U.S. Government official: Coronavirus vaccine trial starts Monday
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Even during our darkest times, we're going to see the most remarkable science and engineering capabilities exposed in the coming weeks and months, for the sake of humanity.
My one concern is once this whole thing is over there will be a long pause followed by a blame game.
There are already conspiracies floating out there being pushed forward by officials in various countries.
Humans have done amazing things in the face of dire odds. Nothing brings them together like these sorts of challenges.
Since then I've been reading a book called "The Rise and Fall of Dinosaurs" and there's been so many extinction events, yet life still bounced back each time stronger than before. Looking at life on that timescale, what humans managed to accomplish in such a short one doesn't get enough praise. We've only scratched the surface on how much better we could be as a species.
I'm confident we'll be far better prepared for the next epidemic and at the very least hopefully China (and others like Vietnam) will eventually ban the wildlife trade for medicine as well, not just for food. Which is what early results by scientists are pointing to as the cause of this whole thing (Pangolins trafficked for Chinese medicine). Animal conservation plays an underrated role in epidemics, same with Ebola (monkeys) and SARS (bats). We don't need to be consuming any of this stuff.
I agree. Being in California, it's a standing recommendation to maintain extra supplies in case of impact from wildfire or earthquake. So, I thought I was pretty well prepared. I already stock and rotate extra water, toilet paper, n95 masks, canned food, etc. But, I discovered some holes in my preparedness that I will rectify when the stores are back to normal supply levels -- I will be even better prepared for the next state of emergency.
I'm sure the preparedness will go wide and deep across many government and private organizations. At a minimum, I hope the CDC ensures there are plenty more ventilators ready for the next one.
My only thought here is that we don't know that "the next one" will require ventilators. While I'd certainly like to see our national stockpile of PPE and emergency equipment like ventilators improved, I'd like to see the CDC preparing to face a wider-set of the "next one".
I think we should be looking at our manufacturing infrastructure and ability to rapidly ramp-up the production of any life-saving hospital equipment in the face of a sudden need. With a national stockpile that's strong enough to cover the ramp-up period.
If this goes really badly in the next couple of weeks or months, that's not going to be a true assumption. A changed nation is going to be looking at its spending priorities and a lot of reassessing will be done. Predicting exactly what the result will be is difficult, but predicting that there could be a lot of change is not.
If we cross the logistic curve's inflection point today, then this may ultimately blow over and be remembered as an inconvenience (and, humans being humans, an overreaction). If this continues on for much longer and kills hundreds of thousands and (based on some of the nasty stuff I've read about) permanently damages the lungs of millions more or other such things, causing disability and long-tail mortality increases for the next 50 years, this will be a generation-defining event comparable to the Great Depression, and the usually-reliable "tomorrow will be mostly like today" prediction methodology will catastrophically break down in the next couple of months.
Here in the UK, there used to be training that anyone could take that was offered by the main first aid organisations, lasted 2-4 days, and covered significantly more serious but not necessarily life-threatening conditions. There were a few variations you could do, including things like common sports injuries, conditions you might encounter while in the wild outdoors and how to handle a situation as well as possible if professional help is going to take a long time to arrive, variations on first aid for children and babies, and so on.
Those courses for the general public seem to have all but disappeared now, presumably due to a lack of demand. This isn’t entirely surprising, as they weren’t cheap to do, but if you did have the means to afford it, what is the value of knowing how to help someone recover better from an injury, or preventing a serious condition from maybe becoming a life-changing one, or in extreme cases even saving a life? My wife and I did take a course specifically on first aid for little ones when we were about to become parents, but even finding that wasn’t easy.
The main ways to get more than very basic first aid training here now seem to be through either statutory obligations for first aiders at work (where the courses are widely available and longer but also have to cover the official paperwork you need to do as a first aider at work) or through becoming a much more serious amateur first aider (either joining one of the first aid organisations and in due course going out to work as a volunteer at major events and the like, or through things like sports coaching organisations that have the scale to make special arrangements for first aid training). That leaves quite a large gap in provision for “ordinary” people who just want to know enough to help out in a serious situation, but as far as I’m aware, there isn’t really anybody trying to fill that gap at the moment. I did ask the trainers on that last course I took if there was anything I’d overlooked in terms of more comprehensive general first aid training, and they said that unfortunately the above is about right at the moment.
I don’t know how much first aid training would really help with the current coronavirus situation anyway. It seems like what is needed in this case is more people with nursing skills and the ability to set up equipment like ventilators. But as a more general point, I would strongly support measures to increase general knowledge of first aid within the population, at least for anyone who is willing and able to help when they can. If nothing else, it might free up more of the fully trained professionals to deal with the most serious situations and so help reduce the strain on them.
Just like a reserve army full of reservists has a serious cost (those people all have to spend weekends training, after all: time that could be spent doing other things), a "health care army" would require people to get regular training to stay up-to-date and in practice. Basic first aid can be useful for anyone, but for having people ready to jump in and become healthcare workers in a crisis, they need a lot more than a first aid refresher once a year I think.
Snark aside, we had a similar situation with SARS. In the immediate aftermath, it's easy to say what needs to be done to prevent the next one. It's far harder to get everyone onboard with paying for something 5 or 10 years down the line when "there's no point" and "why do I have to pay taxes"?
I'm happy I don't live in The USA right now. Even the worst hits, I don't have to be afraid of medical bills or if I lost my job. Both are covered by the tax I payed before.
Diseases that are differently transmitted like Herpes and AIDS can be widespread, but they’re unlikely to be the “next one” because they’re easier to contain.
Good point. How about, "the next one that needs ventilators". Either way, it is a concrete example of equipment that we can now add to the list of things we need more of to be better prepared next time, or the time after that, etc. There are certainly many more things that should be on that list too.
One caveat though is that airborne diseases spread much more rapidly and are much more difficult to prevent than other forms of transmission.
Diseases that spread by skin to skin contact (smallpox, for instance) almost universally have visible signs before they're contagious. This makes quarantining easier.
Diseases that spread via contaminated drinking water (cholera) can almost always be stopped by boiling water or iodine tablets. And developed nations have well established ways of ensuring clean drinking water.
Diseases that spread via blood or other bodily fluids (Ebola, HIV) can be stopped by well established sanitary procedures.
Diseases that are not airborne simply don't have the potential to cause the damage covid has already caused, to say nothing of the total damage when it's all over.
[1] https://www.sciencedaily.com/releases/2019/10/191009132321.h...
Nit: The Great Dying, c. 252MYA, took about 10 million years to 'recover' from (though it depended on region, maybe). And the species that came out were not the same that died. As in, they evolved to fill the old niches. The Great Dying was no joke, nearly everything that had more than one cell went poof, like, 96% of all species.
Not to rain on the parade, but we have to work at this. If we do, we are fine, but just posting internet comments is not going to cut it.
Call your congresscritters or other representatives, tell them what you think.
https://en.wikipedia.org/wiki/Permian%E2%80%93Triassic_extin...
I think posting online is a double-edged sword. On the one hand, "clicktivism" and posting hopeful messages soothes that person; on the other hand, if they are that easily soothed, they panic just as easily.
> Call your congresscritters or other representatives, tell them what you think.
This is important. Fortunately I've always lived in a district where my representatives were almost 100% aligned, but even then it is important to double down on the signal to noise. They love to hear positive feedback as well as negative feedback.
Considering the actions of the US government in Germany, and most probably the actions of other governments, I'd say for the sake of national interests, not humanity.
I'd be happy to be proven wrong, though: When a vaccine is found I'm sure the government/company behind it will make available to the world for free...
That's how a national emergency gets declared. The President decides to go forward with it. If California declares a state of emergency, it's the governor that has the final say:
https://www.gov.ca.gov/2020/03/04/governor-newsom-declares-s...
I am pretty sure the U.S. government (or actually Trump) will not do that. He will make the world pay dearly for that.
But I don't blame Germany at all, there came a time where people can see what is important and if economy of their country is healthy - it produces everything people need and if it really make sense to outsource all production elsewhere just to save a few bucks and if the government they elected is able to handle situation.
But - time - is the issue. It's medical. Stuff takes a long time to develop a test, there are real ethical rules that won't get broken I think even now.
50 years ago, there would be either some brave volunteers who would be willing to get infected or some poor souls somewhere who would be unwittingly infected to see the results. No more of this.
It's possible however the CCP may 'volunteer' some prisoners, or they may allow brave citizen volunteers. I can see that happening. (I can see brave volunteers coming from everywhere, but I don't see governments allowing such a program to go forward).
Also, we need to test drugs and therapies that have excessive, even deadly consequences. Again, dilemma.
This is a huge ethical dilemma.
Up to a generation ago, drug companies would run trials in Africa, away from aggressive regulation.
During the Manhattan project, the US Army would run squads of soldiers right through the aftermath of test nuclear explosions, literally to see 'the effect of radiation'.
Many specialist jobs entailed levels of riks unthinkable today. Remember, this is in an era where cars didn't have seat-belts.
In 2020, things have changed, but it's possible totalitarian regimes will find 'volunteers'.
China has been engaging in harvesting the organs of political prisoners, at scale [1]. If they're willing to put people in prison for their ethnicity, and then 'have them die' so that a rich person can get a kidney through back channels ... then absolutely they can do medical trials on these people, it may not even need to be publicized.
[1] https://www.nationalreview.com/corner/china-credibly-accused...
They can be true, but remember the Curveball dossier that helped to start a war.
In a February 2011 interview with The Guardian he [Rafid al-Janabi] "admitted for the first time that he lied about his story, then watched in shock as it was used to justify the war."
With close approaches, it seems (as a layman) that there are always pretty large ranges of just how close they will be. I dont think you'd know "a comet is headed directly at us" until way too late. Instead you'd get some warning that there is a 10% chance or something. Over time that would go up to a near certainty. Maybe I'm pessimistic, but I would predict something more similar to climate change with deniers and paralysis.
Trump was caught out trying to buy a CureVac, who are working on a vaccine, to corner the market and make it only available to America https://www.washingtonpost.com/world/europe/germany-coronavi...
Will we see a vaccine? Maybe. At pumped up costs? Most definitely
IMHO that is the real issue. We didn't need to be in this crisis in the first place : /.
We, especially the US, keep treating CDC like they’re responsible for fixing diseases after they spread when their focus is prevention. This has been happening repeatedly for at least a couple decades.
Every time, it gets worse because we treat disease as a solved problem.
https://www.theatlantic.com/health/archive/2018/02/cdc-fundi...
The rest of the population pray that the Corona quarantine will be scaled back as soon as possible, so we don't have a financial ruin to deal with the next decade or more.
Here's an excerpt from paper about VEEV summarizing the technique's mechanism:
...a disease-causing organism (pathogen) can be exposed to gamma radiation in the presence of a Deinococcus Mn complex, and rendered non-replicative (killed) by overwhelming genetic damage, but still maintain the shape of key surface proteins needed to mount a highly protective immune response.
https://www.sciencedaily.com/releases/2017/05/170530122345.h...
I think this could have the potential to develop a cure but isn't receiving any attention from our (dysfunctional) government (who also happens to own the patents on it!).
The vaccine itself can be developed in literally DAYS (for most viruses). The problem is that it takes a YEAR to test it comfortably in humans. For something that you'll be delivering to otherwise healthy humans, the bar for safety is extremely high.
...now the modern counter-argument is that if 4% of people are going to die globally, then maybe the safety bar should not be so high (this time).
On the Philippines, they gave the dengue vaccine to schoolchildren, a substantial number of whom were seronegative. The disease in that population was much more serious than it would have been otherwise, there were unnecessary deaths, and a good number of parents avoided the measles vaccine for their children, and a measles outbreak promptly followed.
The rushed vaccine apparently substantially increased the risk of Guillain-Barré syndrome in those receiving it. The syndrome is fatal in up to 5% of those that contract it and can cause permanent damage to the peripheral nervous system.
First, do no harm.
Clearly a significant issue, but less so if it was likely to prevent a serious illness. The real issue was the vaccine was administered for a disease that never gained a significant foothold.
Only about 200 cases of swine flu and one death were ultimately reported in the U.S., the CDC said.
More than 500 people are thought to have developed Guillain-Barre syndrome after receiving the vaccine; 25 died
https://www.latimes.com/archives/la-xpm-2009-apr-27-sci-swin...
So in this case, the cure was literally worse than the disease.
Which is my point, the problem was mass vaccination for a non issue. Saving 500,000 lives at the cost of 100 lives is a really easy tradeoff to make. Costing 25 lives to save 0 is a problem.
From another practical concern, we need to preserve the public perception that vaccines are low risk to them, not just that they are lower risk to society than the hypothetical alternative, before healthy people will get vaccinated.
I'm not saying that is how we SHOULD act. I'm definitely not saying that's how we DO act. Clearly, taking into account all of the factors that you mention, we have a very high standard for action, and that's a rational choice given the realities. It's still not a rational choice from the economics perspective, which strictly looks at cost/benefit.
When we get farther along in testing we will have more information and should re-evaluate. Maybe something will prove to work well (we can do a new flu shot in a few months because we have approved the process to create a new one), maybe everything else will fail. Maybe this will fail. We don't have enough useful information to work with now though.
https://news.yahoo.com/government-official-coronavirus-vacci...
Even if initial safety tests go well, “you’re talking about a year to a year and a half” before any vaccine could be ready for widespread use, according to Dr. Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases.
So even if these trials go well that suggests a vaccine is a long way down the road.
[1] https://jamanetwork.com/journals/jama/article-abstract/26649... [2] https://www.fda.gov/patients/drug-development-process/step-3...
That vaccine made dengue significantly worse for those who had not been previously exposed to it. Situations like this are especially bad because they erode trust in vaccines, perpetuating the idea that all vaccines are bad/malicious when in fact a properly vetted vaccine is very safe.
[1] - https://www.npr.org/sections/goatsandsoda/2019/05/03/7190377...
Beyond that we can probably cut another 6 months with judicious strategizing. Have certain populations defined that are high risk and high exposure - like elderly health care professionals - and start using the vaccine before the approval is complete. You might actually mix this with early testing and have the volunteers be actual beneficiaries. This way you get efficiency results from the field - it's trivial to implement a double blind and measure infection rates.
Lots of things can be done, if one is willing to look at the letter of the rule and re-think if it's applicable now.
Public health officials say it will take a year to 18 months to fully validate any potential vaccine
A bad batch could essentially equal to purposefully infecting people with the disease, for example.
Ed: i don't see it mentioned explicitly: while young people might reasonably volunteer to be vaccinated and exposed to the virus - we really need to vaccinate the elderly and at risk - who has a high mortality rate. We might get volunteers, but it's still different to sign up for a 50/50 shot at death, than the risk of two weeks of mild flu...
And we probably do need to test for adverse effects in the at risk population too.
Nope, impossible. mRNA based vaccines don't use a weakened version of the virus to train the body:
> [0]The use of mRNA has several beneficial features over subunit, killed and live attenuated virus, as well as DNA-based vaccines. First, safety: as mRNA is a non-infectious, non-integrating platform, there is no potential risk of infection or insertional mutagenesis. Additionally, mRNA is degraded by normal cellular processes, and its in vivo half-life can be regulated through the use of various modifications and delivery methods
To use a bad analogy mRNA based vaccines train the body using a "signature" of the virus, essentially skipping the first step of actual infection and jumping to the second/third steps where the body's previously exposed to antigens are generated. It is an entirely new form of vaccine that has worked in trails before.
Which isn't to say it is 100% safe for other reasons. I'd say auto-immune reactions are the biggest risk (e.g. the body using the signature encoded to attack the body itself).
Out of curiousity, why couldn't potential auto-immune response be simulated on a computer up to a degree of confidence, if nothing? Would quantum computers drastically rid of current computing related handicaps wrt to simulating a large search space typical of such simulations? What role might yet the recent resurgence in deep-learning play for immediate future?
Basically every answer you could imagine to that question is true. We don't understand the system well enough to simulate it at that level of detail. We don't have the computational power to do it if we did. If we did have aliens from space deliver to us both the power and the simulation, we'd have a difficult time verifying the validity of the simulation!
Quantum computing is still not well-understood enough to know if it's helpful; there's a certain barrier of "what can it actually do" that we won't really understand until we have them, and we start raising up quantum programmers. No slam against the theorists intended, it's just the difference between "the halting problem is unsolvable" and "here's a program for calculating payroll" is small in theory but large in practice. We won't really know what they can do until we work with them for a while.
Quantum computing would definitely help if we had it. And researchers are using deep learning in many parts of the process now.
That vaccine made dengue significantly worse for those who had not been previously exposed to it. Situations like this are especially bad because they erode trust in vaccines, perpetuating the idea that all vaccines are bad/malicious when in fact a properly vetted vaccine is very safe.
[1] - https://www.npr.org/sections/goatsandsoda/2019/05/03/7190377...
https://clinicaltrials.gov/ct2/results?cond=Corona+Virus+Inf...
Why?
If you dose people with a new vaccine, you’ll need to monitor them 6 months at a minimum. 12 months would be better.
It takes 3 months to nail down the protocol and for all the sites to be ready. Then you start recruiting and for a vaccine, you’d want a large population (reflects usage). So assume 6 months to recruit 1000 people. They don’t all start at the same time, so if you’re tracking for 6 months, it will probably take 9 monthsfor the last person to finish the trial.
Then you need to analyze all the data you collected, so another 3 months. Then the FDA takes 3 months to review and approve.
There is a TON of work that goes into running a clinical trial.
> Then you need to analyze all the data you collected, so another 3 months.
Help me understand this. You vaccinate 1000 people. In 6 months, the number of them that get sick is 10% of the rate of the unvaccinated. 0.1% have a bad reaction. How much more analysis do you need?
> the FDA takes 3 months to review and approve
How much time if that is moved to the front of the queue and all hands work on it? Given how enormously disruptive the coronavirus is, we cannot afford to not have all hands working on it.
Then in terms of the trial, 6 months would be nice, but it wouldn't be ethical to actually expose them to the virus. You'd simply need to recruit a very large number of patients and see if the treatment groups has less disease than the non-treated group. With infection rates pretty low across the entire population, you'd need to recruit thousands, just to capture the handful that actually get exposed.
Then when it comes to analysis, you need to clean the data (yes, there will be errors), then you need to do a statistical analysis of not only efficacy but every possible side effect. You're probably measuring things like viral shedding, so that's another entire dataset. Oh, then you'll have missing data. Do you toss that patient's data out entirely? Or keep them? What impact does that have on your conclusion?
I could go on and on, but suffice to say it's a ton of work. And yes, you can speed up some parts, but other parts you just have to let them run their course.
I believe the magnitude of this pandemic will in time push us (rather violently) to think outside the box.
If you're testing a drug for a serious cancer, then there is a lot of tolerance for side effects - the alternative is death, so even if it causes things like nerve damage, it's an acceptable risk.
With vaccines, you're going to treat a huge percentage of the population and they'll be healthy when you give it to them. As such, the risk-benefit analysis is much different since there is a chance for serious harm.
And so on. The exact rate could be set according to the actual infection and death rates in the population. Given the current costs of curfew, we could create an entire government agency just to administer this, and still save trillions.
For inspiration, consider the Manhatten project.
How do you test the efficacy if you don't know who you're injecting? Maybe it works really well on a certain population, and reacts harmfully to people with some pre-existing genetic trait or condition. You wouldn't know, because you took a random set of volunteers.
If you're going to counter and say "we'd still do the pre-analysis on the volunteers"... Well, that's what takes time.
You could do that time-consuming screening after they get the trial vaccine, not before. After all, I suspect it is highly unlikely that a virus vaccine would give someone a bacterial disease or a genetic disorder.
Also, before the 6 month trial is up, you're still going to have data trickling in that will give a good indication whether it's working or not.
Source: I saw the movie "Contagion" and learned that a vaccine is considered safe and effective based on one monkey not getting sick. I believe everything celebrities tell me.
Ok. So let’s say you give the vaccine and run the tests later. This person’s white blood cell count is way above normal.
Is that caused by the vaccine? Was it something else? Was it always there? You have no idea because you didn’t capture a baseline.
The challenge of clinical trials is you don’t know what to expect, and you’re measuring effects on top all the stuff that’s happening in the background with completely healthy people.
The goal is to capture as much data as possible so you can actually draw conclusions from it. Otherwise you’re left thinking “it’s probably the drug, but I’m not sure”.
Normally, yes. But this isn't normally - here the goal is to get a vaccine as quickly as possible.
For example, white blood cell counts. Draw the blood, set it aside, inject the vaccine. Then get around to testing the blood. You save what, a week that way? That's a big deal.
Based on your descriptions, it seems that a lot of time can be saved by doing things concurrently rather than serially.
Other people may have a different risk/reward calculation.
I wonder if the downvoters fully understand that Covid-19 is a big deal. If we don't manage to eradicate it and it becomes as common as the (various strains of) cold, we will likely take a big hit to global life expectancy. It may also evolve to become more virulent and we may yet discover various unpleasant things about it. Even if it stays exactly as it is now and we just let it run it's course and get 70-80% of world population infected, before eradicating it in say two years time with a vaccine, we will eat a huge, multi-year dip in life expectancy in the developed world.
And clearly, we are not accelerating this yet in ways that are completely safe (e.g. would we have more and better volunteers faster and more regularly if we paid them more than $100 for each visit?).
There were news today that first subjects are getting the experimental vaccines already. I don't know if it's fast enough or not. But I doubt people will not try to speed things up, at all levels.
"Although far behind, the United States did work hard to get a jet into the air during the war. Lockheed was engaged to build a jet fighter, using the British De Havilland Goblin engine. Speed was called for, and Lockheed gave Clarence L. “Kelly” Johnson full authority for the project. He set up his special unit, the famous “Skunk Works,” with 23 engineers and 105 shop men, and he did 96 percent of his own fabrication and all inspection. Lockheed's normal development procedure of engineering conferences was by-passed; only 700 drawings were made; sometimes parts were made from a drawing, and sometimes the reverse was done: simplicity was Johnson's keynote. The XP-80 cost only 63 percent of the XP-38 prototype, which had been made by the customary system of development. It was accepted by the AAF only 143 days after the start of development, even though the engine had not been on hand until the 132nd day. After General Electric had designed an improved Whittle-type engine, the 1-40 or J33, the XP-80A was designed around it: the United States had a jet fighter and one of the best aeronautical designs in its history by the end of 1945."
"The most telling criticism of massed-manpower engineering practices is the record of the “Skunk Works.” Starting with the XF-80, this technique has been used periodically by Lockheed's Kelly Johnson to produce the U-2, the JetStar business jet, and the A-11 (F-12). The XF-80, it will be recalled, used 23 engineers and was designed in 143 days; the U-2 also used 23 engineers and took 80 days; the JetStar used 41 engineers and took 241 days; Johnson used 135 engineers to build the A-11, which was designed to go over Mach 3 at 20 miles high. This contrasts with the 3,500 engineers used to build North American's XB-70, which went Mach 3 at 15 miles high. Although it must be acknowledged that none of these aircraft are large, the XF-80, the U-2, and the A-11 all pushed beyond the state of the art, and the repeated success of the “Skunk Works” shows that effectiveness of the system is no fluke."
"The Jetmakers" by Charles Bright (yes, my dad)
Think about it - 23 engineers and 80 days for the U2. Kelly Johnson knew how to get things done.
Though, if 1% of your planes have issue that causes them to stop working midflight after 1 year, at worst you'll lose a few pilots and fix the issue by inspecting rest of the planes.
Backtracking and fixing issues after giving a vaccine to millions of people is a bit more problematic. Not just technically, but also in gaining the trust back, etc.
Is there a type of screening that requires you to do tests over a period of more than a week, because you need the results from some slow tests to order other slow tests? If you just exclude all the people that need unexpected additional tests, is that so many it will ruin the data?
A vaccine could compromise one's immune system and indirectly cause that bacterial disease or genetic disorder. That would be its side effect too.
Besides allergic reactions and contamination, the oral polio vaccine can cause polio:
3 days? That's really aggressive.
This is speculative but what process would you expect them to follow for these next steps of expanding the scope of testing volunteers?
Would they prioritize higher-risk people like medical? Older people? Healthy people? Some random combo? Volunteers?
There are going to be a lot of volunteers.
Personally I'd rather take my chances with COVID-19 than risk injecting myself with an untested vaccine.
Good luck to all!
But the fear part is that they screw up, people get hurt, and the anti-vaxxers dominate the conversation which leads to broader fear of vaccines and a vastly worse outcome overall for the foreseeable future.
I would not envy anyone who has to make such decisions right now. And I would respect the process as it is, rather than be angry at it, because vaccines are overall some of the safest medicine in the history of medicine and that's really important to getting people to use them.
About the same length of time that experts were originally saying that it would take to get it out - unless they corners, I suppose.
If nothing else let’s ramp up production in parallel with testing. If it doesn’t work out we lose some time and money which isn’t a big deal in a crisis.
But logically, if these tests show that somehow it needs to be tweaked, you're practically throwing out funding that could otherwise go towards developing better candidates.
Also, testing is not large scale. The whole point is to do it in a small amount of people who are already at risk of infection.
When have we ever had a perfect process that can’t be improved?
Here's an excellent Planet Money article I heard yesterday going over this issue: https://www.npr.org/2020/03/13/815307821/planet-money-why-th...
At least in the US, there's a policy of 'creating' a market for vaccines for these potential outbreaks in order to incentivize industry to research and produce them.
That makes a lot of sense for a vaccine against, say, chickenpox, or anything else that kills a hundred or a thousand people a year. For something that, at a 3% fatality rate, is about to kill nine million people in this country alone, it's suicidally slow.
(adverse reaction above completely made up)
We do not need everyone to be Martin Luther King Jr. or Gandhi, or Michelangelo, or Bach or Einstein, or Shakespeare, or Newton or Galileo we just need to be smart enough to recognize when one of them is born amongst us. We've not always been good at that.. but we've been getting better at it.
This is such a ridiculous hero praising statement. It's also completely wrong.
While we love to hero worship, none of these heroes worked in isolation or without correspondence with others. Be it their teacher, peers they were having letter relationships with, their partners, their students or other people.
It seems that the proportion of ground-breaking individuals is less a function of population than of the state of things. Meaning, it doesn't matter how many are trying if there are only ever X slots available for 'greatness' at a given time. E.g. when one Musk or one Gandhi arises, a thousand others might have just missed that spot for this life.
At the very least, there is a relation between the two — pushing population to extreme numbers obviously increases the number of exceptional individuals because there is more need; but I see a rather linear bottleneck here, whereas context dictates a lot of what you can and can't do. In that sense, the greatest are the most adaptive (evolution-style, applied to civilization), they find the 'correct formula' to solve in their own space and time. And execute on it.
I think it's more of a “few thousand people” worldwide at any given time in recorded history, maybe 10x or 100x more today than in Ancient times but... nowhere near the population growth ratio.
Obviously, it's all just my subjective perception. I could be so wrong it's actually not-not funny to think about it... ¯\_(ツ)_/¯
It seems that at some point, it takes more of us to crack the same amount of "scientific difficulty" as it were — hard to be a lone genius typically these days.
I don't know. But you definitely speak of a bias that I had and got almost unequivocally debunked by a colder, more statistical (retrospective, empirical) than logical perspective (models, thought experiment). I personally trust the former more ('facts' in layman terms).
Remember the HN guideline to assume the best possible intent of other people's comments.
If original thought was common it wouldn't be original. This seems like it’s basic power-law stuff.
Do you have a citation for this?
I'm probably a bad person for feeling that, but I just wanted to punch the guy in the face, because I'm sure people like him buy all the toilet paper.
Then it dawned on me that if you can't be smart and innovative, evolution-wise, at least be nosy, insidious, envious and without scruples.
Let the 1% bright humans get you out of your mess(like elect Xenophon your leader in times of crysis) then strike them down once the danger has passed.
Quite depressing actually.
They'll think a vaccine will be here soon.
I imagine their thought processes would be like: what's the big deal with this virus, why do we need to mess up the economy by social distancing, if we're going to have a vaccine quite soon?
People are exhausting our supplies of essential hygiene products and cheap, non-perishable foods. Scalpers are re-selling the supplies online with huge markups. Hourly workers are loosing their incomes and parents are struggling to find means to take care of their kids who are suddenly without school for the foreseeable future.
We need public awareness. We need people to take this matter seriously. But we also need a balanced approach to ensure we don't cause even more devastation in the long term.
Frankly, I'm happy for anything that gets people to calm down for a second and just commit to good hygiene practices and avoiding crowds for a few months.
Complacency is a massive problem right now. So many people are not taking social distancing seriously, and it’s going to have disastrous consequences, al la how things are currently playing out in Italy, in many countries.
And compared to that, the temporary exhausting of supplies is a trifling matter. (Wait until the real panic sets in when hospitals can’t keep up). But like I said, it’s not like we have to chose between complacency OR panic. We can take it seriously and take appropriate actions.
This virus is far more dangerous than most people understand now. The news media has been a month late in everything since they started reporting because all of this is evolving too rapidly to confirm to journalistic standards. You have to dig for this information yourself.
There are many smart people on HN who are perfectly capable of reading and understanding research literature in an area that is NOT their primary expertise, and who can make half-decent arguments and deductions.
Reply to the points he raises (if you can). Don't belittle him.
I do find the point about no SARS vaccine compelling, however. Is that true?
I know the flu vaccine gets updated every year or so with new viruses that are prevalent, so if there is no SARS vaccine then I wonder if that is true and if it is true it couldn't be developed.
Again, multiple things thrown out there without sources which are not common knowledge, followed by "you can look this up yourself".
https://dx.doi.org/10.1128%2FJVI.02395-10
> I do find the point about no SARS [-CoV[-1]] vaccine compelling, however. Is that true?
Wikipedia says so, and just gives essentially the same advice as being given for SARS-CoV-2 (or any human-transmissible virus, I imagine).
https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...
Most of those people know that reading papers is far from enough to understand the issues at hand and making such stark statements. I've seen this issue a lot in HN: people who have no experience at all in a field, who think they are very smart, reading something on a paper or Wikipedia and then making these broad statements, specially without any sources. Intellectualism implies being humble and recognizing when one is not an expert in the matter, in order to avoid spreading misinformation and doubt.
Some of us people know that grad school literally consists of learning potentially exclusively from papers. These papers represent the cutting edge of human knowledge and for someone familiar with scientific literature they are not that hard to parse. Doctors and scientists are humans like you and me.
I'm not making policy here, I'm posting on a forum where unusually intelligent people from all disciplines gather and casually speculate on any number of topics. Though I guarantee at this point that I understand the problem at least as well as some 90% of our politicians...with or without sources.
Doctors and scientists are humans that, like you and me, spend years and years of study, practice and research on their own specific topic, with knowledgeable people by their side to guide, question them and answer their doubts. Parsing a paper is very different from actually understanding it, specially if you don't have the context they have.
> I'm not making policy here
You're right, but we have already enough disinformation as it is. We all have a certain responsibility towards not sharing unfounded statements in this situation.
> a forum where unusually intelligent people from all disciplines gather
HN is an echo chamber of programmers, mostly from the start-up world. A constant issue in this forum is programmers thinking that they can solve any problem (I still remember some discussions on sheet music that were extremely out of touch with actual music practice).
Also, "unusually intelligent"? Really?
> Though I guarantee at this point that I understand the problem at least as well as some 90% of our politicians...with or without sources.
The arrogance here is astounding.
by your admission the person you are referring to is an engineer in a highly specialized field and is likely to be skilled at probabilistic inference as well as dissecting (certain types of) scientific publications.
I do have some special knowledge in biological research, from seven years of post-doc work at the Max Planck Institute for Computational Biology. We're the group that created the standard of care software for HIV treatment, and for a time we hosted the global influenza database. In other words, viral disease was a specialty of ours.
In my view, as someone with some high level expertise in the field, is that the original poster is correct in their assessment.
You're constantly having your biases thrown in your face in a way that many other professions do not.
These skills and others do genralize very well.
I've been reaching out to prominent people and I'm getting interest in some kind of collaboration with funding. People are onto the tech and it's myriad applications. There's a reason ML engineer was ranked #1 be demand growth (300%) on indeed last year!
Effectively the same way that we can use equations to make inferences about reality - but because of the nature of mathematical notation and the limitations of human ability, though powerful, math has limitations. E.g. you can write out the idealized equations for heat propagation in a conductive medium, but solving them for a real object requires empirical simulation.
Deep neural nets are the next step. Now you can essentially train these neural networks to infer not just the general idealized behaviors, but specific details, discrete values for X and Y on a fine grid that are beyond the practical limits of applied math.
But this is much bigger. It turns out that, much in the way that idealized equations apply to many problems (e.g. exponential growth arising from diff EQ), neural nets generalize to all manner of real world problems, provided the training data is appropriately curated.
These neural networks excel at learning human like heuristics, with machine level precision. You can make inferences for both continuous and discrete probabilistic systems. This is a major development and it's just starting. We've finally assembled the pieces in the last few years.
from an npr interview[1] :
BRIGHT: Unfortunately, when the virus disappeared, the funding tended to disappear with it. And the companies that were making a SARS virus vaccine lost interest and shipped it back to their more profitable vaccines.
[1] : https://www.npr.org/2020/03/13/815307821/planet-money-why-th...
There does seem to be some evidence that other Coronaviruses may exhibit ADE but it's important to note that ADE is not well understood and that many viruses seem to display it in-vitro but non in-vivo.
In particular, vaccines and monoclonal antibodies targeted at SARS spike proteins seemed to cause ADE in some experiments but not in others.
There has also been at least one paper that speculated that the virus was deadlier in China than South Korea due to pre-existing exposure of the population so similar Coronaviruses and ADE cross-over from them. This was before the big spikes in mortality in Iran and Italy which would be pretty strong counter-evidence to this hypothesis.
I think it is best for us to treat our both our species-level understanding and our personal understanding of immunology and epidemiology (assuming that like me, you are reading papers but have not spent significant pre-existing time studying this field) with an appropriate level of epistemic skepticism. I would be careful of making statements like "a vaccine is unlikely to work" unless you have a high degree of confidence in your own understanding of the state-of-the-art.
(I haven't downvoted you and would encourage others not to do so as that mechanism is intended to remove noise and not to signal disagreement)
Most people have no idea WHY they are doing what they are doing! Like the actual true long-term business objective of a task etc. Successful task completion usually requires only technical details and immediate organizational ones. Fake goals are easy to sell to investors and board members by expert manipulator sociopaths (the kind of people explicitly hired and selected for top executive roles).
You can make immense progress towards a goal you know nothing about. You can't leak a secret you don't know.
That's kind of how human societal evolution works, only the bigger goals are evolved/emergent instead of envisioned by some dark conspiratorial cabal. But you can't rule out the latter.
As a society we need to maintain some "immune reaction potential" against nefarious manipulation by entertaining unlikely conspiracy theories too!
Natural-ADE shouldn't thwart development of a live/innactivated-virus vaccine though. But would immensely slow the dev of RNA or protein ones since you'd have to test through a lot of candidate variants until you find one that is not ADE-inducing...
Otoh, a population of naturally-immune survivors is a living library of antibody cocktails that are know to work. If I were more conspiracy-theory inclined, I'd say the UK gov. has knowledge along these lines and they are willing to sacrifice some of the gen. pop. knowing that (a) it will take a looong time to a good vaccine, so better for the economy if they get natural immunity faster than everyone else, also lots of arbitrage opportunities on international markets once they're first to recover, and (b) they bet their "living library" of good antibodies will maybe make them a leading producer of safe vaccines.
Now, if this COVID bugger does ADE with naturally induced immunity... that's BAAAD! Natural evolution would have no reason to optimize in that direction, and genetic lottery is probably not likely to produce this. You get the conclusion and geopolitical consequences... it's something something about that doomsday-clock striking a certain hour...
DISCLAIMER: I'm not an expert on the topic, or any other topic in general. Just another expert-generalist currently doing mostly software thinggies but having some old and rusty biomedsci background...
https://www.fiercebiotech.com/biotech/president-trump-tries-...
Their rabies vaccine CV7202 requires only two doses of 1 µg mRNA, and they hope to replicate that with the corona-virus. If corona needs approx. the same doses they claim to be able to produce billions of them soon.
https://www.curevac.com/de/news/curevac-focuses-on-the-devel...
Moderna and BioNTech could scale-up to hundreds of millions of doses by EOY without expanding capacity. If the US and German governmetns really hit the gas, we could expand both companies manufacturing at risk and get to hundreds of millions doses in 6 months. Then, if the clinical trials look good, we already have the material ready to go.
As a retail investor living in Germany, this confirms my decision to put a little bit of money into Moderna stock. I would have done the same with CureVac, but they aren't listed at any stock exchange unfortunately.
This is their most recent clinical trial results (2017) https://www.thelancet.com/journals/lancet/article/PIIS0140-6... showing basically failure without more-immunogenic delivery.
This is their most recent clinical publication showing their adjuvanting technology (2019) https://www.sciencedirect.com/science/article/pii/S0264410X1... which in general is needed to make-up for their lack of potency in their mRNA vaccine technology. A problem neither BioNTech nor Moderna have with their mRNA and delivery technology.
Bareknuckle and self-interested as Trump's foreign policy may be at times, I have a hard time believing he'd go so far as to deny the world a vaccine for this, though I do see the sense in attempting to acquire promising research teams in order to avoid the overhead of multi-organizational collaboration.
If the last four years have taught me much, it's that anonymous government officials say a lot of things. I can't read German, does the original article do anything to validate this claim?
[1] https://www.tagesspiegel.de/wissen/so-agiert-trump-beim-coro...
I suspect that this is the same xenophobia that is resulting in the same rumors floating around the US that China has a vaccine that they are denying the rest of the world.
Regardless, it might make sense to wait a bit for facts to come out.
The Xenophobia in the states that there are some who believe that the Chinese are doing the same to the US.
I think outside the U.S. no one would be surprised if he really did that.
Or blackmail other countries into some deal that's only great for him, but not for the rest of the world.
As a non-USAian, I can really see that he doesn't give a shit about the rest of the world, because the rest of the world can't vote him to stay in or out of office, but can be used as a base for his performance, for him to brag "Look how I delivered".
American here: You HAVE NOT been paying attention.
It's hard to imagine anyone would think like that, but keep in mind that Trump sees everything as a zero-sum game. For him to win, others have to lose. If he's losing due to Corona, he assumes others are profiting from it somehow. That's probably where the hoax talk came from.
It's a bizarre and harmful way to view the world, but all evidence suggests that this is how he really thinks.
> There’s no chance participants could get infected from the shots, because they don’t contain the virus itself.
So ... what's in the vaccine? Is it just saline? Without a viral load I don't think we could call it a vaccine in the traditional sense; if this is some crazy new technology that enables the immune system to process the virus without introducing some viral material, that's neat and all, but deserves some deeper explanation.
Worth noting that the SARS (v1) vaccine was abandoned after the disease disappeared. Idiotic lack of long term thinking.
Also, the vaccine was halted due to lack of funding, not ethical reasons.
https://www.nbcnews.com/health/health-care/scientists-were-c...
The only problem humans seem to have with chocolate are supply-related.
Yes, you test on non-humans. But because biology is different, you then need to test on humans.
There's a number of Zika vaccines that have been developed years ago that still aren't close to regulatory approval.
SARS-COV-1 infected people for 2 years, then it was gone. There's certainly a chance that SARS-COV-2 disappears before a vaccine could make it to market.
To get more research, obviously.
Also - epidemics are tail risks. You cannot just leave them to the market to be priced on the expected value basis, that will leave them grossly underpriced.
Unless there's somehow infinite amounts to spend on research that's not viable whatsoever and actively diverting away funding from more pressing needs.
But again, you leave it to markets and people that think in broken expected values and yeah it will seem like the project is stupid.
Expected values make no sense when the system lacks ergodicity.
I think the idea here is since both SARS and Covid-19 are part of the coronavirus type, a vaccine for SARS would make modification and rapid deployment of a Covid-19 vaccine significantly better.
Really, any existing coronavirus vaccine would have helped research efforts tremendously.
> SARS-COV-1 infected people for 2 years, then it was gone. There's certainly a chance that SARS-COV-2 disappears before a vaccine could make it to market.
Highly unlikely. SARS ended up infecting an order of magnitude less people _in its entire 2 year run_ than Covid-19.
We will have this virus around for at least 5+ years, possibly forever.
do we know that's the case? It seems to me that the bottleneck is testing, which need to be done specifically for each vaccine.
- Sars-1 and Sars-2 (COVID-19) are related enough to bear the same name, thus having researched a virus for the former would be incredibly informating to finding a virus for the latter.
- As it stands, we know so little in that regard that we do not know if there is a possible vaccine for COVID-19. If I take an average between 3-10 years (the range of guesstimates floating around in some circles apparently), that's 2026-7 to have a definitive answer on that (it also depends a lot on the behavior of the virus, and we are only 10 weeks into this mess, we just don't know).
- human testing on Sars-1 may have been impossible or rather unethical, but models on animal species are just about the way we do it for everything all the time, so having a 15-year body of research + associated datasets would have been the reasonable, cautious thing to do. Having a vaccine for e.g. mice on Sars-1 available now would help a lot.
- There is no valid reason to have stopped Sars-1 vaccine research, especially given the fact that numerous experts were certain that new coronaviruses would cross again to the human race in the future (this is still true today).
- Because of all this, we are now forced to rush tests on "best guesses" for vaccines, with nowhere near enough data to make a really "educated" guess, far from the usual. Meaning, increased risk to the patients in those trials, but most dramatically for all: we have cornered ourselves into making moonshots in a hurry in the quest for a vaccine.
There is a possibility that we've gotten so good at molecular biology and modelling that we'll actually overcome these obstacles that we've created for ourselves, but the gist is that had we been a little more forward-thinking (including hoarding stocks for medical supplies, etc), the ultimate death count could have been orders of magnitude smaller, possibly anecdotal.
Up until late January I was saying I want a vaccine for the common cold which was more impact on my life and something these researchers could switch to. (I'd like a better treatment to prevent heart attacks even more, but it is unlikely the researchers could switch)
You might want to re-think that perception.
I've recently heard Ralph Baric, an epidemiology Professor from UNC School of Medicine[0]. He's arguably one of the world's foremost experts on the topic — which makes it easy to at least listen to the man, you'd think... Have a look at his publications:
- Dec 2015 ⇒ A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence.[1]
- Mar 2016 ⇒ SARS-like WIV1-CoV poised for human emergence.[2]
Few sentences from the abstract of the latter:
> Outbreaks from zoonotic sources represent a threat to both human disease as well as the global economy. Despite a wealth of metagenomics studies, methods to leverage these datasets to identify future threats are underdeveloped. [...] Focusing on the severe acute respiratory syndrome (SARS)-like viruses, the results indicate that the WIV1-coronavirus (CoV) cluster has the ability to directly infect and may undergo limited transmission in human populations.
I mean... What more is there to say?
You may listen to a (great but rather technical) podcast[3] featuring him, among other experts, and there's even a layman-friendly companion post made by a listener[4] (whom I fully credit and thank for sharing the knowledge).
____
[0]: https://www.med.unc.edu/microimm/directory/ralph-baric-phd-1...
[1]: https://www.ncbi.nlm.nih.gov/pubmed/26552008
[2]: https://www.ncbi.nlm.nih.gov/pubmed/26976607
[3]: http://www.microbe.tv/twiv/twiv-591/
[4]: https://medium.com/@hpcngmoh/you-will-be-hard-pressed-to-fin...
As someone not well-versed in virology, would you know what happens to the germline the virus leaves permanently in the infected host? Or, am I drastically on the wrong line of thinking here when someone says the "virus has disappeared"?