Covid-19 #25: The Prisoner’s Dilemma

[Clueless Northman]

4 hours ago, IheartIheartTesla said:

There is a little bit of truth in the old Chris Rock routine, where he notes that the reason we dont have a cure/vaccine for cancer or diabetes, because all the money is to be made in having people come back every month for curing the symptoms. Anyway, vaccines are more one-and-done (or two-and-done), so I imagine in terms of a business model its not as profitable as a drug model. Even though the latter addresses a smaller portion of the entire population, its returns accumulate over time. There may also be money in formulating drugs (for instance, proper release profiles) that may allow for commanding better prices.

Anyway, dont know how India ended up as the largest vaccine producer in the world. It may be that Western countries tried to keep high IP, high margin cures in-house, and offshore the lower hanging fruit to places where labor was cheap. Also, India needs to vaccinate a larger number of people every year for standard diseases.

I think you're correct about how India developed vaccine manufacturing: the West lost interest because it's not profitable enough. That drugs that need to be taken for life is way more interesting to pharma than cheap vaccines is a key reason why the "This is a plot from Big Pharma" theory is just pure bogus.

And when it comes to producing vaccines, this shit is turning into a sad sick joke, truly: EXCLUSIVE-AstraZeneca to miss second-quarter EU vaccine supply target by half - EU official | Reuters

These scumbags don't just underdeliver in 1st quarter by 2/3, they're also going to underdeliver by 1/2 in 2nd quarter. Goddamn, EU really needs to get its shit together and approve other vaccines - even Sputnik it if comes to that and they can at long last provide solid and convincing data to EMA (not sure why this hasn't happened yet, whether it's EU that's suspicious or not interested, or the Russians who don't or can't deliver official data).

Edited February 23 by Clueless Northman

[Iskaral Pust]

The state of CT just announced the next tiers for vaccine eligibility.  After teachers and child care workers, they’re just jumping into age tranches.  55+ are eligible now, then 45+ are eligible from March 22nd.  I’ll be eligible in mid April, not that there’s any guarantee that there will be vaccine supply and appointments available.

The grocery store workers are pretty pissed off that they weren’t given priority as frontline/essential workers before the eligibility devolved to just age brackets.  They’re absolutely right.  I know Lamont is saying simple is better and it’s hard to enforce many criteria, but that’s no way to treat people who’ve shown up work in risky environments all this time.  

[Mlle. Zabzie]

If today's testimony can be relied upon, Pfizer and Moderna are projecting huge production increases over the next 5 weeks that will result in 140 million more doses in the US. They sound confident, but I'll believe it when the shot goes in my arm....Biden administration is predicting that about 200 million doses distributed by the end of March (that's a cumulative number including Dec-Mar). 

That said, sounds like the big bottleneck is at the fill/finish level.  So what we really need is more putting vaccines in bottles to ship out.  Also sounds like J&J will have significantly more availability in April, assuming there is a positive recommendation Friday and approval over the weekend. There are very few doses now, but they say 60 million by the end of April.  If that holds, then I would think by the second or third week of May we would be looking at a very large number of fully vaccinated people in the US.  

 

 

Edited February 23 by Mlle. Zabzie

[Tywin et al.]

Am I horribly for momentarily thinking I might have to Heisman an older lady today?

[Mlle. Zabzie]

Just now, Tywin et al. said:

Am I horribly for momentarily thinking I might have to Heisman an older lady today?

No more than you were the moment before and the moment after?

[Zorral]

39 minutes ago, Mlle. Zabzie said:

140 million more doses in the US. They sound confident, but I'll believe it when the shot goes in my arm.

Hear ya, there, you betcha! 

[Tywin et al.]

13 minutes ago, Mlle. Zabzie said:

No more than you were the moment before and the moment after?

We were walking towards each other in a standard hospital hallway. For whatever reason she randomly started to veer towards me.

[Mlle. Zabzie]

46 minutes ago, Tywin et al. said:

We were walking towards each other in a standard hospital hallway. For whatever reason she randomly started to veer towards me.

Justified.

[Padraig]

3 hours ago, Clueless Northman said:

And when it comes to producing vaccines, this shit is turning into a sad sick joke, truly: EXCLUSIVE-AstraZeneca to miss second-quarter EU vaccine supply target by half - EU official | Reuters

There is some confusion on this issue (seems i'm always conflating confusion with AZ).  AstraZeneca is now saying that it will deliver the expected amount in Q2 but that half will come from its international supply network (and half from its EU network).  I wonder what that means.  Does some other country lose out?  COVAX is a big recipient of AZ supplies.

Astrazeneca-says-it-will-deliver-all-contracted-second-quarter-vaccines-to-EU

But yes, you certainly would prefer if other suppliers were emerging given the consistent issues.  I don't think Sputnik will be the saviour though.  They still haven't applied.  For weeks they were insisting that they already had, despite the EU saying "nope".  I fear they have no idea what an EU application requires.  And people don't think they have the capacity to deliver significant volumes to the EU.  Far easier to supply a few smaller countries.

I don't think we'll see anything substantial delivered from J&J until April, even if/when it gets approved in March..  (Sanofi announced today that it was going to produce vaccines for J&J but not until Q3.  I presume J&J's own factories will lead things in Q2.  I'm wonder was Macron making calls.  After all the delivery issues in January, this is the second collaboration that Sanofi have announced.  A couple weeks ago it was Pfizer.  The EU has ordered 300m Sanofi vaccines but they are embarrassingly way off having their own vaccine approved.  I can see this as one way for it to quietly rebuild bridges).

Moderna and Pfizer are ramping up deliveries in the EU but I don't know are they to the kind of levels been reported by Mlle Zabzie for the US.  At the same time, deliveries in Ireland are supposed to go from 80k a week (right now) to 250k a week in April.   So maybe it is similar.

We have been told today, of the vaccines already administered in Ireland, 311,741 were the Pfizer-BioNTech vaccine, 33,634 were AstraZeneca and 4,947 were Moderna.  The Moderna number was shocking to me.  I was wondering did some EU countries swap orders? We'll take your Pfizer, you take Moderna?  Might be easier to deal with fewer types and they are practically identical efficacy wise.

[Clueless Northman]

Since other AZ production locations are basically India and US and these countries seem keen on keeping a lot of that production for their own big vaccine needs, I wouldn't trust AZ guarantees at all.

At this point, the EU should really shift to ask and pressure to make the vaccines public and lift the patents. Heck, as we see with collaborations with Sanofi and others, even then it'll take months to have the production lines ready. EU should've joined other countries in 2020 to make this a precondition - but these idiots were all about how International properties are oh so important, as if tens of thousands of human lives (even more, tens of thousands of human lives of their own fellow European citizens) were worthless by comparison.

[JoannaL]

7 hours ago, Padraig said:

Moderna and Pfizer are ramping up deliveries in the EU but I don't know are they to the kind of levels been reported by Mlle Zabzie for the US.  At the same time, deliveries in Ireland are supposed to go from 80k a week (right now) to 250k a week in April.   So maybe it is similar.

We have been told today, of the vaccines already administered in Ireland, 311,741 were the Pfizer-BioNTech vaccine, 33,634 were AstraZeneca and 4,947 were Moderna.  The Moderna number was shocking to me.  I was wondering did some EU countries swap orders? We'll take your Pfizer, you take Moderna?  Might be easier to deal with fewer types and they are practically identical efficacy wise.

Our delieveries are about to go up in the same order (got delivered until now 8 mio altogether, is forecast to be 18,5 mio end of March). Since we always get 19% of the EU deliveries (as this is proportional to population) I would think EU deliveries in March will be about 50 mio. Thats better, but really not good enough for 450 mio people. I do not have the exact moderna number but it wasnt that much here either I think about 150000 altogether until now. Actually I was wondering why we get Moderna at all? Isnt that a US company with US factories which should be forbidden to export? Not that I am complaining.

[JoannaL]

12 minutes ago, Clueless Northman said:

At this point, the EU should really shift to ask and pressure to make the vaccines public and lift the patents. Heck, as we see with collaborations with Sanofi and others, even then it'll take months to have the production lines ready. EU should've joined other countries in 2020 to make this a precondition - but these idiots were all about how International properties are oh so important, as if tens of thousands of human lives (even more, tens of thousands of human lives of their own fellow European citizens) were worthless by comparison.

No, that is a too simple view. It just isnt possible to ramp up production for so many people that quickly. Israels success is great, but is has 9 mio citizens, so with the right prize (and it seems they pay a lot more per dose than the EU), they can get a large amount (in realtion to population)  delivered quickly. there is no incentive in the world that would have made it possible for the companies to get as many doses for the EU that quickly which has 450 mio people and not 9 mio. It just takes more time and has nothing to do with lifting patents, they are producing as good as they can.

That does not mean that the EU countries shouldnt help which production lines now (or actually starting last summer), but all I hear they do. Actually I read somewhere that they met last summer to discuss the quickest way to supply everyone - since a lot of the potential candidates were new technology and hard to produce, and decided to order AZ - because thats just more simple to do and here the production lines will be safe and stable...

[JoannaL]

4 minutes ago, JoannaL said:

Actually I read somewhere that they met last summer to discuss the quickest way to supply everyone - since a lot of the potential candidates were new technology and hard to produce, and decided to order AZ - because thats just more simple to do and here the production lines will be safe and stable...

...another reason for also ordering AZ was that it would be an European supply line so not dependend on the US and their export limits and so certainly able to deliever to the EU without having to prefer other customers...

Actually it is  quite funny really,  if we would not talk about people dying daily because of their shortcomings...

 

 

[rotting sea cow]

8 hours ago, Padraig said:

There is some confusion on this issue (seems i'm always conflating confusion with AZ).  AstraZeneca is now saying that it will deliver the expected amount in Q2 but that half will come from its international supply network (and half from its EU network).  I wonder what that means.  Does some other country lose out? 

Canada maybe?

as well as any possibility of EU vaccine diplomacy.

8 hours ago, Padraig said:

COVAX is a big recipient of AZ supplies.

With India blocking exports, AZ european problems and other suppliers far behind the lines, ti's likely that COVAX is at the verge of collapse, despite all the money poured into it.

[Clueless Northman]

1 hour ago, JoannaL said:

decided to order AZ - because thats just more simple to do and here the production lines will be safe and stable...

Apparently, they're not - as you noted.

1 hour ago, JoannaL said:

 there is no incentive in the world that would have made it possible for the companies to get as many doses for the EU that quickly which has 450 mio people and not 9 mio. It just takes more time and has nothing to do with lifting patents, they are producing as good as they can.

With their mindset, we would've lost WW II, and very badly.

Plenty of grandstanding pols, including the Trumpster, said this was the greatest crisis since 1945, that it was akin to fighting a war and other claims. Well, turns out they still acted as if it was a nothing-burger. Were they serious about the war comparison, then they would've turned the society into a war economy with war emergency powers over private companies. They shouldn't have asked nicely in 2020 if pharma would like to produce vaccines, it should've been an order with specific targets, stressing that failure isn't an option, shifting entire parts of the manufacturing capacities of European countries towards vaccine production. They failed utterly because they are useless pols without any idea willpower, totally blinded by their neo-liberal ideology that "private business Good", shouldn't be limited or forced (or taxed!) in any way. This sick ideology has now been proven once again to be an abject failure and a murderous one.

[rotting sea cow]

Pretty much spot-on @Clueless Northman . They wanted to win a war with a market economy. Any competent enemy would have trashed them. At least US invoked the Defense Production Act, but I don't know how much that helped.

[Padraig]

2 hours ago, JoannaL said:

 Actually I was wondering why we get Moderna at all? Isnt that a US company with US factories which should be forbidden to export? Not that I am complaining.

Moderna has an agreement with Lonza, a Swiss company to produce the vaccine for the European market.  And I think there are Spanish and French companies involved in the supply chain also.   I wonder are they still ramping up and that's why there is a big increase in total numbers expected in April?  The EU has ordered 310m doses for delivery this year, so they have to start arriving eventually!  And an option for another 150m next year.

If the Moderna numbers in Ireland reflect EU numbers, we really are almost completely reliant on Pfizer/Biontech right now.

2 hours ago, Clueless Northman said:

Since other AZ production locations are basically India and US and these countries seem keen on keeping a lot of that production for their own big vaccine needs, I wouldn't trust AZ guarantees at all.

At this point, the EU should really shift to ask and pressure to make the vaccines public and lift the patents. Heck, as we see with collaborations with Sanofi and others, even then it'll take months to have the production lines ready. EU should've joined other countries in 2020 to make this a precondition - but these idiots were all about how International properties are oh so important, as if tens of thousands of human lives (even more, tens of thousands of human lives of their own fellow European citizens) were worthless by comparison.

I thought there would be clarification stories about AZ this morning but there isn't.  Hmm.  Right to be wary.  And yes, I do wonder did the EU overly trust the pharma companies.  Especially as most of them were relatively small and had no history of generating the scale required.  Pfizer is doing best but its also, by far, the biggest manufacturer.  Joanna is right that the sheer size of the EU would always mean this was a long process but the US has administered twice the volumes that the EU has.  Hindsight is great but those kind of deals that Sanofi are signing could have been done months ago (or they have been working on them for the last 8 months.  They were that complicated!).

2 hours ago, JoannaL said:

...another reason for also ordering AZ was that it would be an European supply line so not dependend on the US and their export limits and so certainly able to deliever to the EU without having to prefer other customers...

Yes.  I remember reading how AZ was likely to be the best option last August (or so).  Tried and tested technology.  No strange mRNA tech.  A British/Swedish company etc.

1 hour ago, rotting sea cow said:

With India blocking exports, AZ european problems and other suppliers far behind the lines, ti's likely that COVAX is at the verge of collapse, despite all the money poured into it.

The first deliveries happened today.

https://www.bbc.com/news/world-africa-56180161

But you are right to keep an open mind.  I don't think India would ever stop all deliveries.  That would be self-destructive but it could certainly delay the speed of deliveries.  There is a Korean factory involved also but I don't know whether that facility is ready.

[L'oiseau français]

As far as I know, AZ has plants manufacturing vaccine in many places all over the world. Japan will get 90 M doses from a plant in Japan, Australia will be supplied from a plant in Australia, a Chinese plant was expanded and production will be doubled from 100 M to 200 M doses, and there’s India and Korea.

It seems like the only place they refused to manufacture was in Canada. The government asked them to and they refused.

[ljkeane]

39 minutes ago, Padraig said:

 Hindsight is great but those kind of deals that Sanofi are signing could have been done months ago (or they have been working on them for the last 8 months.  They were that complicated!).

Sanofi were trying to make their own vaccine until recently. It's only an option now because they've decided it isn't going to work in the time frame needed.

41 minutes ago, Padraig said:

Yes.  I remember reading how AZ was likely to be the best option last August (or so).  Tried and tested technology.  No strange mRNA tech.  A British/Swedish company etc.

It's tried and tested in the sense that a few adenovirus vaccines have been developed before but I don't think any of them have been mass produced yet. I think the mRNA vaccines were the first of their kind in any sense so there there was probably a bit more concern that it wouldn't work at all.

[Clueless Northman]

Moderna has production sites in Belgium, Spain and Switzerland, I think, all part of the big assembly line, basically. I don't think any site can produce the whole product on its own, which is a shame, but I suppose it would mean downsizing production for months if they wanted to fix it. So, Europe is where most of EU vaccines will be made, I don't think there will be much imports from the US or India in their case.

 

2 minutes ago, ljkeane said:

Sanofi were trying to make their own vaccine until recently. It's only an option now because they've decided it isn't going to work in the time frame needed.

Yup, but plenty of big names have just entirely stopped researching and producing vaccines. Switzerland is supposed to be big in pharma, but they sold or outsourced their entire vaccine R/D. Yet they still should be able to produce components, if not whole vaccines, if they were told to.