outbreak! (ebola, sars, coronavirus, etc)

Yup

I can’t see the whole linked article but this is very strangely worded, and unless they conducted another trial since they announced the results of the first one they completely fucked up, I don’t think it’s saying the AZ vaccine has been proven to be “95% effective”. And you can ignore that guy’s interpretation. He’s covid Louise mensch.

Sorry this is very strangely worded:

Astra Zeneca’s chief executive, Pascal Soriot, today reveals that new data will show the vaccine is as effective as the Pfizer and Moderna jabs that have already been approved, protecting 95% of patients, and is “100% effective” in preventing severe illness requiring hospital treatment.

Thanks for the context, duly noted. The FT are now saying that the vaccine will be approved within days, so fuck knows, tbh?!

💥 Good news!

UK will approve the Oxford/AstraZeneca coronavirus vaccine within days. Announcement could come from MHRA as soon as Tuesday, with vaccinations starting in the first week of January.

Latest with @SarahNev and @donatopmancinihttps://t.co/l3PyBP4pY8

— Sebastian Payne (@SebastianEPayne) December 27, 2020

Oh sorry no. It will be approved. But the trial results are already known and they’re not 95%.

new data will show...

what new data? where from?

Ironically the true efficacy might actually be 95 rather than the “60-90 (but who knows really)” they reported. They messed up the trial very badly, probably badly enough that several countries will not approve it. The UK kind of has no choice though and it will probably be fine.

_new data will show..._

what new data? where from?

xps: Dr. Feigl-Ding is talking more out of urgency than expertise (his field is medical economics, IIRC), but he was spot-on that the coronavirus would be a global problem in mid-January, that masks were a critical element for reducing transmission in mid-February, and that airborne was the major means of transmission in March=April. When practicing infectious disease epidemiologists were wrong, he was earning credibility. I don't follow him as he spends most tweets repeating himself, but I'll pay attention when someone else retweets.

You’ll know if you get the vaccine from Oxford because it’ll tell you

— Billie (@_BillieBelieves) December 27, 2020

Highlighting how underreported coronavirus in Peru, Ecuador, Mexico, Bulgaria, Lithuania, and Russia has been:

https://pbs.twimg.com/media/EqQmZ9IXEAEGIKF?format=jpg

turns out an n95 with a valve is not ideal, but it's probably the next best thing to an n95 without a mask

https://www.cdc.gov/niosh/docs/2021-107/default.html

These findings show that FFRs with an exhalation valve provide respiratory protection to the wearer and can also reduce particle emissions to levels similar to or better than those provided by surgical masks, procedure masks, or cloth face coverings.

you mean without a valve?

right. next best thing to an n95 without a valve.

LA county reported 13,492 cases today. Factor 0% ICU availability to that number and the next month in LA might be as bleak as NYC in Mar/Apr.

(just drilled down and the STATE of New York never had more than 13k new cases in a single day in Mar/Apr)

it's very difficult to make meaningful comparisons between *case counts* in march and now because testing is ubiquitous now in a way it wasn't then. official counts are missing many (probably most) cases earlier this year.

you can compare deaths though. NYS was running about 1000 deaths a day in march/april. LA county (half the population of NYS) is currently around 100 deaths per day. very bad, to be sure!

https://www.latimes.com/california/story/2020-12-28/hospitals-postpone-surgeries-warn-of-rationed-care-amid-covid-19

some select quotes:

At Los Angeles County-USC Medical Center, the situation reached “massive crisis” mode Sunday evening, according to chief medical officer Dr. Brad Spellberg.

“We are just completely overwhelmed,” Spellberg said, adding that the hospital is trying to “daily, hourly, cobble together solutions to get us through this crisis.”

Conditions at the hospital — one of the largest trauma centers in the western U.S. — have been steadily worsening since Thanksgiving, with an average of 10 new COVID-19 patients arriving each day.

As of Monday, the hospital had about 240 COVID-19 patients in all areas of the hospital, according to Spellberg, nearly twice the amount as during the July surge.

And the expected “Christmas bump” hasn’t even begun.

“When you walk into the ICU, and you see every bed occupied by a ventilated COVID patient, with tubes coming in all orifices of their body, you begin to understand that we are not dealing with what we were dealing with 10 months ago,” Spellberg said.

Hospitals are so inundated that they’ve resorted to placing patients in conference rooms or gift shops. Some are contending with aging and insufficient infrastructure that threatens to interrupt the flow of life-saving oxygen.

Health officials said Monday they are sorting through a reporting backlog they expect will add 432 deaths to the toll.

“As bad as it is, the worst is almost certainly yet to come,” said Dr. Christina Ghaly, the county’s health services director.

“The situation,” she added, “is truly dire.”

There are situations in which 10 ambulances are waiting to offload patients at emergency rooms, forcing patients to be treated in the vehicles for as long as eight hours.

Among the four county-operated hospitals, a stunning 86% of ICU patients have COVID-19, Ghaly said. The majority of nonessential surgeries and procedures in those facilities have been postponed, and officials are working to discharge patients to skilled nursing facilities, outpatient dialysis sites and other locations.

Watching case counts spike day after day you know that hospitalizations will climb soon after, predictably followed by ICU beds filling up. This is as predictable as water flowing downhill. This is the dynamic playing out in nearly every state. Some are just getting there quicker.

xp yep i hear the sirens. it's terrible and if it gets a little worse it's going to get a lot worse because of ICU capacity. i'm just saying the number of cases confirmed by testing anywhere in march (when we were barely testing in the US) is not a useful comparison.

yeah, i wasn't saying what is happening in LA today is on par with peak COVID in NYC, but rather that there exists potential to be at that level and very soon. Newsom has ordered thousand of bodybags and refrigerated container trucks to be shipped to LA county hospitals.

When ICU patients are filling up the gift shop, the breaking point is only days away. No matter how many tents and beds you can truck in, there are only so many nurses and physicians and they need to sleep and eat sometime or they collapse.

the only positive in LA right now is, even accounting for holiday reporting weirdness, the daily cases seem to be flattening off a little. but flattening off at 15k/day is still on track for a disaster. and even this might be wishful thinking.

https://i.imgur.com/05vC90y.png

we were thinking about sending the kid back to daycare if the case rate got below 1000/day and stayed there for a few weeks, which it nearly did.

t's very difficult to make meaningful comparisons between *case counts* in march and now because testing is ubiquitous now in a way it wasn't then. official counts are missing many (probably most) cases earlier this year.

you can compare deaths though. NYS was running about 1000 deaths a day in march/april. LA county (half the population of NYS) is currently around 100 deaths per day. very bad, to be sure!

the uk death numbers are not good. about 450 a day. that’s a lot of people to die of something every day! it hasn’t hit the daily peak of the spring, but it’s plateaued - it’s not coming down. in the spring it went up rapidly and came down rapidly.

yes, I'm starting to feel anxiety and panic now on a par with how I felt last March, when everything shut down, there seemed to be risk everywhere and there was no way out in sight.
Even with vaccines on the horizon I'm back to having the desperation and deaths on my mind quite a bit and trying to reduce going anywhere as much as humanly possible. not sure if I'll send my littlest back to preschool. case numbers are still low in my immediate area but it won't take much to send them rocketing again.

it seems much more grimmer going into this for a second time as well. I find much it harder to be thankful for small mercies, such as having food in my cupboards and no-one in my family dying of the rona. Such complacency is wrong, but I do feel it.

Some very unhappy NHS staff out there too. When they're misty-eyed about the clapping you know it's getting tough for them

At least first time round there was a bit of novelty and for some inexplicable reason I had some vague optimism that people on the whole would act responsibly and with everyone's best efforts and obviously sacrifices we could get numbers down. It worked for a bit I guess. (And not dismissing the real toll it has had on people, I mean people being total dicks).

Do you think we should have a new thread for 2021?

yes

should wait til it hits 9,999 posts imo

So a lot of chatter happening on the slow vaccine roll out

Personally, I'm incredibly frustrated.

Did we not know that vaccines were coming? Is vaccine administration a surprise?

Several complex issues so lets break things down a bit

Warning, this is a bit of a rant

Thread

— Ashish K. Jha, MD, MPH (@ashishkjha) December 29, 2020

I've said it before, but Trump's egotism and fundamental incompetence was what I worried about more than anything when he was still in the primary race, because of things like this. Granted, I was very much not thinking of a pandemic, but something a little more temporary which required a strong federal/Executive response.

I had to stop thinking of all the things that went wrong in the early stages of COVID-19 because so much of it was so easy to avoid. I don't think we would have magically avoided COVID-19 even with a strong Federal response. Even countries who handled it well still had to deal with it.

But without a flawed initial COVID test or ridiculously low number of tests available, we may have identified the cases that arrived early a lot sooner, been able to more effectively contact trace, and perhaps manage to keep the person to person spread to more manageable numbers. I'm sure a lockdown would have been needed at some point - not in reaction to an out of control transmission, but proactive measures to stop what eventually happened.

Death tolls would be much smaller. Our way of life would still be disrupted but maybe not as severely/for as long? I do think state government obstinacy and "live free or die" rebellion would have played a factor, but now, the incoming administration is going to be like Atlas trying to continue to hold the globe while a bunch of tiny gremlins keep whacking him in the knees with baseball bats.

I think we'll get there eventually, but the idea that vaccines are going to be this fast-working miracle is a pipe dream. Just glad my folks are getting their doses starting...this weekend!

Here’s the math: If the goal is to reach 80% of Americans vaccinated with a 2-dose #covid19 vaccine, it will take 10 years at our current pace. We are at 1 million vaccinations a week. To get to herd immunity by June 2021, we need to be at 3.5 million vaccinations a day. pic.twitter.com/E78e0xg10z

— Leana Wen, M.D. (@DrLeanaWen) December 29, 2020

the rollout of the vaccine has been very bad, but the "if we continue at our current pace we'll fall far short" point is not very illuminating, given that we're still in the initial roll-out phase

Dr. Wen otm. These initial weeks of vaccination have been at a creeping rate wholly unequal to the need.

xxp I don’t think that stands up? For one thing, we already know that even the initial vaccines confer protection on people. They don’t know with certainty whether vaccination stops you passing the virus on - a big unanswered question - but once the most immediately vulnerable are vaccinated and deaths and cases start falling... people are not going to wait for everyone to be vaccinated and no government will encourage them.

xp to aimless

agreed on that, for sure.

the initial goal for december was 20 million. they've fallen far short of that - only 11.4 million doses sent to states so far, and only 2.1 million doses given to people

June 2022, maybe.

Still betting I'll be forced to vaccinate for my job by September. But as a school worker (not teacher) I might be in one of the early rounds

I've said it before, but Trump's egotism and fundamental incompetence was what I worried about more than anything when he was still in the primary race, because of things like this. Granted, I was very much not thinking of a pandemic, but something a little more temporary which required a strong federal/Executive response.

this is what kept me up at night in November 2016 - I figured we could get through 4 years somewhat intact so long as he didn't have to face any real challenges but the combination of knowing nothing about anything and insisting on being in charge of everything was a guarantee for disaster as soon as any real decision had to be made. I think it's probably true that any Republican response would've been a disaster but Trump actively made things worse in ways that even idiots like Rubio and Cruz wouldn't have done. I feel like when people are gonna be learning about this in 50 years Trump is gonna be a central figure

Are textbooks even honest about Reagan yet?

Pretty sure the Reagan era in survey-type textbooks would be mostly foreign policy stuff, Iran hostage crisis resolved, Gorbachev summitry, Nicaragua war, some Iran-Contra material, maybe touch on the Grenada invasion and the Volcker-Reagan recession. Criticizing his horrifying domestic policies would be too touchy for public school textbooks since we're still in that era, politically speaking; they'd vague it down and pretty it up and try not to offend anyone.

*whispers* we could increase the rapidity of vaccine uptake by just making them mandatory for everyone

That seems like it would be counter productive in the current environment

Demand will outstrip global availability for at least 6 months anyway - might as well cross that bridge when doses are more available

The very high incidence of side effects like fatigue, headache and muscle soreness, even though they're short duration and non-life-threatening makes it difficult to mass vaccinate entire hospital or care-giving staffs in a few days. But spacing out vaccinations for those reasons can't explain the problems getting this done faster. These have to be failures in communication, coordination, and logistics, which all should be controlled by a central authority, meaning the facilities of the US government.