Comment by jariel | Hacker News Reader

Comment by jariel | Hacker News Reader

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It's interesting there wasn't direct economic injection from governments.

Both the humanitarian and economic toll of COVID is off the charts. 20% contraction in the economy, is like 4 Trillion in GDP loss for the US alone, maybe 20 Trillion for the world.

And that's just the money, not the human loss.

Given that, I don't get why nations didn't give them basically blank cheques, enabled the socialization/commandeering of factories and equipment, 5-10% of the Armed Forces for whatever needs etc..

Literally every drug company can 'report their assets' to the COVID task force and they will get deployed as needed. The companies will be happy to do that because they'll earn 3-10x return on those assets otherwise anyhow.

That seems a little dramatic but it's basically nothing compared to the damage COVID is causing.

Also: they didn't go into the actual manufacturing details to much, sadly.

Edit: also interesting would be the sunk cost / opportunity cost calculation on ramping up production of untested vaccines.

If opportunity cost didn't factor in i.e. if ramping up one vaccine didn't come at the cost of another, my bet is that it would have been worth any price.

If the US had spent $2B on ramping up every vaccine candidate before they were approved, and only 1 out of 10 came through, costing $20B for the first massive batch and accelerating subsequent batches, instead of merely $2B - would it have been worth it?

$200 a dose instead of $20 dose?

The math would say it's way beyond worth it. There's a case for 'prepping' every single vaccine candidate to the extent it's possible and even starting to manufacture in quantities way ahead of time.

This financial calculus doesn't work in the context of Pfizer - it doesn't make sense for them - however it absolutely does in the bigger picture.

A 'remedy' for this could have been to offer Pfizer massively increased price per dose for earlier delivery, in which case it would have made sense for the to spend $20B instead of $2, or simply some kind of national 'blank cheque' intervention. The former concept is neat but would be hard to nail down, the later is probably more workable.

Given that vaccine manufacture is 1/2 the equation, not just the R&D, I hope the 'after action reports' will put this in context.

The article answers this. Because further government involvement would slow down the process. E.g.

“To assemble its mRNA production network, Pfizer used its own money and didn’t take any from the federal government. Executives said they didn’t want to give agencies outside the FDA more leverage over the design of the trials.”

“Rival Moderna, which took funding from a division of the U.S. Department of Health and Human Services, suffered a three-week delay in completing its own mRNA trial after federal officials there asked the company to slow down enrollment to boost the racial and ethnic diversity of study subjects.”

So basically the answer is that government is completely incapable to give money with no strings attached. There are always strings and they always slow things down.

Another way to interpret this is that when unrestrained, Pfizer cut some corners and insufficiently represented the test population. Of course, this all depends on the reasoning behind that request.

That's a completely unsubstantiated allegation.

It's not meant to be an allegation; my point is that the government asking to increase test diversity isn't inherently a negative. However, the parent comment interpreted that it was, because it was stated earlier that it "slowed things down", without showing that such a request was frivolous.

"Executives said they didn’t want to give agencies outside the FDA more leverage over the design of the trials" substantiates it, given that this was the leverage sought.

No it does not. Your assuming that was the leverage sought. You're also assuming that's the primary reason for avoiding government interference when there are many reasons for that. The primary possibly being that bringing the government into it would slow things down. Finally you're assuming that they didn't have a diverse trial, and you're wrong about that:

https://news.ycombinator.com/item?id=25408528

The FDA still has to approve and cutting corners will end up being when searching for approval

yeah but it increases government's control. Which, depending on how you see it, may be a good thing.

1) The FDA sets the rules, even in a pandemic, not Pfizer - and this is good. It's pointless to test a vaccine if the result are not valid for Black people. This is not an example of 'slow government bureaucracy' - this is normal regulatory oversight, akin to 'approval' of the drug in the first place.

2) That they didn't take the money is a second order issue in the context of $4 Trillion hit to the economy with 300 000 dead in the US alone. Pfizer will do whatever is best for their economic outcome. Not taking money because they believe it may have slowed them down is one thing, but not taking it because they'd not make as much profit is another.

The profit motivation has obviously distorted early response, to the point that good organized leadership would have required some kind of regulated but open regime for manufacture, with some kind of negotiated price.

Why on earth are we only letting Pfizer manufacture it? The answer is 'free markets' - except they are obviously dysfunctional at the moment.

A better answer would be some kind of 'Open IP' agreement whereby an established royalty would be set for the vaccine, and basically anyone can make it.

We already have government established rates for every single natural resource, and we have controlled rates for energy as well - this is not a new idea.

Also - the government could provide 'infinite credit' for approved pre-production of select vaccines by select manufacturers at a set price, thereby encouraging mass-manufacturing of vaccine candidates even if the candidate failed.

i.e. socialize the risk.

Its counter-intuitive but only in a regular market based context. The math shows how that's upside down though, the ROI is much, much higher with intervention.

Now - if the government has is literally incompetent in every operating capacity, that's another storey, but what I have described here is not 'government manufacture', but rather, a different kind of market-based solution, with a different incentive structure.

If we didn’t waste so much time in dealing with politics and formal gossiping we’d would be living in the future.

> It's interesting there wasn't direct economic injection from governments.

I didn't read the article, but I don't believe this is true. The vaccine is ultimately not Pfizer's but BioNTech's, and the German government gave them $445 million to develop it.

We're talking about trials and manufacturing, not development of the vaccine itself.

The former is R&D intensive, the later is op-ex expensive.

The former relies on talent, the later is mostly just bodies and money. The former can be done much earlier in the process if the risk equations are aligned, which they are not, which is why Pfizer ramped up in October, and not back in April, when the could have, but wherein it wouldn't make sense for them.

The humanitarian and economic toll has nothing to do with virus itself but more of because of the government response to it. Namely the lockdown.

They were pretty smart about it. The guy leading project warp speed knew all the new vaccine platforms and funded 2 companies for each approach. I don’t think you could’ve gotten things much faster than this. Big pharma wants to cover their tail because a serious side effect would tarnish their - and vaccines reputation for decades and cause existential lawsuits.

Moncef Slaoui is the guy in charge. He also mentions how they filter out candidates - for example ones needing an exotic ingredient that would make scaling manufacturing too hard. Check out his interview on Steven Levitts new podcast.

It’s pretty incredible the mRNA vaccine candidate was created only a few days after China released the genetic data of the virus.

"I don’t think you could’ve gotten things much faster than this. "

???

It could have been done 5 months ago, by 5 different manufacturers.

We could have had 50M doses in Oct, the rest by January.

Why didn't Pfizer start ramping up? Because of the risk involved with an unproven candidate. That's literally in the article.

It's 'financially crazy' for them to invest billions ramping up on an unproven vaccine. But only 'crazy' for them, not for us. This speaks to the dysfunction of markets in crisis situations.

And why are we entrusting the manufacture of this essential IP to only one company? Pfizer? Because they paid for it? 'We' can 'pay for it' as well. And we can pay a lot more.

If the government established royalty rates for a vaccine, thereby ensuring Pfizer gets a cut if the vaccine is a winner, and allows any manufacturer meeting regs to manufacture it, you'd 10x production.

If the government basically 'pre-paid' or provided guaranteed credit for any manufacturer (up to standard) for any 'early candidate' vaccine, then not only would 10 manufacturers be involved - not just one - but they would have started 5 months ago.

It would have been 'insanely' more expensive to do it this way, probably costing 10x as much.

... but it's actually not 'insane' is my point, it's extremely rational for us to put $200B on the table to accelerate this by 5 months. It's a bargain. It's a win-win-win - Pfizer frankly makes just as much profit (royalties have no underlying unit cost), manufacturers make some, Americans are safer and the economy starts earlier.

We handled it 'poorly' because we didn't manage the situation, put in the right regs, or create the right incentives.

The current systems support elaborate ways for people to keep other people in check. These systems suck at fighting viruses (or anything else - except other people).

You think minorities are more or less likely to trust a rushed out vaccine?

??? What does this have to do with 'minorities' (If you are referring to the FDA requirement, it's not about public trust so much as literally a medical requirement to include people of different ethnic groups to measure potential differing response, which is normal in such trials)

??? And what are you talking about 'rushed'. I'm not talking about changing the nature or timeline of the trial. I'm talking about ramping up production before the vaccine is proven to be safe and working, because the opportunity cost of 'COVID shutdowns' are 1000x greater than the lost opportunity cost of wasted spending on manufacturing vaccines that work.

Again: we should have been mass producing the potential 'good candidate' vaccines months ago. It doesn't matter if some of the failed to pass muster, it would have been well worth any potential wasted money on making vaccines that we can't use.

We pretty much have DNA/RNA printers that can make anything from data.

And turning RNA into "mRNA vaccine" is just putting in in a little ball of fat (I think) which they know how to do because they worked on this technology for years.

Random question: why are we saying, "the economic toll of covid," rather than, "the economic toll of the response to covid?" If the lockdowns hadn't happened, more would have died, but presumably the economy would be fine.

Why does everyone seem to think the economy would be fine without lockdowns? You think that the entire population would've continued just headed to restaurants while hospitals declared "not accepting patients anymore" and refrigerator trucks stacked up outside nursing homes?

What actually happened in stupid countries is that they reacted too late, too lightly, and everyone's been complaining that "oh the cost was too high". It takes a lockdown of ONE month, enforced strictly, to clear out COVID from the population and resume effectively normal activity (you still need to limit international passenger travel but that's proportionally far simpler).

I think some if it is that it is an appealing contrarian take, and even as stark as things are, it is common to not have suffered much personal impact from infections (either direct consequences or severe illness/death of friends/relatives).

I'm not terribly well connected socially so I don't take it as a universal, but the people I've heard about having it are a single friend of a friend and my doctor's husband (she volunteered the info during a routine appointment).

So the responses are more visible in peoples minds than the pandemic, and they are thinking intuitively about it, not reasoning about the precarious situation that (pretty much continuously) exists with such a fast spreading infection.

I think that's definitely true for a lot of people. But there also seems to be a more active sort of intense denialism, fueled by a need to score political points at all costs, that leads even people who _have_ been directly impacted by COVID to continue insisting it's not a big deal.

It's why Herman Cain's staff kept tweeting even after he died from COVID. And why people in the White House have been making a big show of hosting superspreader events, even as so many of them have to rely on the best medicine other people's money can buy to recover. Ultimately, I don't think there's a way to understand it rationally, because as you say, it's not rational; it's an emotional response.

It's both. Both a dwindling number of folks with no personal connection to the virus, and the political stuff going on.

Doesn’t it tell something that every government on earth “chickened out” and did some kind of lockdowns when the numbers got bad enough? Sounds extremely naïve to think the economy would’ve been fine with unmitigated spread and hospitals becoming unusable. You’d be off by several orders of magnitude on the chaos that would cause in society

And interestingly in many places there were excess deaths in the first wave, but not the second. So it is a big question just how many more would have died.

Even more interestingly, this is bullshit.

(Unless you mean countries like New Zealand where the second wave just isn't happening)

There is a lag between cases and death, and death and the publication of cumulative reports on all-cause mortality.

If you happened to have read anything on the topic during the first wave, you'd know as much. Because it was repeated ad nauseam, until it became too ridiculous for even the most dedicated to keep on insisting that there were no excess deaths.

The case fatality rate was considerably lower in the second wave in almost all cases, and the total number of deaths generally lower as well.

The 'lag' is accounted for in that most 'second wave' places have past the peak over their waves.

Deaths were 'higher' in the second wave in places that had a small first wave, like Austria.

But for places that had a 'real' first wave, the second wave was generally milder in terms of overall deaths, and much milder in terms of CFR.

We can't ignore the real risk of 'waves' but it's also important not to deny the nuanced reality of them. In particular, the 'second wave' had many more younger people, probably accounting for the lower case fatality rate.

We had few COVID deaths in the first wave and no excess deaths. Now we have lots of cases ~3000 daily, some 20-30 daily deaths but excess mortality is waaaay higher than COVID deaths. Most can ve explained by reduced accessibility to the medical services because of COVID precautions and general fear in public. Only now we start to feel pressure on the healthcare system caused directly by COVID cases.

How on earth would the economy be fine when people die left and right?

Do you really think shops were full and everyone was out an about just ignoring their health (and potentially death) just because of some government mandate? Do you think people don't have their own will or brain?

In my home Sweden the government has enforced no limitation in liberty due to this virus - they have recommended social distancing, but no force.

Restaurants, shops, and bars have fewer customers, but they and other business is surviving.

That is just one data point, but it’s something

The drop in economic activity in Sweden is, roughly, just as large as in Norway, Finland, and Denmark. But with 4 to 10 times the number of deaths. So, no, the lack of lockdown (which is a fallacy itself) didn't protect Sweden from economic impact.

Most of the deaths in Sweden happened early in the pandemic and are more result of a bad luck than some policy. Now my country has more daily deaths than Sweden despite having 1/3 of the population and being in the second quarantine since Nov 7th. The restrictions will be way stricter from this Wednesday.

Dateline today, 2020-12-13:

"Sweden's neighbours offer them emergency help as its hospitals fill up with coronavirus patients"

[1] https://www.businessinsider.com/sweden-offered-urgent-corona...

No more deaths in Sweden this year than previous years.

Our hospitals already suffered from lines long enough for people to die before getting care. Waiting in line is always the result of socialist government monopolies, and this was the case before COVID as well.

https://emanuelkarlsten.se/number-of-deaths-in-sweden-during...

Swedish King Carl XVI Gustaf says coronavirus approach 'has failed'

https://www.bbc.com/news/world-europe-55347021

No. The lockdowns didn't cause the economic damage, the people's response to the risk of death and injury caused it.

To recover the economy you have to suppress the virus. Period. There's no magic wand to let people party away.

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