lbeltrame

Biology doesn't work like that. Certainly not for replication-deficient adenoviruses used by AZ, Gamaleya and J&J.

At least one for Ebola, IIRC.

I agree if you're in the US or in any other place with abundant supply of other vaccines. If you're in a place like the EU, like myself, every single dose counts and a setback can seriously screw things up.

I would rather have policy push for interventions that have a better impact on transmission. While the latest ECDC report[1] says "use them, can't hurt", it acknowledges the lack of evidence of masks (and thus effectiveness) in preventing transmission in a community settings.

[1] https://www.ecdc.europa.eu/sites/default/files/documents/cov...

> But he also says vaccinated people should keep wearing masks, because they could still get infected and be infections.

I wonder if, like when he "pushed" the numbers for the herd immunity threshold higher to push people to vaccinate he's deliberately omitting the data coming from Israel, which says that a full vaccination reduces the transmission of the virus and even prevents infection.

This is what irks me of the current public health policies worldwide. Every "good" news must be buried under a pile of terrorizing, negative news, because those in charge foolishly believe that hope for an improved situation might lower compliance with non pharmaceutical interventions.

In the end, they're either covering up for their failures (botched EU vaccine rollout) or just going to increase vaccine hesitancy (why bother, when everything stays the same?).

> these same variants tend to be more contagious regardless,

It may be the case for B 1.1.7 (but around 30%, not the 70% originally flaunted by the UK government and the media), but at this time there are no data on transmissibility of B 1.351 (the variant discussed here).

> The dominant strain of Covid in South Africa is different and existing vaccines are far less effective at countering due to changes in the spike protein which these vaccines target.

Only Johnson&Johnson data may say something about it for real. Novavax's investigation was underpowered (4000 people, wide confidence intervals), and this one is even more so.

The rest of the evidence comes from antibody neutralization assays in vitro, which although very useful they are not representative of the whole immune response.

> in the US it is not playing much of a role

That's because the FDA is waiting for the completion of AZ's trial in the US. This should be definitely better run than the meta-trials done elsewhere and give clearer numbers.

A likely readout would be in March, or April.

The data the EMA (at least, the public stuff) is from the first "lock" of the data for analysis - November 4th. The current preprint from Oxford is from about one month later.

It is a constant in any vaccine, including the "lowest" performers from Sinovac and Sinopharm. At this point, I'm inclined to believe that any resonably effective vaccine will have this effect.

It is a reduction of the risk of symptomatic disease by 76% once vaccinated.

But more importantly, there were no hospitalizations or deaths in the vaccinated people. This is a point the media often overlooks.

> exhibited a severe chest X-ray 70%-80% of the time

What is a "severe chest X-ray"? This story was debated on Twitter[1].

I agree with the (unforgiving) statements put there.

[1] https://twitter.com/Craig_1_1_7/status/1351203220878716928

That's ridiculous. The elimination ship has long sailed: it is much better to vaccinate the health care workers and the population at risk, then reopen and walk through the vaccination of other people, relying on a combination of vaccine immunity and natural immunity to avoid straining hospitals.

The virus is becoming endemic already: pursuing "zero COVID" strategies in most countries is unworkable, will cause additional suffering in a population already strained by lockdowns, and will take a very long time.

One thought: do we need herd immunity at all? Wait, hold off pushing the downvote button.

Why is this virus a problem? Not strictly because of deaths, although one would want to avoid unnecessary ones. It's due to the pressure on the healthcare system, because many people end up hospitalized, even though most of them recover (more on long COVID at the end of the post).

The vast majority of people ending up in hospitals are also belonging in the "at risk" population. To relieve pressure on the healthcare system, these must be vaccinated (along with healthcare workers). But once the most vulnerable and the most at risk of hospitalization are vaccinated, the pressure on the healthcare system should lower or cease for the most part (and the early data from Israel seem to indicate just that).

Of course, vaccination should continue (for those who want to get vaccinated), but with the risk of overwhelming hospitals gone completely, it would not be a problem. So society should reopen. And yes, in this case the virus will become endemic (it almost is already, save for a handful of places).

What about the others? Aside those who vaccinate, those recovered who did not have serious complications can go on like normal, like everyone else. According to data from Qatar[1] the risk of reinfection is low, and, most importantly, the vast majority of reinfections are asymptomatic (and asymptomatic people spread much less than symptomatic people, FTR[2]). In the context of the virus mutating towards (in the timespan of years, rather than months) completely escaping immunity, it is much better to rely on a combination of vaccination and natural immunity, so that subsequent, possible reinfections are not severe. That would also give time to adjust the vaccines if need be.

Unfortunately even throwing natural immunity along with vaccination is now a taboo topic, given how politicized the debate has become.

"What about long COVID?" some people may say. Well, the problem with long COVID is that, while it certainly exists, it is poorly characterized. Most studies lack a baseline before infection (or rely on self-reporting), so it is hard to determine what and for how long happens after an infection. Lastly, "regular" pneumonia can actually wreck someone for months or even a year, and some of these issues we're seeing may due to that: we're just seeing them at an increased rate because more people are experiencing that.

[1] https://www.medrxiv.org/content/10.1101/2021.01.15.21249731v...

[2] https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

Interesting. Did anyone make a similar checklist for passwords and what not? I have something in a binder which is meant to be used in case of emergency, but it's a bit out of date and I wanted to revamp it.

Flagged. Dr. Eric Feigl-Ding is the exact opposite of the "skeptics" but with the same lack of rigour: only promotes doom and gloom without much evidence. For an example, see this Twitter thread:

https://twitter.com/Craig_1_1_7/status/1351203220878716928

Except it's a meager 1M vaccinated and nowhere close the efforts of the UK, for example.

As someone with the "feet on the ground", I can say that there has been no information on the vaccines to the general population (at least, not a large information campaign). Not even among healthcare professionals, of which a part refuses to be vaccinated.

That is exacerbated by statements "threatening" mandatory vaccination, which don't help the cause at all.

Of course, also the EMA is to blame, because it is far slower than MHRA or FDA when looking at market authorizations for vaccines. "Perhaps" we'll see a decision by the end of the month on AstraZeneca.

> Unlike other vaccines being trialled, the Oxford team had been taking weekly swabs from all volunteers to check whether they were infected but showing no symptoms.

FTR, this only happened for one of the trials (the AZ results are actually from several trials combined) in England and Wales. In Brazil, for example, this was not done.

There are some indications in animal studies for Moderna and Pfizer, and some preliminary data given by Moderna at the FDA meeting about reduction of transmission, but it's nothing definitive.

Also J&J's Ebola vaccine, which is IIRC approved in Europe.

They gave more data to MHRA. Let's not forget that the data used for the Lancet publication was from November 4th.

And the Jenner Institute in Oxford doesn't do preprints or press releases for data, they go for publications (so that takes more time).

That said, I expect the missing information to appear in MHRA's guidance notes.

N501Y itself has already appeared around the world. By itself, it does look that it is not more transmissible (see Prof. Francois Balloux's Twitter for some explanations). The deletion, again by itself is not new, and also in this case it doesn't seem it has (on its own) increased fitness over the others.

N50Y has also a similar antibody neutralization profile as the non-mutated version.

Of course, these data refer to the mutations on their own, not together.

More on the deletion (on its own, again): while it is supposedly tied to a faster entry into the cells (twice as efficient in experimental assays), it look like it has lower fitness in absence of an ongoing immune response (it would lower in presence - but not disappear - in the immunocompromised patient it was first found into between treatments with convalescent serum).

I realized I made a mistake here but can't correct now: the sera used were 5, not 4.

The confidence intervals go as low as 37% and as high as ~120%. That's a load of uncertainty.

Also the latest document by PHE highlights also the limitations of the current data behind modeling (PCR negative for the S gene, but positive for the others). At this point the good questions haven't been answered yet.

Reading the latest document out, I can't rule out sampling bias, and the methodology used to gather data is also vulnerable to bias (get samples which are PCR-negative for the S gene, but positive to other genes, which is, by their own admission, a poor proxy).

The confidence intervals shown by PHE on potential increased transmissibility are also very wide (not the ones from the NERVTAG minutes, but the new analyses by PHE).

It needs larger sampling (already doing so, I'm sure) and some biological evidence.

N501Y is properly neutralized by vaccination (there's a paper in Science with these data, but I don't have a link handy right now).

The deletion seems to reduce antibody neutralization, but:

- In the preprint where this was shown, only 4 convalescent sera were tested;

- The same 4 sera had large variation in neutralization activity per se;

- There is no investigation on potential impaired T cell reactivity (cellular immunity): FTR, the "mink mutation", although it exhibited slightly lower antibody neutralization, did not change the reaction of T cells to it.

Is this also taking out potential confounders out of the equation? I believe the currently available data (as opposed to the SAGE minutes, which has the conclusions) is not sufficient to rule that out.

That doesn't rule out a combination of slightly increased infectiousness and a founder effect, which is equally possible at this stage.

> I think most people seem to be underestimating just how bad this is.

No, there is no reason to panic yet. Concern, perhaps, but not panic.

There are a truckload of confounding factors in the middle, including potential "founder effects" (when a variant becomes dominant because it is the first to take hold, and just outruns the others out of larger starting numbers).

There is not yet solid proof of "70% more transmissible" given that all the data there are is the SAGE meeting minutes. We don't know from where the data came from, and how the estimations were made. There are huge uncertainties.

Until the biological analyses are done, one needs to keep their cool. Sadly, that wasn't what the UK government did.

There's a major difference. Antigen tests identify a protein of the virus, which can be detected only if you have infectious viruses in your respiratory tract.

Less sensitive, but highly useful in absence of symptoms, because you know that you need to isolate as you're infectious.