Covid-19 #25: The Prisoner’s Dilemma

[Fragile Bird]

3 minutes ago, Impmk2 said:

So Australia has just approved the AstraZeneca vaccine which is being manufactured locally. But the approvals board (TGA) is being cautious as far as the over 65s along with the several other European countries, saying it should be used on a case-by-case basis taking into account co-morbidities. Insufficient infection data in the clinical trials for that cohort. I'm kinda surprised that's still an issue.

I was just coming here to ask if anyone has any news about the AZ trial going on outside of Europe. This is the one they started up after the original Phase 3 trial screwed up their doses. At that time, if you recall, I said the US would never approve the AZ vaccine. I believe the new trial is the one Fury is a part of. Surely it must be pretty far along by now.

[The Anti-Targ]

So one thing COVID has reminded govts is the need to secure critical supply chains. I've just been skimming an unreleased govt paper looking at how to approach securing supply chains for NZ. I can't quote large sections or details because it is a classified (at a low level, but still classified) document. But I can quote this bit which is not particularly critical in terms of confidentiality of information:

Quote

·            Broadly five approaches are under consideration or already being used by other governments to improve supply chain resilience:

-           Leave it to the market.

-           Shortening or re-shoring supply chains.

-           Agreeing supply contracts with strategic countries and/or companies.

-           Establishing a strategic national stockpile.

-           Legislating or regulating minimum stock levels to be maintained by business (as is done in Switzerland)

The paper also summarises approaches that have been put in place, or planned by other countries*, including USA, UK, EU, Japan, Australia, India and China. Guess how many of these countries are taking the leave it to the market approach?

 

 

If you guessed a number higher than zero you are wrong. There are aspects of the market to most of the approaches, but in every case the central govt is intervening to ensure particular outcomes happen.

 

*Yes, EU is not a country, but for the purposes of centralised decision making on this topic it more or less is the equivalent of a country.

 

[Fragile Bird]

7 hours ago, BigFatCoward said:

Good news coming out of Israel. Pfizer does seem to work as well in the real world with 94% success rate at preventing symptomatic infection. 

More important, what are the statistics coming out of the UK after all this time?

[rotting sea cow]

5 hours ago, The Anti-Targ said:

So one thing COVID has reminded govts is the need to secure critical supply chains. I've just been skimming an unreleased govt paper looking at how to approach securing supply chains for NZ. I can't quote large sections or details because it is a classified (at a low level, but still classified) document. But I can quote this bit which is not particularly critical in terms of confidentiality of information:

I remember reading somewhere that NZ is using some policies first planned in the 60s in the event of a full scale nuclear war. The assumption was that NZ was unlikely to be directly affected by the confrontation but the collapse of the international system would have dire consequences and thus careful planning was necessary. Do you know what I'm talking about?

Countries should really need to stop mindlessly trusting in globalization and make sure that they can survive through some other global catastrophes at least in key areas like health, energy and food security.

 

[rotting sea cow]

7 hours ago, Impmk2 said:

Yeah that very much mirrors the Australian experience with it. We've had 3 breaches involving the B.1.1.7 so far, but only one of those has spread further than the quarantine staff and their immediate family (and currently has the entirety of Melbourne in a short lockdown, though the cluster seems to be under control). That both us and NZ are suddenly getting more breaches does support the now pretty solid epidemiological evidence of the increase in transmissibility (whether that be through higher viral load or lower infectious dose), but how infectious any one individual is still seems to be highly variable.

I'm somewhat skeptical that the B.1.1.7 variant is significantly more infectious than the previous ones.

[The Anti-Targ]

1 hour ago, rotting sea cow said:

I remember reading somewhere that NZ is using some policies first planned in the 60s in the event of a full scale nuclear war. The assumption was that NZ was unlikely to be directly affected by the confrontation but the collapse of the international system would have dire consequences and thus careful planning was necessary. Do you know what I'm talking about?

Countries should really need to stop mindlessly trusting in globalization and make sure that they can survive through some other global catastrophes at least in key areas like health, energy and food security.

 

The paper I skimmed is kind of along those lines, but it's not going that far. For small countries like ours it is just not possible to bring production of everything you need in an extended crisis onshore. Not least because we (and most countries in fact) lack the raw materials to be genuinely self-suifficient. The fact is globalisation is unavoidable for most countries to prosper and very few can be truly self-sufficient (from extraction to consumption) in all of the things that one would deem essential. Without significant technological advances in non-agrarian food production there are many countries that cannot be self sufficient in food for a substantial period of time, and that includes several very wealthy countries.

The bunker mentality is as futile for countries as it is for individuals, and less practical for countries. So, you have a bunker somewhere that you can live fully self contained for 1 year while you ride out whatever is going on up / out there. What are you going to find when you take your first step back out into the light of day? Either it's going to be a barren, lawless wasteland in which case what exactly did you hide yourself away for? Or, society will have recovered and is doing well, and probably completely passed you by. And they won't exactly thank you for not pitching in and helping out with getting society back on its feet, in fact you will simply act as a reminder of what was wrong about the past.

So in my opinion, the solution is a combination of all the options I listed, because strategic and mutually beneficial relationships are essential.

[Impmk2]

1 hour ago, rotting sea cow said:

I'm somewhat skeptical that the B.1.1.7 variant is significantly more infectious than the previous ones.

I find the evidence that there's an increase in transmissability to be reasonably compelling at this stage. The extent of it... yeah still very much debatable.

[JoannaL]

28 minutes ago, Impmk2 said:

I find the evidence that there's an increase in transmissability to be reasonably compelling at this stage. The extent of it... yeah still very much debatable.

I am also unsure. As far as I know, there is no lab evidence? Just that the transmission went up like in UK in December? But that could be also some other factors: less lock-down, Christmas shopping, seasonality of virus. perhaps temperature/humidity was ideal. also much less sun -UV-light-  in December.

[Heartofice]

I do suspect that the case rates shot up over Christmas in some part because people’s behaviours changed, as well as seasonal changes.

Seeing huge crowds of people shopping in London kind of gave it away a bit, and just anecdotally I know a lot of people ( under 30 years old) who got it over that period, and I know they got it because they socialised a lot more than before. I don’t really think young people are adhering to the rules anywhere near as much as we think. 
 

I think there is evidence the new variant was more transmissible but I don’t know how solid that is. 

[ljkeane]

10 hours ago, Fragile Bird said:

More important, what are the statistics coming out of the UK after all this time?

The situation in the UK is improving but it's a bit hard to distinguish what's down to lockdown and what's down to the vaccination programme. Given it takes about 2 weeks for the protection from the first vaccine dose to kick in and, generally speaking, the people dying tend to have been infected about a month ago I think it's probably more down to lockdown at the moment. That's a complete guess on my part though.

[rotting sea cow]

2 hours ago, Impmk2 said:

I find the evidence that there's an increase in transmissability to be reasonably compelling at this stage. The extent of it... yeah still very much debatable.

 

2 hours ago, JoannaL said:

I am also unsure. As far as I know, there is no lab evidence? Just that the transmission went up like in UK in December? But that could be also some other factors: less lock-down, Christmas shopping, seasonality of virus. perhaps temperature/humidity was ideal. also much less sun -UV-light-  in December.

 

1 hour ago, Heartofice said:

I do suspect that the case rates shot up over Christmas in some part because people’s behaviours changed, as well as seasonal changes.

Seeing huge crowds of people shopping in London kind of gave it away a bit, and just anecdotally I know a lot of people ( under 30 years old) who got it over that period, and I know they got it because they socialised a lot more than before. I don’t really think young people are adhering to the rules anywhere near as much as we think. 
 

I think there is evidence the new variant was more transmissible but I don’t know how solid that is. 

Quoting from memory, so correct me if I'm wrong. There are three compelling pieces of evidence for increasing trasmisibility

1.- Higher affinity to the ACE2 receptor (computational work) plus lab evidence (in vitro) that the variant is out-competing the wild type in cell cultures. I don't remember reading anything with animal models.

2.- Increase viral loads in nasopharyngeal swabs.

3.- Serotype replacement rate of the variant B.1.1.7 in comparison to the wild type, which led  to the estimate of a increase of R0 of about 0.7 in comparison to the wild-type. A huge and scary jump.

However, there are limitations and confounding factors in all cases. Computational and in vitro work are often hard to translate into in vivo and human. Viral loads might be seasonally dependent (we all heard those stories of lower viral loads in summer). The replacement of variants might be just because of a founder effect like superspreading events. I read a compelling hypothesis about how hectic work in UK ports ahead of the Brexit might have played a role, exactly in the places where the variant started to spread.

The later is important because virologist and epidemiologist as well as health authorities often ignore the social conditions that help the virus to spread. We need to have people on the ground to understand what is going on.  As @Heartofice points out other factors might influence this.

So, I think it might be more transmissible but I'll still wait for more clear evidence over a longer period of time.

 

 

 

 

 

 

[Spockydog]

On 2/15/2021 at 12:45 AM, Chataya de Fleury said:

Hey, just thank your lucky stars and send good thoughts to those of us waiting

Absolutely. I'm so happy to have had it and I hope that those still waiting don't have to wait too long.

It's five days since my jab, and I didn't have any side effects at all, not even a sore arm. Probably down to all the immune system boosters I've been guzzling daily since last March. Vitamin C & D, cod liver oil, garlic capsules and calcium. 

 

[Clueless Northman]

16 hours ago, The Anti-Targ said:

So one thing COVID has reminded govts is the need to secure critical supply chains. 

It's quite simple: any sensible country should have the means of producing locally as much of critical supplies as possible and should stockpile the rest. This has always been true and will always be. "Leave it to the market" is basically a suicide pact.

 

8 hours ago, Impmk2 said:

I find the evidence that there's an increase in transmissability to be reasonably compelling at this stage. The extent of it... yeah still very much debatable.

It might be more transimissible when there are limited measures around. Of course, when everyone is under lockdown, easier transmisison won't help the virus to spread much, because there's just too few contacts between people, so even cases of new variants will go down, at least until reopening.

[IheartIheartTesla]

Regarding AZ trials, there was one run in India that had some problems because a guy developed some neurological issues post injection and sued the Serum Institute of India (who countersued, who dies that). Details are still murky, but I believe it has received approval for emergency use by the Indian regulatory body  The conclusion I guess was that his issues were unrelated to the vaccine.

Not sure which of the (two now) vaccines my parents back home will eventually take. The approval process appears to be a royal mess.

[Ormond]

I was finally able to make an appointment for Covid-19 vaccine here in Douglas County, Nebraska, since I just found out they are now taking appointments for everyone born in 1951 (my birth year) or earlier. Unfortunately the first available was February 27, 11 days from now. I can't wait. Hopefully the weather will be a lot less frigid that day, as they tell people to wear short sleeve shirts for the vaccination!  

[Zorral]

I'm receiving notifications from more distant friends these last two weeks, reporting that either their partners, or they, are positive.  It's from their kids. 

Heard from one this morning.  They all went through last winter w/o a hint of even  cold.  But the kids are in school and socializing a whole lot more.  And their friends have trumpist type parents, who seem not to believe in masks or anything else. Though this dad's kids live with his ex-wife, they visit him and his partner every couple weeks.  So now his partner is positive, and they're waiting to learn if she will get sick.  So everybody is quarantined, even dad, though he is negative and had his first Moderna shot two weeks, ago he said, and his ex-wife is also positive.

[Spockydog]

42 minutes ago, Chataya de Fleury said:

Cod liver oil. You, sir, are truly dedicated.

Been taking that stuff for years now. It's done wonders for my arthritis. 

[williamjm]

18 hours ago, Fragile Bird said:

More important, what are the statistics coming out of the UK after all this time?

https://www.theguardian.com/society/2021/feb/16/encouraging-signs-covid-vaccine-over-80s-deaths-fall-england

has some early indications of a fall in death rate among elderly people who are more likely to be vaccinated

Deaths from coronavirus have fallen by 62% among over-80s since 24 January, the point at which a third of that age group had some level of immunity against coronavirus, having received their first vaccine dose at least two weeks earlier, data analysis by the Guardian showed.

This drop was larger than among groups with a lower level of vaccination. Among people aged between 20 and 64 the drop in deaths was 47%, while the drop among those aged 65 to 79 was 51%.

[Spockydog]

41 minutes ago, Chataya de Fleury said:

Really? Shit. I have awful arthritis (jaw, spine, knees) and even though I’m vegetarian, I’d be “pescatarian for cod liver oil” if it truly helped.

Tell me more - how much do you take? Are there pills or do you have to take a liquid?

(if liquid, does it mix with vodka?)

I used to get it bad in my knees. Plane journeys were unbearable. I had to stop going to the cinema because 2+ hours of not being able to straighten my legs was straight up torture.

Also in and around my hip. Standing up, in the same place, for any length of time was bad. Doing the dishes was a literal pain in my ass. 

Anyway, my mum was telling me to take cod liver oil for years before I tried it. Started taking oil-fllled capsules, and within weeks I could feel the benefits. 

Now, I take one capsule a day and laugh in the face of Christopher Nolan and his pesky three-hour movies. 

You should try it. If you can't bring yourself to drink the fish oil, CBD oil is a decent veggie alternative.

 

[Impmk2]

Back on to B117 transmissability. Don't have time to write much now, but the major evidence behind increased transmission is that it's out-competing wild type virus. And has done so (or is in the process of doing so) across several countries we have good data in at this point - notably Israel and the Netherlands.

That could be a big coincidence, but taken with the lab work and modelling showing increased ACE2 receptor binding giving it a plausible mechanism for increased transmission... yeah I don't think it's unlikely.

As I said though, the extent is still contentious. The % numbers put on it seem very sensitive to the local conditions (as well as having massive statistical uncertainty), as well as assuming an across the board increase in all subpopulations, and as such I don't think are particularly helpful.