• Guest, The rules for the P & N subforum have been updated to prohibit "ad hominem" or personal attacks against other posters. See the full details in the post "Politics and News Rules & Guidelines."

NON_POLITICAL China Coronavirus THREAD

Page 522 - Seeking answers? Join the AnandTech community: where nearly half-a-million members share solutions and discuss the latest tech.

CZroe

Lifer
Jun 24, 2001
24,195
856
126
I include endpoint vaccination sites as being the distribution chain - not simply the physical transport. The tier system made allot of sense medically. If it is screwing things up, then it's just terrible planning an implementation - again.
As long as there is a stockpile of vaccine then they should probably open it up to more people but throttle the rate it is dispensed according to how fast it is replenished. Let people who would have been in the current Phase jump to the front of the line and we no longer have the issue of vaccines sitting around, waiting for the right people to stick.

If we also adopt the UK's plan to give out single-doses to more people I'm all for it once the most vulnerable and frontline workers are all fully vaccinated. After they reach some threshold with single-shot doses (like half the population seeking the vaccine or whatever) people can start coming back for their second dose and it will be throttled by demand. People without their first dose get to skip the line and people who have had it get throttled by availability. Don't want to wait in line? Then come back some other day. It self-regulates.
 

ponyo

Lifer
Feb 14, 2002
19,521
2,698
126
We're in the beginning innings of the vaccine rollout. So there's going to be hiccups, confusion, and errors made. Plus it's the holidays. So I'm going to cut the government and all parties involved with vaccinations lot of slack. If we're seeing the same screwups 6 months to 1 year from now, then we have major problem. My guess is by this time next year, we're going to have more vaccines than we know what to do with. All the different vaccine makers and all the production ramp up could cause oversupply. I know oversupply might sound like crazy talk right now but it wouldn't surprise me that things go to the other extreme.
 

ch33zw1z

Lifer
Nov 4, 2004
34,566
13,564
146
We're in the beginning innings of the vaccine rollout. So there's going to be hiccups, confusion, and errors made. Plus it's the holidays. So I'm going to cut the government and all parties involved with vaccinations lot of slack. If we're seeing the same screwups 6 months to 1 year from now, then we have major problem. My guess is by this time next year, we're going to have more vaccines than we know what to do with. All the different vaccine makers and all the production ramp up could cause oversupply. I know oversupply might sound like crazy talk right now but it wouldn't surprise me that things go to the other extreme.
I think oversupply will occur simply because people will refuse it (lol, seriously). Also, we're not entirely sure how long someone is inoculated for, so I would expect this to end up like the flu where it's something we're inoculated for each fall/winter. IMO, that should've been done 15 years ago with SARS-1
 

Ajay

Lifer
Jan 8, 2001
10,535
4,486
136
As long as there is a stockpile of vaccine then they should probably open it up to more people but throttle the rate it is dispensed according to how fast it is replenished. Let people who would have been in the current Phase jump to the front of the line and we no longer have the issue of vaccines sitting around, waiting for the right people to stick.
Guess my view is, in part, colored by my own higher risk level putting me is phase 1b (the only time having diabetes has been a plus). I, and others like me, really have to live a hermit's life right now. I didn't finish my last round of PT for my back injury because of COVID. I'd like to do that because then I can return to the gym - and going to the gym will allow me to reduce the dose or eliminate one of my medications. So, my current situation is frustrating as all hell. And yes, I'd like some cheese with my wine :p. There are, however, worse things. At least I have good insurance, so I can use this high priced medication.

If we also adopt the UK's plan to give out single-doses to more people I'm all for it once the most vulnerable and frontline workers are all fully vaccinated. After they reach some threshold with single-shot doses (like half the population seeking the vaccine or whatever) people can start coming back for their second dose and it will be throttled by demand. People without their first dose get to skip the line and people who have had it get throttled by availability. Don't want to wait in line? Then come back some other day. It self-regulates.
Waiting for data. Doing this on a whim is a catastrophically stupid move. I can't believe we are considering this in the US (Pfizer & Moderna vacs) without data on the efficacy of delayed second doses (or single doses). We are, supposedly, a reasonably advanced western nation.
 

CZroe

Lifer
Jun 24, 2001
24,195
856
126
Guess my view is, in part, colored by my own higher risk level putting me is phase 1b (the only time having diabetes has been a plus). I, and others like me, really have to live a hermit's life right now. I didn't finish my last round of PT for my back injury because of COVID. I'd like to do that because then I can return to the gym - and going to the gym will allow me to reduce the dose or eliminate one of my medications. So, my current situation is frustrating as all hell. And yes, I'd like some cheese with my wine :p. There are, however, worse things. At least I have good insurance, so I can use this high priced medication.



Waiting for data. Doing this on a whim is a catastrophically stupid move. I can't believe we are considering this in the US (Pfizer & Moderna vacs) without data on the efficacy of delayed second doses (or single doses). We are, supposedly, a reasonably advanced western nation.
I don't know that officials are considering this in the USA.

Also, the "data" is right there in the original trial:
Not one single case required hospitalization after the first dose and a significant amount had immunity. That's what they are basing this on.

It would be no different for you since the issue is not supply. As part of Phase 1 you would skip the line... just like vulnerable people out for early voting in Georgia yesterday. People like my mother didn't have to wait in the queue (age).
 
Dec 10, 2005
21,527
3,215
126
NIH seems to think it's a solid plan and the single-shot already meets their minimum target effectiveness for a single-shot vaccine. The trial demonstrated that of the people who have had one shot and acquire the virus anyway, none were hospitalized. Our goal is supposed to be outcome-based, not to give a few as close to 100% immunity as possible before moving on to the next few. This method can get nearly twice as many people "immune enough" exactly where the far more infectious strain is already dominating the total cases. Community exposure will not mean the same thing when nearly everyone has one shot.
The trials did not demonstrate that at all. They were not statistically powered to measure the efficacy of a one-shot regime, especially given the short window of time between the first and second shots. If we run the general assumption with many vaccines of needing 2-3 weeks post-shot for peak immunity, that means the analysis window of this one-shot regime is exceedingly short. Plus, you're effectively doing a subgroup analysis on a very small patient population (patients who got COVID after only the first shot) - sweeping conclusions should not be drawn from such analyses.
 

CZroe

Lifer
Jun 24, 2001
24,195
856
126
The trials did not demonstrate that at all. They were not statistically powered to measure the efficacy of a one-shot regime, especially given the short window of time between the first and second shots. If we run the general assumption with many vaccines of needing 2-3 weeks post-shot for peak immunity, that means the analysis window of this one-shot regime is exceedingly short. Plus, you're effectively doing a subgroup analysis on a very small patient population (patients who got COVID after only the first shot) - sweeping conclusions should not be drawn from such analyses.
They are proposing three months. They do have more than three months of data for single-shot vaccinations because the trials continued collecting data. That is what they are basing it on.

 

Kaido

Elite Member & Kitchen Overlord
Feb 14, 2004
46,261
3,265
126
You know, if you had asked me 5 years ago what a CNN headline would look on New Year's Day 2021, I wouldn't have guessed it would be this: (non-political post FYI)

1609531639309.png
 

Kaido

Elite Member & Kitchen Overlord
Feb 14, 2004
46,261
3,265
126

CZroe

Lifer
Jun 24, 2001
24,195
856
126
The trials did not demonstrate that at all. They were not statistically powered to measure the efficacy of a one-shot regime, especially given the short window of time between the first and second shots. If we run the general assumption with many vaccines of needing 2-3 weeks post-shot for peak immunity, that means the analysis window of this one-shot regime is exceedingly short. Plus, you're effectively doing a subgroup analysis on a very small patient population (patients who got COVID after only the first shot) - sweeping conclusions should not be drawn from such analyses.
In fact, the recommended vaccine schedule has always been 3-12 weeks (21 days to 3 months), so all they've done is decide to go with the longer one. The data actually seems to show a stronger immunity the longer the wait. More people vaccinated sooner with a stronger immunity in the end is a win-win .
 

local

Golden Member
Jun 28, 2011
1,837
485
136
Yeah but is that in addition to what they are already doing? So far for my group at least they have opened up all 1a and 1b people. There are only about 450 total participants in DFW so I suppose I can see them accelerating vaccination of the roughly 250 placebo arm people.

Based on what I have seen I'm guessing there will be less than 50 people that don't qualify for 1a or 1b category in the placebo arm here so that's not much to just go ahead and take care of them.

I know I'm ready.
 
Dec 10, 2005
21,527
3,215
126
They are proposing three months. They do have more than three months of data for single-shot vaccinations because the trials continued collecting data. That is what they are basing it on.

Based on Table 4, it would seem like the overall numbers of patients (only ~6000/arm) and the secondary-analysis nature, I would still hesitate to make sweeping public health policy changes contrary to the original design of the trial and the primary results presented.

They may have had some original design or intention, but there isn't data to support it. If they wanted to go with the longer interval, run a trial using the longer interval to confirm.
 

K1052

Lifer
Aug 21, 2003
38,050
12,935
136
Yeah but is that in addition to what they are already doing? So far for my group at least they have opened up all 1a and 1b people. There are only about 450 total participants in DFW so I suppose I can see them accelerating vaccination of the roughly 250 placebo arm people.

Based on what I have seen I'm guessing there will be less than 50 people that don't qualify for 1a or 1b category in the placebo arm here so that's not much to just go ahead and take care of them.

I know I'm ready.
I think finding doses in TX if you are in 1b is likely to be a challenge for months so if Pfizer offers I'd probably take them up on it were I you. God only knows for later priority.
 

local

Golden Member
Jun 28, 2011
1,837
485
136
I think finding doses in TX if you are in 1b is likely to be a challenge for months so if Pfizer offers I'd probably take them up on it were I you. God only knows for later priority.
I think it depends, my family members that qualify already have appointments setup for next week. Through one of the drug chains Walgreens or CVS not sure which. From what I have been reading it's the hospital systems that are failing to distribute. Once regular pharmacies are getting their supplies it is moving along pretty well. But I suppose they do have the experience in distributing vaccines every year to millions of people.
 

CZroe

Lifer
Jun 24, 2001
24,195
856
126
Based on Table 4, it would seem like the overall numbers of patients (only ~6000/arm) and the secondary-analysis nature, I would still hesitate to make sweeping public health policy changes contrary to the original design of the trial and the primary results presented.

They may have had some original design or intention, but there isn't data to support it. If they wanted to go with the longer interval, run a trial using the longer interval to confirm.
Again, the "original design" was 3-12 weeks, so 3 months is NOT "contrary to the original design." For whatever reason you just assume the original design was 21 days/3 weeks. It wasn't. It was 3-12 weeks, and the same data that supported 21 days suggested immunity just as strong if not stronger at 12 weeks. All they have done is picked which end of the recommended dosing schedule they want to target so that they can get more widespread immunity earlier. Get it? 12 weeks is no less scientific than 21 days and no less recommended except for the absolute most vulnerable/at-risk.

 

K1052

Lifer
Aug 21, 2003
38,050
12,935
136
I think it depends, my family members that qualify already have appointments setup for next week. Through one of the drug chains Walgreens or CVS not sure which. From what I have been reading it's the hospital systems that are failing to distribute. Once regular pharmacies are getting their supplies it is moving along pretty well. But I suppose they do have the experience in distributing vaccines every year to millions of people.
Know a few people who qualify 1b here in Austin and nobody can find appointments. Most places aren't even waitlisting. It's kind of chaotic.
 

MrSquished

Lifer
Jan 14, 2013
13,584
10,495
136
Romney is calling the vaccine rollout a mess by the feds:

Mitt Romney slams vaccine distribution roll out: 'As incomprehensible as it is inexcusable'

"That comprehensive vaccination plans have not been developed at the federal level and sent to the states as models is as incomprehensible as it is inexcusable," Romney, who represents Utah, said in a statement Friday.




 
  • Haha
Reactions: ch33zw1z

local

Golden Member
Jun 28, 2011
1,837
485
136
Know a few people who qualify 1b here in Austin and nobody can find appointments. Most places aren't even waitlisting. It's kind of chaotic.
Yeah, it seems to definitely be a crap shoot. The success stories I am seeing though do not involve the hospital system. The doses sent to pharmacies are being distributed quickly and even our county actually put together a waitlist to handle scheduling themselves.

I thought the military would be handling not just shipment logistics but distribution logistics as well, it doesn't take a rocket science degree to learn to jab the pointy thing into the fleshy part and squeeze. Setup tents in large parking lots and have car loads of people roll through and get the jab. Have the cars park for half an hour and honk if there is a reaction that needs attention. Forget this magical perfect rollout that is obviously failing and get needles in arms.
 
  • Like
Reactions: Zorba and K1052

Zorba

Lifer
Oct 22, 1999
10,751
4,835
136
The holidays also appear to have caused a lot of stuff to just stop that should not have. Health departments closed, inoculation sites closed or reduced, distribution/ deliveries slowed etc. The lack of leadership and resources from the top is extremely apparent, basically the PPE and testing debacles all over again.
At least around here testing shut down for 3 days around Christmas too. Walmart is open all three days, so should testing and vaccination.
 

K1052

Lifer
Aug 21, 2003
38,050
12,935
136
Yeah, it seems to definitely be a crap shoot. The success stories I am seeing though do not involve the hospital system. The doses sent to pharmacies are being distributed quickly and even our county actually put together a waitlist to handle scheduling themselves.

I thought the military would be handling not just shipment logistics but distribution logistics as well, it doesn't take a rocket science degree to learn to jab the pointy thing into the fleshy part and squeeze. Setup tents in large parking lots and have car loads of people roll through and get the jab. Have the cars park for half an hour and honk if there is a reaction that needs attention. Forget this magical perfect rollout that is obviously failing and get needles in arms.
My presumption was that state national guard units with relevant expertise might be staffing central mass vaccination sites for the state/local health departments, paid for by the feds. I mean you just need a huge ass parking lot or maybe a convention center in cold climates and you should be able to run 10s of thousands through a site per day once it's up and running.
 

Red Squirrel

No Lifer
May 24, 2003
61,656
9,385
126
www.uovalor.com
Medical related stuff like doctor offices, clinics etc tend to have the weirdest hours. 9:00-12:00 and 1:00-4:00 is typical and they definitely won't work on or even near holidays. You would think they could extend that given the situation.

Maybe Walmart should have vaccine clinics lol. Seriously though... they do have the supply chain and logistics capability for something like that and are open more hours.
 

ch33zw1z

Lifer
Nov 4, 2004
34,566
13,564
146
Medical related stuff like doctor offices, clinics etc tend to have the weirdest hours. 9:00-12:00 and 1:00-4:00 is typical and they definitely won't work on or even near holidays. You would think they could extend that given the situation.

Maybe Walmart should have vaccine clinics lol. Seriously though... they do have the supply chain and logistics capability for something like that and are open more hours.
Walmart has pharmacies, I get my flu shots at CVS, but I'm pretty sure Walmart has them also. My doctor don't care, just let him know that you got one and the office puts it in the chart.

CVS, Walgreens, walmart, all will likely have it afaik
 

ASK THE COMMUNITY