What if a vaccine or "effective treatment" never comes?

71 posts / 0 new
Last post
Aristotleded24

NDPP wrote:
#WearAMask (and vid)

https://twitter.com/Schadi_CRS/status/1317845726257401856

"Wear a mask. Is it really too much to ask?"

What does mask wearing have to do with the viability of a vaccine?

NDPP

Either with or without a vaccine mask-wearing is essential to staying safe.

Aristotleded24

But they sold us on the idea that a vaccine, and only a vaccine, would get us "back to normal." If it's the case that we still need masks in either scenario, then why are we even bothering with a vaccine?

Ken Burch

At a bare minimum, it would have to be compulsory masking and social distancing.  We might simply never be able to have large gatherings again.

It goes without saying that, without a vaccine, herd immunity would not happen- or at least not without so many casualties that it would be morally and ethically unacceptable to try for it- so the Swedish model cannot ever be an option.

Unfortunately, it is a moment where some aspects of the bourgeois version of "individual rights" matter less than simply keeping people alive.

 

Pondering

"They" don't seem to have sold you on that idea Aristotled. I am against mandatory vaccination as a general rule although I think it is fair to demand that children have the usual set of vaccines in order to attend school. 

If there is never any vaccination we could be stuck with perpetual openings and closings depending on where the hot spots are. It should get easier over time as eventually we will have enough PPEs. Treatments will definitely improve as they have already with more knowledge of how the virus attacks various organs. 

In such a situation, however unlikely, we will probably have more drastic temporary shutdowns followed by a more complete openings, like in Atlantic Canada. 

Improved testing and contact tracing will help. Tracking it in sewers will alert us to which communities it is spreading in. 

There will be no massive international events. Vaccine or not I expect all international events to be canceled for next summer. If we get a vaccine I think the earliest we can expect large events, even with a vaccine, is 2022.

 

Aristotleded24

The thing is Ken, viral pandemics generally burn out on their own over a given amount of time, and one of the reasons is that people become immune to the virus. Even the 1918 pandemic, which killed far more people than what the coronavirus is doing, ended, although the specific virus became another endemic disease we have to deal with. And large gatherings still went on after the pandemic ended. Flattening the curve does not change this reality, it only spreads things out over a long period of time. It might be necessary at some stages as a last resort in order to prevent hospitals from being overwhelmed, and if you've tried everything else you can to avoid that scenario. I'm not convinced that we tried everything else, and in any case, if you try too hard to flatten the curve, you just end up extending the pandemic.

Obviously Sweden failed to protect their elders. I'm curious as to why else you think the Swedish model failed. They have a hard cap on gatherings that is not going to be lifted anytime soon. Most people in Sweden are actually choosing to follow public health gudiance. Check out this resource to compare curves in different countries, and you will see that Sweden is the only major European country to avoid a second wave. Most importantly, in my view, you aren't seeing people in Sweden taking to the streets protesting their government's response to the pandemic (with this one exception asking for tighter restrictions, which took place at the end of May during the height of the pandemic in Sweden) the same way you have seen much more recent protests in Europe, New Zealand, and Australia.

I'm very sorry for what you have experienced in the United States with your government's response. There are trade-offs and costs to keeping things open versus closing them down. It seems like the United States got the costs associated with both decisions and the benefit of neither. But even in a pandemic, public health is a complex thing, and you can't look at any one metric. Sure, the death toll from the pandemic is horrible, and steps should be taken to prevent that. At the same time, I can list any number of impacts from attempts to stop the spread which I belive can also kill people in the short, medium, and long term, possibly in even greater numbers. It's far too complicated for me to expand on in this post, but public health is always about the bigger picture. I also suspect that one big reason the United States has done so poorly is because it has done a poor job keeping its people healthy in the first place.

Aristotleded24

Pondering wrote:
"They" don't seem to have sold you on that idea Aristotled. I am against mandatory vaccination as a general rule although I think it is fair to demand that children have the usual set of vaccines in order to attend school.

The "usual set of vaccines" for sending children to school does not include an influenza vaccine, and influenza kills children in far greater numbers than covid.

Pondering wrote:
If there is never any vaccination we could be stuck with perpetual openings and closings depending on where the hot spots are. It should get easier over time as eventually we will have enough PPEs. Treatments will definitely improve as they have already with more knowledge of how the virus attacks various organs.

We don't have a vaccine, and that shut-down-open-up cycle has not happened in Sweden. Their measures and restrictions on gatherings have, in large, remained far more constant and stable than what was seen in other parts of the world.

Pondering wrote:
There will be no massive international events. Vaccine or not I expect all international events to be canceled for next summer. If we get a vaccine I think the earliest we can expect large events, even with a vaccine, is 2022.

We will see how that goes. Right now in Western Canada and the northwestern United States, hockey leagues are coming back in modified formats. In some cases, even spectators are allowed. This will certainly be used to learn lessons as to how these things go and how to have more such events. Even Japan's Prime Minister supports the idea of the Olympics going ahead. Of course, the reason they were cancelled this year is because athletes from other countries began to pull out, so that is not something he has complete control over. It remains to be seen how it plays out.

Aristotleded24

Do you trust a vaccine?

Quote:

The study, titled Social Contours and COVID-19, surveyed nearly 5,500 people from across Saskatchewan between May 4 — the launch of the province’s Re-Open Saskatchewan plan — and Sept. 30. The survey was also administered by researchers in Switzerland at the same time, so the two data sets could be compared.

Wading through the data, Muhajarine saw that as people began to take more precautions, trust in the government fell.

In mid-May, 81.6 per cent said the government was handling the pandemic well. That number fell sharply to a low of 37.1 in early August, before climbing back up to 61.7 per cent by the end of September.

Muhajarine links the drop in trust to two events: the outbreaks in Hutterite colonies and the release of the province’s back-to-school plan. Once the initial panic around those events had settled down, trust began to build again, he said.

Over the same time period, more people reported wearing masks, growing from 41.1 per cent to 59.6 per cent; however, more people also said others around them were not taking the proper precautions.

Optimism around a new vaccine also fell.

In mid-May, 84.9 per cent of people surveyed in Saskatchewan said they would get the vaccine when it was available. By the end of September, that number had fallen to just 56.5 per cent of respondents.

Aristotleded24

Will vaccines even do what we want them to?

Quote:
In all the ongoing phase III trials for which details have been released, laboratory confirmed infections even with only mild symptoms qualify as meeting the primary endpoint definition.9101112 In Pfizer and Moderna’s trials, for example, people with only a cough and positive laboratory test would bring those trials one event closer to their completion. (If AstraZeneca’s ongoing UK trial is designed similarly to its “paused” US trial for which the company has released details, a cough and fever with positive PCR test would suffice.)

Part of the reason may be numbers. Severe illness requiring hospital admission, which happens in only a small fraction of symptomatic covid-19 cases, would be unlikely to occur in significant numbers in trials. Data published by the US Centers for Disease Control and Prevention in late April reported a symptomatic case hospitalisation ratio of 3.4% overall, varying from 1.7% in 0-49 year olds and 4.5% in 50-64 year olds to 7.4% in those 65 and over.13 Because most people with symptomatic covid-19 experience only mild symptoms,14 even trials involving 30 000 or more patients would turn up relatively few cases of severe disease.

In the trials, final efficacy analyses are planned after just 150 to 160 “events,”—that is, a positive indication of symptomatic covid-19, regardless of severity of the illness.

Yet until vaccine manufacturers began to release their study protocols in mid-September, trial registries and other publicly released information did little to dispel the notion that it was severe covid-19 that the trials were assessing. Moderna, for example, called hospital admissions a “key secondary endpoint” in statements to the media.15 And a press release from the US National Institutes of Health reinforced this impression, stating that Moderna’s trial “aims to study whether the vaccine can prevent severe covid-19” and “seeks to answer if the vaccine can prevent death caused by covid-19.”16

But Tal Zaks, chief medical officer at Moderna, told The BMJ that the company’s trial lacks adequate statistical power to assess those outcomes. “The trial is precluded from judging [hospital admissions], based on what is a reasonable size and duration to serve the public good here,” he said.

Hospital admissions and deaths from covid-19 are simply too uncommon in the population being studied for an effective vaccine to demonstrate statistically significant differences in a trial of 30 000 people. The same is true of its ability to save lives or prevent transmission: the trials are not designed to find out.

Zaks said, “Would I like to know that this prevents mortality? Sure, because I believe it does. I just don’t think it’s feasible within the timeframe [of the trial]—too many would die waiting for the results before we ever knew that.”

Stopping transmission

What about Hotez’s second criterion, interrupting virus transmission, which some experts have argued17 should be the most important test in phase III studies?

“Our trial will not demonstrate prevention of transmission,” Zaks said, “because in order to do that you have to swab people twice a week for very long periods, and that becomes operationally untenable.”

He repeatedly emphasised these “operational realities” of running a vaccine trial. “Every trial design, especially phase III, is always a balancing act between different needs,” he said. “If you wanted to have an answer on an endpoint that happens at a frequency of one 10th or one fifth the frequency of the primary endpoint, you would need a trial that is either 5 or 10 times larger or you’d need a trial that is 5 or 10 times longer to collect those events. Neither of these, I think, are acceptable in the current public need for knowing expeditiously that a vaccine works.”

Zaks added, “A 30 000 [participant] trial is already a fairly large trial. If you’re asking for a 300 000 trial then you need to talk to the people who are paying for it, because now you’re talking about not a $500m to $1bn trial, you’re talking about something 10 times the size. And I think the public purse and operational capabilities and capacities we have are rightly spent not betting the farm on one vaccine but, as Operation Warp Speed [the US government’s covid-19 vaccine plan] is trying to do, making sure that we’re funding several vaccines in parallel.”

kropotkin1951

Aristotleded24 wrote:

But they sold us on the idea that a vaccine, and only a vaccine, would get us "back to normal." If it's the case that we still need masks in either scenario, then why are we even bothering with a vaccine?

Who is the "they" and the "us" in your statement. You are obviously not part of either group since you don't appear to be sold. I know I don't believe a vaccine will be the end of public health measures to deal with COVID so I am also neither a "they" or "us" but I sure as hell don't agree with your perspective.

Us real people don't fit into your little thought boxes

Pondering

kropotkin1951 wrote:

Aristotleded24 wrote:

But they sold us on the idea that a vaccine, and only a vaccine, would get us "back to normal." If it's the case that we still need masks in either scenario, then why are we even bothering with a vaccine?

Who is the "they" and the "us" in your statement. You are obviously not part of either group since you don't appear to be sold. I know I don't believe a vaccine will be the end of public health measures to deal with COVID so I am also neither a "they" or "us" but I sure as hell don't agree with your perspective.

Us real people don't fit into your little thought boxes

In addition, no single measure is 100% on its own. A mask is not a replacement for distancing. Assuming there is a vaccine mask wearing would decrease but as it also protects against the common cold and flus etc. I think it will become more popular as it is in other countries. 

Aristotleded24

Of course drug company claims of effectiveness should be taken at face value:

Quote:

Pfizer says an early peek at its vaccine data suggests the shots may be 90 per cent effective at preventing COVID-19, indicating the company is on track later this month to file an emergency use application with U.S. regulators. The vaccine is among seven that Canada has pre-ordered.

Monday's announcement doesn't mean a vaccine is imminent: This interim analysis, from an independent data monitoring board, looked at 94 infections recorded so far in a study that has enrolled nearly 44,000 people in the U.S. and five other countries.

Pfizer Inc. did not provide any more details about those cases, and cautioned the initial protection rate might change by the time the study ends. Even revealing such early data is highly unusual.

"We're in a position potentially to be able to offer some hope," Dr. Bill Gruber, Pfizer's senior vice-president of clinical development, told The Associated Press. "We're very encouraged."

Authorities have stressed it's unlikely any vaccine will arrive much before the end of the year, and limited initial supplies will be rationed.

...

No participant so far has become severely ill, Gruber said. He could not provide a breakdown of how many of the infections had occurred in older people, who are at highest risk from COVID-19.

Aristotleded24
Pondering

No it doesn't.  Even if they said there wuuld never be a vaccine we would still have lockdowns because our health care system would soon be overwhelmed which would lead to a real lockdown.

Aristotleded24

Again with the sensationalist fearmongering about overhwelmed hospitals based more on sensationalized media reporting than actual verifiable data, context, and facts.

Aristotleded24

This is interesting:

Quote:

Pfizer Inc. Chief Executive Officer AlbertBourla cashed out 62 per cent of his stock in the company on the same day it announced the success of its experimental COVID-19 vaccine, a regulatory filing showed.

Bourla on Monday sold 132,508 of his shares at an average price of US$41.94 — a total of US$5.6 million — not far off the 52-week high of US$41.99 Pfizer at which the stock traded.

Pfizer’s shares increased in value almost 15% on the day of the vaccine announcement, Business Insider reported.

The sale was part of a routine, pre-determined trade, admissible under a specific rule in the Securities and Exchange Act. Rule 10b5-1 allows major holders in a corporation to prearrange the sale of a fixed amount of shares at a fixed time.

On August 19, 2020, Bourla filed to sell his shares.

“The sale of these shares is part of Dr. Bourla’s personal financial planning and a pre-established (10b5-1) plan, which allows, under SEC rules, major shareholders and insiders of exchange-listed corporations to trade a predetermined number of shares at a predetermined time,” Pfizer said.

Presumably if this vaccine works then these shares would be going up in value soon. So why would he sell now rather than waiting to cash in?

Pondering

Maybe he wants a yaught or owes alimaony, or has gambling debts or is starting a new company of his own. It was planned in August so there is no connection to the announcement. 

Left Turn Left Turn's picture

Aristotleded24 wrote:

With questions about how long immunity against covid lasts, that has major implications for the viability of a vaccine. If our own immune systems, which were designed to provide long-lasting protection against pathogens (think chicken pox, for instance) can't provide permanent protection against covid, any vaccine we try to develop in the coming months and years will not be effective over the long term. Suppose you need booster shots after a year. You then have a situation where there is massive demand, plus the time, energy and resources that need to go into producing, distributing, and administering these boosters. Is all of this really wise, or should it be directed at providing care for people with other medical conditions, rather than constantly vaccinating otherwise healthy people against this disease?

People get flu shots every year. How is getting an annual COVID vaccine any different?

Left Turn Left Turn's picture

Quote:
Again with the sensationalist fearmongering about overhwelmed hospitals based more on sensationalized media reporting than actual verifiable data, context, and facts.

Hospitals would absolutely be overwhelmed in short order if everybody was not wearing masks and not physical distancing. Public health restrictions are an aboslutely necessary part of ensuring that does not happen.

Aristotleded24

Left Turn wrote:
Quote:
Again with the sensationalist fearmongering about overhwelmed hospitals based more on sensationalized media reporting than actual verifiable data, context, and facts.

Hospitals would absolutely be overwhelmed in short order if everybody was not wearing masks and not physical distancing. Public health restrictions are an aboslutely necessary part of ensuring that does not happen.

Let's take a look at some actual data. If you look at the hospitalization rates for Ontario, you will see that the rates of hospitalization for covid, while rising, are nowhere near where they were in the spring. I know BC just set a record for the number of hospitalizations. These are the only 2 provinces for which I can find comparative data throughout the duration of the pandemic. Furthermore, hospitals and ICUs are always under strained capacity at this time of year. There is even the occaisional news story, but most of us respond by shrugging and going about our day. The question in regards to the current rise in hospitalizations is how does this compare to what we usually see at this time of year? There are some indications out of the United Kingdom that the number of hospitalizations and people in ICUs is not out of line with what they would expect in any other year.

As for the public health measures? It is time to ask how effective they actually are, because they are becoming tighter amid a rise in cases. The place where I buy groceries didn't start mandating masks until September 1. They became required in indoor spaces in Winnipeg on September 28. The number of gathering sizes has been continually reduced. Winnipeg moved to the highest alert level November 2, with the entire province going into complete lockdown on November 12. So all of these public health measures have not stemmed the rise in cases. So if the public health measures we have been told to put into place work so well, why are cases rising? If they did work, I would have expected the case count in Winnipeg to start dropping in mid-October, but it did not.

Pages