PlagueWatch 2020-23 - Coronavirus

[jv001]

Do you have any hesitation to get the first vaccine available? Are you going to recommend all of your family members get vaccinated ASAP?

Good question for someone that I trust to give a true answer.

[rsvman]

Do you have any hesitation to get the first vaccine available? Are you going to recommend all of your family members get vaccinated ASAP?

I will take a good look at the actual data and then make my decision. But yes, I expect that as a frontline medical worker, I will be among the first to get it. For all I know, it may even end up being required by my employer.

If the data look good, I will recommend that my family members get it. My wife volunteered to be in a vaccine trial, but was rejected, so i know she will be early in the line and get it as soon as she can.

[Jeffrey]

I will take a good look at the actual data and then make my decision. But yes, I expect that as a frontline medical worker, I will be among the first to get it. For all I know, it may even end up being required by my employer.

If the data look good, I will recommend that my family members get it. My wife volunteered to be in a vaccine trial, but was rejected, so i know she will be early in the line and get it as soon as she can.

Thanks!

Did you have any concerns about your wife volunteering for a vaccine trial? How much riskier is a trial vaccine than an approved vaccine?

[CameronBornAndBred]

Thanks!

Did you have any concerns about your wife volunteering for a vaccine trial? How much riskier is a trial vaccine than an approved vaccine?

Ask the two AstraZeneca volunteers that are suffering neurological orders that question. (And rsvman too.)

For me it would be akin to being Bob & Doug going up in the Dragon capsule, vs being the astronauts that follow them. I'm letting Bob & Doug go first.

[rsvman]

Thanks!

Did you have any concerns about your wife volunteering for a vaccine trial? How much riskier is a trial vaccine than an approved vaccine?

I did, but she didn't tell me she had done it!

A trial vaccine is much, much scarier than an approved vaccine.

[Jeffrey]

I did, but she didn't tell me she had done it!

Our wives might be related. My wife frequently makes financial decisions without consulting me. It would be rather scary, if she had any money.

[Bluedog]

"Policy-making must be informed by the best available evidence without it being distorted, concealed, or otherwise deliberately miscommunicated," said Marcia McNutt, president of National Academy of Sciences, and Dr. Victor Dzau, president of the National Academy of Medicine.



Hmmm, that Victor Dzau guy sounds familiar...

[rthomas]

https://www.axios.com/viral-load-dos...VmOb8djtuzKxfU

[tbyers11]

https://fivethirtyeight.com/features...id-19-vaccine/

Good info. I appreciate the heavy lifting the experts in this thread have done on this topic. RSVMAN and tbyers11 specifically but not solely. I follow this thread religiously. Thoughts from the experts?

The article is correct in its 4 main points. However, I have a little more faith than some of the experts quoted in the article that the independent review boards (prior to the FDA review) will review the data "independently". My personal experience is that these boards are usually pretty legitimate. Of course, they might not be but the industry standard is definitely toward legitimacy.

Moderna and Pfizer already releasing their full clinical protocol at this stage is a good sign of transparency. The assertions to release the full data set, the statistical analysis plan are viable requests as well. Although if you dig into Moderna's protocol they have already listed some pretty detailed information on how they will calculate the primary endpoint of greater VE in vaccinated vs placebo groups.

I absolutely agree with the 3rd point that any vaccine licensure before the 2nd half of December or January should be met with skepticism. For Moderna, the mechanics of how efficacy is determined (they don't count people who get sick until 14 days after the second dose) with the numbers of people enrolled (as of Friday 9/18 Moderna had enrolled 25,976 participants but only 11,879 have had 2nd dose) and the estimated COVID incidence rate of 0.75% means they don't think they will have enough positive COVID cases in both groups to make an initial interim analysis until late November at the earliest. Pfizer says their data should be ready for evaluation by end of October but are short on the details. This article goes into a little more detail about timing. So if the data is ready for FDA review by December even a super expedited process would take several weeks.

Agree with the article and rsvman that 80-90% efficacy of a measles vaccination should not be expected. 50% or better is required by the FDA and a more likely range for COVID vaccine. Also agree that efficacy does not equate to absolute protection but that lessened severity would be beneficial for survival benefit and strain on the healthcare system.

One other thing that has not received much attention until very recently (here is an NYT article from 3 days ago) is that if a vaccine is approved in say January 2021 it will only be for adults 18 and above. Only AstraZeneca in a small group in their phase 2 have tested the vaccine in children at all. No companies have clearly defined plans for trials in children yet (Moderna hopes to start by the end of the year). There are obvious safety/dosing reasons (discussed in the NYT article) for why pediatric trials generally lag behind adult trials but COVID is not normal. COVID vaccines for children will probably be a minimum of 6 months behind adult. Thankfully children are statistically much less affected by severe disease but it still isn't optimal for a "normal" start to the school year in 2021 if we have to rely on vaccines alone and don't have a better national COVID response plan in place

[rsvman]

I must spread comments around. Somebody spork tbyers for me, please.

[cato]

I must spread comments around. Somebody spork tbyers for me, please.

Got you covered. Thanks to both of you (and others)

[ClemmonsDevil]

Tbyers11 and rsvman, thanks for the input!

[budwom]

As concerns about transportation and refrigeration (very low temp freezing) mount, I'm still seeing a whole lot of merit to Johnson and Johnson's one shot, no refrigeration (so i'm told) approach.

[rsvman]

Here's an interesting approach....apparently (and this is not particularly surprising) dogs can sniff out people with the virus even if they are presymptomatic or asymptomatic. This power is being used at an airport in Finland, screening all arriving passengers. They have the passengers wipe their skin with a small wipe and place it into a container. The containers are then screened by the dogs. Anybody who gets singled out by the dogs is then sent for molecular testing.

Full story here: https://www.cnbc.com/2020/09/24/dogs...i-airport.html

[LasVegas]

Here's an interesting approach...apparently (and this is not particularly surprising) dogs can sniff out people with the virus even if they are presymptomatic or asymptomatic. This power is being used at an airport in Finland, screening all arriving passengers. They have the passengers wipe their skin with a small wipe and place it into a container. The containers are then screened by the dogs. Anybody who gets singled out by the dogs is then sent for molecular testing.

Full story here: https://www.cnbc.com/2020/09/24/dogs...i-airport.html

Dogs are amazing. Sometimes I can’t even smell when my soon has poop in his diaper. My wife will get home and go “uhhhh, you know he is full of poop”. Usually ends very well for me.

[Bluedog]

Here's an interesting approach...apparently (and this is not particularly surprising) dogs can sniff out people with the virus even if they are presymptomatic or asymptomatic. This power is being used at an airport in Finland, screening all arriving passengers. They have the passengers wipe their skin with a small wipe and place it into a container. The containers are then screened by the dogs. Anybody who gets singled out by the dogs is then sent for molecular testing.

Full story here: https://www.cnbc.com/2020/09/24/dogs...i-airport.html

That's crazy awesome. I saw reports a couple years ago that dogs can smell early-onset Alzheimer's as well.

[tbyers11]

Dogs are amazing. Sometimes I can’t even smell when my soon has poop in his diaper. My wife will get home and go “uhhhh, you know he is full of poop”. Usually ends very well for me.

Wait, are you comparing your wife to a dog? If so, I can why things usually "end well" for you

[MartyClark]

That's crazy awesome. I saw reports a couple years ago that dogs can smell early-onset Alzheimer's as well.

I coached an adult, Special Olympics basketball team for about ten years. We had a couple of players who suffered from Grand Mal seizures. One of the young men ended up with a "seizure dog" who could sense, I guess smell, the seizure before it happened. Amazing.

[camion]

Here's an interesting approach...apparently (and this is not particularly surprising) dogs can sniff out people with the virus even if they are presymptomatic or asymptomatic. This power is being used at an airport in Finland, screening all arriving passengers. They have the passengers wipe their skin with a small wipe and place it into a container. The containers are then screened by the dogs. Anybody who gets singled out by the dogs is then sent for molecular testing.

Full story here: https://www.cnbc.com/2020/09/24/dogs...i-airport.html

But wait*, dogs can be infected also...

What if they lose their sense of smell?



*I kid because I'm bored.

[MChambers]

I coached an adult, Special Olympics basketball team for about ten years. We had a couple of players who suffered from Grand Mal seizures. One of the young men ended up with a "seizure dog" who could sense, I guess smell, the seizure before it happened. Amazing.

I'm reading a book about dogs right now, "Through A Dog's Eyes", by Jennifer Arnold, who is the founder of Canine Assistance, a service-dog school in Georgia. She describes instances where dogs not only could sense a seizure before it happens, but take steps to prevent adverse consequences, such as preventing their human from trying to cross the road right before seizure. Fascinating stuff.