Coronavirus (COVID-19) Outbreak

[Mpache]

4 hours ago, Carnivore Chris said:

They were speaking about some of the victims on Tele this morning and it's sad viewing.

Many may be in their 70s, 80s, 90s, but that doesn't mean they deserve to die prematurely from a virus that wouldn't even be present in the first place had the governments around the world acted 12 months ago when the virus was first made public knowledge.

Maybe it wouldn't have completely eradicated the virus or prevented it reaching other countries, given how it was around for a few months before the world was made aware of its existence, but it certainly wouldn't have become this extreme.

It's not just victims of the virus itself either, as this will cause a shitload of death and misery from the lockdowns themselves. It'll be a country(or world..) full of zombies on prescription drugs for mental health issues when all settled down. Suicides, physical illnesses caused by stress or being stationary too much, lowered and weakened immune systems, shattered front line workers who can't cope...

I also don't know why they are speaking about March all the time either? January is when it was made public knowledge. If a new virus appears in a country, you take actions immediately surely? 

This isn't only England, but the majority of the world. Just fuck ups everywhere, it wasn't taken seriously enough and the mixed messages from the WHO didn't help either.

The more a virus can be contained to one country, the less chance an epidemic becomes a pandemic, surely? It's lucky ebola appeared in a part of the world where people aren't well travelled(well, not lucky for them obviously) as that would have been devastating itself.

I won't pretend to be an expert on viruses, but it seems quite obvious to me.

The scenes from Brazil are like Medieval times with people literally suffocating in hospitals due to a shortage of oxygen. Awful to see.

I think the 2 issues at hand were that we've never seen a pandemic like this in our current lifetimes, with few survivors from Spanish Flu in 1918, and also that it's a new virus that we didn't know about for some time. I honestly think spread was inevitable just due to the asymptomatic nature of this thing. 

I think if something like this happens again, many governments will act quickly, but the worrying thing is it takes just 1 government to fuck up and screw everyone else. If the USA for example decides it's a hoax again, that's all it takes for it to spread around the world.

[Stan]

11 minutes ago, Mpache said:

I think the 2 issues at hand were that we've never seen a pandemic like this in our current lifetimes, with few survivors from Spanish Flu in 1918, and also that it's a new virus that we didn't know about for some time. I honestly think spread was inevitable just due to the asymptomatic nature of this thing. 

 I think if something like this happens again, many governments will act quickly, but the worrying thing is it takes just 1 government to fuck up and screw everyone else. If the USA for example decides it's a hoax again, that's all it takes for it to spread around the world.

It probably was inevitable, but for some island countries (like UK) it could have been so much more avoidable. 

[Mpache]

1 minute ago, Stan said:

It probably was inevitable, but for some island countries (like UK) it could have been so much more avoidable. 

Absolutely, Australia and China have shown that it could be stalled enough for a vaccine to come into play with so many less deaths and cases. The pandemic was coming though, as by the time the virus was detected, it was already spreading.

[RandoEFC+]

This is quite the decision. I still don't know whether this story is one of people in high places not understanding statistics, sample sizes and confidence intervals, one of the countries who have approved the AZ vaccine taking a calculated risk, or one of, god forbid, the start of an utterly mental phase of vaccine wars.

I don't like where the story is going. I could be completely wrong because I know what the media are like in the UK and I might have nowhere near all of the facts, but it does seem to be a case of the UK taking a risk by ordering the AZ vaccine early while the EU were conservative and are now forced to wait. I think some of the stuff that's come out of some EU figures over the past few days isn't the best look for them. Thankfully for now our government figures are staying out of it when you fear that they'll try to mark this as a Brexit success.

[nudge+]

29 minutes ago, RandoEFC said:

This is quite the decision. I still don't know whether this story is one of people in high places not understanding statistics, sample sizes and confidence intervals, one of the countries who have approved the AZ vaccine taking a calculated risk, or one of, god forbid, the start of an utterly mental phase of vaccine wars.

I don't like where the story is going. I could be completely wrong because I know what the media are like in the UK and I might have nowhere near all of the facts, but it does seem to be a case of the UK taking a risk by ordering the AZ vaccine early while the EU were conservative and are now forced to wait. I think some of the stuff that's come out of some EU figures over the past few days isn't the best look for them. Thankfully for now our government figures are staying out of it when you fear that they'll try to mark this as a Brexit success.

In the interview with AZ's CEO I posted earlier, I really didn't like the way he answered the question about vaccine's efficacy in older age groups. He denied the reports that it's only 8%, but failed to provide any actual number, even if a very preliminary one from the new trials, and just kept on talking about immunogenicity instead. 

Also, while I agree that the EU placed their order later and thus shouldn't expect same delivery times as the UK, there are still quite a few questions regarding the supply and delivery times that AZ hasn't answered clearly, either. 

All these recent developments are very worrying indeed. While I think it is highly unlikely that the AZ vaccine is not working in those over 65, the lack of transparency is far from ideal, and the apparent rise of "vaccine nationalism" is the last thing we need right now. 

[nudge+]

 

 

[RandoEFC+]

7 minutes ago, nudge said:

In the interview with AZ's CEO I posted earlier, I really didn't like the way he answered the question about vaccine's efficacy in older age groups. He denied the reports that it's only 8%, but failed to provide any actual number, even if a very preliminary one from the new trials, and just kept on talking about immunogenicity instead. 

Also, while I agree that the EU placed their order later and thus shouldn't expect same delivery times as the UK, there are still quite a few questions regarding the supply and delivery times that AZ hasn't answered clearly, either. 

All these recent developments are very worrying indeed. While I think it is highly unlikely that the AZ vaccine is not working in those over 65, the lack of transparency is far from ideal, and the apparent rise of "vaccine nationalism" is the last thing we need right now. 

Do you know where the 8% comes from? I saw one theory that the Germans had seen that only 8% of the sample were over 65s and misread this as the vaccine only being 8% effective in this age group, that level of mathematical illiteracy seems completely farfetched to me though.

I saw a more likely suggestion that they were worried because the lower bound of the 95% confidence interval of the vaccines effectiveness is 8% in that age group, which makes more sense. It's conceivable that the vaccine is highly effective in that age group but a small sample size of over 65s leads to a broad confidence interval. Having a confidence interval from 8% effectiveness to 98% wouldn't necessarily mean that this evens out at a most likely actual effectiveness at 53% in the middle. The effectiveness could be something like 80% but obviously the upper end of your confidence interval can't go over 100% so this theory sort of became what I assumed.

As for the AstraZeneca stuff, I haven't read up much on the stuff you mention but I don't really see what's in it for them to prioritise the UK over the EU if they can avoid it, unless there's interference from the government, but I don't really think there is, I might be wrong. There does surely come a point though where the UK and EU have to cooperate over where the supply should go as it shouldn't really be for a private company to make that decision when it's a question of global health.

I do find this an odd decision from Germany though unless they know something others don't. Fair enough if there's a lack of rock solid evidence for that age group but the doubts seem to be a bit of a storm in a teacup when it has been approved elsewhere and the UK have been getting on with it without any known issues although admittedly it's early days.

Hopefully none of it is actually political, I'm sure more will come out soon.

[RandoEFC+]

5 minutes ago, nudge said:

 

 

Unless I'm being stupid, drawing conclusions from a sample size that small and overriding the whole sample.

In fact, the infection rate is lower in the over 65s with the vaccine than in the younger group.

Ironically, their confidence interval come from the quirk of the placebo group's infection rates being lower than you'd expect for reasons we don't know.

This is just bad maths. If the over 65 group is important enough of a demographic to treat as separate to the rest of the sample (I don't know whether they should or shouldn't be because I'm a mathematician not a virologist), they should have made sure that they had a lot more of them in the treatment group and the placebo group.

Unless I'm missing something, that part of their trial just isn't fit for purpose.

[nudge+]

2 minutes ago, RandoEFC said:

Do you know where the 8% comes from? I saw one theory that the Germans had seen that only 8% of the sample were over 65s and misread this as the vaccine only being 8% effective in this age group, that level of mathematical illiteracy seems completely farfetched to me though.

I saw a more likely suggestion that they were worried because the lower bound of the 95% confidence interval of the vaccines effectiveness is 8% in that age group, which makes more sense. It's conceivable that the vaccine is highly effective in that age group but a small sample size of over 65s leads to a broad confidence interval. Having a confidence interval from 8% effectiveness to 98% wouldn't necessarily mean that this evens out at a most likely actual effectiveness at 53% in the middle. The effectiveness could be something like 80% but obviously the upper end of your confidence interval can't go over 100% so this theory sort of became what I assumed.

As for the AstraZeneca stuff, I haven't read up much on the stuff you mention but I don't really see what's in it for them to prioritise the UK over the EU if they can avoid it, unless there's interference from the government, but I don't really think there is, I might be wrong. There does surely come a point though where the UK and EU have to cooperate over where the supply should go as it shouldn't really be for a private company to make that decision when it's a question of global health.

I do find this an odd decision from Germany though unless they know something others don't. Fair enough if there's a lack of rock solid evidence for that age group but the doubts seem to be a bit of a storm in a teacup when it has been approved elsewhere and the UK have been getting on with it without any known issues although admittedly it's early days.

Hopefully none of it is actually political, I'm sure more will come out soon.

Handelsblatt still stand by their claim, despite everyone (including German government) denying the 8% figure, so I honestly don't know what to think. You'd think that the biggest business and financial publication in the country would have enough statistically and mathematically literate people to evaluate the numbers before posting something as controversial? 

But take a look at the table in the twitter post I just copy pasted, the confidence interval of the over 65 group clearly indicates lack of data, but the calculated efficacy based on existing data is 6% - that maybe the source of Handelsblatt claims?

[nudge+]

6 minutes ago, RandoEFC said:

Unless I'm being stupid, drawing conclusions from a sample size that small and overriding the whole sample.

In fact, the infection rate is lower in the over 65s with the vaccine than in the younger group.

Ironically, their confidence interval come from the quirk of the placebo group's infection rates being lower than you'd expect for reasons we don't know.

This is just bad maths. If the over 65 group is important enough of a demographic to treat as separate to the rest of the sample (I don't know whether they should or shouldn't be because I'm a mathematician not a virologist), they should have made sure that they had a lot more of them in the treatment group and the placebo group.

Unless I'm missing something, that part of their trial just isn't fit for purpose.

Just to clairify, that's Astrazeneca's data - the German expert panel is simply claiming that there's no proof of efficacy in over 65 age group because of lack of data; they are not claiming the efficacy is 6%!

[RandoEFC+]

1 minute ago, nudge said:

Just to clairify, that's Astrazeneca's data - the German expert panel is simply claiming that there's no prove of efficacy in over 65 age group because of lack of data; they are not claiming the efficacy is 6%!

That's fine. They are correct that the evidence isn't there either way but it annoys me how much more emphasis there should have been on why. Is there any evidence that the effectiveness is likely to be different in that age group?

[nudge+]

2 minutes ago, RandoEFC said:

That's fine. They are correct that the evidence isn't there either way but it annoys me how much more emphasis there should have been on why. Is there any evidence that the effectiveness is likely to be different in that age group?

If you look at other vaccines, then yes, efficacy of most vaccines, especially DNA based ones like AZ is much lower in elderly compared to younger people. In fact, flu vaccine for elderly is designed specifically for that age group and contains much higher dose and also usually some adjuvant in order to boost the immune response. You can usually see slight differences of how vaccine works in different age groups by looking at the immunogenetical data, but it does not always reflect the efficacy (real life example with some flu vaccines), so it is hard to draw conclusions. On one hand, given that immunogenicity of AZ vaccine in older people was similar to that in young people could suggest that the efficacy is expected to be similar too, on the other hand, it doesn't guarantee that. So basically what it comes to, we don't really know - there is a risk that it might not work, but it should. In the end, it depends on the approach each country is taking. The UK seems to be willing to take the risk, whereas the EU (or at least Germany, at this point) isn't - I believe the US didn't approve it yet for the same reason, and AZ are conducting new trials just for FDA. 

[nudge+]

In view of all this, I think India deserves public admiration for providing more than 3 million doses of the vaccine for free to Bangladesh, Bhutan, Nepal and Maldives, over 0.5 million doses to Sri Lanka, with more free shipments to Mauritius, Myanmar, Seychelles and Afghanistan set to follow. What a refreshing change of attitudes.

[RandoEFC+]

[Stan]

1 minute ago, RandoEFC said:

Good to see.

Is there any more specific data about age groups for this one in the trial?

[RandoEFC+]

6 minutes ago, Stan said:

Good to see.

Is there any more specific data about age groups for this one in the trial?

Not that I've seen yet but only had a quick look.

[nudge+]

3 minutes ago, Stan said:

Good to see.

Is there any more specific data about age groups for this one in the trial?

More than 15,000 participants between 18-84 years of age, 27% of them over the age of 65. No breakdown for each age group yet, but at least the sample size is representative.

 

Similar to the Pfizer vaccine, this one is very effective against the original variant and the UK variant, and less so against South Africa variant - 95.6%, 85.6% and 60% accordingly.

[Mpache]

1 minute ago, nudge said:

More than 15,000 participants between 18-84 years of age, 27% of them over the age of 65. No breakdown for each age group yet, but at least the sample size is representative.

 

Similar to the Pfizer vaccine, this one is very effective against the original variant and the UK variant, and less so against South Africa variant - 95.6%, 85.6% and 60% accordingly.

So are the South Africa and Brazil variants vaccine resistant, or are the vaccines just less effective against those? I read up a bit about it and not sure how it works entirely.

[RandoEFC+]

This is why international cooperation is so important in the vaccine rollout and the richest countries with the most resources should recognise that it's in their interest too if the whole "love thy neighbour" thing isn't enough. Every transmission of the virus increases the risk of mutation and you don't want one coming back that resists these vaccines. I don't think it's likely to become an issue but if one strain is already 40% resistant to this vaccine it shows you that the risk is there.

[Mpache]

Just now, RandoEFC said:

This is why international cooperation is so important in the vaccine rollout and the richest countries with the most resources should recognise that it's in their interest too if the whole "love thy neighbour" thing isn't enough. Every transmission of the virus increases the risk of mutation and you don't want one coming back that resists these vaccines. I don't think it's likely to become an issue but if one strain is already 40% resistant to this vaccine it shows you that the risk is there.

Yup, why Anti-Vaxxers aren't to be respected. They are increasing the risk of this becoming endemic.

[nudge+]

1 minute ago, Mpache said:

So are the South Africa and Brazil variants vaccine resistant, or are the vaccines just less effective against those? I read up a bit about it and not sure how it works entirely.

South African variant has many mutations in the spike protein (the main structure that the virus uses to bind to and infect host cells), which may result in it partially escaping neutralising antibodies that your body produces after vaccination (the vaccine uses the genetic sequence of the original virus without the mutations). Good thing about mRNA vaccines is that they are quickly and easily modifiable, hence why genetic sequencing should be a priority.

[Mpache]

1 minute ago, nudge said:

South African variant has many mutations in the spike protein (the main structure that the virus uses to bind to and infect host cells), which may result in it partially escaping neutralising antibodies that your body produces after vaccination (the vaccine uses the genetic sequence of the original virus without the mutations). Good thing about mRNA vaccines is that they are quickly and easily modifiable, hence why genetic sequencing should be a priority.

Did this ever happen during Swine Flu? Because how will this pandemic end if they have to modify it every time?

[nudge+]

2 minutes ago, Mpache said:

Did this ever happen during Swine Flu? Because how will this pandemic end if they have to modify it every time?

All viruses mutate, that's natural. Flu viruses mutate extremely fast and there are so many different strains, hence why we have a new flu vaccine pretty much every season. Coronaviruses mutate at a much slower rate and are much more stable as they have an inbuilt genetic proofreading mechanism, so a vaccine is likely to be effective longer and protect against numerous variants (most mutations are completely insignificant and do not matter). There's a good chance that this virus will never go away and will just circulate every winter as other four coronaviruses or flu, but with a high percentage of world's population acquiring immunity through vaccination or infection, it will not be a real threat anymore. That's how the pandemic will end, most likely.

[Stan]

Another vaccine on the board...

https://www.bbc.co.uk/news/health-55857530

Quote

 

The Covid-19 vaccine developed by Janssen is 66% effective, the Belgian company has announced.

An international trial looked at giving just one dose of the vaccine, which makes it significantly easier to roll out than those requiring two.

The UK has already pre-ordered 30m doses.

The news comes shortly after Novavax announced their jab was 89% effective. Both will need to be reviewed by regulators before they can be used.

Janssen, a pharmaceutical company owned by Johnson & Johnson, is also investigating whether giving two doses will give either stronger or longer-lasting protection.

The company said its initial findings showed one dose prevented 85% of severe cases.

However part of the trial in South Africa, where a new version of the coronavirus is spreading found it was just 57% effective.

Dr Paul Stoffels, the chief scientific officer at Johnson & Johnson, said that would "potentially protect hundreds of millions of people from serious and fatal outcomes of Covid-19".

The company is aiming to make one billion doses this year.

The Janssen vaccine uses a common cold virus that has been engineered to make it harmless.

It then safely carries part of the coronavirus's genetic code into the body. This is enough for the body to recognise the threat and then learn to fight coronavirus.

This trains the body's immune system to fight coronavirus when it encounters the virus for real.

This is similar to the approach used by the University of Oxford and AstraZeneca.

 

 

[SchalkeUK]

15 hours ago, nudge said:

All viruses mutate, that's natural. Flu viruses mutate extremely fast and there are so many different strains, hence why we have a new flu vaccine pretty much every season. Coronaviruses mutate at a much slower rate and are much more stable as they have an inbuilt genetic proofreading mechanism, so a vaccine is likely to be effective longer and protect against numerous variants (most mutations are completely insignificant and do not matter). There's a good chance that this virus will never go away and will just circulate every winter as other four coronaviruses or flu, but with a high percentage of world's population acquiring immunity through vaccination or infection, it will not be a real threat anymore. That's how the pandemic will end, most likely.

Haven't  checked with my daughter on this, but perhaps nudge seems to have insight into some of the problems so here's a question for her!

With the variations assumed to be slight - however more problematical - assuming that we have to keep vaccinating to ensure safety, could the annual flu vaccine incorporate this to be useful for both with just one injection or will we have to have two in future?