I don’t think you should make that restriction, because, at the onset of a new disease our situation is not so different.
Of course it is. It's about a year since Covid-19 was identified, and vaccines exist already.
Before that, one of the features of modern medicine is that we understood quickly how the virus was likely to spread, that it was spread readily by asymptomatic and pre-symptomatic people, and so as a consequence knew exactly what sort of measures to take to restrict its spread.
One of the features of people being stupid is that despite knowing all this, our countries by and large fucked it up.
The bit we fucked up, was the bit about managing till modern medicine could kick in - which was the really, really precedented bit.
The bit we fucked up, was the bit about managing till modern medicine could kick in - which was the really, really precedented bit.
The point is that "modern medicine" actually knows quite a lot about viruses. "Modern medicine" isn't just being able to manufacture whizzy mRNA vaccines very quickly - it's the whole ensemble of reasonable extrapolations based on our knowledge of how similar viruses behave. If you go and look at what the sensible people were saying back in March or April, and compare it to what the sensible people are saying now, it's basically the same thing. "The virus is spread by small-droplet-size moist exhalations" went from being probably true to being probably the dominant transmission method - but that's just a difference of degree. Lots of other statements went from "it probably works this way" to "we're certain it works this way" with the accumulation of more evidence.
We don't have to wonder about whether holding a posy to our noses will dispel the foul miasma that causes sickness. We don't have to think about whether getting hot and sweaty in a crowded dance club is likely to offer the virus a good breeding ground - we know it will.
But what we have is a bunch of idiots playing rules-lawyer games with medical advice. "Stay at least 6 feet away from other people" doesn't mean that there's some magic line at a 6 foot radius beyond which you can't get infected, and another bunch of idiots who don't understand that "this hasn't been proven, but based on the behaviour of similar viruses..." is likely to be good advice, and not "well, doctors don't know, so I'm going to keep doing what I want."
But what we have is a bunch of idiots playing rules-lawyer games with medical advice. "Stay at least 6 feet away from other people" doesn't mean that there's some magic line at a 6 foot radius beyond which you can't get infected
Not just common or garden idiots either. A lot of business were - and some still are - operating in this way, doing the bare minimum that would enable them to stay open, and bending the rules creatively to the max.
"The virus is spread by small-droplet-size moist exhalations" went from being probably true to being probably the dominant transmission method - but that's just a difference of degree.
Yes, what's with the Russian guy (who looked a right prat in his *robes*)?
A little Christmas present for Uncle Vlad?
I think this kind of thing does more harm than good tbh; it obscures the nature of power and how it corrupts, and by mooring it in speculation that doesn't so far have any evidence makes it ultimately easier to dismiss.
There's plenty to object about in this appointment without seeing Putin as the catspaw behind the particularly unhealthy relationship the press has in this country with parts of the political establishment.
It's part of a pattern. 52 new peers this year, despite prior agreement to reduce the number of peers to less than the number of MPs (but, when has breaking the rules been a problem for him?), a lot of them his cronies. The effect is to stamp his influence on the Lords for years after he's voted out of office - some similarities to Trump appointed Supreme Court justices. The Lords needs reform, and a big part of that is to remove (or at least significantly reduce) the power of the PM to appoint peers.
It's part of a pattern. 52 new peers this year, despite prior agreement to reduce the number of peers to less than the number of MPs (but, when has breaking the rules been a problem for him?), a lot of them his cronies. The effect is to stamp his influence on the Lords for years after he's voted out of office - some similarities to Trump appointed Supreme Court justices. The Lords needs reform, and a big part of that is to remove (or at least significantly reduce) the power of the PM to appoint peers.
It isn't only that. By packing the House of Lords with his friends, it moves the division figures in his favour. So it's less likely to alter, vote down or defer his legislation.
Just got the Downing Street briefing on in the background. Classic confused answer to a question from our PM, in this case relating to schools and whether parents can keep their children out of school if they don't think it's safe. Paraphrase of his answer: schools are safe, the problem is the mixing between households that inevitably happens at school.
Anyone else think he's saying that mixing between households is dangerous, that schools are places where mixing between households is unavoidable ... and somehow by some mysterious magic household mixing in schools is safe despite it being dangerous in all other contexts? Any guesses what the magic would be?
I can't help associating this cry of desperation with the thread about Thomas Beckett. You don't really want me to assassinate Boris do you?
There probably is a good egalitarian argument for that particular course of action.
The problem is that I do believe in moral absolutes.
But to be serious for a moment, I'm sure someone will complain about this particular tack. However, it's clear to me me that those people also understate the huge damage Boris has done and continues to do.
He’s saying ‘schools are very safe places’. Which is entirely true. It’s just when you put pupils in them that they become breeding grounds for the virus. 🙄
My cry of desperation was just that - albeit rhetorical.
Just to be clear, I am NOT advocating assassination, although I do admit to hoping that the Lord Protector's political career will soon shrivel and die.
Yet his talent for that has continued to the present day, as we know to our cost.
There is a certain irony, though, in the possibility that British sausages (aka offal-tubes) of whatever shape may no longer be acceptable on the other side of the Sleeve.
Yet his talent for that has continued to the present day, as we know to our cost.
There is a certain irony, though, in the possibility that British sausages (aka offal-tubes) of whatever shape may no longer be acceptable on the other side of the Sleeve.
What concerns me is this week, Morrisons failed to deliver my Btatwurst.
Yet his talent for that has continued to the present day, as we know to our cost.
There is a certain irony, though, in the possibility that British sausages (aka offal-tubes) of whatever shape may no longer be acceptable on the other side of the Sleeve.
What concerns me is this week, Morrisons failed to deliver my Btatwurst.
Our diplomats in Brussels and EU capitals can feels confident that their supply of British will be maintained via the Diplomatic Bag and our heroic Queen's Messengers.
Just got the Downing Street briefing on in the background. Classic confused answer to a question from our PM, in this case relating to schools and whether parents can keep their children out of school if they don't think it's safe. Paraphrase of his answer: schools are safe, the problem is the mixing between households that inevitably happens at school.
That has to go down as one of the - if not the - stupidest things I’ve ever heard a national leader say.
Yet his talent for that has continued to the present day, as we know to our cost.
There is a certain irony, though, in the possibility that British sausages (aka offal-tubes) of whatever shape may no longer be acceptable on the other side of the Sleeve.
What concerns me is this week, Morrisons failed to deliver my Btatwurst.
The government have decided that instead of scheduling the second shot of the vaccine four weeks after the first as per the clinical trials they will schedule the second shot twelve weeks after the first. On what evidence they believe the second shot will be as effective I don't know. Meanwhile GPs will have to reschedule a lot of appointments that have been already booked.
Does this smell to me of PR taking precedence over health needs in order to cover for incompetence? Yes, it does.
Like turtles, it's incompetence all the way down. If they'd not left it so late to order the first lockdown, they'd have not had to not fire Cummings, they'd have not lost the confidence of the public, they'd have not had to reopen shops early, they'd have not had a second wave, they'd have not had to have a second lockdown, they'd have not had to reopen the shops early for a second time, they'd have not had to cancel Christmas, they'd have not had to have a third lockdown, and they'd not have had to think that sacrificing 95% immunity for 50% immunity is worth it in the face of 1000 deaths a day.
What is worrying is that the Oxford vaccine has been approved for a longer gap, but the Pfizer has not. Surely, they're not going to mess this up as well? There are also issues of consent, if you have agreed to a 3 week gap.
What is worrying is that the Oxford vaccine has been approved for a longer gap, but the Pfizer has not. Surely, they're not going to mess this up as well?
AIUI, the AstraZeneca vaccine trials included a range of periods between the two doses, and that the majority of the protection against covid was given by the first dose with the second dose being a smaller boost (that may impact how long protection lasts). The data suggests that there's little difference in final outcome with the period between doses. Hence there's some sense in prioritising giving as many first doses as quickly as possible, even if the time between doses has to be increased a bit to permit that.
Conversely, the Pfizer and Moderna vaccines were only trialled with a single 21d interval between doses, and the data suggest that the second dose is the one which gives the majority of protection. Thus, there's no data to suggest it's acceptable to extend the period between doses, and there's little point in getting as many first doses as possible.
The reports I've seen suggest that this is a rational strategy - keep the protocol for the Pfizer vaccine unchanged from the trials and current license, and use the AstraZeneca vaccine in a different manner to get reasonable protection to as many people as possible as quickly as possible with the second booster administered a bit later. It appears to be a strategy devised by medical experts reviewing the data and accounting for the current needs created by a new version of the virus and poor decisions by the government which allowed that to spread uncontrolled. Maybe they took advantage of the PM being distracted by a deal with the EU to slip a sensible programme past him.
What is worrying is that the Oxford vaccine has been approved for a longer gap, but the Pfizer has not. Surely, they're not going to mess this up as well? There are also issues of consent, if you have agreed to a 3 week gap.
It's worth reminding people that the Pfizer and Oxford vaccines are different beasts. The Pfizer and Moderna vaccines are both mRNA vaccines. The injected mRNA instructs the body to produce spike proteins that match those on SARS-CoV-2, which the body then produces an immune response against. P and M are rather similar vaccines (and this is why they have to be kept so cold etc.)
By contrast the Oxford vaccine is an adenovirus modified to have CoV-2 spike proteins. So although the end result is the same (body makes antibodies against CoV-2 spike proteins etc.), the mechanism isn't quite the same, and it's not unreasonable that the two different kinds of vaccine would have different optimum times between doses etc.
So we have the trial data, which Alan refers to, and there are plausible arguments for there actually being a difference between optimum strategies for the different kinds of vaccine (rather than just "we didn't test that with this one".)
Interesting points, and we all hope, I'm sure, that the scientists have Got It Right.
I'm afraid I still think that the *government* will no doubt f*ck it all up at some point in the not-too-distant future, once the Lord Protector has recovered from his Brexshit-induced orgasm (ewww...).
What is worrying is that the Oxford vaccine has been approved for a longer gap, but the Pfizer has not. Surely, they're not going to mess this up as well?
AIUI, the AstraZeneca vaccine trials included a range of periods between the two doses, and that the majority of the protection against covid was given by the first dose with the second dose being a smaller boost (that may impact how long protection lasts). The data suggests that there's little difference in final outcome with the period between doses. Hence there's some sense in prioritising giving as many first doses as quickly as possible, even if the time between doses has to be increased a bit to permit that.
Did they intend to test a range of periods, or is that just another thing they fucked up, like the different doses?
I rather suspect the latter - I doubt they enrolled enough people to get reliable results for several different regimes. This new government directive smells of desperation.
The AstraZeneca vaccine is more conventional than the Pfizer and Moderna mRNA vaccines. That means there's a much larger body of knowledge about the behaviour of similar vaccines. It could simply be that there wasn't an expectation for a strong dependence on the timing between doses, and this was a relatively uncontrolled variable. The number of people involved in the trials probably wouldn't show up a difference in efficacy of a few percent, but a stronger dependence of 10% or more probably would be evident. If the data isn't there to determine an optimal interval to gain a few percent extra efficacy then if you make a decision to set that to 21d (or, whatever) then a) you might have got the interval suboptimal and b) you add difficulties in delivering the vaccine - whereas more flexibility makes delivery easier, allows more people to get the first (and most effective) dose sooner, and probably will only be a second order effect on overall efficacy.
They enrolled 24000 people. Statistical power should be pretty good. More to the point, nobody vaccinated on any of the dosing regimes required hospital treatment for Covid.
The AstraZeneca vaccine is more conventional than the Pfizer and Moderna mRNA vaccines. That means there's a much larger body of knowledge about the behaviour of similar vaccines. It could simply be that there wasn't an expectation for a strong dependence on the timing between doses, and this was a relatively uncontrolled variable. The number of people involved in the trials probably wouldn't show up a difference in efficacy of a few percent, but a stronger dependence of 10% or more probably would be evident. If the data isn't there to determine an optimal interval to gain a few percent extra efficacy then if you make a decision to set that to 21d (or, whatever) then a) you might have got the interval suboptimal and b) you add difficulties in delivering the vaccine - whereas more flexibility makes delivery easier, allows more people to get the first (and most effective) dose sooner, and probably will only be a second order effect on overall efficacy.
"A relatively uncontrolled variable?" Was this really the most fucking slip-shod trial in history?
They enrolled 24000 people. Statistical power should be pretty good. More to the point, nobody vaccinated on any of the dosing regimes required hospital treatment for Covid.
Statistical power is determined not not by the number of people enrolled, but by the number of people who get COVID, which would be much, much smaller. And again, they didn't really have any "dosing regimes" by plan - that was a total fuckup, and the demographics of the two groups weren't the same.
According to the AstraZeneca protocol, the 2nd dose was supposed to be given 28 days after the first, and they needed 150 infections for their primary efficacy analysis.
I believe that 4 weeks is the usual interval for a lot of multi-dose immunisations. Certainly that's what the UK infant programme works on, and anyone needing Hep B as an adult would be scheduled for that although it can be extended.
According to the news this morning, the interval between the Pfizer doses is also being significantly increased, whereas the announcement the other day only applied to the AstraZeneca vaccine. The narrative being presented by the chief medical officers seems to be deviating from that given by the MHRA the other day. Which suggests that whereas the MHRA was presenting the schemes to give maximum protection to individuals (21d interval for Pfizer, but longer intervals with more flexibility for AstraZeneca) the chief medical officers are looking at reducing impact of the virus on health services (accepting reduced individual protection to provide some protection for more people). If what was being presented a few days ago is correct, that the mRNA vaccines provide limited protection on first dose and that protection is non-persistent requiring a second dose at 21d to boost protection to the high level with persistence, then spreading out those two doses could result in an earlier requirement to re-vaccinate (if after 12 weeks the vaccine is largely ineffective, and there's no trial data for that period, then that second dose could be largely considered the first dose of a re-vaccination needing a 3rd dose 21d after that). Given that even spreading the doses out the number of people who will be getting a single dose is still very small compared to the number of people who will need it the gains from this high-risk strategy don't seem to be that significant - maintaining lockdown conditions for another month or two would be far more effective (it will also reduce the strain on health services from 'flu and other seasonal transmissible diseases), unfortunately we can't go back in time and cancel the 'eat out to help out' scheme and other steps that demolished the good done by the first lockdown.
Comments
The bit we fucked up, was the bit about managing till modern medicine could kick in - which was the really, really precedented bit.
The point is that "modern medicine" actually knows quite a lot about viruses. "Modern medicine" isn't just being able to manufacture whizzy mRNA vaccines very quickly - it's the whole ensemble of reasonable extrapolations based on our knowledge of how similar viruses behave. If you go and look at what the sensible people were saying back in March or April, and compare it to what the sensible people are saying now, it's basically the same thing. "The virus is spread by small-droplet-size moist exhalations" went from being probably true to being probably the dominant transmission method - but that's just a difference of degree. Lots of other statements went from "it probably works this way" to "we're certain it works this way" with the accumulation of more evidence.
We don't have to wonder about whether holding a posy to our noses will dispel the foul miasma that causes sickness. We don't have to think about whether getting hot and sweaty in a crowded dance club is likely to offer the virus a good breeding ground - we know it will.
But what we have is a bunch of idiots playing rules-lawyer games with medical advice. "Stay at least 6 feet away from other people" doesn't mean that there's some magic line at a 6 foot radius beyond which you can't get infected, and another bunch of idiots who don't understand that "this hasn't been proven, but based on the behaviour of similar viruses..." is likely to be good advice, and not "well, doctors don't know, so I'm going to keep doing what I want."
Not just common or garden idiots either. A lot of business were - and some still are - operating in this way, doing the bare minimum that would enable them to stay open, and bending the rules creatively to the max.
Just wondering how Evgeny Lebedev passed the vetting
A little Christmas present for Uncle Vlad?
I think this kind of thing does more harm than good tbh; it obscures the nature of power and how it corrupts, and by mooring it in speculation that doesn't so far have any evidence makes it ultimately easier to dismiss.
There's plenty to object about in this appointment without seeing Putin as the catspaw behind the particularly unhealthy relationship the press has in this country with parts of the political establishment.
Probably 45 or more years sine I last read any. Your post reminds me of archy's inability to use the shift key
Same here - I had a book of poetry as a child that had "archy the cockroach is shocked" in it.
Anyone else think he's saying that mixing between households is dangerous, that schools are places where mixing between households is unavoidable ... and somehow by some mysterious magic household mixing in schools is safe despite it being dangerous in all other contexts? Any guesses what the magic would be?
How long, O Lord, how long do we have to continue to put up with this waffling Scarecrow of a PM?
There probably is a good egalitarian argument for that particular course of action.
The problem is that I do believe in moral absolutes.
But to be serious for a moment, I'm sure someone will complain about this particular tack. However, it's clear to me me that those people also understate the huge damage Boris has done and continues to do.
AFZ
Just to be clear, I am NOT advocating assassination, although I do admit to hoping that the Lord Protector's political career will soon shrivel and die.
There is a certain irony, though, in the possibility that British sausages (aka offal-tubes) of whatever shape may no longer be acceptable on the other side of the Sleeve.
What concerns me is this week, Morrisons failed to deliver my Btatwurst.
Never mind we have worse brat in Number 10
That has to go down as one of the - if not the - stupidest things I’ve ever heard a national leader say.
And we’ve just had four years of Trump.
I'd say they're generally safe (barring covid), they're just cold, damp and ugly.
Nice one!
Does this smell to me of PR taking precedence over health needs in order to cover for incompetence? Yes, it does.
As to messing it all up, yes, they'll do that. They're world-beatingly good at messing things up.
Conversely, the Pfizer and Moderna vaccines were only trialled with a single 21d interval between doses, and the data suggest that the second dose is the one which gives the majority of protection. Thus, there's no data to suggest it's acceptable to extend the period between doses, and there's little point in getting as many first doses as possible.
The reports I've seen suggest that this is a rational strategy - keep the protocol for the Pfizer vaccine unchanged from the trials and current license, and use the AstraZeneca vaccine in a different manner to get reasonable protection to as many people as possible as quickly as possible with the second booster administered a bit later. It appears to be a strategy devised by medical experts reviewing the data and accounting for the current needs created by a new version of the virus and poor decisions by the government which allowed that to spread uncontrolled. Maybe they took advantage of the PM being distracted by a deal with the EU to slip a sensible programme past him.
It's worth reminding people that the Pfizer and Oxford vaccines are different beasts. The Pfizer and Moderna vaccines are both mRNA vaccines. The injected mRNA instructs the body to produce spike proteins that match those on SARS-CoV-2, which the body then produces an immune response against. P and M are rather similar vaccines (and this is why they have to be kept so cold etc.)
By contrast the Oxford vaccine is an adenovirus modified to have CoV-2 spike proteins. So although the end result is the same (body makes antibodies against CoV-2 spike proteins etc.), the mechanism isn't quite the same, and it's not unreasonable that the two different kinds of vaccine would have different optimum times between doses etc.
So we have the trial data, which Alan refers to, and there are plausible arguments for there actually being a difference between optimum strategies for the different kinds of vaccine (rather than just "we didn't test that with this one".)
I'm afraid I still think that the *government* will no doubt f*ck it all up at some point in the not-too-distant future, once the Lord Protector has recovered from his Brexshit-induced orgasm (ewww...).
Cynical? Moi?
I rather suspect the latter - I doubt they enrolled enough people to get reliable results for several different regimes. This new government directive smells of desperation.
Statistical power is determined not not by the number of people enrolled, but by the number of people who get COVID, which would be much, much smaller. And again, they didn't really have any "dosing regimes" by plan - that was a total fuckup, and the demographics of the two groups weren't the same.
Oh I can...