent in the population death rate (it will of course make no difference if you do get it - just lowering the number of high risk people that do get it) - perhaps bringing it down to flu levels. Another simple thing, which should be done Covid or no covid, is ensure nobody is vitamin D deficient. That is very easy, but studies have shown anybody with vitamin D deficiency, and a surprising number of people are, are at significantly greater risk and should take supplementation to bring them up to normal levels:
https://www.nature.com/articles/s41598-020-77093-z

I take Vitamin D, as well as some other stuff with less proven benefit - but certainly we could make a big difference in this pandemic by 2 simple things you should do anyway:

1. Get a physical to determine if you have any comorbidities.
2. Make sure you are not deficient in vitamin D.

There are other things there is some evidence will help eg the I-Mask protocol which I take:
https://covid19criticalcare.com/i-mask-prophylaxis-treatment-protocol/i-mask-protocol-translations/

Without the Ivermectin (recommended for prevention in high risk patients or if you do get it), it is pretty harmless - but the evidence is not as strong as the two I mentioned. Do NOT under any circumstances take Ivermectin without seeing you doctor first. It has recently been given a neutral recommendation rather that a not recommended by US authorities. You can discuss the pros and cons of taking it with your doctor.

Thanks
Bill

 

[bhobba]

The stealth destroyers are getting closer with the new strains. I really hope NZ can maintain isolation that long.

Australia has already commenced back in November manufacturing 58 million doses of the Oxford vaccine in monthly batches which will cover both Aus and NZ:
https://www.csl.com/news/2020/20201...rsity-of-oxford-astrazeneca-vaccine-candidate

The above says 30 million - but since the failure of the UQ vaccine it has been raised to 58 million. NZ is expecting its first batch by Australia Day. Both countries are waiting a bit before deploying it just to see what happens elsewhere. Plans are in place to quickly distribute it. If anything bad happens it can be 'unleashed' quickly in either country.

As of now do the two things I mentioned in my previous post:
1. Get a physical to determine if you have any comorbidities.
2. Make sure you are not deficient in vitamin D.

That way when it is released it can be prioritised to all those in the high risk category better and reduce your chances of getting it in the first place.

Thanks
Bill

 

[Tendex]

I heard in the news last year that the flu killed millions a year in the US alone and tens of millions worldwide.

As several people have said earlier those figures are totally wrong. It is more like around 30000-40000 anually in the US, and this is an estimate. It is very hard to exactly pinpoint a real number of people that dies from a single disease(not only for flu or Covid). And all these estimations are prone to bigger or smaller errors.

It would be interesting to determine exactly the overall impact on the total mortality by country from all causes, comparing 2020 total deaths with the growth estimation given for this period from the mean increase in total deaths of the previous years. But this takes time, and it might be some months until we have that record straight.

 

[mfb]

The Pfizer vaccine is more effective at preventing you getting it, but the information at the moment is it may not be as effective at preventing death as the Oxford vaccine - again as vaccinations progress we will get more exact numbers.

Do you have sources/numbers for that? The absolute number of deaths from people who were vaccinated long enough ago to have the vaccine work must be tiny.

 

[bhobba]

Do you have sources/numbers for that? The absolute number of deaths from people who were vaccinated long enough ago to have the vaccine work must be tiny.

Yes - see Ygggdrasil's post:
https://www.physicsforums.com/threa...excitement-or-fear.997299/page-3#post-6446580

But I made an embarrassing goof - it was severe cases - not death - and I will update my post. Sorry. And you are correct the difference in getting severe cases is tiny - for exact numbers we will need to wait until we have more information.

Thanks
Bill

 

[DrGreg]

The same is true of the Oxford Covid vaccine - it is only 60-70% effective but so far is 100% effective if you do manage to get it at preventing death. It is now being rolled out in the millions in India and England ... and we will see how well that 100% holds up.

Unfortunately in England people are only being given a single dose and being told they will get their second dose 3 months later (instead of the recommended 3 weeks later). The logic behind this is that supposedly more lives will be saved in the short term by giving a larger population a single dose than by giving a smaller population a double dose. But the decision is not without controversy.

 

[PeroK]

Unfortunately in England people are only being given a single dose and being told they will get their second dose 3 months later (instead of the recommended 3 weeks later). The logic behind this is that supposedly more lives will be saved in the short term by giving a larger population a single dose than by giving a smaller population a double dose. But the decision is not without controversy.

I was just thinking recently that the phrase "guided by the science" is actually totally meaningless. Is one guided 99% by the science or 1% by the science?

In this case, the UK government has been guided by the science in that it recognises the effect of a vaccine, but it has chosen its own interpretation of the vaccination process. The recommended three weeks between doses has become three months.

This is a variation on epidemiology called "Boris Johnson seat-of-the-pants science".

 

[bhobba]

Unfortunately in England people are only being given a single dose and being told they will get their second dose 3 months later (instead of the recommended 3 weeks later). The logic behind this is that supposedly more lives will be saved in the short term by giving a larger population a single dose than by giving a smaller population a double dose. But the decision is not without controversy.

First I made a goof - it was severe cases not death - nobody so far who was vaccinated has actually died. And yes I am aware of what they did in England and to be blunt I am appalled. We do not know the consequences of doing that - it could put the whole vaccination programme in jeopardy. But the situation in the UK, at least as reported here in Aus, is dire, so I understand why - even though IMHO it is the wrong responce.

Thanks
Bill

 

[bhobba]

I was just thinking recently that the phrase "guided by the science" is actually totally meaningless. Is one guided 99% by the science or 1% by the science? In this case, the UK government has been guided by the science in that it recognises the effect of a vaccine, but it has chosen its own interpretation of the vaccination process. The recommended three weeks between doses has become three months. This is a variation on epidemiology called "Boris Johnson seat-of-the-pants science".

Unfortunately true. For me it is very worrying.

Thanks
Bill

 

[PeroK]

Unfortunately true. For me it is very worrying.

Thanks
Bill

The big blunder was ignoring calls for a three-week "fire-break" lockdown last October. Johnson waited until November when he was absolutely certain we needed a lockdown, but by that time the numbers were so high that, in effect, we have been in lockdown ever since and will be for some time to come.

There's a clear pattern to me that our Government finds it impossible to make a decision until it is 100% certain that action is needed. And, as a result, necessary action is delayed too long. That's more or less the story of our COVID containment efforts. Everything has been done at the last possible moment. It's taken us a year to mandate mask-wearing in shops.

And here we are, 3.6 million cases and nearly 100,000 deaths later still bumbling and pottering around.

 

[Astronuc]

I am starting to believe this is as much a people issue as it is about a virus.

It is a human behavior/psychology issue. There is a proportion of the population that does not 'believe' or accept the science or epidemiology concerning coronavirus. Some authorities have been dismissive of the severity of the Coronavirus or COVID-19, and some will not observe precautions simply because 'the government' or 'bureaucrat' told them to do so.

 

[bhobba]

And here we are, 3.6 million cases and nearly 100,000 deaths later still bumbling and pottering around.

See another post I did:
https://www.physicsforums.com/threa...tainment-efforts.983707/page-185#post-6448230

Except in Taiwan (there may be others I do not know of) where the government bureaucracy changed their approach based on information about Covid, that bureaucracy has proven themselves very inept or as you say - bumbling and pottering around. If it wasn't so deadly serious your eyes would roll back and say - I knew they were bad - but this bad? Instead the consequences are often so catastrophic you want to 'cry'.

Thanks
Bill

 

[Ygggdrasil]

Yes - see Ygggdrasil's post:
https://www.physicsforums.com/threa...excitement-or-fear.997299/page-3#post-6446580

But I made an embarrassing goof - it was severe cases - not death - and I will update my post. Sorry. And you are correct the difference in getting severe cases is tiny - for exact numbers we will need to wait until we have more information.

Based on the small numbers of cases in the trials data, I do not think there is enough evidence to show that the Pfizer-BioNTech and Oxford-AstraZeneca vaccines differ in their ability to prevent severe disease (both seem effective at preventing severe disease). If anything, I would guess that the Oxford-AstraZeneca vaccine is less effective based on the lower efficacy of preventing symptomatic disease.

 

[bhobba]

Based on the small numbers of cases in the trials data, I do not think there is enough evidence to show that the Pfizer-BioNTech and Oxford-AstraZeneca vaccines differ in their ability to prevent severe disease (both seem effective at preventing severe disease). If anything, I would guess that the Oxford-AstraZeneca vaccine is less effective based on the lower efficacy of preventing symptomatic disease.

Yes, on second thought I should not have mentioned it - we need more data. I possibly will not have a choice anyway because for high risk cases like me here in Aus they are prioritising the Pfizer vaccine. I would like to see the data on the vaccines in people on Biologics - or even if it will work. But my doctor insists, and when I say insist it is a rather strong one, I get the Flu vaccine every year, so my Biologic must not totally shut down my immune system.

Thanks
Bill

 

[nsaspook]

Australia has already commenced back in November manufacturing 58 million doses of the Oxford vaccine in monthly batches which will cover both Aus and NZ:
https://www.csl.com/news/2020/20201...rsity-of-oxford-astrazeneca-vaccine-candidate

The above says 30 million - but since the failure of the UQ vaccine it has been raised to 58 million. NZ is expecting its first batch by Australia Day. Both countries are waiting a bit before deploying it just to see what happens elsewhere. Plans are in place to quickly distribute it. If anything bad happens it can be 'unleashed' quickly in either country.

As of now do the two things I mentioned in my previous post:
1. Get a physical to determine if you have any comorbidities.
2. Make sure you are not deficient in vitamin D.

That way when it is released it can be prioritised to all those in the high risk category better and reduce your chances of getting it in the first place.

Thanks
Bill

The NZ hotel quarantine is not completely effective with the more contagious strains as shown by the latest community cases spread.
https://www.stuff.co.nz/national/he...ested-positive-for-coronavirus?cid=app-iPhone

It came a week after she left managed isolation at Auckland’s Pullman Hotel after returning from a trip to Europe.

Covid-19 Response Minister Chris Hipkins and Director-General of Health Dr Ashley Bloomfield said there were about 30 locations of interest linked to the woman’s movements.

People always underestimate emergency logistics when dealing with masses of people. Plans are great, actual operational usage is light-years better. I wish them well but waiting to see what happens in the middle of a world-wide pandemic seems to be pushing the risk of containment loss higher and higher..

 

[WWGD]

We'll be reaching 100,000,000 case next week. Maybe these will help convince the skeptics

 

[russ_watters]

I meant delivered as the in Pfizer -> US delivery. If that's not what "distributed" (by Pfizer) means, then how can we tell anything about the supply?

[edit] You can access the edit history, so you can see I wrote a long post in response to this and have since deleted it. I assume that's all you responded to because it's all you felt like objecting to. So I'll respond to that only. What you said there is too vague to have any value. The US is a country of a couple of million square miles - does "US delivery" mean it was pushed out of an airplane over Kansas? We should be clear on what we think the words we are using mean, so here's what I think they mean:

• Delivered: What a pharma company calls it when a shipment leaves their facility.
• Distributed: What the government calls it when a shipment leaves a pharma company facility (same as above).
• Administered: when a vaccine is injected into an arm.

Agree/disagree? Be specific.

 

[bhobba]

I wish them well but waiting to see what happens in the middle of a world-wide pandemic seems to be pushing the risk of containment loss higher and higher..

I gave it my like. But this is not clear cut. If a country where it is well under control, and they go into lockdown for even one case, then the chances of getting out of control, while not zero, has proven to be quite low. The main issue is the bureaucracy do not 'muck it up' like they did in Victoria here in Aus. By being an early adopter you run the risk of what happened with the 1976 flu vaccine:
https://www.smithsonianmag.com/smart-news/long-shadow-1976-swine-flu-vaccine-fiasco-180961994/

Considering how bad it is in the UK, and the US, IMHO those coutries are doing the right thing being an early adopter. But Australia and NZ does not have the same risk vs reward. It's a 'gut feel' call - the kind of call politicians should and do make - that is what they are elected for. If they decided to be an early adopter I would not think them crazy or anything like that - like I say it is not something that is cut and dry.

In fact I was a proponent during the middle of the Victorian 'muck up' that caused a lot of deaths, especially in aged care facilities, of Professor Petrovsky's plan to carry out stage 2 and 3 trials of his vaccine to control the breakout. To me the risk vs reward was tipped to using the 'unproven' vaccine. But again it is a 'gut feel' call.

Thanks
Bill

 

[waternohitter]

In fact I was a proponent during the middle of the Victorian 'muck up' that caused a lot of deaths, especially in aged care facilities, of Professor Petrovsky's plan to carry out stage 2 and 3 trials of his vaccine to control the breakout. To me the risk vs reward was tipped to using the 'unproven' vaccine. But again it is a 'gut feel' call.

Definitely, this is a trusting our instincts process and for me it is one vital tool to survive all uncertainties. "Trust your instincts"

 

[mfb]

Concerning severe cases: 1 vs. 9 (Pfizer/BNT) and 0 vs. 1 (Oxford) have no statistical difference. If anything we can conclude that Pfizer/BNT will reduce the frequency of severe cases while we don't have that evidence for Oxford (0 vs. 5 hospitalizations provide some evidence that it reduces severe cases). Of course we generally expect that behavior from the reduction in milder cases.

We should be clear on what we think the words we are using mean, so here's what I think they mean:

• Delivered: What a pharma company calls it when a shipment leaves their facility.
• Distributed: What the government calls it when a shipment leaves a pharma company facility (same as above).
• Administered: when a vaccine is injected into an arm.

Agree/disagree? Be specific.

"Delivered" would imply reaching some destination in the US at least, but that shouldn't make a big difference. We take CDC numbers for "distributed", so you expect them to be in the US.
We see the pattern that administered followed distributed with a two-week delay until the "distributed" graph increased its slope and administered vaccines couldn't keep track.

"Administered" follows a nearly perfect linear track that's slower than "distributed", I added the most recent CDC numbers:

 

[Ygggdrasil]

For those interested in a very in depth discussion of the mRNA vaccine supply chain see: https://blog.jonasneubert.com/2021/...fizer-biontech-and-moderna-covid-19-vaccines/

Regarding vaccine administration, note that current administration rates are not necessarily guaranteed to keep rising at the same pace. Initial vaccine distribution was to relatively easy groups to vaccinate (healthcare workers and residents of long term care facilities). As wider segments of the population eligible for the vaccine, distribution challenges will grow.

 

[bhobba]

Concerning severe cases: 1 vs. 9 (Pfizer/BNT) and 0 vs. 1 (Oxford) have no statistical difference.

Yes - I goofed on that one - in more ways than one. You are correct - at the moment either vaccine seems to be just as effective in preventing hospitalisations, severe cases, and death if you are unlucky enough to get it while vaccinated. This is good - and what I was hopeful of. It looks, like the flu vaccine, while neither vaccine is 100% effective (especially the Oxford one) they both reduce severity and risk of death if you do manage to get it when vaccinated. Statistically we do not have enough data to draw any firm conclusions yet on exactly how effective it is in that regard, but overall it does look promising.

Even though logistical problems are being experienced in distributing the vaccine and inoculating people (as experts predicted) it seems it is still progressing at a very fast pace according to the following:
https://www.hindustantimes.com/worl...d-in-india-and-the-world-101611510452388.html

That being the case hopefully we will get better statistical information soon.

One problem that occurred to me is with such a rapid take up, how does one carry out phase 3 DBT studies of future, possibly better vaccines? So I looked around and found this interesting article from Nature:
https://www.nature.com/articles/s41591-021-01230-y

I personally for what it is worth am an advocate of challenge trials, especially for things like checking the efficacy of current vaccines against new ones:
https://www.healthaffairs.org/do/10.1377/hblog20201208.921141/full/

But ethically it is dynamite.

Thanks
Bill

 

[russ_watters]

"Delivered" would imply reaching some destination in the US at least, but that shouldn't make a big difference. We take CDC numbers for "distributed", so you expect them to be in the US.

That's still quite vague. What is "some destination"? A giant warehouse? 15,000 ft over Kansa? An end-user(vaccination clinic)? If we equate "delivered" (stated by the pharma company) with "distributed" (stated by the CDC), the problem goes away. Agree/disagree? If you disagree, again, be specific about what you think "delivered" means. Delivered where?

We see the pattern that administered followed distributed with a two-week delay until the "distributed" graph increased its slope and administered vaccines couldn't keep track.

"Administered" follows a nearly perfect linear track that's slower than "distributed", I added the most recent CDC numbers:

Looks like you're hand-sketching on top of my graph, and doing a poor job of it (not that it's easy). Here's today's actual updated graph, with the 16 day offset:

Yesterday's "administered" point is literally on top of the "distributed" point from 16 days ago (I don't have daily data from 2 weeks ago to correspond to today). Ok, that's lucky since the day-to-day variability is somewhere around 100%, but even still the two have been tracking extremely closely together since the very first real "distributed" data point on Dec 21 (15 days to Jan 2 for "administered"; 4.6 to 4.2M). This shows an almost completely unwavering 16 day distribution pipeline/lag. I would tend to expect it to shrink over time (maybe not, as the logistical problem gets tougher as the numbers grow - but we can discuss that), but it hasn't yet.

And now that we're past Jan 20 and the media now has free time to look at less important things like the COVID vaccine distribution pipeline, we're starting to see articles on it. They are pretty clear about the cause of the slow administration rate:

And when will supply exceed demand? [subtitle]

Some mayors and governors say they have run out of available vaccines, and have had to cancel appointments...

There are simply not enough doses of authorized vaccines to meet the enormous demand. And that is not likely to change for the next few months...

Both companies are manufacturing the doses at full capacity, and are collectively releasing between 12 million and 18 million doses each week... [that's not quite borne out by the "distributed" numbers, but it is close]

There is no significant reserve of vaccines to speak of. For the most part, vaccines are being shipped out each week as they are manufactured...

https://www.nytimes.com/2021/01/21/health/covid-vaccine-supply-biden.html

 

[mfb]

For those interested in a very in depth discussion of the mRNA vaccine supply chain see: https://blog.jonasneubert.com/2021/...fizer-biontech-and-moderna-covid-19-vaccines/

That brings some clarification to the delivered/distributed question. Pfizer never ships "to the US", they ship to individual sites on request. Which means we can't really judge how many they could ship. If the sites can't vaccinate more people they won't request more doses.
For Moderna we don't know.

If we equate "delivered" (stated by the pharma company) with "distributed" (stated by the CDC), the problem goes away. Agree/disagree? If you disagree, again, be specific about what you think "delivered" means. Delivered where?

I don't even know which "problem" you see.

Looks like you're hand-sketching on top of my graph, and doing a poor job of it (not that it's easy). Here's today's actual updated graph, with the 16 day offset:

I forgot you used 16 days, I added data points using a 14 day delay. But after reading the article posted by Ygggdrasil I'm not sure how useful that approach is overall.

https://www.nytimes.com/2021/01/21/health/covid-vaccine-supply-biden.html

That article makes it pretty clear where the bottleneck is for now. In most places it's still local, only a few places could benefit from a larger production.

 

[russ_watters]

That brings some clarification to the delivered/distributed question. Pfizer never ships "to the US", they ship to individual sites on request. Which means we can't really judge how many they could ship. If the sites can't vaccinate more people they won't request more doses.
For Moderna we don't know.

I don't even know which "problem" you see.

Two ways to look at the problem:

• The definition of "delivered" is unclear.
• I've repeatedly asked you to define "delivered" and you won't do it.

Perhaps the answer to both is that you don't know and are declining to speculate. This is based on your prior statement:

The deliveries exceed the administered doses massively. That's incompatible with deliveries being the bottleneck. Based on your graph there are 20 million doses somewhere that have been delivered but not being used yet.

Since you seem to now recognize that "ship to the US" or "deliver to the US" as you put it before (again, the problem is with the word "deliver") is meaningless, then maybe we can identify where those 20 million doses are:

1. In the "cold chain" (between the pfizer/Moderna warehouse and an arm).
2. In a Pfizer/Moderna warehouse waiting to be shipped because nobody has requested/authorized shipment.

In the last couple of weeks of December there were indeed reports of problem #2, but I haven't heard any since. So I believe that all of the 'missing doses' are in transit between the pharma company and an arm.

I forgot you used 16 days, I added data points using a 14 day delay.

Fair enough. Anyway, I'll provide updates of that graph as we go since I think it's important. One feature that makes day-to-day tracking less useful is that the shipments ("distribution") happen in batches and the injections (administration) happens continuously. As a result, there is much more day-to-day variation in the "distributed" numbers. For now I'll track them daily to see if there are identifiable patterns, but otherwise it won't be useful to report them daily.

But after reading the article posted by Ygggdrasil I'm not sure how useful that approach is overall.
That article makes it pretty clear where the bottleneck is for now. In most places it's still local, only a few places could benefit from a larger production.

Please explain. I see nothing suggesting "the bottleneck is... still local". I'm not even sure it ever was "local". The data I'm seeing suggests the bottleneck is and always has been manufacturing capacity -- save for an initial fill of the 16 day distribution chain (which shouldn't really be called a bottleneck).
[edit] Oh, wait, it's this, isn't it:

That brings some clarification to the delivered/distributed question. Pfizer never ships "to the US", they ship to individual sites on request. Which means we can't really judge how many they could ship. If the sites can't vaccinate more people they won't request more doses.

Though you say "we can't really judge", you are actually judging/assuming there are ~20 million doses in Pfizer/Moderna warehouses that are ready to ship but with no place to send them, aren't you? Completely without evidence? It's those 20 million doses again. Rather than believing the face value data that says the 20 million doses are somewhere in the distribution pipeline, you're assuming they are in warehouses awaiting authorization to ship. Right?

 

[mfb]

Two ways to look at the problem:

• The definition of "delivered" is unclear.
• I've repeatedly asked you to define "delivered" and you won't do it.

Perhaps the answer to both is that you don't know and are declining to speculate.

"Delivered" doesn't even appear in the CDC page. I still don't know where you see a problem.
I used "deliveries" to refer to the "distributed" number once. Distribution implies something is getting delivered somewhere. Is this really what you are arguing about the whole time? That would be quite a waste of time.

Since you seem to now recognize that "ship to the US" or "deliver to the US" as you put it before (again, the problem is with the word "deliver") is meaningless

What?

then maybe we can identify where those 20 million doses are:

1. In the "cold chain" (between the pfizer/Moderna warehouse and an arm).
2. In a Pfizer/Moderna warehouse waiting to be shipped because nobody has requested/authorized shipment.

In the last couple of weeks of December there were indeed reports of problem #2, but I haven't heard any since. So I believe that all of the 'missing doses' are in transit between the pharma company and an arm.

Yes, that's what I said the whole time. Good that you came to the same conclusion now.

Please explain. I see nothing suggesting "the bottleneck is... still local". I'm not even sure it ever was "local".

See the part of the news I quoted. You focused on the few places that said they could use more doses, but skipped over what happens everywhere else.

 

[PeroK]

I hope I'm not posting journalistic exaggeration, but according to the BBC, Germany is limiting the AstraZeneca vaccine to people under 65. What is going on here?

https://www.bbc.co.uk/news/world-europe-55839885

 

[Ygggdrasil]

I hope I'm not posting journalistic exaggeration, but according to the BBC, Germany is limiting the AstraZeneca vaccine to people under 65. What is going on here?

https://www.bbc.co.uk/news/world-europe-55839885

According to the first line of the article:

The committee cited "insufficient data" over its efficacy for older people.

At least in their published phase III clinical trial data, there does seem to be somewhat of a lack of data from individuals >65 (for example, the UK arm of the trial had no one over the age of 55). We know that vaccines tend to be less effective in older individuals, so it is scientifically valid to question whether the vaccine would be effective in older individuals. However, some questionable vaccine is probably better than no vaccine, so it would probably make more sense to wait until there is data showing that the vaccine is not effective (versus waiting for data to show that it is effective) before making the recommendation. The recommendation could make sense, however, if coupled with recommendations to reserve use the mRNA vaccines (Pfizer-BioNTech or Moderna) in older individuals.

Note that questioning the efficacy of the Oxford-AstraZeneca vaccine is not limited to Germany. For example, the US FDA has not yet issued an EUA to allow use of that vaccine in the US.

 

[nsaspook]

Is it OK to talk about herd immunity again?

https://www.nytimes.com/2021/01/27/...ronavirus-cases-testing-variants-vaccine.html

I mean, it’s not an artifact of testing for holiday travel and then a lag. There really are fewer cases each day in the United States. And we see that state to state to state. Literally every state except Rhode Island is seeing a decline in cases. So this looks like we really are seeing a turning point in the trajectory of the virus, that the number of cases has gone up to a peak and look like it’s coming down. We’ve reached the point now where about a third of the country has been infected. If you look at the total number of cases — 25 million cases. Basically, most epidemiological models now multiply that by about four to get the number of real infections we have in the country. So roughly we’re between 100 million cases and 110 million cases of actual infections, including the asymptomatic ones, which means that about a third of the country has been infected.

And when you reach the point in any herd, in any population where about a third of it is infected, the virus doesn’t stop, but the virus begins to slow down. Because in any herd, whether it’s a bunch of horses in a corral or it’s a bunch of people at a bar, about a third of them are immune to the virus. So the virus can’t just ricochet through that crowd as fast as it did months ago when everybody was susceptible to it.

Michael Barbaro
So behind this good news decline in the pandemic is the kind of awful reality that the Coronavirus has run wild through the United States and infected a third of our population and rendered a third of our population essentially immune.