Israeli study finds 94% drop in symptomatic Covid-19 cases with Pfizer vaccine
reuters.com
reuters.com
Here in Europe, articles are coming out complaining that the slow vaccination could be harming the economy which, well, fucking duh. (https://www.brusselstimes.com/news/belgium-all-news/154626/c...)
Fast rollout. Involve pharmacies. Involve the army. Distribute widely and efficiently. Prepare for months before the vaccine is here. Follow-up campaign to convince vax holdouts. A real War Effort.
There's barely any calls for volunteering here in Belgium. Hospitals and vaccination centers will complain to the government that they are understaffed but you seldom hear them urgently asking for new volunteers to assign to COVID teams and vaccination centers. We spent a ton of time debating whether the social bubble should be 2 or 3 large, whether kids should be 12 or 14 before they count for it, etc etc and those spending that time were the same people who didn't prepare for the eventuality of a vaccine, and started doing so in late December.
Sorry this has veered off topic. The number of articles that can be summed up to "Vaccines work, are good, and israel is doing it right" frustrate little european me. :(
By this rate, people won't be vaccinated by 2021.
The dashboard for Germany: https://impfdashboard.de/
The production is going very slow, and therefore the rollout it's super slow...
It's very likely that europe failing to supply us is saving the jobs of other politicians who failed to organize us better.
This is a huge, enormous screw-up which can be almost entirely pinned on promoting people that have achieved nothing but failures into EU offices, the latest and most egregious case of which is Ursula von der Leyen. Guess what, when you're promoting an incompetent moron who failed at every job so far into an office with actual power and responsibility, they're going to fuck things up. Previously they'd only promote idiots to Commissioner level or so, which was already pretty bad if you ask me, but not this bad. Not "billions worth of economic and innumerable social damage"-bad.
Like I said in another reply: if you're ahead of schedule when your supplier is dry, your schedule is awful. Isn't it? It makes no sense otherwise.
If we had 1 million vaccines to distribute right now, we couldn't. We have 150 "vaccination centers", all of which are converted testing centers but which makes only 10 percent or so of them full time; most of them are open a couple days a week. If you crunch down the numbers you end up very optimistically at the ability to distribute 250-350k vaccines per month... In a country roughly the same population as israel.
Edit: i don't even sort of understand why I'm getting downvoted for sharing plain numbers.
Who could have guessed that paying the right price would guarantee the supply of a rare commodity everyone would want? :)
Manufacturing capacity at the continental AZ facilities have been hit by teething issues. There were also teething issues at AZ's UK facilities, but the impact was less because the order was placed three months earlier in the UK.
Sure, Israel did a great job negotiating for vaccines, but it's a zero-sum game so only a few countries could have pulled this off.
The story right now is one of the entire industry ramping up production as fast as they possibly can with money being no object.
Given claims like "I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April." from https://www.theguardian.com/global-development/2021/feb/14/w... it seems like claiming that the bottleneck is production needs some serious caveats....
I'm curious where these 70M doses are bought but not approved. As far as I can tell, AstraZeneca is approved all over Europe.
So it's entirely possible that the specific vaccines approved in Europe are supply-constrained, while other vaccines are in the situation described in the article. All that means is that saying that "the problem problem is production" is very specific-vaccine and specific-regulatory-unit dependent and needs to be evaluated carefully.
If you wait until Q3, you can get a proven vaccine for $3 per person, so $90m instead, so going early is going to cost you ... $3.1bn? So that's still 10% of GDP ish. Not sure that's an easy sell.
I was very impressed. I am looking forward to seeing how it continues. If there is a way to improve supply I have no doubt they could go even faster.
As a side note; The side effects to the Oxford jab was less than ideal. Bad chills (on an already very cold day) and a cracking headache. Feel much better now but I wasn't expecting it to be so bad! I had had COVID before, although it was mild, and I've heard this can make the reaction a bit worse than normal. So maybe that was why.
There are vaccine centres in London (certainly the one I attended) having to close early because a lot of people in group 1-4 are refusing to take up their appointments. I believe that so they can make use of their supply they've had to transition to lower groups a lot sooner than planned.
0: by which of course I mean strong institutions like the NHS, apolitical and well-organised army, regional councils, and the civil service
So I'm not sure it's only a supply issue.
My pet theory is, that someone looked for a scapegoat why German vaccinations are so low. AZ was a welcome one, especially after the question of whether AZ had to use its UK factories for EU orders. After that stunt, I have the impression AZ is somewhat pissed.
The EMA allowed the use of AZ for patients over 65 (because they guess that it'll probably be effective), but the STIKO and other government institutions of the various EU countries restricted it.
I don't think it'll make a huge difference, since more than a third of german vaccine doses were used based on occupation, where AZ can be used. The obvious scapegoat for slow vaccinations is that AZ cut deliveries by a large amount, which might not be AZs fault, so the different scapegoat wasn't needed.
The most important thing to remember is that both the UK and EU pre-paid for AZ to manufacture their vaccine pre-approval. The date of regulatory approval and the manufacturing schedule are supposed to be completely decoupled.
It's true that the UK got their vaccine order in first and nobody is denying that. That's why the UK was getting shipments from AZ back in December. When the EU finally signed their contract they were told that their deliveries could start in February.
While I doubt the EMA is going to comment publicly on the timing of their decisions, I don't think it's a coincidence that their approval of AZ was done in late January. They already knew that the meaningful supplies were starting in February so they simply collected as much data as they could before making the "go/no-go" decision.
So while the "feckless EU bureaucrats screwed it up" storyline is forever popular (both in the UK and EU press) they seem pretty blameless on the issue of AZ approval. They just had to get it approved before the manufacturer was ready to start deliveries and they managed that.
What kicked this into a crisis is that AZ announced that their February deliveries to the EU would be less than half of the expected amount. The EU's position is that the UK and EU should be treated equivalently at this point: they both pre-paid for certain quantities to be delivered in February, so any production shortfall should be shared. Needless to say, the UK sees it differently and doesn't want any UK-based manufacturing to go to the EU. Hence we got this ugly diplomatic standoff.
The US for all the criticism it can take, closed this negotiation in weeks. We spent a whopping 3 months arguing with pharma companies about price and liability before closing these contracts.
There are people dying avoidable deaths while we allowed for this inertia. There are no serious media outlets pushing the European Comission for answers on this failing. There will be no hearing to find a cause for this failing. As a very pro-european citizen this made me very bitter, there could have been a strong EU wide vaccination programme and EU transnational solidarity but instead we see this blunder that will set us back for months probably +1 year of these lockdowns and economic damage.
No pharma exec wants to be the one that killed the golden goose.
The issue is the EC went on a panel wide long discussion to then get to more or less a carbon copy of the initial german contract. Those were 3 months wasted that could have made a difference in ramping up vaccine manufacturing.
The EU's economy is roughly the same size as the US's[0], but the EU has roughly a little over 445 million citizens compare to the US's ~330 million.
I would imagine that EU countries paying for the healthcare of 445 million citizens would be considered as quite a large "customer" for pharmaceutical companies and could strike a good deal.
How does the US get an edge in negotiations over the EU? It feels that military power wouldn't factor here, but I'm having trouble coming up with other ideas. What else could it be?
[0]: https://ec.europa.eu/eurostat/documents/2995521/10868691/2-1...
In Israel, where everyone has received a military training and is ready to organise, the IDF is of course very involved in the vaccine rollout though the Home Front Command. The supply of the vaccine is also controlled by the government, not private healthcare providers.
But my point was not even this. It was about how to consider the pandemic and its potential consequences as part of the internal government's discussions on how to respond and then the capacity to act quickly. I have no doubt that Israel has deemed Covid a very serious threat to national security and has thus mobilised accordingly using their experience of the de facto continuous state of war or at least high alert to organise and act quickly and effectively.
In addition to nurses employed by the health plans, supplemental staff were recruited from the Home Front Command of the Israel Defense Forces (IDF), private companies, and others.
In the current vaccination campaign, the Home Front Command of the Israel Defense Forces (IDF) is playing several vital roles. It is responsible for ultra-cold storage of the vaccines in a central location, transporting those vaccines to a large number of vaccination sites, and also organizing vaccination sites in small localities [1]
IDF facilities have also provided 50% of all covid tests.
[1] https://ijhpr.biomedcentral.com/articles/10.1186/s13584-021-...
It is percent of population that matters not absolute number of vaccinated people. Israel is near 70%, while India is only 0.5% [1].
CFR per capita, while looks good (113.97 deaths per million) is not actually good compared to Mongolia (0.62 deaths per million)[2]. You know, who else is doing well - Belarus (195.31 deaths per million). I don't believe Belarus numbers as all countries around are burning (500+ deaths per million). Could it be that India is faking it as well? Based on corruption index [3] it is even worse than Belarus.
sources:
[1] https://ig.ft.com/coronavirus-vaccine-tracker/?areas=gbr&are...
[2] https://www.statista.com/statistics/1104709/coronavirus-deat...
[3] https://en.wikipedia.org/wiki/Corruption_Perceptions_Index
Which is more commendable considering the vastness of the land itself. Israel == Delhi and surrounding reasons.
Given the economic parameters of the country, it has better CFR than US, Italy, Germany and UK. Thats pretty amazing considering the health expenditure and wealth of US, Italy, Germany, UK is enormously high than India.
As when number fudging that is not happening.You can look at data from independent foreign houses stationed in India.
* Average age in India 26.8
* Average age in countries you are comparing with is 38+
And about independent foreign houses: sources please :)
> Israel feels like the only nation taking the importance and urgency of vaccination seriously.
It's a mixed situation here.
* Israel supposedly paid 3 times more than others per shot (but if it works, it's cheaper than the economy losses).
* Israel has free public health care.
* All public health care databases are connected.
* Pfizer gets very detailed annoymized dataset.
* centralization means the health care also hospitalization covered by health care and connected to database.
* Israel is a small country. I can easily cover it by 7hrs drive bottom top.
All those helped get enough jabs.
Yet, There's enough population that don't social distance / comply to basics such as wearing a mask (even indoor!). Some population even did huge events during lockdowns with zero enforcement.
Hope this gives some proportion.
More than that even, closer to a factor of 10.
https://www.jpost.com/israel-news/the-cost-of-vaccinating-is...
$47 / head!
VS closer to $5 in other countries.
Given the better efficacy, I think the comparison doesn't boil down to a single number very well.
It's not that likely that a comparable investment from the US would have accelerated vaccine availability to the same extent as happened with Israel, which was able to get substantial shipment in part because the US invested a lot in the mRNA vaccines, and in part because the EU waffled about making orders.
To put that into context: the US has a population ~36x the population of Israel.
1: https://observer.com/2020/11/covid19-vaccine-price-pfizer-mo...
Instead they were de prioritized in the list.
Israel simply paid more and bought a larger amount of vaccines delivered earlier. Which is smart but it's not a strategy that all countries can replicate, not because we cannot afford it but simply because there is a bottleneck in production. There is not enough vaccines for all no matter how much we pay, so we would end up competing in price for no real speed up.
Anyway, getting the first vaccines is always going to be zero-sum for the same reason getting first-row in a concert is zero sum.
Actually you can. When dealing with a pandemic causing the level of disruption we've seen, you throw money at propping up production of every serious vaccine candidate, hoping that at least one of them works out.
Every additional day of lockdown probably costs as much as the entire production lifecycle of a vaccine, including distribution.
I think the EU economy contracted at least 5% in 2020. The EU GDP was $18.3 tn, so 5% is about $915bn. That's $2.5bn per day (!). And that's just the direct impact, the whole psychological, PTSD, etc. longer term impact probably makes that higher, I'd be shocked if the total cost isn't something like $3bn per day.
They should have been throwing money at every reputable vaccine producer, including burning all red tape to make sure that excessive production capacity will be ready before the final approval is even given.
To be clear, I agree that the return on investment of a quick and successful vaccination campaign is so big that it makes sense to aggressively bet on it. But I also think the evidence shows we have bet quite aggressively on it, at least to unprecedented levels.
What I cannot comment on is how much better we could have done, the supply chain and logistics of producing 1 x (world population) for each candidate vaccine in the hopes at least one of them works and we can roll-it out quickly are so ridiculously complicated I don't know how it could have been made to work. I fear I would just be misdirecting my frustration with the current situation and an incomplete understanding of the problem from the comfort of my armchair.
My 81-year old grandparents will get their first dose of vaccine on February 28, while other countries are already vaccinating much younger people.
Now some states _are_ close to 100%. Some are close to 60%. Investigating the differences in approach that lead to those differences in numbers mostly comes down to whether states prioritize vaccinating people or creating complicated rules and sticking to them.
When combined with things like this from https://www.theguardian.com/global-development/2021/feb/14/w... : "Instead we have a patchwork of approvals and I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April.", it sure seems like a large part of the apparent supply bottleneck is self-inflicted. Some basic "if it's approved in another G-8 country (or whatever criterion you want to pick) we should auto-approve it here" logic would probably significantly help with this sort of thing....
Searched for the well written article I've seen, to link it here, but I'm only getting SEO bullshit.
It's complicated. Right now there are vaccines that have been purchased and produced but not delivered due to regulatory approval issues (70 million from just one manufacturer, according to https://www.theguardian.com/global-development/2021/feb/14/w... ), vaccines being delivered but not used (see https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... "Supply used" statistics), and so forth.
Blaming supply constraints is a great cover for these organizational and regulatory failings, though. "We don't have enough vaccine" sure sounds better than "we've only bothered to use 60% of the vaccine we got our hands on" (hello, Rhode Island and D.C.).
What some describe as smart moves by Israel is also rather selfish. It’s made possible by the fact that they are a rather small country that has a large support by major powers for historical reasons, but they made a pact with the devil here: They simply outbid everyone so the vaccine goes to them INSTEAD somewhere else (including Palestine). They sold all kinds of patient data on top in order to get where they are now.
Vaccinating the 100x larger EU is simply a different beast. If the EU had been as "smart" as Israel here and bid as much, don‘t forget we‘d all be stuck at 5% vaccination speaking in absolute numbers of vaccine availability.
1: https://www.jpost.com/israel-news/the-cost-of-vaccinating-is...
I think there was a lot of skepticism in Europe initially regarding the vaccine while in Israel the demand was very high from the get-go.
I agree that in Belgium things are not as well organized as they should, as usual. They should for months they were preparing and plans would be ready and working by the beginning of January. But it turned out nothing was ready, debates about who to give the vaccine first were only starting instead of being started many months before. But at this point none of that really matters: it's simply not the bottleneck. Vaccination centers are ready for thousands of people per day, but only get 100 doses.
By the way I've read and heard about calls for volunteers for hospitals and vaccination centers. Vaccination centers don't really need many people now though because of the low supply.
That's why they did digitize - every resident has a digital medical file, and healthcare providers can easily track and report back to Pfizer and the ministry of health on side effects and efficacy (i.e. it's easy to look up who got the vaccine and when, when they get admitted to a hospital with COVID).
But you're presenting that as somehow being bad, while it's actually better than what a lot of other countries have.
And as somebody who currently resides in USA, I am well aware that it's better compared to local state of affairs
Maybe I missed it, but you'd think with something so devastating we'd just make a bunch of candidates, get them out to the clinics for storage, and as soon as we thought a given candidate was effective start injecting everyone?
And if a given drug doesn't work, what's a few billion?
The truth is just that mass-manufacturing of a brand new vaccine is a hard problem. The fact that we're only a couple months from the very start of vaccinations and the world is already nearing 200 million doses delivered is, frankly, amazing. The only problem is that due to the severity of the crisis we wish we had a magic wand that gave us 10x the supply right this instant.
The good news is that manufacturing continues to ramp up dramatically. It just feels like it's slow because we're all so eager for it to improve. If you look at the month-on-month growth, though, it's clearly ramping up fast: https://covidvax.live/
The site you linked is really nice! Not sure where they get the numbers from, but regardless a great resource.
One of the more interessting metrics in there is "daily doses per mil", as it shows the difference between the vaccination campaigns. Would be even better if the also shwed when each campaign started.
I can't personally vouch for its exact accuracy -- every government reports their metrics on a different schedule and I guess they're building realtime estimates based on that. Certainly seems reasonable enough to look at for the broad trendline.
If you look at https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... and scroll down to "U.S. Vaccination Campaign" you will see that in the US 74.5% of the vaccine doses that have been delivered have actually been used.
This could happen for a combination of two reasons, as far as I can see: either delivery is ramping up so fast that most of the delivered doses were delivered very recently, or because people are doing a terrible job of using doses that get delivered.
My impression is that the latter is a larger factor than the former, so far, based on the wide variation by state in the "Supply used" column. West Virginia has used ~96% of their supply. D.C. and Rhode Island have used only 60% (and it's not like their populations are larger or more spread out than West Virginia's!). And I should note that I can imagine various poverty-and-social-whatever issues D.C. might be facing, but they don't obviously apply to Rhode Island in the same way.
Things like http://www.arnoldkling.com/blog/virus-update-3/ item 3 are pretty common: crazy vaccine-distribution setups meaning people who want vaccines can't get signed up to get them, while vaccines are getting thrown out due to spoilage.
Things like https://www.nytimes.com/2021/02/10/us/houston-doctor-fired-c... are, I hope, not common, but you can bet that case will have a chilling effect on efforts by doctors to avoid wasting vaccines.
https://www.theguardian.com/global-development/2021/feb/14/w... includes this incredible from a major vaccine manufacturer: "Instead we have a patchwork of approvals and I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April."
Does that sound like a manufacturing supply constraint to you?
Similar is https://marginalrevolution.com/marginalrevolution/2021/01/ap... where we have a vaccine, and a factory that can produce it, and the vaccine is approved in the UK, but it's not approved in the US. This is also not a supply constraint.
I don’t think this is true. Rhode Island has tremendous wealth disparity.
https://www.providencejournal.com/news/20180210/studies-inco...
And just to be clear, right behind DC and Rhode Island we have Alabama (OK, maybe poverty). Then just a few % above them New Hampshire, Kansas, Alaska, Pennsylvania.
These are all quite different from each other on various socio-economic and geographical axes.
And of course the states with the most successful vaccination campaigns in the US (with ~98% of vaccine supply used) are West Virginia, North Dakota, and New Mexico. Which are also quite different from each other in various socio-economic ways.
So it's hard to blame the socio-economic angle for the state-by-state disparities here, though I would be quite willing to look at data showing otherwise.
This is objectively untrue though
https://www.cnbc.com/2021/02/03/israel-giving-5000-vaccine-d...
And sure, as a fellow Jew I'd like to believe we're better than everyone else, but hey, we're not. I guess maybe better than some.
The complexity of the Palestinian/Israeli conflict can't be reduced to these simplistic terms. Anyone can take some specific incident or piece of data out of context and make their case around it, and all sides take every opportunity to do so while at the same time refusing to accept any responsibility to how they got to where things stand today.
I do hope that once Israel has finished vaccinating its population it will extend the additional vaccines to the PA and to Gaza, I think it's in their own interest and it's the right thing to do.
[0]https://en.wikipedia.org/wiki/Palestinian_Authority_Martyrs_...
Israel is vaccinating Palestinians who are Israeli citizens. It actually runs special promotion campaigns (including the PM visiting Nazareth) because some in Arab population are reluctant to take it.
It does not vaccinate Palestinians in the Palestinian controlled areas as it has no authority to do so. Furthermore, Abbas and the PA leadership make a point of not allowing their citizens access to Israeli healthcare (though they did make sure to get vaccinated themselves).
Some time ago my wife was involved in an effort to provide life saving medical care to a Palestinian child in an Israeli hospital. The hospital waved all costs and the treating surgeon was in daily touch with her. The PA refused to allow the child entrance into Israel to receive that care. This wasn't an isolated case, it's PA policy.
> The Palestinian Authority has not commented on the news. But up until the latest announcement, no vaccines had reached Palestinians except those living in East Jerusalem or working in the Palestinian hospitals there.
> Palestinians expect first large vaccine shipments in March
> The Palestinian Authority expects to receive its first shipments of independently-procured vaccines in March.
> Yasser Bouzia, a Palestinian Health Ministry official, told CNBC that the PA is currently finalizing a bilateral agreement with AstraZeneca for 2 million doses of its U.K.-developed vaccine. It expects to receive another 2 million vaccine doses through COVAX, a global scheme that was established to ensure equitable vaccine access globally.
> “That will cover almost the majority of the population. And after that we will look for other sources to have another almost 1 million people to be vaccinated, because we are aiming to vaccinate almost 5.2 million people,” Bouzia said.
> Until then, infections are still spreading, despite government-imposed restrictions.
2) Generally, the Palestinian Authority can do a better job allocating its resources, uh, you know, to prepare for these sorts of events https://en.wikipedia.org/wiki/Palestinian_Authority_Martyrs_... . Of course, it goes without saying that the terrorist run enclave of Hamas-land in Gaza is another story completely, yet for the purposes of this discussion fall under agreements with the PLO, see point 1.
Israel is vaccinating the Palestinian residents of east Jerusalem since they are part of the Israeli medical system.
Needless to say that the Arab citizens of Israel (20% of Israel’s population, many of whom identify as Palestinian) have full access to vaccines.
Israel, UK and USA procured large amount of doses ahead of time, and now EU is having trouble getting enough doses for their population.
That was my understanding.
https://ourworldindata.org/covid-vaccinations
US has fourth fastest vaccination rate per capita, behind Israel, UAE, and UK.
That’s huge when you realize manufacturing capabilities don’t come online overnight. The us secured the large majority of supply.
There's vaccination centers set up all around the country which are being utilized at 1-5% capacity, just waiting for vaccines to arrive.
They are upgrading the infrastructure even more despite that, anticipating being able to vaccinate 10% of the population per day.
Israel is specifically suited to treat COVID as a test-run for a biowarfare attack. A real War Effort, because it is one.
I don't think the military was involved yet, and religion was in fact working against vaccination efforts as a few anti-vax rabbis drove sectors of the Haredi population off.
EDIT: Saw another comment about a person in uniform doing the immunization so I might've been wrong about the army's involvement. But either way most comments referring to military involvement mean i.e. wartime levels of involvement, military handing out gas masks door-to-door etc. We're not at the level that the army is a sizable force, from what I can tell. (Except immunizing their own soldiers of course)
Examples:
- modernas main bottleneck is filling. They applied weeks ago to fill the same bottles with 15 doses instead of 10. The FDA has still not approved it.
- the us prioritizes second doses over first doses. This creates a ton of cascading issues, including the fact that many places are storing half the doses for 28 days. Many people have reported getting the same lot number for the second shot.
- the FDA takes 3 weeks to schedule approval meetings (after having reviewed the data enough to believe an EUA is warranted).
-the FDA hasn't approved Astrazeneca, one of the last countries to do so.
-our prioritization system is a mess. It's really hard to figure out who is eligible. "Healthcare workers" (which was supposed to be the first group) is vague, so of course what happened is what you would expect. I know about 100 people personally who have gotten the vaccine as healthcare workers. Only 1 works with COVID patients. Most of the others have less contact with people than grocery store workers. They should have just done covid ward workers first (<1M people) then go by age only. Super easy to know who is eligible. Our local hospital sat on doses from late Dec to late Jan because they didn't know who to give them to. After sitting on them for almost 30 days, they realized if all the doses went bad it would be a scandal so they just gave it to everyone on the property first come first serve.
If 15 doses lead to issues compared to 10, then you jeopardize all those vaccines which are slow and difficult to make. You also give people false sense of hope and possibly either get lower effectiveness or build public distrust. These are tough balancing acts.
Their is a real supply shortage. Israel Can and did secure enough vaccines for all its people. The us cannot, there’s not enough supply.
Because of the lack of supply the us has been focusing its efforts on using the supply it has to go to the groups most likely to face complications from covid, and the folks supporting said group.
The US is leading the world when it comes to total vaccines given.
As for the second shot prioritization. The feds screwed up distribution with there being no strategic reserve. What you have already is what you’ll have. Anything else is not gaurenteed.
Rapidly distributing materials to the population is absolutely within the ability of the IDF and their civil counterparts. Vaccines fall into these categories. It also doesn't hurt that most of the over 18 population have been in the military and know how to follow orders. For those of you who would attribute the successful roll out to the latter, don't. It all starts with anticipating black swan events and being prepared for them.
The numbers are falling all over the western world; probably because the policy response is largely same and maybe also because the virus' natural cycle is at the same stage.
Given how much further Israel is, one would have expected it to stick much more out in the statistics.
But it does not?
There a three big points to make:
1 - There is a delay. While now we have more and more vaccinated people, much of the current cases in the hospital got infected before that.
2 - It changes from community to community but in general we have many people that are really not "disciplined". Either they believe coronovirus does not exist or it won't get them or that god will save them or the herd immunity is high enough (when it isn't)... excuses all over
3 - The vaccinations are not evenly distributed in the population (for lack of demand, supply is there). While in some places you have 70% in other communities you have 2%. (and those with 2% act like there's no coronavirus, see point 2)
You can take case of yeshivas (religious schools): some have 80% of infected and recovered students. So when authorities come to the head of the school with a story about deadly virus, they don't understand each other. And examples of 90 years old elders dying from COVID-19 are meet with question "What you expected them to do instead at this age?"
I've come to notice this over the last year. We now effectively live in two completely diverged realities. In one, coronavirus is a serious danger that affects our behavior and dominates every aspect of life, where we follow the news of new vaccines and declining case numbers with gratitude and relief, hoping to god that life can return to normal some day. In the other reality, COVID is just a flu. Maybe you might get it but it's not a big deal. Life goes on as normal and you are happily taking advantage of deals on travel, low crowds, and you get annoyed at being reminded to wear your mask. Meeting with friends, going to church, eating at restaurants. All of this is fine because you've convinced yourself it's no big deal.
It's bizarre, and it has torn many of my personal relationships apart. I'm not sure how we ever fix this.
So it's not an "alternate" reality (that's usually used as pejorative), it's a different situation to your own.
However, I can also appreciate that in aggregate, the medical impact is higher than a normal flu. Hospitals have been overwhelmed (in Italy most famously, but here in Iceland it was also dicey for a bit around the peak). In that sense, I see it as being socially irresponsible not to take low-cost/low-effort preventative measures (mask/sanitizer).
Where it gets murkier for me is in the shutdown of businesses. I'm not sure I really have an opinion one way or the other on that. On one hand I can appreciate it sucks hard for those impacted. On the other, Iceland's second wave originated from an outbreak in a bar, so some kind of precautions are clearly needed. On the other other hand, at that time life was back to normal, so even normal precautions were completely ignored, so maybe we could have kept businesses open but just with precautions, which is the path we're taking now which seems to be working so far, though right now we're quite strict on international travel.
And though I've been drawing observations from anecdotes in Iceland, Iceland's numbers have never been very high because there just aren't that many people. Maybe the optimal approach is different in a higher-density location like New York.
IMO the solution to merging the realities is to humbly admit although we have statistics, none of us have all the answers. There is no one-size-fits-all solution.
Also, IMO, relationships are far more important than politics, especially politics as transitory as pandemic response. I argue with family about our differing perceptions of the pandemic, but at the end of the day I still believe they're doing the best they can and how wrong I think they are about some things is totally irrelevant to the relationship.
Probably the latter. Mortality doesn't seem to be affected by (covid specific) policy:
https://www.nber.org/system/files/working_papers/w27719/w277...
https://ideas.repec.org/p/wai/econwp/20-06.html
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...
(there are lots of studies like these, I just picked three more or less at random)
https://www.worldometers.info/coronavirus/country/greece/
Lockdown started in November, and relaxed on Jan 15 or so.
https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
... the curves look pretty similar to that of many other countries. There was apparently (according to Wikipedia) one between Nov 23rd and Dec 15th but that appears to have made no real difference, in fact, numbers per million were stable during those dates when they had previously been falling.
The major holidays in Judaism were 5 months ago, just when the lockdowns started.
The vaccination rate at younger individuals is far lower than elder ones, also the vaccine created a false sense of safety for everyone.
It's now younger people in the ICU: the vaccine started going out as the more contagious (and harmful) British variant started spreading in Israel.
From this article:
>Researchers at the Weizmann Institute of Science, who have been tabulating national data, said on Sunday that a sharp decline in hospitalisation and serious illness identified earlier among the first age group to be vaccinated - aged 60 or older - was seen for the first time in those aged 55 and older.
>Hospitalisations and serious illness were still rising in younger groups who began vaccinations weeks later.
The Haredi population is acting like covid doesn’t exist and has insanely high numbers of cases.
I suspect that despite the vaccine working well on your everyday science-trusting Israeli, the Haredi population is throwing off the average significantly.
Source: I have family there.
Recently the police tried to enforce the lockdown Bnei Brak (a city with a lot of Haredis). The Haredi rioted against this, yelled “Nazis” at the police, and burned down a bus.
What is significant is that they live in much more densely populated areas with much larger families. Every infection is amplified by the number of people who come in contact with that infected person and this is likely what we are seeing with the heredi population. In the heredi community it is not unusual for 10+ people to live under the same roof.
It has absolutely ravaged their older populations with one study estimating that 1 in 73 of the heredim over the age of 65 have died from COVID. Unfortunately among some of their communities the anti-vaccine propaganda has been very effective, but this is something the government is actively working to counter.
What about the weddings and funerals involving 1000s of people?
Just this past weekend the police shut down two nature parties/raves around the town I live in. This happens every weekend. Does that mean the “seculars” are breaking the rules on a larger scale than anyone else? Of course not. You and I do not have enough information to know who is and who is not breaking the rules.
> "Israeli study finds 94% drop in -> SYMPTOMATIC <- COVID-19 cases with Pfizer vaccine"
Asymptomatic cases still spread the virus.
https://www.bmj.com/content/371/bmj.m4851
But a large scale study in Wuhan found no cases of asymptomatic transmission, and the same findings have been found elsewhere. NB: there is a difference between asymptomatic and pre-symptomatic. The latter sometimes can transmit.
Also, see the sibling comments about the difference between asymptomatic and pre-symptomatic.
What they have found, according to our news sites at least, is that it is causing a lot more of the under 65 group to become severely ill. Some groups are more affected than others (for instance they are seeing that a relatively large amount of women who are in their late term of pregnancy are hit hard by this variant)
Making matters a bit worse is that the anti-vaccine propaganda has been quite successful in some areas, with some anti-vaxxers going as far as to book appointments only to intentionally not show up so that the vaccine is wasted.
In Hebrew, but interesting to look at if you want to follow the vaccination campaign https://datadashboard.health.gov.il/COVID-19/general
We still have a fair way to go before all vulnerable groups have had two jabs.
I guess to the extent that people are actually following the lockdown rules, that substitutes pretty well for a vaccinated population. The advantage of vaccination (at least in theory) is that you can maintain those rates without being locked down.
It turns out that almost all people that get sick are the people that were not vaccinated.
Here is an overview of an Israeli study that was finding a more realistic effectiveness of 70% https://dalewharrison.substack.com/p/israeli-vaccination-dat...
If anyone has a link to the actual study, please post it! It is really annoying to see news articles posted about studies that don't link to them or even provide any basic information to find the study.
https://ourworldindata.org/grapher/israel-severe-hospitaliza...
If half of population responsible for 90% of deaths is vaccinated it should affect death-per-case ratio.
Edit: Also, when you look at the JHU data (e.g. via google), it shows a peak at Jan 15th in the number of cases followed by a steady decline. The number of deaths peaks on Jan 28th, followed by a similar, steady decline. Which is as expected, so I would say we are already seeing the effects on the number of deaths.
Sorry that I didn't look at the data earlier before replying.
My hypothesis (it's not mine but I agree with it): if population with high death risks is disproportionately vaccinated, at the level it can make visible effect on case count for this population, it should have effect on case fatality rate. Of course, multiple factors can reduce/slow down the decline, but it should be there. Reducing death probability by half for the 60+ people without changing anything else should significantly reduce case fatality rate.
Yet the data does not support it: https://ourworldindata.org/coronavirus-data-explorer?zoomToS...
The case fatality rate peaked at the end of November, slightly declined until mid-January, then grown a bit and is almost constant in last three weeks.
So, the options I see are: either no effect at all can be seen yet behind the noise (it's hard to believe for me), or there is some factor compensating for the case fatality rate reduction (I can think of what could increase fatality that much and exactly compensate the effect), or the hypothesis is wrong (I can't see why either)
So I would argue that we do see the CFR being lower than the peak we would expect without working vaccinations.
The vaccination also does no good if you are already infected, and with the spike in infections in Israel coinciding with vaccination ramp up, those will be tricky to separate out.
A good explanation is that the vaccine is not working. ( people are in denial) I looked at the Pfizer numbers and my conclusion is the it's doing nothing.
If you vaccinate more people, you would expect that the cases that present at a physician will be selected to be the most severe. If the vaccine reduces most infections to very mild or asymptomatic cases, they will not be counted in the statistics at all.
So it would make sense that introducing a broadly effective vaccine would increase the case fatality rate. (You would also expect fewer severe cases, which is the whole point.)
A functioning vaccine should affect the CFR by changing the denominator of measured cases.
I am reminded of an analogy from improvements in battlefield medicine. As battlefield protocols (on-site treatment, rapid evacuation, etc.) have become more effective, battle fatality rates have fallen. But they have been replaced by a rise in severe chronic injuries like amputations.
Most of cases both before and after vaccinations are not severe. Moreover, the share of severe cases seems to stay the same or even increase ( https://datadashboard.health.gov.il/COVID-19/general , I hope it can be google-translated or something).
As I explained in other reply ( https://news.ycombinator.com/item?id=26142482 ), I expected change in fatality rate due to disproportional vaccination of the group with most of the fatal cases. For 60+ fatality rate is very high, and many of them are vaccinated. For everyone else, the opposite. I agree that if only severe cases were registered, we should've been looking at case number instead (which would be more stable since almost all of those would be registered).
I can't read the dashboard, but as I indicated this is what you would expect if you have a vaccine that broadly works at controlling the most severe forms of the disease. Vaccinated people whose infections manifest as nothing or a day or two of lethargy are not going to get counted in the statistics.
> I expected change in fatality rate
your expected change in the fatality rate needs to take into account that the real-world denominator has changed and that will not be apparent if you just divide number of fatalities by number of cases. (Because vaccinated people may be more likely to be asymptomatic, and we expect them to not get sick enough to ever present as a case.)
It's important to look at the number of people hospitalized or dying.
This reduces the number of cases.
Hard to not comment this cynically. That is bad.
Early vaccinated patients over 60 have 40% improvement. Keep in mind that the group older 60 is smaller in size compared to under 60, and the effect is smaller that adverse response in younger. Net negative.
It does not explicitly discriminate between vaccinated people or non-vaccinated, only possibly by proxy of age. People under the age of 35 were previously not included in the vaccination scheme. At the same time, the two more infectious variants are spreading.
So you’d expect hospitalizations to lag 18-26 days or so. Also the chart is not saying all those groups had vaccines: those under 60 largely haven’t been. The labels could have been clearer.
It’s just a chart of change in hospitalization by age from a starting date.
Why didn't they use that label then?
Of course, you're also correct that another important factor is that some of the cohort are not yet fully protected.
The definitions are here: https://www.medrxiv.org/content/10.1101/2021.02.08.21251325v...
Quote: In order to distill the possible effect of the vaccinations from other factors, including a third lockdown imposed in Israel on January 2021, we compared the time-dependent changes in number of COVID-19 cases and hospitalizations between (1) individuals aged 60 years and older, eligible to receive the vaccine earlier and younger individuals (0-59 years old); (2) early-vaccinated cities compared to late-vaccinated cities; (3) early-vaccinated geographical statistical areas (GSAs) compared to late-vaccinated GSAs;
So 0-59 late vaccinated means some vaccines but later in time and fewer in number.
This is what I gathered from the abstract anyway: https://www.medrxiv.org/content/10.1101/2021.02.08.21251325v...
Apologies for original error.
If you toggle the 'relative' button you'll see the actual numbers - basically, hospitalization count for vaccinated elders is is decreasing, and the hospitalization of unvaccinated non-elders is slightly increasing.
At what point does common sense risk to reward ratio come into play for young people?
> Serious question: How do we know any of this reporting is true?
> There's no data sources provided, no way to check follow up health (i'e. what if these people all dropped dead a week later), no way to prove the data isn't a complete fabrication, etc. Also, they make sure to use dynamic terms so we can't be sure these numbers have any valuable meaning at all (e.g. were Covid tests with drastically different cycle counts used?). Not to mention all of this reporting is praising a single vaccine producer in a billion dollar industry.
> I just read "How to Lie with Statistics" by Darrell Huff and this whole thing is the epitome of a manipulatable situation.
Combine the two and you no longer look "hey lets make sure people aren't lying to us," you just look like you have your own agenda.
So if you can lie with statistics, you can certainly lie even more with claimed anecdotes...
(The point of a vaccine is to trigger and train the immune system. The immune system revving up can cause symptoms of its own. If you get the fever of the immune system responding, without the lung damage cause you don't have the original actual virus, that's a huge win!)
edit: nvm a different chart is shown when javascript is not activated
https://www.medrxiv.org/content/10.1101/2021.02.06.21251283v...
The most recent un-reviewed publication looking into viral load, which is likely associated with the risk of transmission.
Lay reading: https://www.theguardian.com/science/2021/feb/09/pfizerbionte...
A disease that resides amongst chickens for which there exists a vaccine that prevents the disease but not the spread of the virus. And is an example of a scary story (told by antivaxxers I assume) where the introduction of a vaccine allowed the virus flourish and turn itself into a much deadlier form it otherwise would not have had.
Sorry for being a Debbie downer.
For Germany the numbers publicly reported have gotten more conrete the last few weeks. While there are only few doses for the first quater (about 18mio for 9 mio people ~ 11% of the population), in the second quarter there will be lots of doses delivered. Confirmed numbers are, that doses for over 40 million people will be delivered in the second quarter (including some one time vaccines from Johnson&Johnson, as also with them there were contracts). Together with the 9 mio from the first, that is 49mio people (~61%) in the first half of 2021. So while it started slow (as was to expect), numbers will start rising soon.
These numbers were only for Germany, I don't know exactly how this reflects for Europe, but as all orders were made Europe-wide, I guess this is similar for the whole EU, at least that was the whole point for having a Europe-wide strategy.
Maybe paying a bit more would have been more intelligent (see Israel) than negotiating for months on end.
Money also can't be an issue, the EU has come up with 750B euros to fight the economical impact of the pandemics. That was already in April or so. For the vaccine the EU only had around 2.7B available for most of 2020. The UK alone spent more than that, the US over 10B$. The worst thing: 2B of those 2.7B euros were simply repurposed from an already existing fund. That means the EU states only had to come up with 700M euros together in total. Even ignoring all of that, the vaccine is so cheap compared to the costs of lockdowns (and lives) that the price simply does not matter much. Ironically the price they got is the part the EU is especially proud of and EU politicans are quick to point out that Israel payed twice as much per dose.
What they don't say that the Pfizer/Biontech vaccine's price depends on the amount and delivery date. So you could actually pay more to get the vaccine sooner. It seems the EU chose not to do that because they felt good enough with AstraZeneca (they were supposed to start production in October). Unfortunately that information isn't public so we don't know for sure. But this would both explain why the EU didn't expect significant shipments from Non-AZ vaccines in the first quarter and why they got it cheaper.
I thought AZ was €5 a dose.
Well, as for EE countries, the largest by population size (EE country that is in EU) is Poland and they (we, I live here) ordered from multiple sources, and AZ isn't the largest one (J&J is, followed closely by Pfizer):
Janssen Pharmaceutica NV / Johnson&Johnson 16,98 mln
Pfizer / BioNTec 16,74 mln
Astra Zeneca 16 mln
CureVac 5,65 mln
Moderna 6,69 mln
The biggest issue for me is that I don't think I'll be able to select which vaccine I want to use, I don't like the AZ inferior efficacy compared to mRNA vaccines, not to mention how it handles the SA version of COVID-19 virus.
It really must hurt them that even the heavily criticized politicians Johnson, Netanyahu and Trump did a much better job with procurement than the EU.
In one talk show for example a representative of the European Commission at least mentioned twice that in Africa even less people got vaccinated than in the EU. Like this would be the frame of reference.
Overall the EU ordered 4+ doses per inhabitant, incl. minors. That seems to be enough. Single sourcing is never good. In case of vaccines it would mean that a) vaccines are delayed b) manufacturing issues happen. Also ordering enough from each manufacturer would have blown their manufacturing capacites. The necessary capacity increases woud just have further delayed deliveries, as the Pfizer plant in Belgium shows quite clearly.
And yes, as far as I understood the AZ contract, alocations are the same for each EU memeber state. Proportionally of course, Germany will get more doses in absolute numbers than, say, Luxembourg.
Yes, maybe the EU could have tried working harder in ensuring they produce vaccines in enough quantities. This has cost real lives. That being said, a rushed and faulty vaccine is extremely harmful for public health as well, as it breeds anti-vaxxers and the time the next pandemic comes around, people will distrust the vaccine.
Maybe your specific country handled things around covid great, but not the place I come from, not its neighbors, not the place I live in currently, and not its current neighbors (covered some 15 european states by this in east & west/south).
Money spent on vaccine infrastructure would be absolutely nothing, especially when pooled by few/many states together, compared to havoc covid is wreaking on economies and still will in incoming months, no way to avoid it. Plus the small benefit of actually saving many lives should also hold some, not only political capital.
And they are using new site, Biontech in Marburg (a reporposed existing facility if memory serves well), Sanofi will be ready in summer to produce the Biontech vaccine as well. These things take time, rushing them is never a good idea.
All of them. Or at least all of the different kinds of factories (mRNA, vector, live vaccine) for the most promising candidates. If there is a shortage of something, force production, apply imminent domain, force cooperation. War against Corona should be handled like a war, not like a toilet paper shortage.
Done right, one could even get away with not reserving the second shot from the first deliveries. Another parallel between toilet paper and vaccines is the sudden demand spikes, read additional orders from the EU in January, that resulted in reduced short term availablity.
Ideally you spread the doses over a few weeks or months so that you can stop the vaccinations should any issues arise. I'm not saying the current distribution is fine, it's far too slow. But not even Israel has vaccinated everyone in a single day, nor would that be a god idea.
This is btw also the way Google play distributes updates. Instead of every user getting the update right away, they first give it to a small group, then that group increases gradually in numbers.
So there is still the work to find a suitable target on the flu virus. Much of the science on the SARS 2 virus benefitted from the work that had been done on SARS.
That's wrong. BioNTech was the developer, Pfizer only was pulled in for manufacturing and clinical tests.
> clearly the part which can be replaced by anyone else
Not clearly. Looks at trouble with AstraZeneca's trial and manufacturing issues.
This is really a worthless pissing contest but got brought up in every Pfizer/BioNTech thread.
This is even after a down week in cases. Next door Lebanon is seeing cases fall at the same or faster pace and they peaked at the same time as Israel. Lebanon has yet to start vaccinating.
Case fatality rate has not fallen either. You would expect a huge drop in CFR if the elderly were protected, but this hasn't been the case.
That said, their statistics regarding the symptomatic case rate speak for themselves.
Scapegoating the orthodox jews? More than 92% of 70+ in Israel have received both doses of the vaccine. Are you blaming the high number of cases on this very small segment?
What happens when elderly all cause mortality is elevated substantially in 2021? This is the ultimate test for the vaccine.
Edit: shocked (not shocked) you were an early COVID vaccine skeptic, justified your belief with poor interpretation of statistics, and now that a huge amount of data have validated initial findings, you have instead decided to double down on your original gut feel!
Since a COVID death generally happens 5-8 weeks after exposure, what you'd expect is that once the high risk populations have been fully vaccinated, you'd start to see the death counts dropping 5-8 weeks later, and you'd start to see the hospitalization rates dropping 2-3 weeks later. Case counts are going to drop last because the high risk populations are not driving the majority of cases.
Also I don't understand what point you are trying to prove? We have detailed clinical trials about the efficacy of the vaccines. We have strong evidence to believe they work. If you are trying to interpret the data to show this isn't the case, you are probably misinterpreting it because it would be going against what we think we know with a high degree of confidence. It doesn't mean we couldn't be wrong, but it is much more likely you are just misinterpreting the data.
I won't defend the comment author's (apparent) anti-vaccine stance.
However, it's almost universally frowned upon to dig into HN users archives and lambaste them for things they've said in the past. That has been the case here for essentially the entire time HN has existed.
It's properly considered borderline cruel/mean and is entirely unnecessary. If there is something worth debating about what they said in their present comment, that should very obviously be the point of focus in the discussion.
In late 2018 some guy on here basically told me I was an idiot and had no idea about investing for predicting that Facebook's stock was a good investment after the irrational drop it had suffered at the time. I was right, they were wrong to an almost humiliating degree. Now, if I go dig up that post and follow that user around HN torturing them with their past comment/s, it would be considered to be in extremely bad taste in HN-etiquette. And I think it's easy to understand why: given the volume of comments and the long archives, HN would rapidly implode into just about the worst pile of garbage on the Internet if everyone went around hitting everyone else for things they said in the past, focus would shift to weaponizing the archives to attack users based on past comments (which would chill discussion dramatically and poison the well).
Your comment is surprisingly true! And utterly out of context.
As of today, Israel's deaths - both for the 65-and-overs and all-ages - is nearly down to its historical normal range, per your link.
Going back two weeks there was a huge peak at a z-score of 9.7; and going back eight weeks it was at a statistically anomalous low, at a z-score of -2.2.
I'd be tempted to point out the period of the low was the high holidays; the enormous deflection to positive slope started a week after the high holidays, and continued for three weeks. So, you know, "a bunch of people broke all quarantine for the high holidays and new year and did their level best to stay home rather than go to the doctor, and caused a giant spike, which has receded as the cases associated with that spike calmed down."
Edit: Here is an animation that shows the usual correction - https://twitter.com/jburnmurdoch/status/1350079943863115777
The delay in registration is for deaths that occur up until the week-end update; it is a one-week retrospective potential bump. The fall to baseline in Israel began three weeks ago, and has shown a continuous and steady slope.
You spoke too late, and I hope you issue a correction.
There's no data sources provided, no way to check follow up health (i'e. what if these people all dropped dead a week later), no way to prove the data isn't a complete fabrication, etc. Also, they make sure to use dynamic terms so we can't be sure these numbers have any valuable meaning at all (e.g. were Covid tests with drastically different cycle counts used?). Not to mention all of this reporting is praising a single vaccine producer in a billion dollar industry.
I just read "How to Lie with Statistics" by Darrell Huff and this whole thing is the epitome of a manipulatable situation.
Even throwing more money at the problem sounds better than not doing anything but I wish the EU would have forced Pfizer/Biontech and other pharma companies to just produce the vaccine en masse.
This is a war time and only those that cant fight back are forced to suck it up.
From all suppliers with potential vaccines in the pipeline. There was no way to tell which vaccine would be ready first. e.g. the Sanofi one, also an mRNA vaccine, will not be ready before 2022 it seems. Sanofi will produce the Pfizer / Biontech (?) one from summer onwards. Just thrwong money at the production doesn't ramp vaccine production over night. Case in point the reduced deliveries from Pfizer due to capacity increases and temporary shutdowns at their Belgian site.
This is not a quantity issue, it is a distribution issue. And distribution is not the EU responsibility. Right now people are, rightly so, frustrated by the way the vaccination campaigns are running, especially in Germany it is a mess.
First culprit: The manufacturers -> the media in germany sided with Biontech and declared higher availability if the EU just ordered. The result: Culprit 2
Second culprit: The EU because it didn't order earlier -> Order volumes were increased, which led to temporary shutdowns of manufacturing sites to increase capacity. The result: The EU said "sorry, we made some mistakes, but now enough is on back order to get everyone an opportuniy till summer. And by the way, vaccination campaigns are the memeber states responsibility". Step in culprit three in Germany
Third culprit:The federal government. A nice one, as vaccination is a state thing over here and not a federal task. Still, allocation and call ups are going through the federal government to the EU and manufacturers. The result: They implemented a task force at the federal level. Still no increase in daily vaccinations in most German states so far.
Likely forth culprit (and now we are getting closer to the truth): The state governments. Why? Because the EU was very straight forward from day one that once the doses have been delivered to the member states its responisbility ends. They also stated the logistics and distribution will be critical. And that part is so clearly lacking, from appointment management to vaccine availability of the already manufactured and delivered doses. Until now, as that point is not yet really discussed publicly, we have no real improvements.
IMHO, things will get better once traditional vaccines will be available en masse. Then we can use well established supply chains for existing vaccines, e.g. the flew and other standard stuff, done by local doctors. I would also suspect, that once htis starts to work, Biontech/Pfizer and Moderna to find ways to allow the sae doctors to use mRNA vaccines safely and reliably.
Until then I am afraid it will be more a blame game than anything else. And this is the real tragedy here.
https://www.bbc.com/news/world-africa-55975052
vs.
https://www.sciencemag.org/news/2021/02/question-choices-pfi...
The 2nd key reason is that no other vaccine is backed up by so much real world data as BT because of Israel. That is the very topic of this thread. That is why I thought it is self-explanatory.
I expect that the amount of angry people in EU will peak in spring or early summer when UK, US, and Israel are mostly back to normal and we are not.
And yet this should have been the plan from the very beginning.
Considering the vast numbers needed in Europe and the whole world, forcing all available production facilities to produce vaccines should have been part of the plan.
The EU ordered too late and simply not enough. Now they are trying to blame everyone else for their failure.
But all that being said, I think we should move to war-time production here.
However I don't have confidence that the same politicians that just claimed that they couldn't foresee problems with mass production did everything in their power to help here last summer. I mean the EU ordered only in November from Biontech and Moderna (and less doses than the companies offered). That doesn't really look like an incentive for companies to look into opening another factory already in summer.
EU politician really screwed up in summer 2020, so. They had, besides ordering (which was outsourced to the EU anyway), one job. Planning and setting up operations to vaccinate millions of people in the first 6 months of 2021. That would have included coordination between patient appointments, manufcturing and deliveries (invlving the EU ideally), making sure back-up plans are in place, getting processes up and running to make it as easy as possible to get vaccinated, making sure manufacturers can get necessary support in securing their upstream supply chains when needed and so on.
None of that happened. Instead, everyone was so, so happy that Europe had a great summer vacation. And then everyone so so hoped the unsurprising increase in cases starting in October would be just go away. And then everybody so so hoped they could safe Christmas shopping and christmas markets, And then everybody fell back to the only lesson they learned during the first wave: people like politicians that act tough. They just din't realise that back then acting tough, read lockdowns, was inline with expert advice. Basically, the EU had over six months to get ready for an EU-wide vaccination campaign. Member states had also 6 months. And did, it seems, by no means enough, if they did anything at all.
This now shows, and everyone is just happy to point at manufacturers and the EU. We'll see how long that story is going to hold water.
The volumes the EU ordered initially were absolutely sufficient with 4+ doses per EU inhabitant. Manufacturing capacities were sufficient for that as well. It all started to go south as soon as memeber states looked for scape goats why vaccination happened so slowly. First the manufacturers, then the EU, then the federal government (where applicable). It is a last-mile distribution issue if you will now, not a manufacturing one.
Whether there is any truth in the EUs certification being conducted differently is a bit moot given they have approved the same vaccines based on the same trial data.
And they did all that using normal certification. They even pointed out, quite clearly, that the actual managemen of vaccination campaigns, the vaccine ordering and the national distribution is up to the member states.
The last part shows very different results, e.g. in germany Mecklenburg-Vorpommern is far ahead in per capita vaccines. Bavaria for example is behind them. All we won with focusing on the supply of vaccines so far in a shutdown of Pfizer's pant in Belgium to produce more doses, which are not needed, at a later point of time. And a nasty contract dipute with AZ after the media and, at least IMHO, politians singled out AZ as a scape goat.
Trump reserved the US manufactured supply for themselves, only, so Canada is reliant on EU exports, which is kind of crazy to think about, geographically.
My understanding is many Canadian officials were caught off guard by the fact that the vaccine became available Q1 2021, they were thinking Q2/Q3 2021 was more likely and so much of the purchase deals were geared around that.
Overall I would call it useless EU blustering, there won't be an export ban, no matter what happens. It is just the minimum required measure to save face.
The export registration requirements (not an export ban) are, at least in part, in response to this dispute.
https://www.theguardian.com/business/2021/jan/30/lawyers-dis...
UK signed the contracts slightly earlier and jump-started the programme by issuing an emergency approval a few weeks earlier than the regular approval by the EMA.
And above all, it seems despite all efforts of coordination and treaties (COVAX), almost all players (except Norway) are playing the auction game and hoarding.
This is a global pandemic and these "selfish" actions will have global effects :(
A global vaccination strategy is needed if we really want to get on top of Covid for the long term.
Either you vaccinate everyone world-wide at the same time as quickly as possible. Then mutations that make the virus resistant to vaccinations only have the time to occur during the time it takes to vaccinate. However, we do not have sufficient production capacity for doing this. We would have to wait a few years before even starting the vaccinations, otherwise the virus would "mutate away" from the vaccine. Or it would mutate away, if the campaign took too long, because everyone is waiting for the slow drip of doses...
Or you do divide and conquer: Put up travel restrictions, quarantine and testing regimes to split up the problem into smaller areas and subsets of the global population. Quickly vaccinate each of those, so that the virus doesn't have time to mutate away. If possible eradicate the virus in those regions. Then start with the next set of regions and populations, possibly adapting the vaccine to the variants that have occured there. Eradicate the virus there. Then lift the travel restrictions between the regions where the virus has been eradicated. Repeat until done.
Accidentally, the latter one is what we are doing. However, I fear the travel restrictions are too lax to really make it work, because it isn't really planned, just accidential.
But it is true that the AstraZeneca/UK-situation was the trigger event that lead to the public noticing that something was amiss.
Halix in Leiden.
This is not true;
Not sure if i can find the source i read (at spiegel.de) but i will have a look and post it if i find it.)
The second one (already producing today) is in Marburg, Germany. Source in German: > "In the first half of 2021, 250 million doses of the vaccine are to be produced..."
https://www.spiegel.de/wirtschaft/unternehmen/corona-impfsto...
I don't know if there are more factories...?
Israel is getting most of their doses from US factories not EU ones.
It’s paying 10 times more when comparing to the AZ vaccine but that’s not apples to apples.
I doubt that these companies can make such deliveries without first fulfilling the contracts they have with the EU. I looked it up at the time, and they have. contracts with hundreds of millions of doses for the EU.
So what I believe will happen is that deliveries will grow extremely fast at some point before July, when new production capacities come online.
Consider what would happen if capacities increased dramatically: any advantage some countries have right now will shrink, when measured in time, from "months" to maybe just a few weeks. The real end of lockdowns may well still coincide.
Derek Lowe has an in-depth and readable explanation:
https://blogs.sciencemag.org/pipeline/archives/2021/02/02/my...
Vaccine production is still far to low to vaccinated the whole world population any time soon and only then we can prevent the creation of new mutant strains.
https://www.reuters.com/article/health-coronavirus-vaccines-...
https://investors.biontech.de/news-releases/news-release-det...
From their press release: "Facility will become one of the largest mRNA manufacturing sites in Europe and the third site in the BioNTech manufacturing network in Germany expected to produce BNT162 for global supply Expected to be fully operational in the first half 2021 with an annual production capacity up to 750 million doses of potential COVID-19 vaccine"
https://investors.biontech.de/news-releases/news-release-det...
https://blogs.sciencemag.org/pipeline/archives/2021/02/02/my...
> mRNA as a vaccine technology has been worked on for some twenty to twenty-five years now, from what I can see, and (as I never tire of mentioning) we’re very fortunate that it had worked out (and quite recently) several of its outstanding problems just before this pandemic hit. Five years ago we simply could not have gone from sequence to vaccine inside of a year. And I mean that “we” to mean both “we the biopharma industry” and “we the human race”.
By far, the longest step in development was running the trials, not actual development of the candidate vaccine itself.
As all ramp ups, I don't care that much about initial speed, but rather about how fast the goal, in our case a vaccination rate of 60+%, is reached. Justhaving doses produced isn't any good when these doses aren't getting into peoples arms.
If a company were to outsource the risk assessment and documentation effort would be huge and potentially open them up for a lot of legal liability if their third party manufacturer causes harm to a patient
For many manufacturers, it's much easier to use your documented in-house manufacturing, supply chain, training, machinery, etc. that you have risk documented up to the eyeballs so that if the product does cause harm, you have enough paperwork to show that you've done your due diligence
If you bring in a third party, it's incredibly difficult to prove that every aspect of their company meets the standards to which you're happy to hold yourself legally responsible.
And secondly, 'just' producing the vaccine isn't the only bottleneck. Currently the biggest bottleneck seem to be two molecules that are produced earlier on in the production-process, and they're scarce.
So adding more production capacity upstream doesn't help if production capacity in factories downstream aren't scaled as well.
It is almost like the world at are is getting a crash course in supply chain management. One could have asked experts on that before, sure, but why bother when local politians need credits for their election campaigns, right?
This process started in September already. It was founded partly with EU and German money, and will be producing vaccines for the world.
As long as this virus can spread in unvaccinated populations, mutations are bound to happen and sooner or later they will be knockout mutations, circumventing current vaccine effects.
So no one on this planet is truly safe from future lockdown/pandemic status until we are all vaccinated. And even that is debatable.
That's why it feels like that right now. There are many factories around the world gearing up to mass-produce various vaccines. Some will inevitably take a few more months than others to start shipments. Others were being prepared to produce vaccine candidates that ended up failing and are now being re-engineered to produce the vaccines that turned out to work. And the factories that are already producing are constantly working to expand their throughput as well.
Right now the world is being supplied entirely by the first factories. Over the next few months that will change and the total rate of production will be much higher than it is right now.
https://blogs.sciencemag.org/pipeline/archives/2021/02/02/my...
In short - mRNA vaccines are cutting edge & require the most high tech machines and processes in some of their stages, which create the bottleneck. As for partnering/licensing - that's preatty much a thing & has been for a while, still there is quite some time to get a new production line working in a safe and predictable manner.
BTW, there is also a companion article about the bottlenecks for adenovirus based vaccines (Astra Zeneca and others), which have a different set of bottlenecks:
https://blogs.sciencemag.org/pipeline/archives/2021/02/08/ho...
Current government is practically crime syndicate, all the decisions related to COVID-19 are made secret for at least 30 years, agreement with Pfizer is mostly secret, case number is manipulated by gauging tests conducted and selecting appropriate population groups and vaccines are forced on population under pain of limiting access to work, grocery and flights abroad.
The spring is coming, ending the wave like last year. This can reduce the cases by a similar amount. We will have to wait till next season what will happen. The sun and season has a dramatic influence on Covid. We saw that last year. Related with vitamin-D and ultra-violet radiation.
Recently some countries had changes in PCR tests. Austria had a similar reduction after not using the PCR tests. They had 95% false positives on PCR, compared to other tests. The PCR is problematic due to the usage of far too many cycles. When testing random persons, it gives 95% false positives over 35 cycles, but many countries even use 45 cycles or more. Sadly, using too many cycles is not scientific evidence for anything.
Many countries also reached a natural herd immunity. Sweden is now very close to getting 60% anti-body herd immunity. Besides that we have T-cell herd-immunity of which we do not know that much. I already had covid, got my anti-bodies & T-cell-immunity and am now fully immune.
Probably not applicable to Israel. Certain countries use cheap old-school medicine that prevent the disease. Like India and Ghana. Changes in medicine-use give similar changes in cases. If you don't believe it, just talk to some people that live there. They do not have a covid problem. IMHO this is the best but least profitable way to deal with the disease.
Controversial: The vaccines can give strong fevers. This is a well known side-effect. These might have thinned out the weakest people. Which now did not catch covid. While I think the effect is small, it can give a temporary reduction of the cases. I hope the medicine companies will improve the vaccines, so we do not get these side-effects.
The difference between these can be subtle and depends on raw data. But statistical analysis can already show some details.
hight of first wave in Israel was end of march. in Israel it just really started in march.
on average it was in the last weeks colder than last year.
> The comparison was against a group of the same size, with matching medical histories, who had not received the vaccine.
This is despite over 80% of its 70+ age group having both doses of the vaccine. At least half of the 70+ were fully vaccinated by January 23rd.
It is the elderly all cause mortality that ultimately matters to me. If elderly are dying of other causes, then there are problems.
Regardless, 2021 elderly mortality in Israel will serve as a good test for the vaccine as the vast majority of 70+ will be fully vaccinated for nearly the entire year.
https://ourworldindata.org/grapher/israel-severe-hospitaliza...
At the very beginning of vaccination in Israel the demand was very high, since all those waiting for the vaccine rushed and went to get it asap. Now that most of the elderly are already vaccinated and the government is placing sanctions against people who are not vaccinated (can't go shopping for clothes, can't go to sport events, can't go to the gym, can't go to cultural events, etc...) the younger generation is much less anxious to get vaccinated. This is causing the vaccine centers stand mostly idle for the recent month.
The government and media in Israel have also started mentioning that they are anxiously waiting for Phizer to test the vaccines on children 12+yo and are preparing to vaccine children as soon as possible. Some speak out about vaccinating children even before the trials are complete.
At the same time, there is a little known "cure" that was developed in a Tel Aviv hospital that has been tried on 30 people who were in a severe condition due to covid. 29 of them went home after two days. All it took is a little bit of ventilation several times a day.
I want to make it really clear that I am downvoting you for this last sentence. N=30 and no link to a publication is insufficient information for anyone to be talking about it except those organising the next (much larger) trial. Right now, what you say cannot be verified and appears to me to be a comfortable lie to support an anti-vaxxer view.
I don't know where I stand on coercive tactics to get vaccinated, they are for a noble goal, but such tactics can be very dangerous or backfire.