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Ethics of Covid 19 Vaccine(s) Distribution

Gramps49Gramps49 Shipmate
edited May 1 in Purgatory
Now that it looks like the Oxford Vaccine will be ready by September. (Pending approval), and the German Vaccine will be ready by the end of the year, people are beginning to discuss how to distribute them. Here is an interesting article from Harvard Business Review, that discusses this.

I believe Bill Gates is saying he would prefer the poorest countries get it first; whereas, (t)Rump is saying he is ordering big Pharma to mass-produce the vaccines so that the United States can have 300 million doses ASAP. It does sound like Big Pharma is gearing up to start production of the Oxford vaccine even now.

This is not to discount other vaccine candidates coming down the pike. One expert said he would not be surprised if we have multiple vaccines available.

What do you think? Should we allow the poorer countries to go first, or should we allow richer countries to buy everything up as they become available?

Speaking for myself, I could make the argument that says it shows that the United States and some of the EU countries have shown to be the most vulnerable, maybe they should be at the first of the line.

Then too, once countries start receiving their allotments of vaccines, how should those allotments go out? Seems to me, the first ones in the line should be the medical staff, then move to innoculate the more vulnerable parts of the population (I would be included in that group).

Yes, I know, this really sounds selfish. But where do other's stand?

(note to Barnabas if this should merge into the Coronavirus thread, feel free, but I wanted to create it outside the other thread to save you the trouble of having to split it off yourself if you feel it should be independent/)

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Comments

  • Robert ArminRobert Armin Shipmate
    The last I heard, the most optimistic prediction was 18 months away. October sounds too good to be true to me, unless it's October 2021. Who is making this claim?
  • Gramps49Gramps49 Shipmate
    edited May 1
    The BBC is saying the Oxford Vaccine could be ready in the fourth quarter of 2020. https://www.bbc.com/news/business-52483359

    The Telegraph is saying by the end of September https://www.telegraph.co.uk/global-health/science-and-disease/oxford-covid-vaccine-trial-coronavirus/

    CNN says the German vaccine could be distributed by the end of the year. https://www.cnn.com/2020/04/29/europe/germany-pfizer-coronavirus-vaccine-test-intl/index.html
  • lilbuddhalilbuddha Shipmate
    edited May 1
    I think it should be distributed to areas with high population density cross-referenced by poverty/conditions where social distancing more adversely affects people and availability of health care.
  • I'll echo lilbuddha, and say you start by vaccinating medical staff, food production workers, grocery store workers, bus drivers, and anyone else who has to work in proximity to other people in order for our society to function.

    Second pass can pick up everyone else whose job can't be done from home.

    People like me, who can work form home (albeit less efficiently) can wait at the back of the queue - me getting vaccinated will have much less effect on either me or on the state of public health in general as compared to people in the first two groups.

    I don't see a particular need to rush to innoculate older people who live by themselves - while it's true that they're at a higher risk of death if they get it than someone like me, for example, they also don't need to expose themselves to significant risk.

    From a public health perspective, you do better to innoculate the people who have to be out in public having multiple contacts. People who are in vulnerable demographics but can work from home, or who are retired and don't work any more, can hang tight at home for a bit longer.
  • Gramps49Gramps49 Shipmate
    LC

    You wrote:
    I don't see a particular need to rush to innoculate older people who live by themselves - while it's true that they're at a higher risk of death if they get it than someone like me, for example, they also don't need to expose themselves to significant risk.

    The deal of it is, while I am in the category of "older people," I have been working parttime for the past couple of years, and I would like to go back to work just as much as anyone else. However, as long as COVID-19 is around, I cannot take that risk unless I am inoculated.

    Moreover, we old people also like to socialize. We need contact with our families and friends. Some of us still like to go to church. We shop. We like to take cruises and vacations. This summer, for instance, one of our nephews will be married in Indiana. We would like to maybe take the rail out there and fly back.

    Don't count us out, yet.

  • mousethiefmousethief Shipmate
    People like me, who can work form home (albeit less efficiently) can wait at the back of the queue - me getting vaccinated will have much less effect on either me or on the state of public health in general as compared to people in the first two groups.

    But they are at risk by the mere fact that they must get food from the outside world. Which means either they have to go to a store, or have someone come to them (which many are unlikely to be able to afford). Every encounter between two people is a risk for contagion.
  • lilbuddhalilbuddha Shipmate
    It is all academic anyway. The rich will get the vaccine first, third world countries and the poor will get it last.
  • Lamb ChoppedLamb Chopped Shipmate
    You know, occasionally it's worth trying for a better outcome, whether you expect to get it or not.
  • lilbuddhalilbuddha Shipmate
    Of course a better outcome should be attempted. My whole teen through adult life has centred around attempting better outcomes. But that has also informed me that better outcomes take time and a vaccine will be found in a shorter time than that.
  • orfeoorfeo Shipmate
    The fact the EU and US got hit first does not mean they are more vulnerable. It really only means that they had more residents who were able to go travelling around the world, pick the virus up and bring it back with them.

    You can't say that they're more vulnerable unless you wait until the virus has finished sweeping through places like South America, sub-Saharan Africa and Russia where infection is now accelerating, and assess the end result. By which time of course it's a bit late.

    As much as anything, vulnerability is a question of ability to cope with infection. Which has a significant correlation with hospital and health system resources. So there certainly is an argument that countries that lack the ability to treat the serious cases requiring ventilators etc need a vaccine more than those that have that ability.

    Similarly, there's also an argument that countries that don't have the infrastructure to do good testing and tracking of cases need a vaccine sooner. Although from what I understand the USA's capacity in that regard was sorely lacking in the early stages, which was a major factor in the infection taking hold there.
  • Lamb ChoppedLamb Chopped Shipmate
    edited May 2
    Half of this is strategic (where will a vaccine do the most good?) and half pure ethics (who needs it most in terms of saving life and health?). Add in the exact conditions at the time the vaccine becomes available (Where is the current worst COVID hellhole? Who actually possesses the wherewithal to receive, distribute, and adminster the vaccine, and who might leave it sitting in warehouses?). Then add in the perspective of the decision-makers, who are likely to be some combination of government and business types (since they will be the ones in charge at the point it actually gets loaded for shipping, not the scientists who developed it). and who are tasked with specific priorities that might not match the ones we personally have (e.g. keeping the food production chain going, which is a mostly-forgotten issue for most people until it all goes wrong).

    About the best I can say is, whoever does it needs to do it quickly. Not futz around for days because plans haven't been made, equipment hasn't been procured, transport isn't in place. (Is my bitterness showing? Very well, I am bitter, we have been in lockdown for six weeks locally and only now are they hiring people to do the contact tracing that will make it possible for us to re-open. Oh, and our state governor wants to do that in a day or so. Could you not have fucking hired, trained, and equipped these people at an earlier point in the lockdown, so that we could hit the ground running? But now it's going to be playing catchup and a second wave of COVID with a fair chance of renewed lockdown, AND unnecessary deaths, all because somebody couldn't find their butt with both hands and a GPS system.)

    We so don't need a repeat of this. Almost any semi-reasonable plan will do, provided it is carried out quickly and competently. Take all the plans except the obviously amoral and mix them together, I don't care. Just get it done.
  • orfeoorfeo Shipmate
    LC, I pretty much agree with you. Though I'm curious about the distinction you make between the 'doing the most good' aspect and 'who needs it most'.

    Can you explain the distinction? I'm not sure I see the difference in this context.
  • ThunderBunkThunderBunk Shipmate
    I think the argument about older people is pretty poor, really. I think that's called a sentence to life imprisonment. Under what other circumstances is that done without the commission of a crime? I know this sounds inflammatory, but if you're really saying that they can only survive if they don't go out, what else is it?
  • I think the argument about older people is pretty poor, really. I think that's called a sentence to life imprisonment. Under what other circumstances is that done without the commission of a crime? I know this sounds inflammatory, but if you're really saying that they can only survive if they don't go out, what else is it?

    What other circumstances? A lot of disabilities. A friend of mine hasn't been able to leave his small flat for several years now due to complications related to cerebral palsy and the lack of suitable support structures. It stinks and I hope it is not forgotten when those currently "shielded" get to go out again.
  • KwesiKwesi Shipmate
    I think me and mine should be right at the front of the queue.
  • Marvin the MartianMarvin the Martian Admin Emeritus
    I don’t think it matters who’s at the front of the queue. Lockdown and/or social restrictions won’t end until about 80% of the population has been vaccinated, so let’s just focus on getting to that 80% figure as quickly as we can so that we can get back to normality. I honestly don’t care which 80% it happens to be.
  • BoogieBoogie Shipmate
    edited May 2
    My son is part of the vaccine trail - so he’s front of the queue!

    :wink:

    @Lamb Chopped said -
    Almost any semi-reasonable plan will do, provided it is carried out quickly and competently. Take all the plans except the obviously amoral and mix them together, I don't care. Just get it done.

    I agree. I feel the same about testing. Ramp it up and continue ramping it up until all can be tested and traced. All this talk of targets is pointless.
  • Marvin the MartianMarvin the Martian Admin Emeritus
    I don’t think it matters who’s at the front of the queue. Lockdown and/or social restrictions won’t end until about 80% of the population has been vaccinated, so let’s just focus on getting to that 80% figure as quickly as we can so that we can get back to normality. I honestly don’t care which 80% it happens to be.

    On the other hand, if lockdown gets ended in a phased way such that only those who have been vaccinated can go back to living their lives then I’d happily throw the lot of you under the bus to reach the front of the queue. No offence intended.
  • BoogieBoogie Shipmate
    edited May 2
    I don’t think it matters who’s at the front of the queue. Lockdown and/or social restrictions won’t end until about 80% of the population has been vaccinated, so let’s just focus on getting to that 80% figure as quickly as we can so that we can get back to normality. I honestly don’t care which 80% it happens to be.

    On the other hand, if lockdown gets ended in a phased way such that only those who have been vaccinated can go back to living their lives then I’d happily throw the lot of you under the bus to reach the front of the queue. No offence intended.

    Of course you would. Said in Christian love, I’m sure.

    You could always join one of the the vaccine trails.

  • Furtive GanderFurtive Gander Shipmate
    edited May 2
    I don’t think it matters who’s at the front of the queue. Lockdown and/or social restrictions won’t end until about 80% of the population has been vaccinated, so let’s just focus on getting to that 80% figure as quickly as we can so that we can get back to normality. I honestly don’t care which 80% it happens to be.

    If the 80% getting this only take a few days, then I agree.

    It's much more likely that it'll take weeks or longer, so who gets priority affects how it spreads until the job is done and who suffers in the meantime.
  • Marvin the MartianMarvin the Martian Admin Emeritus
    Boogie wrote: »
    You could always join one of the the vaccine trails.

    In all honesty, I genuinely don’t care whether I personally get vaccinated or not. I just care about getting out of lockdown.
  • Marvin the MartianMarvin the Martian Admin Emeritus
    I don’t think it matters who’s at the front of the queue. Lockdown and/or social restrictions won’t end until about 80% of the population has been vaccinated, so let’s just focus on getting to that 80% figure as quickly as we can so that we can get back to normality. I honestly don’t care which 80% it happens to be.

    If the 80% getting this only take a few days, then I agree.

    It's much more likely that it'll take weeks or longer, so who gets priority affects how it spreads until the job is done and who suffers in the meantime.

    If we’re all still under lockdown until the 80% is reached then there won’t be any differential suffering.
  • BoogieBoogie Shipmate
    Boogie wrote: »
    You could always join one of the the vaccine trails.

    In all honesty, I genuinely don’t care whether I personally get vaccinated or not. I just care about getting out of lockdown.

    I imagine the vaccinated will get a ‘pass’ to go out and about?

    Joining a trail would quicken that prospect for you and give you hope. Why not do it?

  • I don’t think it matters who’s at the front of the queue. Lockdown and/or social restrictions won’t end until about 80% of the population has been vaccinated, so let’s just focus on getting to that 80% figure as quickly as we can so that we can get back to normality. I honestly don’t care which 80% it happens to be.

    If the 80% getting this only take a few days, then I agree.

    It's much more likely that it'll take weeks or longer, so who gets priority affects how it spreads until the job is done and who suffers in the meantime.
    Though, as at present the talk is of a few hundred million doses being produced. How long for that to be scaled up to several billion needed for 80% vaccination levels? More than a few weeks I'd say.
  • DafydDafyd Shipmate
    It is possible that we (in the developed world) will just have to go back to where we were a hundred years ago where potentially fatal diseases did circulate through the population. That would require increasing the capacity of the health service to cope. (That in turn requires a government capable of forward planning and investment rather than reliance on quick technological fixes.)
  • kingsfoldkingsfold Shipmate
    edited May 2
    Boogie wrote: »
    Boogie wrote: »
    You could always join one of the the vaccine trails.

    In all honesty, I genuinely don’t care whether I personally get vaccinated or not. I just care about getting out of lockdown.

    I imagine the vaccinated will get a ‘pass’ to go out and about?

    Joining a trail would quicken that prospect for you and give you hope. Why not do it?

    Because he doesn't live in an area where they're recruiting/trialling the vaccine? And travelling to (say) Oxford or London may not be considered essential?
  • PendragonPendragon Shipmate
    I think LC is distinguishing between places where it would have the most impact in stopping spread (such as densely populated areas), and the people it would have the most effect on as they're more vulnerable to getting it/having worse symptoms. They will both have to be balanced in determining distribution.
  • CathscatsCathscats Shipmate
    Boogie wrote: »
    Boogie wrote: »
    You could always join one of the the vaccine trails.

    In all honesty, I genuinely don’t care whether I personally get vaccinated or not. I just care about getting out of lockdown.

    I imagine the vaccinated will get a ‘pass’ to go out and about?

    Joining a trail would quicken that prospect for you and give you hope. Why not do it?
    But it is a trial. They can’t give the guinea pigs a free pass till they have discovered if the trailed vaccine really works.
  • jay_emmjay_emm Shipmate
    If India is allowed (and isn't exporting), then it can probably short order look after itself.
    (I'm not sure what it's vaccine production is, but it's generics production I gather is good.

    Contra Marvyn, even in partial lock-down those who lose a relative suffer more than those who miss a football match.
    However the more we break the far chains of transmission, we can probably start partially relaxing things.
    If we've protected the old, then while the 'herd immunity' still leads to 70k deaths, if you can have closed groups of even 100, there'd still be a lot of tragedies, but I could believe it that 'nationally' it would be worth it (at least if a vaccine is following fast).

    Intra-country, I'd go something like Care-workers, Known vulnerable young, Key workers, Elderly, City Flats, Close-workers, City Houses, Rest
    Inter-country it would depend on need, but if we went 50-50, then we probably wouldn't be much slower, while having maximum effect (if we need to be mercenary and self-interested M&S doesn't just need us available to go to the shops!)
  • jay_emm wrote: »
    If India is allowed

    I may be wrong, but I seem to recall that pandemics allow exemptions from international patent laws.
  • HeavenlyannieHeavenlyannie Shipmate
    jay_emm wrote: »

    Intra-country, I'd go something like Care-workers, Known vulnerable young, Key workers, Elderly, City Flats, Close-workers, City Houses, Rest
    Inter-country it would depend on need, but if we went 50-50, then we probably wouldn't be much slower, while having maximum effect
    Yes, that is similar to my response; care workers (they would be needed to administer vaccines, visit vulnerable, etc), followed by the most vulnerable (young vulnerable to older people) then other key workers, before a national roll out (I would not target specific regions within a country though as it would probably cause civil unrest).
  • jay_emmjay_emm Shipmate
    I see what you mean, practically (writing from a town house with garden), we have a better conditions in lock down and less risks out of lockdown. But the class warfare opportunities...
  • lilbuddhalilbuddha Shipmate
    Dafyd wrote: »
    It is possible that we (in the developed world) will just have to go back to where we were a hundred years ago where potentially fatal diseases did circulate through the population. That would require increasing the capacity of the health service to cope. (That in turn requires a government capable of forward planning and investment rather than reliance on quick technological fixes.)
    So, like this, but with lorries?
  • Lamb ChoppedLamb Chopped Shipmate
    orfeo wrote: »
    LC, I pretty much agree with you. Though I'm curious about the distinction you make between the 'doing the most good' aspect and 'who needs it most'.

    Can you explain the distinction? I'm not sure I see the difference in this context.

    That was my less-than-helpful shorthand. "who needs it most" translates into "who is at the highest risk of dying or being permanently disabled if they don't get it right away," and includes old or medically fragile folks as well as people whose lives force them into constant contact with the general public.
    "doing the most good" means "Who, if they did NOT get this vaccine, would fuck up our world the most for the rest of us by going down with the bug?" which includes people in the food staples supply chain, certain key scientists on the verge of a breakthrough, the people who watch over our safe water supply, the guy who knows all the [insert essential crap here] and has it all in his head instead of written down (bad boy/girl) and if he goes down, the whole [world/nation/church/whatsit] is in the shit.
  • Gramps49 wrote: »
    LC
    The deal of it is, while I am in the category of "older people," I have been working parttime for the past couple of years, and I would like to go back to work just as much as anyone else. However, as long as COVID-19 is around, I cannot take that risk unless I am inoculated.

    Sure - and assuming you can't do what you do from home, you'd be in my second tranche of people - workers who can't work at home, but aren't essential to keeping everyone alive.
    Moreover, we old people also like to socialize. We need contact with our families and friends. Some of us still like to go to church. We shop. We like to take cruises and vacations.

    Sure - but I'm not going to prioritize your vacation, your trip to your family wedding, or your game of pinochle over someone's livelihood. I'll agree that vulnerable people should have priority over less vulnerable people in the same category, but that's as far as I'll go.

    Yes, you need contact with your family and friends. So does everyone else. I'd like to get you out of your home and back interacting with other humans. I agree that you shouldn't do that until you're vaccinated. But I'm still going to rank your need after meat packers, grocery store clerks, and nurses.
  • mousethief wrote: »
    But they are at risk by the mere fact that they must get food from the outside world. Which means either they have to go to a store, or have someone come to them (which many are unlikely to be able to afford). Every encounter between two people is a risk for contagion.

    Yes, nobody is at zero risk - but if you have a limited amount of vaccine, there's no point vaccinating me first. Mrs C or I go to a grocery store about twice a week, at times when they're relatively empty. We come in close contact with very few people, for very little time. Our probability of getting infected is low.

    Your vaccine is most effective, from a public health standpoint, if you vaccinate the people with the most social contacts. If I mostly stay at home, I don't do much to spread the virus even if I am infected. Someone who works in close proximity to a bunch of other people is a better candidate for the vaccine.

    I suppose I should add that one of the things that you want to do in the early stages of a vaccine is measure its effectiveness. That implies you want to either saturate a particular community with the vaccine, and watch the virus get eradicated in that community, or vaccinate a more widespread group of high-risk people (key workers etc.) and track them to make sure they and their contacts don't get sick.
  • chrisstileschrisstiles Shipmate
    mousethief wrote: »
    People like me, who can work form home (albeit less efficiently) can wait at the back of the queue - me getting vaccinated will have much less effect on either me or on the state of public health in general as compared to people in the first two groups.

    But they are at risk by the mere fact that they must get food from the outside world. Which means either they have to go to a store, or have someone come to them (which many are unlikely to be able to afford). Every encounter between two people is a risk for contagion.

    What Leorning Cniht said above -- additionally, if you are shopping at a time when the other people in the store are mostly those who are also self isolating, then any mixing is with a population where spread is already constrained.
  • orfeoorfeo Shipmate
    mousethief wrote: »
    But they are at risk by the mere fact that they must get food from the outside world. Which means either they have to go to a store, or have someone come to them (which many are unlikely to be able to afford). Every encounter between two people is a risk for contagion.

    Yes, nobody is at zero risk - but if you have a limited amount of vaccine, there's no point vaccinating me first. Mrs C or I go to a grocery store about twice a week, at times when they're relatively empty. We come in close contact with very few people, for very little time. Our probability of getting infected is low.

    Your vaccine is most effective, from a public health standpoint, if you vaccinate the people with the most social contacts. If I mostly stay at home, I don't do much to spread the virus even if I am infected. Someone who works in close proximity to a bunch of other people is a better candidate for the vaccine.

    I suppose I should add that one of the things that you want to do in the early stages of a vaccine is measure its effectiveness. That implies you want to either saturate a particular community with the vaccine, and watch the virus get eradicated in that community, or vaccinate a more widespread group of high-risk people (key workers etc.) and track them to make sure they and their contacts don't get sick.

    I know this isn't what you quite meant, but I couldn't help reading part of that as an argument that extroverts need to be vaccinated before introverts. ;-)
  • orfeo wrote: »
    I know this isn't what you quite meant, but I couldn't help reading part of that as an argument that extroverts need to be vaccinated before introverts. ;-)

    It's not quite what I meant, but it's not so terribly far away either :wink:

    (Yes, I know, just because you're an introvert doesn't mean you don't talk to people...)
  • Gramps49Gramps49 Shipmate
    Please tell me where people get the idea we will have to immunize 80% of the world's population? John Hopkins estimates we will achieve herd immunity as 70%. There is a difference of 1 billion (5.6 billion @ 80% vs 4.9 billion @ 70%).

    Moreover, there are two ways of achieving herd immunity. Either a sufficiently large proportion of the population gets the disease and recovers, or an effective vaccine develops. Since many people seem to contract this disease and are either asymptomatic or have a very mild case of it, we are already moving towards herd immunity, we just do not know what at what percentage this will be after two years--yes, this appears to be around at least two years. And we may just likely have a vaccine within the latter part of 2020.

    So we will end up moving towards herd immunity from two fronts--through the natural progression of the disease and through the use of a vaccine.

    When the scientists were first talking about herd immunity, they were saying, given the known infection rate (Ro) we would need at least 60% to achieve herd immunity. Let's use that 60% as a jumping-off point. Say we need enough doses to immunize 60% of the world population, and the other 10% to 20% achieve immunity through the recovery of the disease, that would mean we would effectively need around 4.2 billion doses.

    I know some will object that it seems some are getting reinfected, but the jury is still out on what is happening here. Even John Hopkins says it will be likely that we just may need a booster shot about every four to five years to maintain immunity.

    Look at how long it has taken to eradicate smallpox. Same with polio--that vaccine program started out in the '50s and they are still having to administer that vaccine in some populations.

    In other words, we just cannot vaccine the whole world overnight--it just might take more than 20 years to get this done.

    Last night, I heard this analogy: When you are in an airplane, and there is a sudden decompression you are told to put the mask on for yourself and then assist children--or others incapable of putting on the mask. Likewise, when the vaccine comes out, first take care of yourself, and then move to the others.

    I do know when the vaccine first becomes available in my community, I will be at the head of the line to take it. I nearly died from influenza 10 years ago. I know what it is like to become oxygen-starved to the point of near-death. Ever since that experience, when the next influenza vaccine is available I am there pdq.
  • Lamb ChoppedLamb Chopped Shipmate
    Wait a sec. We don't have to immunize 80% of the world's population in order to get back to normal, whatever normal may now be. We need to vaccinate 100% of the people who come into contact with infected individuals--and if we play our cards correctly and think strategically, that will be a far, far smaller number than 80% of 7 billion, and will happen far, far faster than 20 years.

    Have you ever played one of those checker or paper games where one side uses its markers to surround and immobilize the other side's markers? It's like that, with the added detail that the other side's markers self-destruct given enough time (say, six weeks).

    What we are aiming for is a situation where actively infected people never come into contact with non-immune people. There is a safety zone around the infected, and no one who is not immune enters it. Isolation is one way of creating such a safety zone, though as we all know, it's a painful and difficult strategy to enforce and easy to mess up.

    Now add vaccination for anybody who is likely to come into contact with an infected person. Those vaccinated people become part of the safety zone around the infected. By their mere presence they decrease the chance of an infected person coming in contact with a non-immune person. The more people vaccinated in the immediate vicinity of an infection pocket, the more chance there is of completely containing that pocket until the virus has burnt itself out and died without reproducing.

    What of the people who have no immunity, but never come into contact with an infected person--because they are protected by the safety zone surrounding the infected people? Do those non-immune people need a vaccine? No, actually. If you never contact an infected person (or eat a bat, I suppose), you have no need of a vaccine. You are right down at the bottom of the priority list for vaccination--may in fact never be vaccinated at all, if we can safely contain every virus pocket worldwide until the last illness has run its course.

    So you see it isn't going to take 20 years to vaccinate everyone and get life back to the new normal. We can do it much faster, if we think strategically.

    Now, people being what we are, things aren't going to run perfectly. We will attempt to cordon off pockets of infection, and the virus will slip through--someone will fuck up, or a vaccination won't take, and the virus will escape its safety pocket and get out among the general population again. We know that, so we plan for it. And the way we handle that (besides constant vigilance) is by slowly and methodically vaccinating the remaining people, the ones who probably don't need it but just in case. And the beauty of it is, we can vaccinate these people after we've gone back to work, school, social lives, etc. If it takes twenty years then, who cares? Because the virus has already been contained at that point, is probably not even active on their continent, let alone within 100 miles of them, and all we're doing now is due diligence to prevent a long-shot disaster--such as a second bat sandwich.
  • KarlLBKarlLB Shipmate
    Can we all be a bit careful with the Eating Bats meme, since we do know that is not how this thing started and it underlies some racist attitudes in society (although not on the Ship from what I've read).

    One thing we don't know is what degree of immunity infection bestows. If the vaccine (as is looking increasingly likely) will need a regular booster) then the answer is probably "not much". We won't have much herd immunity if the only individuals immune are those who've been infected within the last couple of years.
  • Dafyd wrote: »
    It is possible that we (in the developed world) will just have to go back to where we were a hundred years ago where potentially fatal diseases did circulate through the population. That would require increasing the capacity of the health service to cope. (That in turn requires a government capable of forward planning and investment rather than reliance on quick technological fixes.)
    I actually think that this is right - although pretty awful to contemplate. We have been in a privileged place over the last 50 or 60 years - and, of course, the risk of contracting deadly diseases (eg malaria) is still very high in some less developed countries.

    At the end of the day we have to decide how much risk we are prepared to tolerate: advances in medical science and health & safety (which of course I welcome) have led us in the West to believe that we can live in an almost risk-free environment. We may simply have to accept that this is unrealistic - for there will be more pandemics down the line, not to mention the very real threats posed by the bacteria which lead to other illnesses (eg TB) becoming immune to antibiotics.

  • Robert ArminRobert Armin Shipmate
    It's a shame we can't eat Bats. I was looking forward to Batman ;)
  • Lamb ChoppedLamb Chopped Shipmate
    KarlLB wrote: »
    Can we all be a bit careful with the Eating Bats meme, since we do know that is not how this thing started and it underlies some racist attitudes in society (although not on the Ship from what I've read).

    Okay, got it, thanks.
  • Wait a sec. We don't have to immunize 80% of the world's population in order to get back to normal, whatever normal may now be. We need to vaccinate 100% of the people who come into contact with infected individuals--and if we play our cards correctly and think strategically, that will be a far, far smaller number than 80% of 7 billion, and will happen far, far faster than 20 years.

    But knowing who the infected individuals are isn't normal. Having invasive public health surveillance isn't normal - and that's what you need to be able to do this. This only works if you're able to tag and isolate all the infected people.

    The idea that we need 80% (or 70% or whatever the number is) of people vaccinated is that that's the number that reduces R_effective from whatever someone's model currently thinks R_0 is for "normal" behaviour in our society to less than 1, and once we have R_effective less than 1, then the epidemic dies away.

    These models assume that all people are average people, and have the same number of contacts. We know that's not true - we know that some people meet a lot of people, and some don't - so if you can preferentially innoculate the popular people, you can maybe immunize 80% of contacts with only 60% of people or something.
  • Lamb ChoppedLamb Chopped Shipmate

    But knowing who the infected individuals are isn't normal. Having invasive public health surveillance isn't normal - and that's what you need to be able to do this. This only works if you're able to tag and isolate all the infected people.

    This is the key. This is why testing and contact tracing are so important. It's a lot of work, but the alternative is the nightmare of trying to reach 80% herd immunity, which offers us a choice of the fast-and-deadly route or the looooooong-and-very-restrictive route, neither of which is a decent alternative.
  • jay_emmjay_emm Shipmate
    But even a lower percentage should slow it down which buys you a bit of time, which you can then use to buy more time (localised lockdowns) and targeted local vaccination.
    I'm not sure what the maths is.
  • jay_emmjay_emm Shipmate
    To put that in context, with a crude 'engineers' model.

    r=6 (in a week), less the vaccinated people.
    Week 4 our single case has become 216 cases
    With 20% vaccination it is only 111, (although that only buys 3 days of grace)
    At 50% it's only 27, and we have 2 whole weeks grace to plan and do stuff
    At 70% we have 6 whole weeks (which we're hopefully using to vaccinate and contact trace)
    And at 90% it's going extinct.

    When combined with other measures, then things get better.
  • Gramps49Gramps49 Shipmate
    @jay_emm

    Please explain where you get the value of r.

    If I am reading this article right it looks like Britain can achieve herd immunity at around 50% vaccination.

    Feel free you give me your read of the article.
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