outbreak! (ebola, sars, coronavirus, etc)

my GP texted me this afternoon asking me if I'm still a carer (they should already know I am not, might as well have asked me if my wife's still dead) - but that was so they could offer me carer counselling services (thanks a bunch for your swift response, it's only been 2 years since I registered) not a covid vaccine.

good piece

https://newrepublic.com/article/161375/west-virginia-covid-vaccine-new-york-california

manhattan federal courthouses otm

https://nypost.com/2021/02/16/manhattan-federal-court-buildings-now-require-two-masks/

(the headline is bad. they require a (K)N95 or two masks. but don't wear two masks. wear a (K)N95.)

Which (K)N95 mask maker do you work for so I can make sure to order the right ones for your kickback, caek?

Nature on the future of life with covid.
https://media.nature.com/lw800/magazine-assets/d41586-021-00396-2/d41586-021-00396-2_18861336.png

you still haven't booked your flu jab", which puzzled me as I was 46, with no obvious health issues and had never had a flu jab.

Hopefully this will be less puzzling to both you and your GP next season!

Human Challenge study has gotten ethics approval:
https://www.gov.uk/government/news/worlds-first-coronavirus-human-challenge-study-receives-ethics-approval-in-the-uk

jesus

Hope the money's good.

Over many decades, human challenge studies have been performed safely...

Which prompts the questions, what percentage of them, and "safely" by what measure?

Good SF-specific read

https://www.sfgate.com/news/editorspicks/article/Bob-Wachter-pandemic-exit-interview-COVID-19-UCSF-15954178.php

That's a good read and I like the idea of the series, but I have to say it feels a little like tempting fate to be so sure we are in the "exit interviews" stage. Undoubtedly it feels like we've entered a new stage, a hopeful one at that, but I guess the last year (and four years, if I'm being honest) has pushed me to be a little more tempered in certainty that anything is truly "over".

Yeah I don't like it either, but that's on the site, not Wachter.

For me the meat of that Wachter interview is toward the end:

I think we'll be at something that resembles normal in the fall. I think we will stay ahead of the variants since the vaccine is moving quickly and having competent leadership at federal level is a big deal.

Everything we needed to happen has happened: There's more vaccine production, we're cutting red tape to get people vaccinated quicker, we're setting up vaccines in poorer communities. Many things are being done now that unfortunately came a year too late, but news about vaccines remains great. It’s a race but I think we’ll mostly win it. The variants may cause a surge in April but I think we'll mostly win.

Something that Wachter has not addressed is that the despite the steep decline in local case rate, the death rate in SF has been surging at/around peak levels. He dances around the issue without being absolutely direct about it in his COVID Chronicle threads which have been coming less and less often.

https://i.imgur.com/VwEHRgq.png

Like does that look like "Brunch time is LIT af, reopen everything!!!" to you? After spending the last 11 months not seeing friends and family and reducing exposure so that people do not die, city leaders think that NOW is the time to start relaxing without risking the consequences?

The variants may cause a surge in April but I think we'll mostly win.

This is what gives me pause, mostly because, as pointed out above, a lot of leaders are already in the, "fuck it, numbers are down, let's brunch it up" mode. I mean, it hasn't even been two weeks since they opened up indoor dining at 25% capacity in Illinois and they already bumped it up to 40% capacity. Drive me absolutely nuts.

5% isn't enough but I'm glad to see some attention by a national leader to the global inequity of the vaccine rollout so far.

Emmanuel Macron urges Europe to send vaccines to Africa now

French President Emmanuel Macron has said Europe and the US should urgently allocate up to 5 per cent of their current vaccine supplies to developing countries where Covid-19 vaccination campaigns have scarcely begun and China and Russia are offering to fill the gap. 

In an exclusive interview with the Financial Times by video link from the Elysée Palace, Macron said African nations were sometimes buying western vaccines such as those made by AstraZeneca at “astronomical prices” — two or three times the price paid by the EU — and being offered Chinese and Russian vaccines of uncertain efficacy against new variants of the virus. 

“We are allowing the idea to take hold that hundreds of millions of vaccines are being given in rich countries and that we are not starting in poor countries,” he said ahead of a G7 meeting by video link on Friday of the leaders of the world’s biggest economies called by UK prime minister Boris Johnson.

“It’s an unprecedented acceleration of global inequality and it’s politically unsustainable too because it’s paving the way for a war of influence over vaccines,” Macron said. “You can see the Chinese strategy, and the Russian strategy too.” 

The French president said it was crucial for pharmaceutical groups making vaccines to transfer technology abroad in order to accelerate global production of vaccines — “we will apply all the pressure we can” — and to be transparent about pricing. 

The concept of intellectual property was essential for innovation, but if vaccine manufacturers were not co-operative “inevitably the political question of intellectual property will arise in all our countries,” he said. “I don’t think it’s the right debate, it’s not helpful, but it will arise — this discussion over excess profits based on scarcity of the vaccine.”

Macron acknowledged that the EU had been slower than the US at ensuring production and supply of vaccines for its own populations and was facing shortages, but said diverting a small share of the doses to Africa from European supply chains would not hinder vaccination campaigns.

“The key is to move quicker,” he said. “We’re not talking about billions of doses immediately, or billions and billions of euros. It’s about much more rapidly allocating 4-5 per cent of the doses we have. 

“It won’t change our vaccination campaigns, but each country should set aside a small number of the doses it has to transfer tens of millions of them, but very fast, so that people on the ground see it happening.”

Macron said he had discussed the idea “a lot” with German Chancellor Angela Merkel. “She supports it and we are in agreement,” he said, calling for a “fully European and co-operative initiative” and adding that he hoped also to convince the US, where vaccine supplies are more plentiful than in the EU.

He said the plan would be a test of the reality of multilateralism. “It’s not about vaccine diplomacy, it’s not a power game — it’s a matter of public health,” Macron said, adding that he welcomed the global provision of Russian and Chinese vaccines provided they were certified by scientists for use against the appropriate variants of the virus.

“It’s unacceptable when a vaccine exists to reduce the chances of a woman or a man according to the place where they happen to live.” 

While implicitly acknowledging that the rollout of vaccines to developing countries was a diplomatic battle that western countries were currently losing, Macron said it was in the interest of all countries that wanted their borders to remain open to extend vaccination programmes beyond their home territory. 

“It’s in the interest of the French and the Europeans. Today I have more than 10m of our fellow citizens who have families on the other side of the Mediterranean,” he said. 

Macron, whose government has been criticised for the slow rollout of vaccinations in France, insisted that transferring “3-5 per cent of the vaccines we have in stock to Africa” would have no impact on the domestic inoculation programme. “It won’t delay it by a single day given the way we use our doses.” France has promised vaccinations to all adults who want them by the end of the summer. 

Without helping their neighbours around the Mediterranean and in the Middle East and the Balkans, European countries would never be able to reopen because they would end up reimporting Covid-19 variants resistant to their vaccines, he said.

there was a lot of concern over the winter that ICU availability in california was 0%, but it wasn't obvious if that was a problem in practice at the time, or if it was just reporting artifacts (lots of places had plenty of availability according to the county but non according to the state, etc.)

it's now looking like a bunch of people in fact died because of lack of hospital capacity

In the two months before LA's massive COVID surge, 12% of COVID patients admitted to hospitals in L.A. County died. Between Nov. 3 and Jan. 20, that percentage had nearly doubled to 23%.

the latest from @ronlin and me https://t.co/5GhpHjTTvT

— Soumya (@skarlamangla) February 18, 2021

Good on Macron. (probably last time I type that!)

XP to Albert - deaths have pretty consistently lagged cases by a few weeks. It looks to me like San Francisco’s deaths are in fact now well past peak and dropping following case declines.

https://abc7news.com/feature/health/bay-area-covid-19-data-cases-deaths-vaccines-by-county/9891245/

...I'm having trouble finding any SF specific #s in your link (caveat: my browsers are all pretty locked down unless they're my own projects.)

Dr. Wachter who I referenced above is on a taskforce advising SF's city govt on guidelines/restrictions, not the Bay Area (which includes, yet is obviously a completely different animal than then the city of SF). Thanks though.

https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/san-francisco-county/

(which is where my chart clip came from)

ah sorry

well fwiw since you posted it the death rate is more clearly down a bit, and it defies logic that the case rate would fall and the death rate wouldn't follow.

but any claims about the death rate in SF county are going to be in the eye of the beholder because it's a very small community that regularly has 0 deaths in a day and you're dealing with small number statistics so the chart is a mess, even if you take the 7 day average.

and if you're not comfortable extrapolating from falling cases to falling deaths you can see ICU hospitalization falling very clearly too (down almost 50% from peack, although not falling as quickly as cases, which is normal). i guess that more than anything is probably why wachter seems less concerned about the unclear trajectory of the death rate.

Extremely good news

JUST IN: Pfizer's Covid vaccine stopped 89.4% of transmission in Israel, the first real-world sign that immunization will curb the spread of coronavirus https://t.co/8dswCcFo65 pic.twitter.com/yXRwe2i0SQ

— Bloomberg (@business) February 21, 2021

Give me more of this!

I just felt a jolt of happiness

Needed this news

fuckin' A

Good news apart from the fact that I'll probably get the shitty Union Jack British vaccine instead.

Think yourself lucky you're not getting one knocked up in his kitchen by Matt Hancock's five-a-side buddy.

WHO slams rich states for hogging vaccines

The World Health Organization on Monday blasted wealthy countries for not only hogging Covid vaccines but in doing so, hindering the pathway for poorer nations to get them too.

Global justice...next time

This is good and necessary].

Here’s my best attempt at summarizing what we know:

The Moderna and Pfizer vaccines — the only two approved in the U.S. — are among the best vaccines ever created, with effectiveness rates of about 95 percent after two doses. That’s on par with the vaccines for chickenpox and measles. And a vaccine doesn’t even need to be so effective to reduce cases sharply and crush a pandemic.

If anything, the 95 percent number understates the effectiveness, because it counts anyone who came down with a mild case of Covid-19 as a failure. But turning Covid into a typical flu — as the vaccines evidently did for most of the remaining 5 percent — is actually a success. Of the 32,000 people who received the Moderna or Pfizer vaccine in a research trial, do you want to guess how many contracted a severe Covid case? One.

Although no rigorous study has yet analyzed whether vaccinated people can spread the virus, it would be surprising if they did. “If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of one!” Dr. Paul Sax of Harvard has written in The New England Journal of Medicine. (And, no, exclamation points are not common in medical journals.) On Twitter, Dr. Monica Gandhi of the University of California, San Francisco, argued: “Please be assured that YOU ARE SAFE after vaccine from what matters — disease and spreading.”

The risks for vaccinated people are still not zero, because almost nothing in the real world is zero risk. A tiny percentage of people may have allergic reactions. And I’ll be eager to see what the studies on post-vaccination spread eventually show. But the evidence so far suggests that the vaccines are akin to a cure.

Offit told me we should be greeting them with the same enthusiasm that greeted the polio vaccine: “It should be this rallying cry.”

Except the polio vaccine patent rights were disclaimed by Jonas Salk for humanitarian purposes

sure, but $ is not the limiting factor in getting everyone vaccinated right now. i don't think people were celebrating his enlightened approach to intellectual property, they were celebrating not getting polio. same applies.

if the vaccine were owned by the federal government or just generally open for use, i daresay a lot of the issues we're running into regarding distribution would evaporate.

this winter storm slowing the pace of vaccinations in the US is very unfortunate (though those in Texas without water, that probably isn't the first thing on their mind atm).

re: lack of vaccine enthusiasm, I think a part of the issue is that people don't read cautionary news properly. when a healthcare professional says you having two shots of the vaccine doesn't mean you should go out clubbing again immediately or stop masking, they mean "we haven't determined yet if this actually stops or reduces transmission, and until then, to be on the safe side, we should continue as previously". the general public hears "this is a useless vaccine, because you can't merely resume your normal activities right after you get it". There was a meme circulating broadly saying exactly that a few weeks ago.

likewise, the moment news broke that it is possible that vaccines could be partially or fully neutralized by some or all of the variants, friends of mine began braying loudly that the vaccine didn't work against *any* variants...even the ones we now know it does work against with about the same success rate. any corrections or clarifications issued later are useless, the public often goes by what they heard first.

Even though they shouldn't have to, it really does mean folks like the CDC, WHO, and other public speakers have to strongly caveat what they're saying - "this is just a precaution, it doesn't mean the vaccine doesn't work, but we want to err on the side of caution until we have stronger data regarding its effect on transmissibility".

if the vaccine were owned by the federal government or just generally open for use, i daresay a lot of the issues we're running into regarding distribution would evaporate.

Fauci sounded confident yesterday that the storm delays wouldn't be trouble after a few days.

I’m assuming you mean distribution inside the US there. It’s takes four months to make a batch of mRNA vaccine. No supply chain problems will ever evaporate given that lead time. We’re dependent on decisions made months ago.

I'm wondering if the flip side of the storm delays is that it kept lots of people stuck inside and slowed down transmission

true

Fun fact: the covid crisis has produced over 1200 new words in German over the past year. Personal favourites are coronamüde (tired of covid) & Impfneid (envy of those who have been vaccinated).

— Liz Hicks (@LizHcks) February 21, 2021

Impfneid is the name of my nu metal band

ride the impfneid

Impfneid to say goodbye and I choke, try to walk away and I stumble

Incredible what Chile is achieving in their vaccination rollout.

Within the last three weeks Chile overtook all EU countries.
Now they are catching up to the US.

[all our @OurWorldInData data on all countries https://t.co/7lOyDamxxx] pic.twitter.com/Bh8xZTu28v

— Max Roser (@MaxCRoser) February 22, 2021

Just re-upping this since there’s a new strange doubling down on one side of the “schools” debate. Here we see that moving from safe schools (hybrid/distanced) to 100% in-person has not worked well. Schools can be safe if you try. Here’s the opposite of try https://t.co/nlK358haQq

— Eli Perencevich, MD MS🧼 😷 (@eliowa) February 23, 2021