[HN Gopher] Moderna raises 2021 vaccine output forecast to at le...
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       Moderna raises 2021 vaccine output forecast to at least 600M doses
        
       Author : KoftaBob
       Score  : 192 points
       Date   : 2021-01-04 15:32 UTC (7 hours ago)
        
 (HTM) web link (www.reuters.com)
 (TXT) w3m dump (www.reuters.com)
        
       | xenocratus wrote:
       | It's worth remembering that there's a need for 2 doses per person
       | to vaccinate - don't think the article talks about dose as "the
       | amount needed to fully protect one person"
        
         | testplzignore wrote:
         | This particular points concerns me the most. All the numbers we
         | have now should be considered "half vaccinations". Very soon
         | (if this hasn't already happened), we'll be hitting the point
         | where people start getting the second dose. Assuming the second
         | dose takes as long to administer as the first dose, the rate of
         | people getting the first dose will be cut in half.
         | 
         | I think the logistical challenges of administering the second
         | dose will be even worse. You have to contact and schedule all
         | of the first dose people, you need to have them actually show
         | up when they are supposed to, and you need to have sufficient
         | doses on hand.
         | 
         | I am expecting that a large number of people will, voluntarily
         | or otherwise, either not receive the second dose or receive it
         | later than they are supposed to.
         | 
         | Areas of the US that are looking "good" now in terms of the
         | rate of vaccinations may look far worse very soon.
        
       | mynegation wrote:
       | I believe it is a first case of hopefully many others of vaccine
       | producer coming up with conservative estimate and then increasing
       | it as they optimize the production process and remove the
       | bottlenecks in the supply chain. One example of the bottleneck
       | would be a limited supply of special glass vials produced
       | somewhere in China.
       | 
       | https://news.cgtn.com/news/3355544f34514464776c6d636a4e6e626...
        
         | NegativeLatency wrote:
         | Sounds like they're also made in other countries
         | 
         | > Most of the tubes are imported from other countries, like
         | Germany and Japan
        
           | blywi wrote:
           | It seems more like the majority of borosilicate vials are
           | produced outside of China. It doesn't even look like China
           | has any significant domestic production capacity for the type
           | of high quality chemically inert glass needed for vaccine
           | vials, that's why the tubes for production are mostly
           | imported.
           | 
           | Main producers of vials seem to be SCHOTT, Stevanato Group,
           | Gerresheimer, Corning, and DWK Life Sciences, from Germany,
           | Italy and the US.
           | 
           | SCHOTT alone is looking to increase production until the end
           | of 2021 by about seven billion vials [1], which would be 3.5
           | times more in additional production output than the complete
           | annual production capacity of Zhengchuan Pharmaceutical,
           | which according to the article is one of China's largest
           | producers.
           | 
           | [1] https://www.pharmtech.com/view/readying-glass-vials-for-
           | vacc...
        
           | dmix wrote:
           | It also says there are 60 other companies working in China.
           | 
           | > China has some 60 glass medicine container providers
           | 
           | Plus we've seen markets adapting really quickly already a ton
           | of times through out the pandemic.
        
         | dcolkitt wrote:
         | My understanding is that the primary bottleneck is clotting
         | factor, which is still harvested naturally from horseshoe
         | crabs. So it's a balancing act between maximizing yield while
         | not collapsing the population.
         | 
         | There's an artificial version, but it was only recently
         | approved by the FDA, so there's not significant industrial
         | capacity.
        
           | cactus2093 wrote:
           | Artificial version was denied by the FDA I believe
           | https://www.theguardian.com/environment/2020/may/31/crab-
           | blo...
           | 
           | Unless it has since been reversed?
        
         | retSava wrote:
         | I love when things like this gets visible (even if I may not
         | love why, or the result from it).
         | 
         | Eg how a very large percentage of the worlds christmas
         | decorations are made in one Chinese city, or large % of
         | harddrives in Thailand, or quartz movements for basically all
         | of the worlds watches are from one-two suppliers, etc etc.
         | 
         | Opens your eyes to both how fragile some niches of the world
         | are, and to how some markets are completely commoditized under
         | a shallow layer of branding (most headphones, many phones,
         | etc).
        
           | Cerium wrote:
           | Fragile, yes, but also beautiful. The Chinese "single product
           | city" is something of a free-market wonder. I visited Dehua
           | (a ceramics city) and spent the time fascinated at how
           | anything related to ceramics production is cheap in that
           | city. It is no one individual factory that achieves economy
           | of scale, but rather the full city, and everyone in it
           | benefits. Small producers can achieve globally competitive
           | pricing on their goods without having to take delivery of
           | truckloads of input materials.
        
             | bobthepanda wrote:
             | This works really really well until it really really
             | doesn't. There's a reason why these towns don't exist in
             | the West anymore, Detroit being the biggest example (though
             | they got out of their predicament by trying to diversify).
        
               | maxerickson wrote:
               | There's still a pretty huge concentration of automakers
               | and suppliers in the greater Detroit area.
        
               | bobthepanda wrote:
               | Hence the keyword "trying".
        
               | maxerickson wrote:
               | When I started composing my reply, your comment read
               | "This works really really well until it really really
               | doesn't. There's a reason why these towns don't exist in
               | the West anymore, Detroit being the biggest example."
               | 
               | Perhaps our edits overlapped.
        
             | afandian wrote:
             | Reminds me of Tula, the Russian city where a huge number of
             | accordions were made. I'm not sure if it was dictated by
             | the Soviet government or whether it happened organically,
             | but I'm not sure it was due to a free market.
        
               | mynegation wrote:
               | If anything, Tula is famous for metalworking, weapons,
               | and gingerbread before anything else.
        
             | fermienrico wrote:
             | There is nothing beautiful about this I see.
        
           | ac2u wrote:
           | Yeah there's a part of AntiFragile that I'm reading right now
           | about the average calories burned to transport consumable
           | calories on average.
           | 
           | The soviet union focus on agricultural production efficiency
           | achieved the opposite effect right after the breakup.
           | 
           | Crops were produced inefficiently compared to centralisation,
           | but after the breakup the calories to transport vs consumable
           | calories ratio was close to 1:1, compared to a 12:1 in the
           | USA at the time, because the crops were grown super close to
           | where they were consumed.
           | 
           | Same with toilet roll availability in lockdown... lots of
           | control built in over the years to give the appearance of
           | reduced volatility.
           | 
           | So when relatively minor real volatility came in the form of
           | an uptick in demand over a shorter period of time, it had a
           | drastic effect.
           | 
           | We should be thankful these lessons are being doled out in
           | the form of toiler paper, Christmas decorations and hard
           | disks instead of food and meds.
        
             | credit_guy wrote:
             | > compared to a 12:1 in the USA at the time
             | 
             | That doesn't sound quite right.
             | 
             | After a quick google, here's some typical numbers for
             | shipping meat: a big rig with refrigeration can transport
             | more than 40000 pounds of meat; at about 1000
             | (kilo)calories per pound, that's abotu 40 million kcal.
             | Such a rig travels about 500 miles per day, has a fuel
             | economy of about 6 mpg and burns an extra 15 gallons for
             | the refrigeration, all in all, about 100 gallons per day.
             | At about 35000 kcal/gallon, that's about 3.5 million kcal
             | to travel for one day. So you need to move around for more
             | than 11 days to get just to a 1:1 ratio.
        
               | ac2u wrote:
               | >at the time
               | 
               | Your numbers need adjusted for 30 years of fuel
               | efficiency improvement (but to be honest I think your
               | calculations would still illustrate the same point).
               | 
               | The passage I'm reading doesn't cite an exact study/paper
               | except to cite that it's from the works of Dmitri Orlov.
               | 
               | I think the point was more likely centred upon 1:1
               | calorie transport/consumption of the variety of staples
               | needed rather than taking one of the most calorie dense
               | categories of food like meat for the purpose of back of
               | the envelope math. I also took a quick glance at a
               | passage from Google from Orlov's book which takes all the
               | calories involved in the growth of the food as well, so
               | there's probably a little more to it.
        
               | credit_guy wrote:
               | Most people don't realize how huge chemical energy is
               | compared to mechanical energy.
               | 
               | Here's a different way to look at the same thing: one
               | gram of carbs has an energy content of 4.2 kcal. That's
               | about 18000 Joules. One Joule is the same as 1 kg*m2/s2;
               | it takes one Joule to lift a mass of 1kg to a height of
               | about 10cm (because the gravitational acceleration is
               | about 10m/s2). So, with 1 Joule you can lift one gram to
               | a height of about 100 meters. With the energy content of
               | 1 gram of carbs, you can lift 1 gram of matter to a
               | height of 1800 kilometers, i.e. more than 4 times higher
               | than the orbit of the International Space Station. When
               | shipping things around, we don't change the elevation too
               | much, for the simple reason that the highest elevation on
               | Earth is less than 10km. Moving 1g of matter 1km in the
               | horizontal direction requires much, much less energy that
               | 1km on the vertical.
               | 
               | Now food has some water content, the energy does not get
               | converted with 100% efficiency, etc. But the idea that
               | the energy used in transportation is anything close to
               | the energy content of food is quite far fetched.
               | 
               | Let's put it differently: it's hard to lose weight. It's
               | damn hard. Precisely because the energy content stored as
               | chemical energy in our fat cells is so large compared to
               | how much we burn by performing mechanical actions. For
               | example, an average runner burns about 100 (kilo)calories
               | per mile. Since one pound of fat has about 3500 kcal, you
               | need to run about 35 miles to burn that. If you want to
               | burn all the energy stored in all your body, you need to
               | run more thousands of miles. And we humans, are very
               | inefficient. We don't have wheels in particular.
               | 
               | Or, let's put it yet another way. One of the most
               | inefficient ways to transport things around is by rocket.
               | The planned Starship will have a launch mass of about
               | 5000 tons and a payload of 100 tons in orbit. That's a
               | ratio of 50:1. So, to take one gram of stuff from being
               | stationary on Earth to moving at orbital speed (8km/s)
               | perpetually in the sky it takes about 50g of propellant
               | (fuel plus oxidizer). When we move things on Earth, we
               | obviously can use the Oxygen that's all around us. Of the
               | 50g of propellant, only about 11g are actual fuel, so you
               | end up with a ratio of about 11:1 of fuel vs payload,
               | using the most inefficient way of moving things around.
        
               | maxerickson wrote:
               | I think in their metric, the wheat that the US
               | occasionally shipped to the USSR counts as a downside to
               | US agriculture.
        
               | idiotsecant wrote:
               | I suspect warehousing and other distribution logistics
               | factor in as well. 'Transport' is from farm to plate.
        
           | vidarh wrote:
           | Makes you wonder, though, to what extent there are market
           | opportunities in identifying weak product chains like that,
           | preparing to look like a viable alternative, and then staging
           | a marketing campaign based on drawing public attention to the
           | risk and pushing demand for second source contracts.
        
         | hnsr wrote:
         | This could be wishful thinking, but it would not surprise me if
         | these numbers will go up for many or all of the vaccines. If
         | the numbers of doses we've heard so far are contractually
         | agreed upon, I would make sense that the manufacturers erred on
         | the safe side regarding the number of doses they promise to
         | deliver.
        
       | oli5679 wrote:
       | I am so grateful for their hard work.
       | 
       | They developed a 90% effective vaccine in weeks, before proving
       | safety and efficacy, and scaling up to 600M doses in months.
       | 
       | It makes me emotional to think of the number of lives they will
       | save.
       | 
       | I didn't think this was possible and I hope I one day get the
       | chance to thank some of the people that worked on this in person.
        
         | parimm wrote:
         | It took 25days from the time the Covid-19 sequence was
         | published to make the Moderna vaccine.[1]
         | 
         | [1]https://www.bostonmagazine.com/health/2020/06/04/moderna-
         | cor...
        
           | jjice wrote:
           | Holy cow. That's absolutely incredible. Does the use of mRNA
           | make these vaccines faster to develop?
        
             | choeger wrote:
             | There is a large caveat, though: The virus is a SARS
             | variant, which in turn is well-studied. Prior research sped
             | up sequencing and analysis significantly. I think we had
             | the first PCR test even _before_ the full genome was
             | sequenced. It is also somewhat easy to target with the mRNA
             | approach. So don 't expect the same speed for everything
             | else.
             | 
             | I think this particular virus was one of the best possible
             | for a pandemic. One the one hand it causes a serious,
             | potentially deadly, illness. But on the other hand the
             | illness does not immediately destroy our health system, let
             | alone our industrial basis. It is also ideally suited for
             | the relatively new mRNA vaccines.
             | 
             | This might be cynical, but the whole thing might turn out
             | to be a net positive. Many more viruses could be attacked
             | now. Personalized, immediate cancer treatment could be just
             | one step away after this. Heck, we might even have found
             | the solution to the problem with antibiotics resistent
             | bacteria.
        
             | blhack wrote:
             | Yes. You could almost think of the mRNA as being "printed".
             | 
             | The real technology in these vaccines is actually encasing
             | them in a lipid, which prevents your immune system from
             | attacking the mRNA.
        
             | sytse wrote:
             | mRNA vaccines can be printed on a DNA printer! You might be
             | interested in this article: Reverse Engineering the source
             | code of the BioNTech/Pfizer SARS-CoV-2 Vaccine
             | https://twitter.com/sytses/status/1345854099464470528 It
             | lets you see the exact mRNA contents of the BNT162b2
             | vaccine, and for most parts understand why they are there!
        
         | fassssst wrote:
         | NIH developed the vaccine, Moderna and Pfizer are manufacturing
         | it.
        
           | jonplackett wrote:
           | And monetising it.
           | 
           | Oxford vaccine is slightly less effective, but about an order
           | of magnitude more affordable.
        
             | esja wrote:
             | They are all incredibly affordable, measured against the
             | benefits to individuals and society.
        
               | sanxiyn wrote:
               | I agree, but those are not in contradiction. 1000x
               | affordable vaccine is still an order of magnitude more
               | affordable than 100x affordable vaccine.
        
               | jonplackett wrote:
               | You can say they are cheap compared, but affordable is
               | what can actually be afforded. And for a country like
               | India with a billion people, paying ~$1 per dose VS
               | something like $15 for moderna is a huge difference.
               | 
               | All I'm saying is you should give more credit to
               | companies doing the right thing and essentially giving
               | the vaccine away at cost while there's a pandemic, even
               | if their vaccine isn't quite as good.
        
               | valarauko wrote:
               | In India the Pfizer vaccine works out to $35 per dose,
               | and AstraZeneca at $3
               | 
               | * [Pfizer Vaccine's Price May Be Throwing off Indian
               | Government, Report Says - The Wire
               | Science](https://science.thewire.in/health/pfizer-
               | vaccines-price-may-...)
        
               | esja wrote:
               | The companies giving this away at cost are obviously
               | doing something good for the world. That's not my point.
               | 
               | I just find it odd that companies like Pfizer and Moderna
               | are about to lift the world out of a catastrophe in
               | unprecedented fashion, and we have people complaining
               | about prices which are not overly high when compared to
               | the benefit, even in the developing world. India's GDP in
               | 2019 was almost 2.9 trillion and the virus has knocked
               | 300 billion or more off that just this year. Even under
               | your extreme example they aren't going to care about
               | spending an "extra" 14 billion.
        
               | jonplackett wrote:
               | I'm not complaining about the prices. I think they've
               | done something amazing for sure. I just think the
               | companies doing that same thing, and at cost are more
               | amazing.
               | 
               | Without the Oxford one, a lot of countries around the
               | world would still be just as screwed as they are today.
               | 
               | But don't get me wrong I think what they all have done is
               | amazing. And it makes me happy.
        
             | mongol wrote:
             | This is the list of what the EU is paying:
             | 
             | Oxford/AstraZeneca: EUR1.78 (PS1.61). Johnson & Johnson:
             | $8.50 (PS6.30). Sanofi/GSK: EUR7.56. Pfizer/BioNTech:
             | EUR12. CureVac: EUR10. Moderna: $18.
             | 
             | Compare with the price of 1 liter of hand sanitizer. These
             | vaccines are incredibly affordable.
        
               | jonplackett wrote:
               | Yes, they are, but companies doing it at cost should get
               | more credit than those doing it for profit.
        
               | cipher_system wrote:
               | Maybe some vaccines are more expensive to produce? Do we
               | know the profit margins on each of these vaccines?
        
               | jonplackett wrote:
               | From wikipedia, comparing it to the old fashioned method:
               | 
               | > RNA vaccines can be produced faster, more cheaply, and
               | in a more standardized fashion
               | 
               | So should be cheaper if anything rather than more
               | expensive.
        
               | tlb wrote:
               | Given a choice between producing enough doses in 1 month
               | for $10 each, and producing enough doses over 10 months
               | for $1 each, which would you prefer they do?
               | 
               | The cheap-slow version costs a million lives, and several
               | billion extra man-months of lockdown, in return for a
               | globally insignificant cost savings. Valuing lives at
               | maybe $1000 each.
               | 
               | Increasing production 10x for 10x the cost is pretty
               | typical of things where you build a lot of special-
               | purpose equipment which is then worthless after the
               | production run.
        
               | jonplackett wrote:
               | That isn't the calculation though.
               | 
               | No-one is saying make it slower for less money. The
               | Oxford vaccine is being rolled out fast, millions of
               | doses available - actually millions more because, since
               | they aren't so concerned with making money, India are
               | able to make their own locally.
               | 
               | This isn't a questions of scale - everyone is doing this
               | at maximum scale. Some are just making more money from it
               | than others. The Moderna one is more expensive because
               | it's for-profit not because they've spent more money
               | scaling up.
               | 
               | If anyone knows otherwise let me know.
        
           | bpodgursky wrote:
           | Nothing is true about this statement.
        
             | s1artibartfast wrote:
             | My Understanding is that the stabilized Spike Protein
             | sequence was developed and patented by UT Austin and the
             | NIH. This was hen encoded using Moderna's mRNA delivery
             | technology. I'm sure there were also countless other
             | technology innovations that contributed to the quick
             | rollout. It seems very reductive to attribute credit to one
             | individual or organization over another.
        
         | iridium_core wrote:
         | As of December 18th, 2020 deaths in Sweden are only the 3rd
         | highest for the past decade:
         | 
         | https://www.statista.com/statistics/525353/sweden-number-of-...
         | 
         | So its unlikely that COVID has lead to much excess death
         | outside of what could be expected from an unusually strong 'flu
         | year'.
         | 
         | However the avoidable major driver of death is lockdown (from
         | suicides, overdoses, homicide, destitution, interrupted medical
         | care) and mismanagement (eg. sending symptomatic people back
         | into nursing homes as in New York).
         | 
         | This whole state of affairs has been great for Billionaires
         | though - who have increased their wealth by 36% in the past 9
         | months thanks to egregious money printing and economic
         | disruption:
         | 
         | https://yubanet.com/usa/net-worth-of-u-s-billionaires-has-so...
        
           | y-c-o-m-b wrote:
           | From the WHO (https://www.who.int/news/item/13-12-2017-up-
           | to-650-000-peopl...)
           | 
           | > Up to 650,000 people die of respiratory diseases linked to
           | seasonal flu each year
           | 
           | Current COVID-19 deaths: 1.85 million. That's more than
           | double the flu. This is not the flu. Sweden is not
           | representative of the rest of the world. You do not know what
           | long-term complications to longevity COVID-19 has. It's quite
           | possible you live a full healthy life or it's possible you
           | drop dead in 5 years because of permanent damage to the lungs
           | and/or cardiovascular system.
        
           | jonathanjaeger wrote:
           | Deaths from the current year can take a while to be
           | finalized, and Decembers can be one of the deadliest months.
           | If the U.S. hits 500k excess deaths this year, that's still a
           | 20-25% hike on our normal death rate (2.7M give or take).
           | Seems like Sweden will surpass past years in the end, perhaps
           | by a similar percentage.
        
             | iridium_core wrote:
             | If we linearly extrapolate the December 18 data to December
             | 31st, we get 91773 * (366/353) = 95,152.
             | 
             | Which would indeed be the highest level this decade, but
             | still only 3.2% higher than 2018.
             | 
             | Sweden's 2019 deaths were also the lowest in the decade, so
             | there was a lot of built up 'dry tinder'. In fact the
             | excess deaths in 2020 match up almost exactly with the
             | 'non-deaths' of 2019.
             | 
             | This concept is also matched by research:
             | 
             | https://www.news-medical.net/news/20201116/Study-compares-
             | de...
             | 
             | "In Sweden, the observed increase in all-cause mortality
             | during Covid-19 was partly due to a lower than expected
             | mortality preceding the epidemic and the observed excess
             | mortality, was followed by a lower than expected mortality
             | after the first Covid-19 wave. This may suggest mortality
             | displacement."
        
               | djsumdog wrote:
               | Thanks for posting this. I do think we are greatly
               | overreacting to this. The drug industries have wanted to
               | push mRNA treatments for years and have never been able
               | to get them approved. They have a vested interested in
               | leveraging this perceived crisis.
               | 
               | Vitamin D, ivermectin and even some inhaled steroids have
               | all shown to been effective in treating the worst cases.
               | The insanely high amplification of PCR assays are padding
               | case numbers with false positives. Any contradictory
               | information and academic viewpoints are getting censored
               | on every major platform. This is totally madness.
        
               | strictnein wrote:
               | Referring to fragile humans as "dry tinder" is really
               | something.
        
         | rhacker wrote:
         | I'm very much opposed to the current news cycle about the
         | vaccine when the much more immediately available fix is
         | available on the shelf at any store that carries vitamins or
         | milk.
         | 
         | https://vitamind4all.org/letter.html
        
           | dsjoerg wrote:
           | The evidence for the effectiveness of the vaccine is stronger
           | than this: https://www.medrxiv.org/content/10.1101/2020.11.08
           | .20222638v...
        
             | rhacker wrote:
             | The vaccine won't be available to 10% of the world's
             | population for at least 1 year.
        
               | wang_li wrote:
               | Pfizer is aiming for 1.3 billion doses this year. That
               | alone gets us to 10%. The WHO also rough guessed that
               | there are already 750 million people who have been
               | infected with the virus. So that's another 10% who likely
               | don't need a vaccine this year. Then there's the 600
               | million from Moderna. AstraZeneca is aiming for a billion
               | doses plus partner producers, e.g. Siam Bioscience to
               | produce 200 million doses. We're probably getting to
               | 30%-40% globally by the end of the year. Less populous
               | western countries will probably be fully vaccinated by
               | the end of the year.
               | 
               | https://www.cnn.com/2020/12/14/us/pfizer-ceo-albert-
               | bourla-v...
               | 
               | https://www.nationthailand.com/news/30400664
        
               | rhacker wrote:
               | That still doesn't help the hundreds of thousands of
               | people that will be dead because they or their doctor
               | didn't know that vitamin D is actively saving people's
               | lives right now. Even after a diagnosis. This advice will
               | save more than one life right? I think that's more
               | important than just pushing the vaccine.
        
       | polote wrote:
       | One thing I don't understand, is why government don't give free
       | money to manufacturers ? Locking down is costing so much to
       | society and governments. Instead of giving money to people who
       | don't work, just give money to produce vaccines faster and let
       | those people work ASAP.
       | 
       | Why we don't do that ?
        
       | testfoobar wrote:
       | It is the rate of vaccination that is interesting to me. Doctors
       | and nurses are turning down the shot at rates that are
       | surprising. These are supposedly the most informed group - the
       | group that counsels everyone else.
       | 
       | Why?
       | 
       | Look at these death totals by age
       | 
       | Age 25-34: 2087 deaths. Age 35-44: 5398 deaths. Age 45-54: 14496
       | deaths.
       | 
       | https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
       | 
       | These are small numbers.
       | 
       | I don't think we're going to get herd immunity without vaccine
       | mandates.
        
         | viggity wrote:
         | I too have been surprised. I'm more surprised about physicians
         | turning it down than nurses. I love nurses, we've got 15 on our
         | payroll, they're kind and wonderfully exceptional people. But
         | they operate heavily under various protocols outlined for them,
         | and while they have more health knowledge than your random
         | person when it comes to the nitty gritty details they are
         | naive.
         | 
         | The number of nurses who think that the mRNA vaccines
         | permanently alter your DNA would surprise you.
         | 
         | My hope is that after the roll out and the number of serious
         | adverse events is shown to be miniscule, people will be less
         | reluctant to take the vaccine.
        
           | testfoobar wrote:
           | IMHO, there either has to be a mandate or a personal
           | incentive to get to herd immunity faster. With the low
           | fatality rates for younger people, the personal incentive to
           | get the vaccine is not high. This leaves mandates. Workplaces
           | and schools can do this.
        
           | amanaplanacanal wrote:
           | I'm not even in health care and I have a reasonable
           | understanding of how dna, rna, translation and transcription
           | work. Do nurses not learn this stuff?
        
             | davrosthedalek wrote:
             | Not sure about nurses, but a broad section of the
             | population _does not know how percentages work_. This is
             | true for almost all countries. The width in science skills
             | is breathtaking.
        
             | f6v wrote:
             | You'd be surprised how many software developers have no
             | idea how https works.
        
             | viggity wrote:
             | lol. no. no way. I would guess that about 2/3 of our nurses
             | could give you the 8th grade explanation of dna - "a sperm
             | and an egg each contribute half of each chromosome and that
             | is the instruction book on how to make every cell blah blah
             | blah". rna, translation and transcription. I don't think a
             | single one would know. They need to know the common drugs
             | in their field, how to take vitals, when to raise the red
             | flag to a physician. That's it. That is all still super
             | important, if they don't use it at least once a year,
             | they're not going know.
        
         | sigstoat wrote:
         | > Why?
         | 
         | overall rates for a group contain millions or tens of millions
         | of people probably aren't going to be dominated by a single
         | explanation. maybe they want to leave them free for groups that
         | are at higher risk? not every kind of doctor is dangerously
         | exposed to risky patients.
        
           | testfoobar wrote:
           | Any group that is offered the vaccine but turns it down at
           | any significant rate is a useful data point in projecting the
           | date date we reach herd immunity.
           | 
           | For example, consider if vaccine uptake was 100% - we would
           | immediately know that we were supply and rate of delivery
           | limited. Alternative consider if the vaccinate uptake rate
           | was 10% - then we have the opposite problem. Demand is too
           | low.
           | 
           | In this case, with some doctors and nurses rejecting the
           | vaccine, it is reasonable to project that overall demand for
           | the vaccine across the general population will be low. This
           | means that the date we reach herd immunity is farther in the
           | future than if the uptake rate was 100%.
        
             | sigstoat wrote:
             | i was quoting your "Why?", not asking you a question.
             | 
             | and if you continue to treat a group of millions as a
             | homogenous unit, you can't have thoughts like "maybe the
             | doctors turning it down right now will accept it after the
             | elderly are all vaccinated" which wouldn't slow down the
             | overall vaccination rate.
        
               | [deleted]
        
               | testfoobar wrote:
               | "maybe the doctors turning it down right now will accept
               | it after the elderly are all vaccinated" - This is a
               | conjecture and not a fact observable in any collected
               | data about vaccine uptake.
               | 
               | What your thoughts or my thoughts are really don't
               | matter. What matters is observable facts and how they
               | inform us about future policy decisions.
               | 
               | To me, medical professionals turning down the vaccine
               | when offered suggests that public policy makers should
               | consider vaccine mandates if we're to reach herd immunity
               | faster.
        
       | hhkb wrote:
       | At current rate of vaccination in the US, it's going to take more
       | than a full year to get it done.
        
         | colincooke wrote:
         | This is a bad take, vaccinations are rapdily increasing in the
         | USA and around the world:
         | 
         | https://ourworldindata.org/grapher/daily-covid-19-vaccinatio...
        
         | standardUser wrote:
         | Using the current rate as the constant rate over the next 12
         | months makes absolutely no sense.
        
           | blhack wrote:
           | Why? States have known since _this summer_ that a vaccine was
           | coming, likely by the end of the year, and somehow they have
           | all neglected to prepare.
           | 
           | We've got what is by all measures a modern _miracle_ , an
           | answer to the most horrifying global event of the last
           | century, given to us by a bunch of scientists who have been
           | working nonstop for the last year to give it to us, and state
           | health workers are doing things like taking weekends off and
           | only opening a single vaccine site.
           | 
           | And then they also seem to concerned about _fairness_ WRT to
           | the vaccine distribution that they are willing to simply let
           | this _literal miracle_ go to waste on a shelf, rather than
           | accidentally give it to somebody who didn 't deserve it.
           | 
           | The way that almost every state seems to be treating these
           | vaccines are not in any way in alignment with what I would
           | expect from _the worst pandemic in the last 100 years_. It is
           | _infuriating_.
        
           | hhkb wrote:
           | And why not? What makes you think it will improve? Specialty
           | distribution is not something you can easily scale in a short
           | period of time.
        
             | oblio wrote:
             | I think Pfizer has already found a cheaper and easier to
             | manage dry ice based distribution method. If there's a
             | will, there's a way.
        
             | JosephRedfern wrote:
             | > Specialty distribution is not something you can easily
             | scale in a short period of time
             | 
             | That doesn't mean that you can't scale it at all, and one
             | would assume that scaling over a super short period of time
             | (like, weeks) is harder than scaling over a slightly longer
             | time span (like months).
             | 
             | On that basis, is it not fair to assume that there'll be at
             | lease some non-linearity in production and distribution
             | rates over the next year or so?
        
             | mrosett wrote:
             | For starters, distribution is currently restricted to a
             | very small slice of the population.
        
               | markkanof wrote:
               | Yes, it seems like ultimately the distribution problem
               | will come down to communicating who can get vaccinated
               | and when. Like right now I have been hearing scattered
               | reports that there are places where doses of the vaccine
               | are available and not being used. So if I wanted to go
               | get one could I? I'm certainly not in any demographic
               | that should be prioritized, but if it's just sitting
               | there then someone should use it.
        
             | standardUser wrote:
             | "Specialty distribution is not something you can easily
             | scale in a short period of time."
             | 
             | You admit distribution is something that can increase over
             | time, so it should be plainly obvious that capacity will
             | increase as time moves on (as opposed to staying stagnant
             | or slowing down), especially considering everyone involved
             | in the process has explicitly stated it will.
             | 
             | The additional vaccines that are close to approval give us
             | further reason to expect the rate of vaccinations to
             | increase significantly.
             | 
             | We have no reason to believe the current rate of
             | vaccinations will remain stagnant or slow down, and many
             | reasons to believe it will increase significantly in the
             | coming months.
        
             | icedchai wrote:
             | It's a logistical nightmare. It won't be improved. It could
             | be, but it won't. At least, not in time for it to matter.
             | 
             | We're only about half way done with this.
        
       | eganist wrote:
       | Is this in response to reports the US is considering cutting
       | dosing requirements? The Reuters story is pretty bare (the title
       | of this HN post essentially covers it), so without added context,
       | this really feels like the cause.
       | 
       | In re: dosing - https://www.cnn.com/world/live-news/coronavirus-
       | pandemic-vac...
        
         | TheCoelacanth wrote:
         | It's probably in response to the entire planet wanting as many
         | doses of vaccine as they can possibly get their hands on.
        
         | maxerickson wrote:
         | This is the first large production run Moderna has managed,
         | there's not much reason to assume it is anything more than
         | their information about supplies and so on firming up.
        
         | packetlost wrote:
         | Unless they're counting both doses as a single "dose" in their
         | announcement, I doubt it.
        
       | fareesh wrote:
       | Is this vaccine immunity lifelong ? Or do you have to take it
       | every few months/years?
        
         | Symmetry wrote:
         | With common cold coronaviruses we see that reinfection is
         | possible for many people after a year, though they don't seem
         | to develop symptoms if they get it again so quickly. I'm sure
         | if you look at enough people you'll see a wide variation in
         | response though.
        
         | tonyhb wrote:
         | We have only had the vaccine for 9 months so there's not enough
         | data to know.
        
         | wang_li wrote:
         | Natural anti-bodies to other coronaviruses in the same group
         | seem to last more than a decade. People who had SARS in 2003
         | still show an immune response 17 years later. There's a good
         | chance this vaccine is a one-time thing or perhaps just a
         | couple of times in your life.
         | 
         | https://gulfnews.com/uae/how-long-does-immunity-to-sars-coro...
         | 
         | https://www.nature.com/articles/s41586-020-2550-z_reference....
        
         | luto wrote:
         | last time I checked, the answer was "we don't know". There
         | seems to be a >=8 months figure floating around now, though.
         | 
         | https://www.cidrap.umn.edu/news-perspective/2020/12/two-stud...
        
       | rcardo11 wrote:
       | Are these US only numbers? 600M sounds like very very few doses
       | given worldwide population and even western world population.
        
         | maxerickson wrote:
         | Total production. It's an increase of their previous estimates.
         | It's enough for 300 million people following the schedule
         | studied in the US trial that led to FDA emergency use
         | authorization.
         | 
         | Pfizer projects making more than that.
         | 
         | The AstraZeneca vaccine has much larger production, and the J&J
         | vaccine will also, if it is approved.
        
           | SamBam wrote:
           | My understanding is that both the Moderna vaccine and the
           | BioNTech one are being made in only a couple sites each.
           | 
           | Is there any reason why more labs across the globe couldn't
           | start producing the vaccines, under a license from those
           | companies? Is the technology needed to create them so unique
           | that it literally can't be made anywhere else?
        
             | epistasis wrote:
             | It's more the difficulty in standing up a new site for GMP
             | (good manufacturing practice). Closest analogy in the tech
             | word would be standing up a new fab, but quite a bit
             | cheaper. It takes time to iron out all the kinks and show
             | that everything is being produced correctly and safely. And
             | skipping this would be disastrous, since we are already
             | reaching dangerous amounts of vaccine hesitancy.
        
             | pvarangot wrote:
             | The Sputnik adenovirus vaccine is easier to manufacture and
             | they are allowing some countries to install their own
             | capacity. I don't know if they improved the accuracy of
             | their tests, they were kinda sketchy when they announced
             | it.
             | 
             | The PR and marketing is not targeting the US for some
             | reason, maybe because they think no one will want a
             | "Russian" vaccine in the US or maybe because it's more
             | expensive... but in other countries it's going to be "the"
             | vaccine, so I hope it works.
        
               | s1artibartfast wrote:
               | I suspect that the Chinese vaccine will be the most used
               | outside of US and Europe.
        
               | maxerickson wrote:
               | They would need to do an FDA supervised trial.
               | 
               | Edit: the Oxford AstraZeneca and J&J vaccines are
               | adenovirus and are nearing completion of their trials, so
               | we are on track for much wider availability.
        
             | mchusma wrote:
             | In this particular case the mRNA technology Moderna (and
             | Pfizer) is completely new, these are the first two vaccines
             | approved. Yes they spent a lot (including OWS money) to
             | ramp production, all previous mRNA vaccine production was
             | <1M doses per year in 2019 and before. So between Moderna
             | and Pfizer, we are looking at probably 1.8 billion - 3
             | billion doses produced.
             | 
             | There are many genuine complaints about the vaccine ramp
             | up, but this is one of the few cases where these numbers
             | are a "good job".
             | 
             | This is why its so important for the FDA to give EUA to
             | Astrazeneca now, that is a technology that can be scaled
             | quickly. They should also encourage a readout now of J&J,
             | which is almost certainly over the efficacy threshold and
             | can also be scaled. With these two approvals, we can have
             | enough vaccine for a 1st dose for everyone within the next
             | 60 days.
        
             | marcinzm wrote:
             | That depends on what the bottleneck is. If it's a precursor
             | or component then more sites won't help at all. Others have
             | commented that it's either vials or clotting factor.
        
         | nostrademons wrote:
         | Yes. I've got relatives in the Philippines and they're not
         | expecting to get vaccinated until 2023/2024, assuming the virus
         | doesn't get to them first.
         | 
         | We're amazingly lucky in the developed world and U.S. in
         | particular. Wealth makes it possible to buy up all the supplies
         | (which, reportedly, the U.S. has done) and make sure your
         | people get first in line for it. This is also why the U.S. is
         | both idolized and hated in much of the world.
        
         | nend wrote:
         | >600M sounds like very very few doses given worldwide
         | population and even western world population.
         | 
         | Which is why people are so keen on getting more vaccines
         | approved (in the US and abroad). Pfizer is targeting 1.3B doses
         | manufactured in 2021, 600M from Moderna, which still leaves the
         | world plenty short (remember each person needs 2 doses). It's a
         | group effort, and there are additional vaccines under
         | development/review that will hopefully contribute to the
         | effort.
         | 
         | There's also discussion around whether Moderna's vaccine can be
         | reduced from 100ml to 50ml while retaining the same efficacy,
         | which would obviously double the amount of doses provided by
         | Moderna.
        
           | lisper wrote:
           | > each person needs 2 doses
           | 
           | That's not quite true. You need 2 for full effectiveness, but
           | it's not like missing the second dose leaves you with no
           | benefit at all. In fact, it's far from clear, from a global
           | perspective, that having twice as many people with less-than-
           | full-effectiveness would not better than half as many people
           | with full effectiveness.
        
             | mullingitover wrote:
             | I'm not so sure that a less effective vaccine is better
             | than no vaccine at all. If the virus has a less-effective
             | immune response, it could have a better chance of mutating
             | into something that's resistant to the vaccine, in which
             | case all the work creating the vaccine goes out the window.
        
               | andybak wrote:
               | I vaguely remember reading something along the lines of
               | "You're thinking of antibiotics. Vaccines and viruses are
               | different".
               | 
               | Anyone got any solid insight into this?
        
               | mullingitover wrote:
               | I found the article.
               | 
               | > "My concern, as a virologist, is that if you wanted to
               | make a vaccine-resistant strain, what you would do is to
               | build a cohort of partially immunized individuals in the
               | teeth of a highly prevalent viral infection," Bieniasz
               | told STAT. Even rolling out the vaccine at all when there
               | is so much transmission occurring is far from ideal, he
               | said, suggesting it would have been safer to beat down
               | the amount of virus in circulation before beginning the
               | vaccine deployment.
               | 
               | >"You are essentially maximizing the opportunity for the
               | virus to learn about the human immune system. Learn about
               | antibodies. Learn how to evade them," he said.
               | 
               | [1] https://www.statnews.com/2021/01/04/britain-takes-a-
               | gamble-w...
        
             | valarauko wrote:
             | That's true, but the FDA EUA specify that Pfizer & Moderna
             | stick to the dosage regime as tested. It's very likely that
             | a half dosage/reduced dosage might be deemed acceptable,
             | but AFAIK no national authority has allowed a dosage regime
             | deviation from what was tested in the Phase III trials. The
             | closest would be the UK allowing upto a 12 week gap between
             | doses of the Oxford vaccine. I agree that it's probably
             | worth it to half the dosage and double the number of people
             | who can be covered when initial supplies are so limited,
             | but till the FDA makes that call, we have to stick to the
             | dosage as specified.
        
               | lisper wrote:
               | No national authority has had to deal with a world-wide
               | pandemic for the last 100 years. Treating this situation
               | as if it were business as usual and following the normal
               | rules may not lead to the best outcome.
        
               | valarauko wrote:
               | I don't disagree with you, but they also have to balance
               | risk. They need numbers to work on, and those numbers
               | barely even exist right now. The 2K in the Moderna trial
               | who received the single dose is a statistical blip
               | compared to the hundreds of millions for whom the FDA
               | would make decisions.
               | 
               | The EUA is their attempt to manage the health risk to the
               | population - an investigational vaccine using an entirely
               | unproven novel technology stack poses some unbound risk
               | (likely small), vs the benefit of an effective vaccine.
               | Once we change the dosage, the effectiveness also become
               | unclear, while the risk remains (eg, potential trace
               | contamination with precursors in the lipid carriers
               | triggering shock in a untested population subset. Perhaps
               | prescription statins greatly reduce the effectiveness of
               | the vaccine, etc etc). It's the job of the FDA to err on
               | the side of caution and see risks where we would not. I
               | agree with you that the situation is unprecedented, but I
               | also do not blame the FDA for only working with the data
               | they have. I suspect that Pfizer & Moderna will conduct
               | Phase IV trials with different dosage regimes based on
               | which the FDA can modify the terms of the EUA.
        
             | jhowell wrote:
             | > In fact, it's far from clear
             | 
             | Seems clear from my perspective. Two doses are recommend by
             | manufacturers. Anything more or less is pure speculation at
             | best. Why speculate in absence of a way to test your
             | hypothesis?
        
               | BurningFrog wrote:
               | The manufacturer doesn't know anything about this that
               | isn't public information.
               | 
               | Yes, two doses are almost certainly better than one. But
               | those are not the choices.
               | 
               | When there are far fewer doses than the number of people
               | to vaccinate, the question is if it's better to give N
               | people 2 shots, or 2N people 1 shot.
               | 
               | The test data looks like 1 dose gives ~80% protection vs
               | ~95% for 2 doses. The 2x80% scenario is clearly better
               | than 1x95%.
               | 
               | And, of course, everyone would get the second dose as
               | soon as production catches up.
        
               | pavelrub wrote:
               | The main unknowns aren't around short-term efficacy, but
               | long term immunity. If it turns out that a single dose
               | provides ~80% protection but only for 3 months, whereas
               | the second dose provides strong long-term protection, the
               | one-dose scenario would be significantly worse.
        
               | BurningFrog wrote:
               | Longer term, everyone gets a booster shot as soon as
               | they're available.
        
               | Bootvis wrote:
               | What if it takes 9 months to have the booster shots
               | available? People will be vulnerable for 6 then.
        
               | Exmoor wrote:
               | Vulnerability isn't binary. You're not immune one day and
               | susceptible the next. It's much more likely that immunity
               | to getting sick might start decreasing over time, but
               | still remain relatively high. So, perhaps 80% in 3
               | months, 60% in 6 months, and 30% in 9 months to use made
               | up numbers. Additionally, production is still ramping up
               | so it's highly unlikely that we'll have less vaccine in 3
               | months than currently. We'll also likely have 1-3 more
               | approved vaccines by then as well.
        
               | Bootvis wrote:
               | Unfortunately, we don't know the exact numbers so
               | following this strategy (which I agree might make sense)
               | is somewhat of a gamble. Maybe the numbers are not very
               | favourable therefore the choice shouldn't be portrayed as
               | such a simple one as in the comment I replied to.
        
               | lisper wrote:
               | Because the manufacturer recommendations are based on
               | achieving the best outcome for the individual receiving
               | the treatment. But we're in a global pandemic, a
               | situation the world has not faced in living memory. A
               | different quality metric might be appropriate under these
               | circumstances.
        
               | mns wrote:
               | So even though the manufacturers (the companies that
               | developed the vaccines, the scientists, the people
               | running the trials, the ones that know the data and went
               | through a full year of tests) keep on recommending 2
               | doses and the advice given to the UK government was still
               | to stick to the 2 doses, we're now going the way that "we
               | think we know better and it's better to try something new
               | and untested because it's a pandemic and it might be
               | better to have less efficiency to more people, than full
               | efficiency to less people", even though it's, again, not
               | tested and a shot in the dark?
        
               | jjeaff wrote:
               | Was there any testing done comparing 2 doses to one? I
               | think it was speculation that led us to test with 2 doses
               | because we'll, we don't have much time, 2 must be better
               | than one.
        
               | lisper wrote:
               | https://www.wbur.org/commonhealth/2020/12/18/coronavirus-
               | vac...
        
               | freeone3000 wrote:
               | The study we have of a two-dose COVID-19 vaccine with one
               | dose administered showed 67% effectiveness, in line with
               | vaccines for other diseases (including eradicated ones -
               | polio vaccine is 80%).
        
               | cltby wrote:
               | > Anything more or less is pure speculation at best
               | 
               | There are two lines of evidence. The first is empirical.
               | It It appears that one dose of Moderna _is_ highly
               | effective, perhaps 85% or more. Note the treatment-
               | control divergence after about fourteen days [1]. The
               | second is theoretical. From our ample medical experience
               | with other vaccines, there is strong prior reason to
               | think that one dose is likely to work well, and that a
               | second shot in the distant future would be even better
               | than a second shot after three or four weeks. Booster
               | shots are given a.) as backup for people who don't
               | seroconvert after one dose b.) to trigger a secondary
               | immune response. In light of a.), we shouldn't be
               | surprised by the 85% number (most people seroconvert;
               | there's no partial immunity, you either seroconvert or
               | you don't). In light of b.), we should be very skeptical
               | of the four week interval, especially since the secondary
               | response takes about two weeks to develop. It's shorter
               | than the interval for every other vaccine.
               | 
               | [1] https://arstechnica.com/science/2020/12/fda-releases-
               | data-on... [2]
               | https://www.cdc.gov/vaccines/schedules/hcp/imz/child-
               | adolesc...
        
               | Exmoor wrote:
               | Agreed. It's also important to remember that the 3/4 week
               | dates for the second dose were not chosen based on it
               | being the most effective timeline, but because it was the
               | minimum time needed to complete the studies as quickly as
               | possible. If they'd chosen 8 weeks we wouldn't have US
               | approval yet. If they'd chosen 12 weeks we wouldn't even
               | know if they were effective yet.
        
             | Bootvis wrote:
             | Giving one dose increases the probability of someone
             | catching COVID and the virus evolving resistance within
             | this person. I don't know how likely that is but the impact
             | could be huge.
        
               | valarauko wrote:
               | Is there evidence of this?
        
               | Bootvis wrote:
               | I think it's too early to have evidence of this I think
               | but knowledgeable people seem to have some concerns:
               | 
               | https://www.statnews.com/2021/01/04/britain-takes-a-
               | gamble-w...
               | 
               | That the impact could be huge doesn't take much
               | imagination: We could be back to square 1 with the
               | vaccination process and the evolved virus might be more
               | dangerous.
        
           | s1artibartfast wrote:
           | People tend to forget the ex-us vaccines.
           | 
           | SinoVac Planned to have capacity for 600 million doses/yr in
           | China by the end of 2020, with more production in Indonesia,
           | Brazil, and India.
           | 
           | Russian Sputnik V also will have several hundred million dose
           | production.
           | 
           | It is quite likely this will already surpass our ability to
           | administer the vaccines or the willingness of people to take
           | them.
        
             | standardUser wrote:
             | To add to the list, India plans to domestically produce 1
             | billion doses of AstraZeneca this year, with 50 million
             | already produced.
        
       | getpolarized wrote:
       | Noe that when deployed properly, we MIGHT not need 85% if we have
       | secondary protocols to inhibit the growth of covid.
       | 
       | For example, requiring all airline passengers or anyone leaving
       | their state to be vaccinated and vaccinating frontline workers
       | including those that work at grocery stores, etc.
        
       | cadence- wrote:
       | Let's hope this is also going to be the case for all the other
       | companies producing Covid-19 vaccine. Hopefully we will have
       | enough vaccine manufactured in 2021 to significantly slow the
       | spread of this virus around the world.
        
       | falcolas wrote:
       | That's a lot; yet it's still nowhere near enough. We've got ~over
       | 9~ around 8 billion who need vaccinations.
       | 
       | EDIT: Even with 5+ different vaccines hitting 600M (some of which
       | require multiple doses per person), we're still talking years to
       | achieve herd immunity. Years of continuing our current
       | conditions.
        
         | amanaplanacanal wrote:
         | Not sure I understand you. If most of the US is vaccinated, do
         | you think the US will have to continue lockdown simply because
         | most of Africa hasn't yet gotten the vaccine? Substitute
         | whatever country you are worried about.
         | 
         | I fully suspect that once the older folks and health care get
         | vaccinated, at some point ICUs will start clearing out and
         | lockdowns will start coming off.
        
           | falcolas wrote:
           | > If most of the US is vaccinated
           | 
           | These vaccines aren't all going to the US (or at least, not
           | that I've heard about). I've been hearing 600,000
           | vaccinations (granted, this is from politicians, so ready
           | your salt) this year in the US.
           | 
           | > ICUs will start clearing out and lockdowns will start
           | coming off
           | 
           | In which case they'll fill right back up (as is being aptly
           | demonstrated in the US _right now_ ). It's not just the
           | elderly who are filling those beds - slightly over half of
           | the hospitalizations are under 65, pretty consistently
           | throughout the pandemic.
        
             | wang_li wrote:
             | > I've been hearing 600,000 vaccinations (granted, this is
             | from politicians, so ready your salt) this year in the US.
             | 
             | I don't know where you're hearing that, but the US is
             | already doing more than 300,000 vaccinations per day
             | (302,000 on 1/1 and 325,000 on 1/2.) If we maintain that
             | rate we'll have 100% vaccination before the end of the
             | year. Of course not everyone will take the vaccine, but
             | "600,000 vaccinations this year" is wrong.
        
         | glouwbug wrote:
         | You mean 8 billion?
        
           | londons_explore wrote:
           | 2 doses per person... No need for 100% vaccination (some will
           | die before being vaccinated, some immunity from already being
           | infected, some too poor to buy it, etc.)
        
             | falcolas wrote:
             | > some will die before being vaccinated
             | 
             | And their replacements (plus a few) will be born, also
             | requiring a vaccination until we hit herd immunity.
        
               | standardUser wrote:
               | To be clear, none of these vaccines are approved for
               | young children (though it helps that they are poor
               | vectors and super low-risk).
        
               | falcolas wrote:
               | It doesn't have to be newborns who replace the dead from
               | the vaccination pool - it can be children outside of the
               | age range growing into the vaccination range.
        
         | standardUser wrote:
         | It's one of 5 vaccines currently in use, with at least a couple
         | more expected to be approved in various countries this and next
         | month. So it does not need to be enough.
        
           | falcolas wrote:
           | Even if all 5 produce 600M doses a year, it'll still take
           | _years_. Some of those also require two doses per person.
        
             | standardUser wrote:
             | India alone plans to produce 1 billion doses of the
             | AstraZeneca vaccine this calendar year, with 50 million
             | already produced. These vaccines were _just_ approved in a
             | few countries and production is _just_ starting to ramp up.
             | Not a great time to be making projections. Give it a month.
        
         | oblio wrote:
         | Yeah, but they don't all need it at the same time. Plus there
         | are multiple companies producing vaccines. There's Moderna,
         | Pfizer/Biontech, Astra Zeneca/Oxford, the Russian one, the
         | Chinese one.
        
           | falcolas wrote:
           | > they don't all need it at the same time
           | 
           | We're talking about years, even if all of the existing
           | vaccines can hit the same or similar production quotas.
           | Compounded by individuals requiring multiple doses of some of
           | the vaccines.
           | 
           | Years is a long time to wait for herd immunity.
        
       | [deleted]
        
       | IgorPartola wrote:
       | I am hoping the incoming administration invokes the defense
       | production act to help with production of vaccine and testing
       | supplies, as well as providing a comprehensive policy at the
       | federal level regarding vaccine distribution. The current admin
       | is basically letting things roll out on their own. What I am
       | seeing is that if we do everything right, which up to now we have
       | not, early fall is a good target for things starting to turn back
       | to normal. I wonder if a more concentrated effort could shave a
       | month off that. And given the projected estimates of how many
       | tens of thousands will die in the next few weeks, and the
       | additional surge after everyone decided to travel for the
       | holidays, February is likely to be straight up lethal.
        
         | djsumdog wrote:
         | Even with vaccinations, this virus will be around for another
         | 10 years. It took 185+ years to eradicate smallpox (mostly from
         | a big WHO push in the 60s/70s). It's still not possible to
         | eradicate Polio. Even with a massive push, it's not like a
         | vaccine will make this go away.
         | 
         | We have a lot of information now about how to treat and not
         | treat this virus. A bunch of early deaths were due to overuse
         | of high pressure ventilators and the Governess of NY and
         | Michigan putting sick elderly people with healthy elderly
         | people in nursing homes without adequate isolation (most had 2
         | or more people per room) killed a lot of people in the first
         | three months. We overreacted to the virus, like a social auto-
         | immune response.
         | 
         | We also know the fatalities are 95% over 55. This virus has
         | mostly reduced our life expectancy. By 5 years? 1 year? That's
         | difficult to determine at this point. Everyone is going on
         | about "long covid" now, but if you actually read the papers,
         | the whole things starts to break down to a couple of case
         | studies of 40~50 people each. There may be long term effects
         | for heavily exposed people (health care workers) and the
         | elderly, but the "long covid" narrative is another one if abuse
         | and fear; not grounded in hard science and accurate risk
         | analysis.
         | 
         | For things to go back to normal, the vaccine is not the
         | solution. The solution is to stop spreading constant fear. The
         | Great Barrington deceleration has been shunned and dismissed by
         | all major media outlets, yet it's signed by many doctors,
         | academics and professionals and it makes a lot of sense.
         | 
         | Humanity has a new virus and we need to learn to live with
         | that. The countries who have avoided it can keep shut down, but
         | at some point it's no longer going to be feasible to do so.
        
           | IgorPartola wrote:
           | The top infectious dresses expert in the country certainly
           | disagrees with a lot of what you are saying. Yes it will
           | stick around. Yes the vaccine will help a great deal. What
           | exactly is your point? That there is no reason to rush?
           | 
           | https://www.cnn.com/2021/01/04/us/coronavirus-pandemic-
           | year-...
        
             | djsumdog wrote:
             | and meanwhile people are losing this businesses, their
             | livelihoods, their mental health and absolutely everything.
             | A women in California invested heavily in outdoor dining
             | equipment, only to be shut down, and then she sees a movie
             | production company setup a full catering set right next to
             | her restaurant.
             | 
             | The top infection dresses experts can be wrong. Don't
             | appeal to authority. There are literally thousands of other
             | doctors and scientists who say further lockdowns are not
             | helping. The WHO is saying lockdowns should not be used
             | except as a last resort!
             | 
             | Don't listen to just one person. Look at all the options.
             | Lockdowns don't work.
        
               | IgorPartola wrote:
               | Seatbelts don't work. Lots of people die in car crashes
               | and lots of them were wearing seatbelts. Stop wearing
               | seatbelts. Some doctors believe this. Don't believe the
               | experts. Be your own researcher. Your Google Fu is
               | certainly a match for the CDC and its $6.5b yearly
               | budget.
        
               | djsumdog wrote:
               | It's not remotely comparable. You can test seat belts
               | with crash dummies. It's a clear experiment, and yes,
               | people should have been skeptical of seat belts until
               | they were proven to be effective. Auto companies were
               | pushing against seat-belts and safety. Today big industry
               | is pushing for lockdowns (and we should question those
               | motives).
               | 
               | It's a bad argument. There are literally thousands of
               | people in the Great Barrington Declaration, who have
               | sound arguments for ending lockdowns. We can literally
               | look at the numbers across the globe from different
               | policies in different countries and see there is no
               | direct correlational between any government action and
               | fatalities. Correlation isn't causation, but we DO NOT
               | even have correlation!
               | 
               | Scientists and doctors are saying we need to end this
               | mass hysteria. We should listen to all the experts, not
               | only the ones we agree with.
        
               | IgorPartola wrote:
               | > Scientists and doctors are saying we need to end this
               | mass hysteria. We should listen to all the experts, not
               | only the ones we agree with.
               | 
               | To quote Wikipedia, citation needed. And please don't
               | like to a YouTube/Facebook/Instagram whatever of someone
               | in a white coat. I have not seen this from anyone with
               | any reasonable credentials.
        
               | djsumdog wrote:
               | The Great Barrington Declaration:
               | 
               | https://gbdeclaration.org/
               | 
               | Signed by literally thousands of experts, doctors and
               | virologists.
        
               | IgorPartola wrote:
               | I was just able to sign it as a medical professional. I
               | am not one. Literally nothing on that site is verified. I
               | keep seeing you quote things in this thread related to
               | this site, which as far as I can tell has zero
               | authenticity, and to random YouTube videos. Hint: if a
               | doctor or researcher can only publish their findings on
               | YouTube/Facebook/Instagram, they don't have anything
               | worthwhile to say.
        
               | djsumdog wrote:
               | Alright, so lets not look at the signers, let's look at
               | the clearly listed authors on that page:
               | 
               | > Dr. Martin Kulldorff, professor of medicine at Harvard
               | University, a biostatistician, and epidemiologist
               | 
               | > Dr. Sunetra Gupta, professor at Oxford University, an
               | epidemiologist with expertise in immunology, vaccine
               | development
               | 
               | > Dr. Jay Bhattacharya, professor at Stanford University
               | Medical School, a physician, epidemiologist, health
               | economist, and public health policy expert
               | 
               | > Dr. Alexander Walker, principal at World Health
               | Information Science Consultants, former Chair of
               | Epidemiology, Harvard TH Chan School of Public Health
               | 
               | Some of these people have done interviews too. You can go
               | look them up on major news programs.
               | 
               | > Hint: if a doctor or researcher can only publish their
               | findings on YouTube/Facebook/Instagram, they don't have
               | anything worthwhile to say
               | 
               | We're talking about an ongoing crisis where we see clear
               | censorship in media, big tech and academic publications.
               | People are basing world changing decisions off pre-prints
               | and pre-pubs. Does it really matter where a doctor or
               | researcher publishes their views so long as it is a real
               | doctor or researcher? Why does the platform make their
               | opinion invalid?
        
               | IgorPartola wrote:
               | I repeat, I was just able to use a fake name to sign that
               | document. Nothing prevents anyone from signing it as any
               | of those people. Just for giggles, I just literally
               | signed it a second time as "Dr. DJ Sumdog, PhD, associate
               | professor at Hacker News". Check your email to complete
               | the process.
               | 
               | Furthermore, the people you listed above have been found
               | to have conflicts of interest regarding this declaration.
               | The medical and public health communities have soundly
               | rejected this declaration. This declaration makes no
               | sense if you examine it with any kind of critical eye.
               | Start with https://en.wikipedia.org/wiki/Great_Barrington
               | _Declaration#R... and from there check the linked
               | sources.
               | 
               | There is no censorship in the media regarding medical
               | research of COVID-19. There is fact checking. Just
               | because _you_ believe something that is false and the
               | media isn 't reporting that falsehood as fact does not
               | mean the media is censoring you. It means it's false.
               | Occam's Razor will quickly tell you that the chances of a
               | global conspiracy are much lower than the chances of what
               | you are saying here being false. Think about just how
               | many people would have to know about this conspiracy and
               | all of them would keep it perfectly secret. Every news
               | organization in the world would have to collectively
               | conspire to keep the truth from us, right? Every
               | journalist, every editor, every publisher, every news
               | anchor, every weatherman, every sportscaster, every
               | public official. Do you know how quickly that would
               | unravel? I know it's easy to believe a conspiracy because
               | it's so appealing but it's just not what is going on.
               | 
               | The platform is an indirect indication: if the scientific
               | community rejects your hypothesis, it's most likely
               | because your hypothesis is bullshit. Think critically for
               | a moment the way they taught in you middle school and
               | realize that what you are quoting are unverified
               | unreliable sources and fringe ideas. If you were saying
               | that drinking motor oil cures COVID you'd have about as
               | much credibility. I am done trying to argue with you
               | because you are not worth arguing about, but I do beg you
               | to use your head and think instead of falling for every
               | damn hoax out there like you seem to have. Happy New Year
               | and stay safe.
        
               | djsumdog wrote:
               | > Furthermore, the people you listed above have been
               | found to have conflicts of interest regarding this
               | declaration
               | 
               | There are also conflicts with Fauci has his strong
               | connections to the Gavi health alliance and many big
               | pharma companies. Some of them might have conflicts, but
               | all of them? And even if they do, what about the
               | arguments themselves? Science is not a consensus.
               | 
               | > There is no censorship in the media regarding medical
               | research of COVID-19. There is fact checking
               | 
               | You have got to be fucking kidding me?! The Hunter Biden
               | story, published by one of the largest newspapers in the
               | United States (the NY Post) was censored on every major
               | platform (Facebook, Twitter, etc.) and was it was later
               | found that he was under active investigation by the FBI.
               | We are in one of the absolutely worst eras of censorship
               | of our times. It has grown ti 1984 levels of insanity by
               | Big Tech and Big Media.
               | 
               | You cannot possible be saying there is no big media
               | censorship and it's all "Fact Checking". That's total
               | fucking bullshit. We have cases where the news media
               | contradicts their own headlines within their own articles
               | (https://www.youtube.com/watch?v=TmgMu5sefzA) and
               | literally fact checks opinions and hyperbolas
               | (https://www.youtube.com/watch?v=xPruYq320MM)
               | 
               | > The platform is an indirect indication: if the
               | scientific community rejects your hypothesis, it's most
               | likely because your hypothesis is bullshit.
               | 
               | You are essentially saying "The Media is the Message."
               | It's a massive logical error. Remember at one time, the
               | major scientific publications said black people were
               | inferior to whites due to their skull size. It was
               | provable science at that time. Science is not about
               | majority rule, it's about examination and facts that can
               | be reproduced by others.
               | 
               | > it's most likely because your hypothesis is bullshit
               | 
               | That's assuming the result based on the medium. You
               | realize a bunch of researches got totally baseless papers
               | published in respected grievance study journals, right?
               | 
               | https://www.usatoday.com/story/opinion/voices/2018/10/10/
               | gri...
               | 
               | furthermore, there have been many cases where the medium
               | has been banned throughout history, by the academic and
               | scientific communities, for things that are commonly
               | accepted as fact today:
               | 
               | https://www.youtube.com/watch?v=BtWrljX9HRA
               | 
               | I feel like your arguments are very similar to those that
               | advocate creationism. It's religion in the guise of
               | science.
        
               | djsumdog wrote:
               | In addition, early on we had statements from two front-
               | line doctors in Bakersfield which were pulled from
               | YouTube:
               | 
               | https://www.turnto23.com/news/coronavirus/video-
               | interview-wi...
               | 
               | and we had professor Karol Sikora, who former ally worked
               | at the WHO, discuss what he saw in his on oncology clinic
               | (also censored on YouTube)"
               | 
               | https://unherd.com/thepost/professor-karol-sikora-fear-
               | is-mo...
        
               | oblio wrote:
               | Lockdowns 100% work. Just like the medieval term
               | "quarantine" proved that it works, 500 years ago. They're
               | very effective at stopping infectious diseases. You don't
               | have to be a brain surgeon to figure out why they work.
               | 
               | The side effects of lockdowns suck A LOT, but less than
               | uncontrolled spread of a virus amongst 8 billion people.
               | Besides the fact that it would completely destroy out
               | healthcare systems, in which case we're back to the
               | Middle Ages, we're a few mutations away from a much
               | deadlier disease. It would be ultimately irresponsible to
               | allow Covid to run rampant.
        
               | djsumdog wrote:
               | Show me the evidence. You look from nation to nation,
               | region to region, and there is no effect at all from
               | masks or lockdowns. You are imagining they work because
               | the TV tells you to, but they don't.
        
               | danhor wrote:
               | Here is the first result from google scholar: https://aca
               | demic.oup.com/jtm/article/27/3/taaa037/5808003?lo....
               | Seems pretty effective to me
        
               | djsumdog wrote:
               | > The positive impact of lockdown in Wuhan on containing
               | the COVID-19 outbreak in China
               | 
               | Wuhan, where they literally welded people in their
               | homes?!
               | 
               | https://www.youtube.com/watch?v=meRUCxlleUc
               | 
               | Are you seriously advocating for elimination this virus
               | by eliminating people's basic human rights?!
        
               | IgorPartola wrote:
               | What tells you that what you are seeing there is them
               | welding people inside their apartment buildings? I see
               | someone welding something. I don't see how you can tell
               | who they are or what they are doing or why based on this
               | video.
        
               | djsumdog wrote:
               | Um, the part where the guy opens the door and sees a bar
               | welded in front of it?! There are Chineese sources that
               | show bars being put up against peoples' doors:
               | 
               | https://www.youtube.com/watch?v=QfzQ8Dag8V8
               | 
               | There are tons of these videos by the way:
               | 
               | https://www.msn.com/en-ae/news/other/is-china-locking-up-
               | ent...
               | 
               | But they are difficult to confirm because China heavily
               | restricts all coms in and out of the country, or are you
               | going to try to deny the Great Firewall of China or
               | extreme media censorship exists next?
               | 
               | Here's an opinion piece from the WaPo by a Chinese
               | citizen also stating people were welded into their homes:
               | 
               | https://www.washingtonpost.com/opinions/2020/02/06/warnin
               | g-c...
               | 
               | and here are a list of Chinese sources as well:
               | 
               | https://skeptics.stackexchange.com/a/46045/15222
        
               | oblio wrote:
               | Every time they impose a stricter lockdown where I am,
               | numbers go down. They relax it, they go up.
               | 
               | It's a roller coaster of disease.
               | 
               | What have you got against lockdowns? Is it some
               | philosophical hatred? You're not alone, governments also
               | hate them. They do it because they have to.
        
               | djsumdog wrote:
               | The actual numbers are totally opposite of what you say.
               | Please show some sources. I think Shapiro covers the
               | arguments against lockdowns very well:
               | https://www.youtube.com/watch?v=ymD9ipSm-eg
               | 
               | I'm against them because they literally do not work, and
               | they violate our basic civil rights. A man in Canada was
               | shot months ago for not wearing a mask, after he left the
               | store, outside his own home. In Quebec over New Years
               | Eve, police arrested someone for having more than five
               | people in their homes. New York wants to pass ordinances
               | that lets them put people in camps if they're infected.
               | 
               | This is absolute insanity. The virus is an excuse to
               | violate all our basic human rights. The United States
               | constitution is basically suspended at this point.
               | 
               | Look at this woman who was arrested for trying to save
               | her deteriorating mother locked in a care home:
               | 
               | https://www.youtube.com/watch?v=S1E390UHzTY
        
               | oblio wrote:
               | There you go, see the links and abstracts below.
               | 
               | But you're emotional, I doubt these sources will change
               | your mind. Have a nice day!
               | 
               | https://www.benjaminborn.de/publication/bdm_lockdown_2020
               | /
               | 
               | > While most countries imposed a lockdown in response to
               | COVID-19, Sweden did not. To quantify the lockdown
               | effect, we approximate a counterfactual lockdown scenario
               | for Sweden through the outcome in a synthetic control
               | unit. We find, first, that a 9-week lockdown in the first
               | half of 2020 would have reduced infections and deaths by
               | about 75% and 50%, respectively. Second, the lockdown
               | effect starts to materialize with a delay of 3-4 weeks
               | only. Third, the actual adjustment of mobility patterns
               | in Sweden suggests there has been substantial voluntary
               | social restraint, although the adjustment was less strong
               | than under the lockdown scenario. Lastly, we find that a
               | lockdown would not have caused much additional output
               | loss.
               | 
               | https://www.thelancet.com/article/S0140-6736(20)32034-1/f
               | ull...
               | 
               | > Lockdown therefore appears to have been successful not
               | only in alleviating the burden on the intensive care
               | units of the two most severely affected regions of
               | France, but also in preventing uncontrolled epidemics in
               | other regions. These simple observations support results
               | from other studies which have estimated the impact of
               | lockdown on SARS-CoV-2 spread to be strong.
               | 
               | https://www.sciencedirect.com/science/article/pii/S204908
               | 012...
               | 
               | > COVID-19's daily increasing cases and deaths have led
               | to worldwide lockdown, quarantine and some restrictions.
               | This study aims to analyze the effect of lockdown days on
               | the spread of coronavirus in countries. COVID-19 cases
               | and lockdown days data were collected for 49 countries
               | that implemented the lockdown between certain dates
               | (without interruption). The correlation tests were used
               | for data analysis based on unconstrained (normal) and
               | constrained (Tukey-lambda). The lockdown days was
               | significantly correlated with COVID-19 pandemic based on
               | unconstrained (r = -0.9126, F-ratio = 6.1654; t-ratio =
               | 2.40; prob > .0203 with 49 observations) and based on
               | Tukey-lambda (r = 0.7402, l = 0.14). The lockdown, one of
               | the social isolation restrictions, has been observed to
               | prevent the COVID-19 pandemic, and showed that the spread
               | of the virus can be significantly reduced by this
               | preventive restriction in this study. This study offers
               | initial evidence that the COVID-19 pandemic can be
               | suppressed by a lockdown. The application of lockdown by
               | governments is also thought to be effective on
               | psychology, environment and economy besides having impact
               | on Covid-19.
        
               | djsumdog wrote:
               | > https://www.benjaminborn.de/publication/bdm_lockdown_20
               | 20/
               | 
               | Literally a pre-print. There's only an abstract. I don't
               | see the actual one on Sci-Hub or anywhere. I can read it.
               | 
               | > https://www.thelancet.com/action/showPdf?pii=S0140-6736
               | %2820...
               | 
               | The full text of the 2nd paper is literally only two
               | pages and only appears to look at regions in France and
               | not other countries. There are literally no graphs, no
               | detailed explanation of the methodology and the very next
               | article is literally "Is COVID-19 being used as a weapon
               | against Indigenous Peoples in Brazil?" which speaks of
               | this very weird identity politics finding its way into
               | major academic journals. There are references to an
               | Appendix that I can't seem to find the full-text of, but
               | it bothers me the paper itself doesn't seem to have a
               | detail methodology section, risk analysis and also lists
               | some pretty big financial incentives/interests.
               | 
               | The 3rd study is the only really detailed source
               | provided, yet it only covers data up to May 5th. It also
               | has this interesting quote:
               | 
               | > In addition, it is claimed that, besides the positive
               | aspects of the lockdown, people who comply with this
               | restriction cause a weakened immune system. The main
               | reason for this is that there is too much food
               | consumption and limited mobility. The effect of the
               | lockdown caused by the COVID-19 pandemic on human health
               | may be the subject of future work
               | 
               | It also tries to look at environmental impacts and
               | mentions the inconsistency of lock-downs across all
               | areas. I'm also having a hard time understand the
               | "Transformed data" as it doesn't seem to correlate to
               | either of the two preceding graphs at all. Also keep in
               | mind, correlational near r=1 shows that Ice Cream sales
               | can lead to Polio:
               | 
               | https://external-
               | content.duckduckgo.com/iu/?u=https%3A%2F%2F...
               | 
               | That combined with the limited window and inconsistent
               | lock-downs should at least throw question on this study.
        
               | oblio wrote:
               | I want your sources.
        
               | vorpalhex wrote:
               | We should be careful here because a lockdown and a
               | medieval quarantine are not the same. In the middle ages
               | quarantine typically meant keeping a ship at port and
               | preventing from landing - and that's a very doable thing.
               | You literally just prevent them from dropping their gang
               | plank, and they have supplies and everything they need on
               | board.
               | 
               | The same does not apply to lockdowns. People need
               | groceries, many people have limited cooking capabilities,
               | and homes are not self sufficient - you need maintenance
               | people, regular supplies, so on. And, those people who
               | live in apartments and other small domiciles are not
               | going to stay cooped up forever on end - they are going
               | to go get food and visit people and no amount of threats
               | is going to prevent that.
               | 
               | And that's the issue. Lockdowns always have a maximum
               | timetable that they're effective for and then they
               | suddenly become less effective - and you don't get to
               | reset that timer all that easily. Masks help but they are
               | a partial solution - they have a relatively low
               | effectiveness rate that is fine individually but in mass
               | don't hold up.
               | 
               | Many governments - and I'll pick on California
               | specifically - keep locking down tighter and tigher.
               | Curfews, dining restrictions, gathering restrictions and
               | more that have been going on for more than 6 months now.
               | Do you really think getting more restrictive will be
               | helpful at all?
        
               | IgorPartola wrote:
               | Right. Quarantine that is suggested, like it's been in
               | the US, and quarantine that's enforced are very
               | different. Again, national strategy for "let's all stay
               | exactly where we are for four weeks while people in
               | hazmat suits deliver you groceries" would have been
               | closer to medieval quarantine.
        
           | wasdfff wrote:
           | The reality is that today in southern california, ICUs are at
           | capacity. Most people end up ok. My whole family got it and
           | had basically just congestion for two weeks, including the 90
           | year old ancients we though were sure goners when they
           | contracted it (we just turned up their oxygen and they were
           | feeling a lot better).
           | 
           | That being said, enough people do need medical care, and
           | thats enough people to entirely burden our capacity to treat
           | any sort of medical emergency, and cases are still going up.
           | It's not good right now.
        
             | djsumdog wrote:
             | California had some of the strongest lockdowns and stay-at-
             | home orders of any state and they're still having ICU
             | issues, meanwhile Florida is not? Tennessee has similar
             | policies to Florida and they have high cases .. Sweden has
             | meanwhile dropped to zero.
             | 
             | If you really look across the board at all countries, there
             | is ZERO corroboration between any of these arbitrary
             | measures and the results. It's all complete random
             | superstition nonsense. COVID response is a new religions
             | ideology, and ideology is "doing without knowing."
             | 
             | Also, why are ICU beds at capacity? Is it all COVID, or
             | tons of people who didn't get the heart surgery they
             | needed?
             | 
             | Your own experiences show that your family survived this
             | and likely has long term immunity (and will continue to do
             | so as long as they get exposed at regular intervals).
             | 
             | The alternate reality is that the virus is real, but the
             | way we've reacted to it will kill more people in the long
             | term. I wrote about this back in March, COVID19 is two
             | diseases. The virus and our over-reaction to it:
             | https://battlepenguin.com/philosophy/covid-19-is-two-
             | disease...
        
               | standardUser wrote:
               | "If you really look across the board at all countries,
               | there is ZERO corroboration between any of these
               | arbitrary measures and the results. "
               | 
               | Care to link a published study or a report from a
               | reputable agency? Because it sounds like this is just
               | your hunch.
        
               | oblio wrote:
               | Check out newer sources for that Sweden claim. They've
               | both admitted that the strategy failed plus their
               | measures are now at least equivalent to those of their
               | neighbors.
               | 
               | https://m.youtube.com/watch?v=SSkGkmY9FcM
        
               | IgorPartola wrote:
               | You are so wrong about this I am not even sure how to
               | start. It's like trying to explain physics to a goldfish.
               | We just can't understand this for you.
        
               | djsumdog wrote:
               | I have a masters degree and three publications. I'm not a
               | fool or an idiot. Your attack is an ad hominem and your
               | divisiveness is patronizing.
               | 
               | "It is the mark of an educated mind to be able to
               | entertain a thought without accepting it." -Aristotle
        
               | cycrutchfield wrote:
               | Your credentials aren't what prevent you from being a
               | fool or an idiot. However, your bizarre beliefs surely
               | put you in that category.
        
               | djsumdog wrote:
               | I'm not a fool or an idiot, and those types or attacks
               | are not allowed on HN. You don't know a damn thing about
               | me. I don't know about you either. You're not even
               | addressing the argument.
        
               | cycrutchfield wrote:
               | your argument has been addressed dozens of times. your
               | credentials are meaningless. seek help, you clearly need
               | it
        
               | djsumdog wrote:
               | Accusing me of mental illness is against HN rules, not to
               | mention it makes you look like an asshole. Just because
               | an argument has been "addressed" doesn't make it wrong.
               | 
               | Your dismissal shows your religion devotion to your
               | viewpoint. Maybe I'm religiously devoted to mine too at
               | this point. If anything, it shows neither of us can be
               | objective. You just wanted to get the last word in. It
               | furthers my belief you're an asshole.
        
               | IgorPartola wrote:
               | > Don't appeal to authority.
               | 
               | > I have a masters degree and three publications.
               | 
               | Enough said.
        
               | djsumdog wrote:
               | I wasn't stating my authority. My degree and papers are
               | in totally unrelated fields. I was stating I'm not
               | uneducated.
               | 
               | Your interpretation speaks volumes.
        
           | lm28469 wrote:
           | I don't think anyone is talking about 100% eradicating the
           | virus.
           | 
           | Getting old people and people at risk vaccinated basically
           | means 99% of death would be avoided and hospital would go
           | back to pre covid numbers. Once people over 40-50 are
           | vaccinated it's game over for covid and most of things will
           | go back to normal.
           | 
           | Of course the virus won't totally disappear and people will
           | still die of it.
           | 
           | > Humanity has a new virus and we need to learn to live with
           | that.
           | 
           | The lockdowns / travel restrictions are part of the "learn to
           | live with that", you can't just ignore it and run major
           | hospitals at 110% capacity forever.
        
             | davrosthedalek wrote:
             | Even if 100% of the dead are in the risk/old group (which
             | is not true), it's hard to achieve a 99% reduction with a
             | 95% efficient vaccine. For that to work, you have to assume
             | that the main way of infection is from inside the group. I
             | think this is highly unlikely in a scenario where you say:
             | protect the weak, let everybody else just get it.
        
             | maxerickson wrote:
             | We should 100% eradicate the virus. We have inexpensive
             | vaccines available. Like you say, much of the harm is
             | controlled well short of eradication, but it wouldn't be
             | expensive to do it (it may even be cheaper to eradicate it
             | than to continue to deal with it).
        
               | standardUser wrote:
               | That may be an unrealistically high bar. Only smallpox
               | has ever been successfully eradicated, which speaks to
               | the difficulty in completely eradicating a disease. And
               | since some animals can carry and spread the virus,
               | eradicating this virus may be impossible with current
               | technology.
        
               | maxerickson wrote:
               | Let's try it and find out if it is realistic or not.
        
           | standardUser wrote:
           | What part of hospital over-crowding are you having difficulty
           | understanding? I am sure someone here can explain it to you.
        
             | djsumdog wrote:
             | Some of these hospitals are being over-crowded because
             | people haven't been able to come in for basic surgeries.
             | People have died because they haven't gotten heart
             | surgeries. If someone comes in for getting their wisdom
             | teeth out, and tests positive for CoV2, they're listed as a
             | COVID case, even if they have zero symptoms (and with 40+
             | PCR amplifications for each test, the false positives are
             | high).
             | 
             | Hospitals are over-crowded ever year in the winter for all
             | kinds of seasonal illnesses including flu, strep and
             | others. The Bakersfield doctors said as much back in March
             | and were censored on all platforms for it. They're also
             | overcrowded because America's health system is just bad as
             | expanding care for bad seasons in general, and we haven't
             | really noticed until this crisis.
        
         | hhkb wrote:
         | It's almost as if the current administration is doing it on
         | purpose in order to make the situation far worse than it needs
         | to be.
        
           | IgorPartola wrote:
           | The only plausible reason I can see for the current admin to
           | not invoke the DPA is because it would hurt short term
           | corporate profits. Long term it makes sense that the sooner
           | we contain the pandemic and open up the economy that those
           | same companies would benefit greatly. I have no explanation
           | for why the current admin isn't spearheading and funding a
           | federal strategy for vaccine distribution.
        
         | faitswulff wrote:
         | It's ridiculous how you're being downvoted for speaking common
         | sense.
        
           | IgorPartola wrote:
           | There is a surprisingly large number of people on HN that
           | cannot stand seeing criticism of anything that Dear Leader
           | does.
        
         | dragontamer wrote:
         | It's not production that's the problem. It's distribution right
         | now.
         | 
         | We can see states with good resources are vaccinating as
         | quickly as the doses come in (a few days of lag time, but
         | otherwise doing good).
         | 
         | But many states are stuck in logistics hell. These vaccines
         | need -80C or -20C storage to remain unspoiled. And the
         | administrators are overworked nurses who haven't had rest for
         | months, due to the pandemic.
         | 
         | Once a dose leaves the -80C or -20C storage center, you only
         | have a few days before the dose is ruined. So you need careful
         | planning, maybe even allow a bit of waste for easier
         | distribution.
         | 
         | The military / national guard can help with distribution, but
         | once again the nursing shortage is biting America in the ass.
         | I'm not really sure how to solve that issue. (Well... I dunno
         | how to solve it this year. Ultimately we just need more
         | immigrants and/or students)
        
           | maxerickson wrote:
           | They aren't seperable. If you have lots of vaccine, there is
           | no reason to do prioritization and things will inevitably go
           | faster. I'd put myself on a list for the hospital to call me
           | any time to come in for a vaccine, but they don't have
           | anywhere near enough vaccine to spend the time making that
           | list (doses for about 5% of the county available, I'm towards
           | the end of prioritization).
        
           | IgorPartola wrote:
           | Investing in the education of your citizens is a proven and
           | popular technique for having a higher quality and quantity of
           | work force.
           | 
           | Both production and distribution are problems. Hence why I
           | hope the new admin addresses both with DPA and a
           | comprehensive strategy respectively.
        
             | dragontamer wrote:
             | It'd be late for that. Logistics takes weeks, or even
             | months, to ramp up.
             | 
             | This is stuff that needed to be planned out last October if
             | we wanted it working this month or next month.
             | 
             | I guess better late than never. But... don't hold your
             | breath. We're going to be having these logistic /
             | distribution problems for many weeks moving forward.
        
               | IgorPartola wrote:
               | Right. Should have done this 20 years ago so we would
               | have plenty of nurses today. Should do this today so that
               | when the next pandemic hits in 20 years we are better
               | prepared.
        
         | loceng wrote:
         | Upvoted because although I agree with your sentiment, the
         | arguably free market in this case, at this point is going to
         | ramp up production as efficiently as possible. I assume all of
         | these companies are each going to make $ billions even if they
         | overproduce. They're also making a name for
         | themselves/furthering their brand awareness, no doubt every
         | 5-10 years we may have a similar pandemic to counter if bad
         | actors rally to spread viruses, at an exponential rate too via
         | different factors. The best defense is a good offense: UBI so
         | people can survive regardless of working, and culturally people
         | not believing that being safe and wearing a mask isn't
         | preventing their freedoms; culturally that this is an issue is
         | a sign of multi-generational dis-ease progression from citizens
         | not being given enough, organized suffering/suppression of the
         | masses for control/submission purposes. Andrew Yang's core
         | policies will break apart the duopoly and "take the boot off of
         | people's throats" - and then people can start to heal these
         | deep wounds, open their hearts, allow their IQ and reasoning
         | skills to open up/develop, to develop empathy, etc.
        
           | IgorPartola wrote:
           | Pfizer is reporting that they have vaccine doses ready that
           | nobody is picking up. Besides, I personally don't believe the
           | free market is capable of telling states what to do or even
           | knows what would be the most efficient way to distribute the
           | vaccines.
        
             | loceng wrote:
             | Right, I remember seeing that headline - that's due to the
             | Trump administration's incompetence and/or treason; can't
             | do much about that except correct the system, break apart
             | the duopoly and the power of what has become the limited
             | players in mainstream media; Andrew Yang's Journalism
             | Dollars and Democracy Dollars both would help counter this
             | adequately, along with his UBI/Freedom Dividend policy and
             | Ranked Choice Voting - 4 simple policies, along with
             | government option for healthcare - would powerfully shift
             | the system immediately, and put the US on an exponential
             | path again, without so much friction, allowing thriving for
             | everyone; the buying power of "$1,000"/month increases
             | exponentially as we automate more and more processes.
             | 
             | Edit to add: Sorry about lazy people downvoting you,
             | whenever I talk about Bitcoin - pro-Bitcoiners don't
             | qualitatively engage, just a quick hit of dopamine
             | satisfies them and suppresses contrarian thoughts that
             | aren't financially incentivized like their Bitcoin
             | propaganda and behaviour is.
        
             | vorpalhex wrote:
             | > I personally don't believe the free market is capable of
             | telling states what to do
             | 
             | States, as functional governmental bodies, are supposed to
             | be able to handle this.
             | 
             | The free market is a tool and it's a good tool for some
             | things like maximizing vaccine production. It's not the
             | best tool for things like resource distribution when those
             | resources need to be distributed at a loss - we literally
             | want to spend money to fix this and it's ok to be less
             | efficient on the cost side if it leads to better immunity.
        
               | IgorPartola wrote:
               | Let's make this simpler and more accessible. You are the
               | CEO of Google you wake up on March 1, 2020 and realize
               | that a malware worm is spreading across your servers,
               | damaging systems and in some cases even the hardware. The
               | long term impact on the systems that are infected and
               | later recovered is unclear but early evidence already
               | suggests it's not good. Do you:
               | 
               | (a) Drop everything and concentrate all your resources on
               | containing and eradicating the worm, using all available
               | internal and external methods.
               | 
               | (b) Tell each department head that the worm is their
               | problem and continue to pretend that it's business as
               | usual. The subcontractors will figure this out because
               | it's in their best interest to do so. Free market works.
               | 
               | If you choose (b) please show your work.
        
               | Consultant32452 wrote:
               | Do you have any evidence that suggests Pfizer is
               | pretending that it's business as usual or is doing
               | anything short of producing and distributing vaccine as
               | fast as they possibly can?
        
               | IgorPartola wrote:
               | I am making the analogy to the federal government, not
               | Pfizer.
        
               | lostapathy wrote:
               | The problem with that line of logic is that states are a
               | lot more like contractors than employees - the feds can
               | only exert so much control. And a lot of the states are
               | frankly incapable of taking direction even if they wanted
               | to.
               | 
               | These are entities that run DMVs like, well, DMV offices
               | - no amount of oversight/yelling/etc from the feds is
               | going to get new IT systems online at the state level in
               | short order in many states.
        
               | IgorPartola wrote:
               | That's just incorrect. This isn't an issue of states'
               | rights. This is an issue of e.g. the federal government
               | directly distributing vaccines/PPE/testing supplies to
               | hospitals: something they can absolutely do. Think about
               | it: a hurricane hits Florida. Can FEMA respond? What do
               | you think "national emergency" means?
        
               | lostapathy wrote:
               | I didn't say anything about states rights - I was
               | speaking to incompetency in state government.
               | 
               | I worked for years in state government IT and with a
               | contractor that worked with state IT in most states.
               | Their ability to make and perpetuate messes is almost
               | incomprehensible to the crowd here - it's that bad.
        
               | vorpalhex wrote:
               | Imagine if you as the CEO actually started ripping
               | servers out of the data center and erasing them! Of
               | course you're supposed to work with your department heads
               | to allow them to run a response - and your departments
               | with 4000 employees are going to handle that task
               | differently than the departments with 40.
               | 
               | Even your example is flawed. The United States is not one
               | giant government - it's a collection of smaller
               | governments. The President does not pass laws in Texas or
               | North Dakota. The Fed has no power on internal state
               | matters.
        
               | IgorPartola wrote:
               | Work with, not say "just handle it". The CEO is playing
               | golf.
               | 
               | The federal government funds states. States like KY and
               | TN for example are a net negative money-wise for the USA.
               | They take in more money than they produce in tax revenue.
               | States like NY, TX, and CA fund their operations.
               | Moreover, the federal government can use its resources to
               | physically drive the vaccines around, help set up
               | vaccination and testing sites, etc. In your worldview,
               | what is the purpose of the USA as opposed to 50 separate
               | countries?
        
               | vorpalhex wrote:
               | > The federal government funds states.
               | 
               | Wrong, try again. States are self funding entities. The
               | fed does give grants for some projects (bridges, rails,
               | etc). Some states do receive more tax/grant benefits than
               | they give, but those funds are earmarked - states can't
               | use that money for any old reason.
               | 
               | > Moreover, the federal government can use its resources
               | to physically drive the vaccines around...
               | 
               | Correct, the Fed can help make resources available to the
               | states but the states have to request and allow the
               | resource. The fed for instance can have the military
               | perform interstate logistics, or rent out all the frozen
               | delivery trucks and lend them to states.
               | 
               | The fed can not force states to take the grants, or
               | perform operations in the state without approval.
               | 
               | > In your worldview, what is the purpose of the USA as
               | opposed to 50 separate countries?
               | 
               | Alaska isn't overly qualified to run a military, form
               | treaties with foreign powers, regulate interstate
               | commerce or run the FDA. The fed does have a place, but
               | the fed doesn't have the power to control states or boss
               | them around (in theory - in practice federal grants do
               | give a fair amount of power over many states). The fed is
               | limited to interstate (that is, things involving multiple
               | states) actions, and can't dictate the internals of a
               | state.
        
               | IgorPartola wrote:
               | The federal government effectively controls things like
               | highways speed limits in all the states. The department
               | of education does a whole lot of wealth redistribution
               | and exerts a ton of control over every single public
               | school in the country. Just some examples. The federal
               | government is also the largest employer in the country.
               | 
               | > The fed can not force states to take the grants, or
               | perform operations in the state without approval.
               | 
               | Fine. States that don't want the vaccine are free to
               | refuse it. Do you think they won't play ball if the fed
               | says "we will deliver and distribute the vaccines and you
               | don't have to pay for them"? In what universe will this
               | be something a state refuses saying "we want to pay for
               | this ourselves"?
               | 
               | If it helps your mental model, you are the CEO of
               | Alphabet, and Google is California, yet the worm is
               | affecting all your subsidiaries.
        
               | vorpalhex wrote:
               | The highway near my house runs at 70 and goes up to 80 in
               | parts. Grants are conditional but also optional and that
               | matters.
               | 
               | In general yes, the Fed does have an important part in
               | what are basically non-capitalist practices - foodstamps,
               | WIC, social security, etc etc. There are also state
               | programs that are non-fed and also occupy a similar role.
               | 
               | None of that disagrees with the basic assertion - the Fed
               | does not fund states general revenue. States are supposed
               | to manage their own budgets and collect their own income.
               | The fed is not an endless income stream.
               | 
               | Nobody is saying the fed shouldn't assist states with the
               | vaccine. The states shouldn't however be entirely
               | dependent on the fed for that help - they are supposed to
               | be functional on their own. If the state is not
               | functional without the fed then the state has screwed up.
        
               | IgorPartola wrote:
               | Fine, semantics aside, the federal government is in a
               | unique position to distribute vaccines and testing
               | supplies and PPE with a higher efficiency coefficient
               | than the collection of the states and territories
               | individually. There are people arguing against this in
               | this very thread. In generally, sure the states shouldn't
               | rely on the fed to do everything. In this case it's
               | better for the states to let the fed handle this. If not,
               | why not?
        
               | vorpalhex wrote:
               | Well, we only need to look at the last time there was a
               | mass vaccination drive. New York City had a smallpox
               | outbreak and administered millions of doses in record
               | time.
               | 
               | https://twitter.com/MarkLevineNYC/status/1345407042769580
               | 032
               | 
               | The city was able to mobilize hundreds to thousands of
               | distribution points, call up city workers (who the Fed
               | has no power over) and run vaccine administration 24/7.
               | 
               | The state knows more about their interior, they have more
               | resources on the ground and more control over schools and
               | other public buildings (libraries, community centers,
               | etc), more ability to use private businesses if needed,
               | and control the local health infrastructure.
        
               | IgorPartola wrote:
               | Did the whole country have a smallpox outbreak? No? So it
               | sounds like it was localized to one state.
               | 
               | The point is that this is a nation-wide problem, and the
               | federal government is in a unique position to be the most
               | efficient at handling production and distribution of
               | vaccine/testing supplies/PPE. What exactly is your
               | argument around why it should have little or no role?
               | There is a shortage of these things and production
               | happens in a few centralized places. It makes sense that
               | one centralized entity coordinate the production and
               | distribution. What is the problem with that? Please show
               | your work on how 50 states plus territories would handle
               | it better.
        
               | godtoldmetodoit wrote:
               | Many, if not most, state level public health authorities
               | have been chronically underfunded. States are facing
               | massive budget shortfalls. Congress has given states and
               | cities approximately 0 relief.
               | 
               | State and local governments are struggling right now.
               | "Supposed to be able to handle" and "actually able to
               | handle" are two different things.
        
               | vorpalhex wrote:
               | You realize states are supposed to fund their own public
               | health authorities right?
               | 
               | States also collect their own taxes. It's on the state to
               | manage their own budget by passing taxes and limiting
               | expenses.
        
               | IgorPartola wrote:
               | That's not how the US actually works. The federal
               | government does quite a bit of wealth redistribution from
               | the states that are net producers to states that cannot
               | generate enough revenue on their own: https://www.usatoda
               | y.com/story/money/economy/2019/03/20/how-...
        
               | vorpalhex wrote:
               | I encourage you to read your own sources:
               | 
               | > Money from the federal government is redistributed back
               | to states in the form of grants, aid programs for the
               | needy and payments to major government contracting firms
               | such as defense companies.
               | 
               | That isn't open funds, it's earmarked grants and things
               | like foodstamps.
        
               | IgorPartola wrote:
               | So earmarking money for specific programs for testing and
               | PPE and vaccine distribution is possible and quite
               | normal?
        
               | vorpalhex wrote:
               | Yes but states should not depend on the fed as the basis
               | of their budget, and should instead be responsible enough
               | to have their own budgets and planning for the vaccine.
        
               | IgorPartola wrote:
               | But we are not talking about states budgets in general.
               | We are talking about the COVID-19 vaccine.
        
               | ceejayoz wrote:
               | > You realize states are supposed to fund their own
               | public health authorities right?
               | 
               | States can't deficit spend, which is why the Feds tend to
               | step in for natural disasters - hurricanes, floods,
               | pandemics, etc.
        
         | Exmoor wrote:
         | I don't really think production of vaccines or test supplies is
         | limited in a way that could be improved significantly with DPA.
         | Vaccine production for both the US approved mRNA vaccines is
         | highly specialized and those companies are heavily incentivized
         | to deliver vaccines as soon as possible since they have a de-
         | facto duopoly for an unknown amount of time. Testing supplies
         | are a probably a lot more scalable, but I haven't heard about
         | supply shortages with tests in months.
         | 
         | The areas where executive policy _could_ make a difference are
         | timelines for approval of additional vaccines and optimizing
         | vaccine delivery to hit the highest number of individuals as
         | soon as possible. Prioritizing quick approval and distribution
         | of the Oxford /AZ vaccine and doing the same for the Johnson &
         | Johnson vaccine when data becomes available would likely save
         | thousands of lives over the next few months, but neither the
         | current nor future US administrations seem to be taking an
         | interest in this.
        
           | IgorPartola wrote:
           | There are lots of things the DPA can help with. Testing for
           | one. PPA. Cold storage pods needed for vaccine distribution.
           | Raw materials for any of the above.
        
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