Why It Will Take Longer Than You Think

The latest editorial from the editors of the Washington Post provides a pretty good example of why I think that the inoculating process will take a lot longer than people seem to think:

THE WORLD HEALTH Organization’s director-general, Dr. Tedros Adhanom Ghebreyesus, warned in August that no country could afford to go it alone in fighting the pandemic. Nations already depend on global supply chains for everything from diagnostic testing to personal protective equipment, he said, and they must avoid “vaccine nationalism” when it comes to the most powerful tool to fight covid-19. When the Group of 20 leaders held their virtual summit meeting last weekend, they again declared their intent not to hoard lifesaving vaccines, saying, “We will spare no effort to ensure their affordable and equitable access for all people.”

But as vaccines come closer to reality, wealthy nations of the world have already taken care of their own needs and signed contracts to buy up hundreds of millions of vaccine doses. And the poor? A global risk-sharing procurement initiative to ensure fair and equitable access to vaccines, the Covax Facility, could bring them protection, but only if it can get sufficient funding in 2021. This is the world’s best chance to help the poorest populations confront the pandemic, being led by the WHO, the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance.

concluding:

The world’s wealthiest countries are on the verge of a science triumph with the arrival of an effective vaccine in less than a year. But in this moment of need, the haves should also extend a hand to the have-nots. As Dr. Tedros said in August, “No one is safe until everyone is safe.”

In other words don’t just think in terms of 330 million people in the U. S. but in terms of 7.5 billion people in the world. Assume that the certified and approved vaccine makers can produce enough vaccine in aggregate to inoculate 2 billion people. That means it would take at least 4 years to inoculate everybody. If you think they can produce more, you’ll need to provide evidence since that’s not what the pharma companies themselves are saying.

17 comments… add one
  • Drew Link
  • Drew Link

    Reported in the NEJM.
    https://sebastianrushworth.com/2020/11/25/new-evidence-on-the-effectiveness-of-lockdown/

    Although deficiencies are noted, the biggest punch line is:

    “That being said, this study clearly shows how effectively the virus spreads even when extremely repressive methods are being used to contain it. In spite of strict physical distancing, rigorous hand and surface hygiene, face masks, PCR based screening, daily symptom checks, and two weeks of quarantine before even arriving at campus, the virus still snuck in and was still able to spread effectively among the recruits.”

  • steve Link

    It took a big effort to get this far but the last mile issue is a big one especially with the temperature issues. As far as the US goes I suspect we can accomplish this in well under a year, but we still dont know for howling the vaccine will be effective. Will all vaccines be effective for the same length of time? Still, even if effective for just a year or two the places that will really take 4 years to vaccinate are largely places that dont have a lot of travel with us.

    As to Drew’s papers I owed wait for confirmation of the Briand paper. It is an outlier. As to the second citation I think I know the Marine paper pretty well. Being an ex-corpsman it did interest me. First, it has no control group, so I dont think the study tells us very much. Second, who here besides me went to boot camp? Andy? Believe me, nature finds a way. I would suggest that 18 y/o males (I think it was all men) when in groups are pretty creative about getting around rules. (I was.) They know the risk of anything bad happening to them if they do get sick is tiny and how many teen males have any sense of mortality? Females for that matter. Also, again, there weren’t enough cases to make much of a conclusion anyway. Not many people advocate for lockdowns (which are mostly a thing of the past) when there isn’t much Covid circulating.

    Steve

  • steve Link

    Query- The only reason we had Covid was because it was an effort to hurt Trump’s re-election efforts. What is the current right wing conspiracy theory to explain why it is accelerating again? Is this like other conspiracy plots? The asteroid didnt hit the planet so you just forget about it? All of the conservatives here claimed that Covid and the response to it was all political. Everyone one of them. Just wondering how you guys cope now.

    Steve

  • Grey Shambler Link

    We’d be irresponsible to immunize children, WRT long term effects unknown, Maybe half of Americans won’t willingly accept the Frankenvac, so we need maybe 150 M doses. Can be done in a year. Most susceptible groups, six months.
    Thank you, President Trump.

  • CuriousOnlooker Link

    The AstraZeneca / Oxford vaccine can be stored in a normal fridge and they think is 90% effective. It also costs $2.5; 90% less then the mRNA vaccines.

    It is in competition with the Chinese vaccine(s); which have similar properties.

    Supposedly both will have multi-billion doses next year.

    Developing countries have options.

    It is also likely that within a year all international travel will require proof of vaccine before boarding an airplane.

    i.e. vaccinating the world won’t be as hard as projected and it won’t be required to vaccinate the whole world.

  • Grey Shambler Link

    how you guys cope now:
    So grateful Trump hammered this thing before the mask man takes over.
    The acceleration of infections shows how virulent this thing is. I don’t know, is it cold weather? Quarantine fatigue? Or has it just taken time for it to circulate to the uninfected vulnerable in Minnesota and the Dakotas.
    New York not hit so hard this wave. Well, many vulnerable are gone. Passed away. God bless their souls.
    Trump as president had the responsibility to keep the economy we all depend upon running, as we were running out of fear, he remained rock solid. Even to the point of risking death to bolster the courage of the nation.
    I honestly hope the sad masked man doesn’t have to face any challenges as nuanced as those Trump faced. History will judge him quite well, IMO.

  • steve Link

    Russia, China, UK and likely other countries have vaccines or will have them shortly. But if you want to think Trump dod something special go ahead. Just as I thought you now accept it as real unlike earlier in t he year, now that you can claim that your hero has solved everything.

    Steve

  • CuriousOnlooker Link

    Well warp-speed looks pretty well executed.

    We will see the distribution plans portion of it next year but remember they focused on 4 things, financing, regulatory approval, manufacturing, distribution.

    The first 3 look on track so far.

  • steve Link

    Well, warp speed was almost as fast as Russia, China and Pfizer, so it was pretty good, but it wasn’t special. It just demonstrates what can happen when you throw a lot of govt money at a problem. What is supposing is that we dont have conservatives complaining about the spending on warp speed that did not yield results. We know how big conservatives are on accountability. (LOL)

    Was looking at numbers while waiting for next pt. Just realized that both North and South Dakota have had more than 0.1% of their populations die due to Covid. But it’s just the flu.

    Steve

  • CuriousOnlooker Link

    I believe Pfizer/Moderna will have the first regulatory approval based on safety and efficiency.

    The Chinese / Russian vaccines I believe have safety data, but no efficiency data (yet).

    The correct phase is Russia, China as almost as fast Warp Speed.

    Pfizer was part of Warp Speed, they got purchase commitments and regulatory approvals from the program.

  • Grey Shambler Link

    Special? Damn straight!

  • steve Link

    Pfizer is part of Warp Speed only in that the government agreed to buy some vaccine. Its a real stretch to say that Warp speed affected them. China has already vaccinated over a million people. Warp speed mostly helped smaller companies like Moderna. It just took away budgetary constraints for them.

    But we need to start with priors here. Biotech is a US strength. If Warp Speed was really successful then I would have expected us to have had vaccines well ahead of other countries and companies like Pfizer. At best you can say it resulted in results a little bit earlier than elsewhere. What we had was the US putting money into vaccine research, like a lot of other countries did. Nothing very special about it, nor was it a lot more effective than elsewhere. Finally, I think we need to see what happens in the long term. A lot of our govt money went to m-RNA vaccines. We dont know what will happen with those in the long term.

    Steve

  • Just realized that both North and South Dakota have had more than 0.1% of their populations die due to Covid.

    This is not intended as a defense of North and South Dakota, just an observation. The comparatively high mortality in those states is in all likelihood due to the heightened risk among Native Americans. Only Alaska and New Mexico have larger percentages of Native Americans.

  • steve Link

    Wasn’t really attacking SD and ND per se, only those who claim Covid is just the flu, though if you made a Venn diagram I guess there would be a lot of overlap. Still, given that the mortality from Covid is about half what it was in the spring it is just shocking to me that rural areas like these would be approaching the same rates of Covid death as New York.

  • CuriousOnlooker Link

    “Pfizer is part of Warp Speed only in that the government agreed to buy some vaccine. ”

    The regulatory / manufacturing / distribution aspects of Warp Speed help and apply to Pfizer as well.

    “China has already vaccinated over a million people”

    The US and the West could have vaccinated a million people as well — if they did what the Chinese did and performed mass vaccination after Phase II trials, without the level of evidence of safety and efficiency in Phase III trials.

    That was an ethics decision reflecting cultural values.

    “A lot of our govt money went to m-RNA vaccines.”

    The first vaccines are mRNA vaccines. But Warp Speed also has non mRNA candidates with J&J and Novavax.

    I was worried that too many bets were made on mRNA; but mRNA did get through R&D / trials the fastest and looks more effective then non-mRNA vaccines; so the bets look correct.

    “Biotech is a US strength”

    Every country is using their strengths. The Chinese are applying the force of a one-party state.

    I don’t disagree that vaccine development should be faster, but to make it faster, we would have to do ethics differently. It would be taking risks like human challenge trials and willingness to mass vaccinate after phase II trials.

    I judge at what Warp Speed promised back in the Spring vs where it is now. They said a vaccine ready to be distributed by the end of the year; and that’s what they have.

    Now we have to see the distribution part of warp speed is well planned and executed.

  • steve Link

    To be clear I am not saying warp speed was a failure, I just dont understand fetishizing it as though it was some great, uniquely American triumph. We did what everyone else did and threw a lot of money at the problem. That is what other countries did also and we all ended up at about he same place. People who knew the vaccine process predicted 12-18 months to have vaccines produced and distributed. That is right about where we will end up.

    Which raises the question of why we didnt do this for other products. We are still limping along with not enough tests and not enough PPE. Promise some companies we will but their products if they make them.

    Steve

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