I guess this is partly a toss up between good enough information and perfect information. Crossed with a global shortage of vaccine, the question is really - is this, or is it not, the least worst option ?
We have the data we currently have, the vaccine shortage we currently have, and the escalating spread we currently have - what should we do ?
Of which the most salient information to the current situation appears to be:
"But we don’t know if this fades between 3 and 12 weeks (before 2nd jab). Also we don’t know if you can still transmit, so keep your mask on!!"
I guess this is partly a toss up between good enough information and perfect information. Crossed with a global shortage of vaccine, the question is really - is this, or is it not, the least worst option ?
Is that global shortage affecting the UKs current order? Because at the moment the working assumption seems to be "Z% of N*2 is greater than 89% of N", which is gambling that the 52% (or whatever) sticks around after 3 weeks.
If there is one message that should have been learned from the response to the pandemic so far and hasn't been, it's that trying to half-arse measures doesn't help things in the long run.
I can see that there might be some logic in doing the spaced out vaccination with the risk that it had no long-term protection if that meant we had enough to cover the whole population in one go - but we don't.
It may be that the decision has come from people who understand this better than I do. The implementation of the decision on the other hand is pretty obnoxious, which doesn't reassure me.
We are back in the world of meaningless risk assessments. The risks are not fundamentally knowable, and the penalty is not discretionary, so can we please stop playing at this shit, and treat the vaccination as an end in itself?
I guess this is partly a toss up between good enough information and perfect information. Crossed with a global shortage of vaccine, the question is really - is this, or is it not, the least worst option ?
We have the data we currently have, the vaccine shortage we currently have, and the escalating spread we currently have - what should we do ?
This, apparently, is what they’re hanging their hat on:
Protective immunity from the first dose likely lasts for a duration of 12 weeks (unpublished data).
Of which the most salient information to the current situation appears to be:
"But we don’t know if this fades between 3 and 12 weeks (before 2nd jab). Also we don’t know if you can still transmit, so keep your mask on!!"
The final phrase is certainly true. Regardless of what interval there is between doses, we don't know how much the vaccines reduce transmission. Therefore, even after we've all been vaccinated we'll still need to maintain some level of social distancing until we know that transmission is reduced enough that the virus can be eliminated (which, globally could be several years if there's still residual transmission). Wearing masks in public spaces is a no-cost simple measure, which along with things like hand washing should be the last measures to go.
Reading through the MRHA rationale the impression I get is that the extension to the interval for the AstraZeneca vaccine is based on evidence from the trials and other vaccines - it may not be the strongest evidence and at this time it may be that further trials to test longer intervals are probably not justified as they'll further delay mass roll out. Which is what I was hearing a few days back. The rationale for the same extension from the mRNA vaccines seems to be based on very little evidence at all - there's no trial data for this, and no analogy with other vaccines possible. To an extent it looks like a hunch, a decision built on an assumption that these novel vaccines will behave like more traditional vaccines without any evidence I can see that there will be a similar behaviour.
If the first dose gives both decent protection from covid and reduces chances of infection and/or transmission of coronavirus then the strategy of getting as many first doses as possible will pay off. If the protection of the first dose wears off quickly and it infers very little protection from infection or transmission of coronavirus it will have very little impact - at best by giving a short period of protection for the most vulnerable it will push the peak of hospitalisation back a couple of months (which will be into the back end of the usual seasonal peak of demand for NHS services, so will be good if that was all that happened). At worst, if many people feel that as many people have been vaccinated then the disease is beaten, and hence start to gather in large groups in homes or bars, stop wearing masks etc then the flood gates for a third wave will be opened.
Of which the most salient information to the current situation appears to be:
"But we don’t know if this fades between 3 and 12 weeks (before 2nd jab). Also we don’t know if you can still transmit, so keep your mask on!!"
The final phrase is certainly true. Regardless of what interval there is between doses, we don't know how much the vaccines reduce transmission. Therefore, even after we've all been vaccinated we'll still need to maintain some level of social distancing until we know that transmission is reduced enough that the virus can be eliminated (which, globally could be several years if there's still residual transmission). Wearing masks in public spaces is a no-cost simple measure, which along with things like hand washing should be the last measures to go.
Do you really believe people are going to be OK with this for several years after everyone has been vaccinated? Wearing masks in public spaces is not a “no-cost measure”, it’s a real pain in the ass - and it’s what you do after adopting more effective measures, like closing all restaurants, so it would be among the first things to go, not the last.
Do you really believe people are going to be OK with this for several years after everyone has been vaccinated? Wearing masks in public spaces is not a “no-cost measure”, it’s a real pain in the ass - and it’s what you do after adopting more effective measures, like closing all restaurants, so it would be among the first things to go, not the last.
I wear glasses so a mask is indeed a pain. But that is an inconvenience not a cost: it doesn't stop me from doing anything that I would otherwise like to do. In particular, it doesn't put anyone else out of a job or prevent me or anyone else from earning money.
What are the costs of wearing a mask (beyond the purchase thereof) or hand washing? A minor inconvenience, but not costly. In sufficient to prevent transmission on their own, so if the virus is being transmitted in the community additional measures are essential. Closing bars costs the bar owners customers, and their suppliers business ... ultimately jobs; plus it costs people somewhere to drink.
Then let them do the vaccination properly. That seems to me to be absolutely key to giving people the confidence to do what you are talking about @Alan Cresswell . I know it's key to giving me that confidence.
What are the costs of wearing a mask (beyond the purchase thereof) or hand washing? A minor inconvenience, but not costly.
If I could, I would pay money not to have to do it, so having to do it is a real cost.
In sufficient to prevent transmission on their own, so if the virus is being transmitted in the community additional measures are essential. Closing bars costs the bar owners customers, and their suppliers business ... ultimately jobs; plus it costs people somewhere to drink.
If everyone is vaccinated, and the number hospitalized and dying is greatly reduced, we won’t keep bars and restaurants closed - and then there’s no point in wearing a mask out in public.
I hope the decision to vaccinate more people with one dose by extending the interval turns out OK, but I'm not reassured by what appear to be overstatements like "The trial demonstrated efficacy at a range of dose intervals." I didn't see that mentioned anywhere in the AZ phase 3 protocol, nor is it established by the PDF Douglas links to. The sample sizes given for evidence of immunogenicity after longer dose intervals are tiny (<200), far too small to determine efficacy. And since this regime variation wasn't mentioned in the protocol, how did it come about - another screw-up? If so, why would these people be expected to be statistically representative?
If they're going to trust this, why aren't they going with the results indicating much greater efficacy with half-doses?
This is what science looks like. "We haven't proven this, but based on what we do know, it is likely to be true." From the MHRA report, "Similar findings were seen with the Moderna mRNA vaccine out to 108 days after the first dose (see Annex A)."
Given that the vaccine is supply-limited, it is rational to vaccinate more people with one dose rather than fewer people with two doses.
Personally, I'd say that this looks like a good call. There's no rush to get a single dose of vaccine to people like me (I don't need to work in close contact with other humans. I can keep doing that for a few more months.), but getting vaccine in twice as many people who have to be in contact with lots of others looks like a good decision.
The nytimes has a story on reports that the U.K. government plans to administer different combinations of the vaccines if it experiences problems with supply:
Those three links do not inspire confidence, Doublethink. The Reuters article describes the Oxford researchers' dosing error in detail (in agreement with their published admission in The Lancet), but also includes quotes from Oxford researchers and the AZ CEO denying it was an error.
The press releases are also misleading, talking of "combining data from two dosing regimens" (ridiculous, since nobody's going to get the average of two different regimens) without mentioning the dosing error or noting that the protocol called for only one dosing regimen.
I think basically, it’s because it wasn’t an error in the sense of accidentally misreading a dose instruction of x ml as y ml.
They assessed the batch and sought permission from the regulator to administer it differently. The assessment was wrong due to a technical issue with the machine. Then they noted the potency problem and went back to the regulator to create a separate arm of the trial.
So all the monitoring, who got what, exactly what they got, all the follow up etc was carried out with sufficient precision to provide scientifically useful information.
The issue of how up you statistically analyse the information is a slightly different issue. Press releases always contain an element of spin - but this is why the role of the independent regulator is important, because they double check all of that.
They made a working vaccine in less than a year, why are you so angry with them.
As regards changing the dosing of the Pfizer vaccine, if the manufacturer tells you not to and that it hasn't been tested for your intended change, you don't. End of story. Unless you're both very, very arrogant and very, very stupid.
As regards changing the dosing of the Pfizer vaccine, if the manufacturer tells you not to and that it hasn't been tested for your intended change, you don't. End of story. Unless you're both very, very arrogant and very, very stupid.
Oh!
Yes, up to a point.
However, in a crisis, it's not always that simple.
Let's try a simple analogy. You're in a war zone, waiting to be evacuated and you have two casualties with blast injuries but only enough morphine for one. Do you treat one and ignore the other or partially treat both?
The aim here is to achieve virus control. Obviously that's best achieved by giving full dose to everyone but if supply is limited is it better to fully treat some or partially treat everyone? That's a tricky question and the answer will be very technical and depend on evaluating a lot of data and models with in-built uncertainty.
It is difficult to judge whether the government is following the best advice in a difficult situation or making a shoddy decision to cover up yet another failing whilst pretending to be world leading.
The exact decision I therefore cannot judge but the government should be condemned for their prior destruction of trust when trust is vital and for their lack of transparency and dishonesty.
But there's no chance of them being honest now; they've bet everything they have on their false narrative of success.
I could live with that bet if it wasn't your and my life that they are betting with.
Speaking of arrogance, immorality, lack of transparency, and dishonesty reminds me that we don't seem to have seen or heard much of The Lord Protector lately.
Not that this is necessarily a Bad Thing, of course, but he could at least emerge from his pit, and say how strongly he supports poor old Gavin Williamson in the latter's hour of need.
Maybe he'll appear in his favourite Hi-Viz and helmet at the sinkhole that has opened up in the Manston Farage-Garage, blaming it on Horrid Foreign Saboteurs, or something.
No matter what you’ve been through, please do take more than a moment to consider the heartaches and ballaches visited upon a man who simply wanted to be world king, but would settle for being the kind of prime minister who smiled and drove diggers through polystyrene walls – yet now has to deal with all this shit in his in-tray instead.
Meh, all this was evident years ago, yet it served large parts of the media (with a few notable exceptions) to play along with it. The same claque who applaud every column by a member of minor nobility writing under an assumed name, while shovelling shit for some right wing mogul day in day out.
I think basically, it’s because it wasn’t an error in the sense of accidentally misreading a dose instruction of x ml as y ml.
They assessed the batch and sought permission from the regulator to administer it differently. The assessment was wrong due to a technical issue with the machine.
No, it was wrong because they misinterpreted the machine's results, failing to realize (through inexperience with actual vaccines, perhaps?) the effect of one of the vaccine ingredients on UV absorption. They didn't actually determine the root cause of the disagreement at this point - apparently they just decided that the Italian contract manufacturers had accidently given them twice the design concentration(!) - and blithely started shooting the unintended dose into people's arms.
Then they noted the potency problem and went back to the regulator to create a separate arm of the trial.
So all the monitoring, who got what, exactly what they got, all the follow up etc was carried out with sufficient precision to provide scientifically useful information.
I don't think this is correct. The half-dose/full-dose combination was never used on anybody over 55 - this would have been recognized as a pretty serious deficiency if there had ever been a real actual plan to test this dosing regimen properly.
The issue of how up you statistically analyse the information is a slightly different issue. Press releases always contain an element of spin - but this is why the role of the independent regulator is important, because they double check all of that.
They made a working vaccine in less than a year, why are you so angry with them.
You're mistaking criticism for anger.
We're not talking about a miracle hair restorer here. This is supposed to be injected into the arms of millions of healthy people to prevent a deadly disease; I think the people at Oxford and AZ should expect to be held to a higher standard of transparency than the pitchmen on a late-night TV infomercial. If they had spent less time shit-talking their competitors in the media and more time understanding how their equipment worked, they might not be in this position.
Meh, all this was evident years ago, yet it served large parts of the media (with a few notable exceptions) to play along with it. The same claque who applaud every column by a member of minor nobility writing under an assumed name, while shovelling shit for some right wing mogul day in day out.
Not a Marina Hyde fan, then?
I'm not sure I appreciate being classed as part of a claque, but hey...I'll just offer it up to Jesus.
I'm not sure I appreciate being classed as part of a claque, but hey...I'll just offer it up to Jesus.
No, I was referring to the bluetick members of the media who will go into her rhapsodies over her latest column but who bear a lions share of the blame for allowing Johnson to get to high office.
The press releases are also misleading, talking of "combining data from two dosing regimens" (ridiculous, since nobody's going to get the average of two different regimens) without mentioning the dosing error or noting that the protocol called for only one dosing regimen.
OK, this is just silly.
There are lots of different ways of combining data that do not include just blindly averaging the numbers. Combining data from different test conditions is something that scientists do all the time, in all fields of science, and never means "just take the average and call it good".
Yes, the half-dose was administered in error. Errors happen. But because responsible people keep good records of what they did, you can account for the error after the fact. In this case, we know that the half-dose was administered, to who, and under what conditions. It's not important to the data analysis why this happened.
(Why this happened is a quality control issue for the lab, certainly, and I would imagine has generated large piles of HPI reports and things. But it doesn't affect the interpretation of the data, and so discussion of it doesn't belong in a report that discusses the interpretation of the data.)
The press releases are also misleading, talking of "combining data from two dosing regimens" (ridiculous, since nobody's going to get the average of two different regimens) without mentioning the dosing error or noting that the protocol called for only one dosing regimen.
OK, this is just silly.
There are lots of different ways of combining data that do not include just blindly averaging the numbers. Combining data from different test conditions is something that scientists do all the time, in all fields of science, and never means "just take the average and call it good".
Yes, the half-dose was administered in error. Errors happen. But because responsible people keep good records of what they did, you can account for the error after the fact. In this case, we know that the half-dose was administered, to who, and under what conditions. It's not important to the data analysis why this happened.
(Why this happened is a quality control issue for the lab, certainly, and I would imagine has generated large piles of HPI reports and things. But it doesn't affect the interpretation of the data, and so discussion of it doesn't belong in a report that discusses the interpretation of the data.)
The press releases are also misleading, talking of "combining data from two dosing regimens" (ridiculous, since nobody's going to get the average of two different regimens) without mentioning the dosing error or noting that the protocol called for only one dosing regimen.
OK, this is just silly.
There are lots of different ways of combining data that do not include just blindly averaging the numbers. Combining data from different test conditions is something that scientists do all the time, in all fields of science, and never means "just take the average and call it good".
Combining these two results is nonsensical on it's face. From the Oxford statement:
Phase 3 interim analysis including 131 Covid-19 cases indicates that the vaccine is 70.4% effective when combining data from two dosing regimens
In the two different dose regimens vaccine efficacy was 90% in one and 62% in the other
It's meaningless to combine the results from the two regimens as they did. Nobody is going to get a combination of the two regimens, and they aren't going to administer a combination of the two regimens to the general population - so why present a bogus number (70.4%) at all? (Unless, perhaps, the point was to obscure the fact that the intended regimen only had an efficacy of 62%.)
Yes, the half-dose was administered in error. Errors happen. But because responsible people keep good records of what they did, you can account for the error after the fact. In this case, we know that the half-dose was administered, to who, and under what conditions. It's not important to the data analysis why this happened.
(Why this happened is a quality control issue for the lab, certainly, and I would imagine has generated large piles of HPI reports and things. But it doesn't affect the interpretation of the data, and so discussion of it doesn't belong in a report that discusses the interpretation of the data.)
I think it's important to know whether or not the lead scientists in a vaccine development effort can be relied upon to be truthful or not.
I think the most interesting result to see would be the result from single dose plus second dose placebo, checked at regular time intervals. Because it would be useful to know if the second dose actually does anything, or whether body is simply taking time to fully actualise its immune response.
Dave W we know they have it’s in one of the links I posted, in Brazil one set of the participants in the trial were given one dose then a saline placebo as the second dose.
Dave W we know they have it’s in one of the links I posted, in Brazil one set of the participants in the trial were given one dose then a saline placebo as the second dose.
Yes, thanks - the AZ press release described the COV003 trial in Brazil. But that doesn't sound like a single-dose trial:
Participants are randomised to receive two intramuscular doses of a full dose (~5x1010 viral particles) of AZD1222 or comparator, meningococcal vaccine MenACWY as first dose and a saline placebo as second dose.
AZD1222 is the Oxford/AZ Covid vaccine - so the treatment arm is getting two doses of that, and the control arm is getting one dose of a meningococcal vaccine plus one dose of saline.
As it happens, the COV003 trial is more fully described in its registry entry with the US National Institutes of Health, according to which there are four groups, not two:
Biological: ChAdOx1 nCoV-19 single dose + paracetamol
Biological: MenACWY single dose + paracetamol
Biological: ChAdOx1 nCoV-19 two dose + paracetamol
Biological: MenACWY prime & saline placebo boost + paracetamol
So there is, in fact, a single dose test. The study is supposed to be complete in September of 2021, but I think that's just when the final 1-year checkups will all be completed. Presumably they could get some results before then (as they have from the two dose test) but there doesn't seem to be any information about when they might be available.
None of the trials are complete, there's still data to be collected from trial participants to determine the longevity of protection. The vaccines have been approved based on preliminary data which show that a) they're safe and b) efficacy exceeds the 50% benchmark that national bodies had set as a minimum requirement. We still need to know whether an additional booster will be required to maintain protection until the virus is effectively suppressed and the extent to which the vaccine prevents infection or just reduces symptoms. If the vaccine prevents infection then that will suppress transmission, in which case if the protection is maintained for more than a year then additional boosters can be targeted to people travelling to areas where the virus is still circulating, to areas where the virus flares up again. If the vaccine doesn't suppress transmission significantly then we need protection from the vaccine indefinitely, and hence regular additional boosters (which impacts supply of vaccine to poorer nations).
The discussion of variations in the dosing regime for the AstraZeneca vaccine are within the context of knowing from trial data (even if that's because the control over the trials was less than perfect) showing that the interval between doses and even the size of dose doesn't have a massive effect on efficacy - with lower than ideal statistical significance all variations of regime gave >60% efficacy. The much longer intervals being proposed which are longer than any of the trial data is a risky strategy, the risk being that a third dose will be needed a few months after the second (which for the UK is simply the cost of buying more doses - but will have a knock on impact of 10s of millions of doses that would otherwise be used in poorer nations). I still don't understand the basis of the confidence that the chief medical officers are displaying in extending the interval for the Pfizer vaccine, where there's very little (if any) data on the impact on efficacy of extending the interval between doses - certainly the large trials stuck strictly to the 21d interval (there may have been problems getting some participants back in for the second dose with a few getting their second dose a day or two late but that's not going to be relevant for an extension of the interval beyond 4 weeks), the earlier safety trials and in-vitro tests may have explored different dosing regimes because there must have been some basis for selecting the 21d interval in the large trials. But, if the mRNA vaccines give >50% protection for a couple of months then from a health care resource perspective this will be sufficient to ease stress on health services from the new variant rapid spread (coupled with ongoing social mixing restrictions which will be needed for at least a few more months whatever*).
* The potential government cock-up I think is most likely is that when we get to 10% of the population vaccinated some leading politician declares the emergency to be over and starts to urge people to mix socially again (a re-run of "eat out to help out" or similar) rather than waiting for vaccination levels to reach 60-70%.
As vaccines prompt the immune system to do stuff - rather than sitting in one’s blood stream to fight the virus themselves; why then would we expect the immune system’s memory to be different between different vaccines ?
There is evidence that the immune system 'memory' is stronger from a vaccine than it is from infection by coronavirus. If the vaccine produces a different 'memory' response from the virus, why should we assume that each vaccine produces the same 'memory' response? Besides, at the moment the question isn't about the vaccine induced immune 'memory' but about how well that 'memory' response is produced in the first place by a combination of two doses of vaccine - does extending the period between doses reduce the ability of the immune system to respond to infection over a period of weeks and months?
.
The discussion of variations in the dosing regime for the AstraZeneca vaccine are within the context of knowing from trial data (even if that's because the control over the trials was less than perfect) showing that the interval between doses and even the size of dose doesn't have a massive effect on efficacy - with lower than ideal statistical significance all variations of regime gave >60% efficacy.
The difference between 60% efficacy and 90% efficacy sounds pretty large to me; I know that I would have a strong preference for the latter over the former. And while a 60% vaccine is better than nothing, it doesn’t seem to offer much of a prospect for returning daily life to a semblance of normality.
Comments
I guess this is partly a toss up between good enough information and perfect information. Crossed with a global shortage of vaccine, the question is really - is this, or is it not, the least worst option ?
We have the data we currently have, the vaccine shortage we currently have, and the escalating spread we currently have - what should we do ?
We risk being back where we were after lockdown number 1 because some fucking chancers decided to see what the worst was that could happen.
Of which the most salient information to the current situation appears to be:
"But we don’t know if this fades between 3 and 12 weeks (before 2nd jab). Also we don’t know if you can still transmit, so keep your mask on!!"
Is that global shortage affecting the UKs current order? Because at the moment the working assumption seems to be "Z% of N*2 is greater than 89% of N", which is gambling that the 52% (or whatever) sticks around after 3 weeks.
A bit like announcing schools going to home learning for a week after pooh-poohing a Council trying to do the same thing.
They remind me of directors who nick your idea having previously rejected it.
I can see that there might be some logic in doing the spaced out vaccination with the risk that it had no long-term protection if that meant we had enough to cover the whole population in one go - but we don't.
It may be that the decision has come from people who understand this better than I do. The implementation of the decision on the other hand is pretty obnoxious, which doesn't reassure me.
Reading through the MRHA rationale the impression I get is that the extension to the interval for the AstraZeneca vaccine is based on evidence from the trials and other vaccines - it may not be the strongest evidence and at this time it may be that further trials to test longer intervals are probably not justified as they'll further delay mass roll out. Which is what I was hearing a few days back. The rationale for the same extension from the mRNA vaccines seems to be based on very little evidence at all - there's no trial data for this, and no analogy with other vaccines possible. To an extent it looks like a hunch, a decision built on an assumption that these novel vaccines will behave like more traditional vaccines without any evidence I can see that there will be a similar behaviour.
If the first dose gives both decent protection from covid and reduces chances of infection and/or transmission of coronavirus then the strategy of getting as many first doses as possible will pay off. If the protection of the first dose wears off quickly and it infers very little protection from infection or transmission of coronavirus it will have very little impact - at best by giving a short period of protection for the most vulnerable it will push the peak of hospitalisation back a couple of months (which will be into the back end of the usual seasonal peak of demand for NHS services, so will be good if that was all that happened). At worst, if many people feel that as many people have been vaccinated then the disease is beaten, and hence start to gather in large groups in homes or bars, stop wearing masks etc then the flood gates for a third wave will be opened.
If they're going to trust this, why aren't they going with the results indicating much greater efficacy with half-doses?
Given that the vaccine is supply-limited, it is rational to vaccinate more people with one dose rather than fewer people with two doses.
Personally, I'd say that this looks like a good call. There's no rush to get a single dose of vaccine to people like me (I don't need to work in close contact with other humans. I can keep doing that for a few more months.), but getting vaccine in twice as many people who have to be in contact with lots of others looks like a good decision.
https://uk.reuters.com/article/us-health-coronavirus-britain-vaccine-sp/special-report-how-a-british-covid-19-vaccine-went-from-pole-position-to-troubled-start-idUKKBN28Y0XU
Looking at Oxford’s press release, it looks as if the follow up studies are ongoing: https://www.ox.ac.uk/news/2020-11-23-oxford-university-breakthrough-global-covid-19-vaccine
Astra-zenca’s press release looks as if they were giving people either:
- 1/2 dose then full dose
- Full dose then full dose
- Single full dose
https://www.astrazeneca.com/media-centre/press-releases/2020/azd1222hlr.htmlThey also had an arm of the study in South Africa but I haven’t found a summary of that.
https://www.nytimes.com/2021/01/01/health/coronavirus-vaccines-britain.html
The press releases are also misleading, talking of "combining data from two dosing regimens" (ridiculous, since nobody's going to get the average of two different regimens) without mentioning the dosing error or noting that the protocol called for only one dosing regimen.
They assessed the batch and sought permission from the regulator to administer it differently. The assessment was wrong due to a technical issue with the machine. Then they noted the potency problem and went back to the regulator to create a separate arm of the trial.
So all the monitoring, who got what, exactly what they got, all the follow up etc was carried out with sufficient precision to provide scientifically useful information.
The issue of how up you statistically analyse the information is a slightly different issue. Press releases always contain an element of spin - but this is why the role of the independent regulator is important, because they double check all of that.
They made a working vaccine in less than a year, why are you so angry with them.
Oh!
Yes, up to a point.
However, in a crisis, it's not always that simple.
Let's try a simple analogy. You're in a war zone, waiting to be evacuated and you have two casualties with blast injuries but only enough morphine for one. Do you treat one and ignore the other or partially treat both?
The aim here is to achieve virus control. Obviously that's best achieved by giving full dose to everyone but if supply is limited is it better to fully treat some or partially treat everyone? That's a tricky question and the answer will be very technical and depend on evaluating a lot of data and models with in-built uncertainty.
It is difficult to judge whether the government is following the best advice in a difficult situation or making a shoddy decision to cover up yet another failing whilst pretending to be world leading.
The exact decision I therefore cannot judge but the government should be condemned for their prior destruction of trust when trust is vital and for their lack of transparency and dishonesty.
But there's no chance of them being honest now; they've bet everything they have on their false narrative of success.
I could live with that bet if it wasn't your and my life that they are betting with.
That is the arrogance and immorality.
AFZ
Not that this is necessarily a Bad Thing, of course, but he could at least emerge from his pit, and say how strongly he supports poor old Gavin Williamson in the latter's hour of need.
Maybe he'll appear in his favourite Hi-Viz and helmet at the sinkhole that has opened up in the Manston Farage-Garage, blaming it on Horrid Foreign Saboteurs, or something.
https://www.theguardian.com/commentisfree/2021/jan/01/boris-johnson-victim-emotions
Nailed it.
Worst Prime Minister ever.*
AFZ
*convince me I'm wrong
I don't think she likes The Lord Protector very much.
Meh, all this was evident years ago, yet it served large parts of the media (with a few notable exceptions) to play along with it. The same claque who applaud every column by a member of minor nobility writing under an assumed name, while shovelling shit for some right wing mogul day in day out.
We're not talking about a miracle hair restorer here. This is supposed to be injected into the arms of millions of healthy people to prevent a deadly disease; I think the people at Oxford and AZ should expect to be held to a higher standard of transparency than the pitchmen on a late-night TV infomercial. If they had spent less time shit-talking their competitors in the media and more time understanding how their equipment worked, they might not be in this position.
Not a Marina Hyde fan, then?
I'm not sure I appreciate being classed as part of a claque, but hey...I'll just offer it up to Jesus.
No, I was referring to the bluetick members of the media who will go into her rhapsodies over her latest column but who bear a lions share of the blame for allowing Johnson to get to high office.
My, my - how sensitive I seem to be getting in my dotage. More WINE is called for, I think.
OK, this is just silly.
There are lots of different ways of combining data that do not include just blindly averaging the numbers. Combining data from different test conditions is something that scientists do all the time, in all fields of science, and never means "just take the average and call it good".
Yes, the half-dose was administered in error. Errors happen. But because responsible people keep good records of what they did, you can account for the error after the fact. In this case, we know that the half-dose was administered, to who, and under what conditions. It's not important to the data analysis why this happened.
(Why this happened is a quality control issue for the lab, certainly, and I would imagine has generated large piles of HPI reports and things. But it doesn't affect the interpretation of the data, and so discussion of it doesn't belong in a report that discusses the interpretation of the data.)
FWIW, when they invite me to have a jab, I shall accept, as a sort of *Act of Faith*.
Well summarised.
Presumably that data should come out fairly soon.
I'm sure their scientific peers and line managers are well-placed to assess them on that, while some random nobody on the internet ... isn't.
Yes, thanks - the AZ press release described the COV003 trial in Brazil. But that doesn't sound like a single-dose trial: AZD1222 is the Oxford/AZ Covid vaccine - so the treatment arm is getting two doses of that, and the control arm is getting one dose of a meningococcal vaccine plus one dose of saline.
The discussion of variations in the dosing regime for the AstraZeneca vaccine are within the context of knowing from trial data (even if that's because the control over the trials was less than perfect) showing that the interval between doses and even the size of dose doesn't have a massive effect on efficacy - with lower than ideal statistical significance all variations of regime gave >60% efficacy. The much longer intervals being proposed which are longer than any of the trial data is a risky strategy, the risk being that a third dose will be needed a few months after the second (which for the UK is simply the cost of buying more doses - but will have a knock on impact of 10s of millions of doses that would otherwise be used in poorer nations). I still don't understand the basis of the confidence that the chief medical officers are displaying in extending the interval for the Pfizer vaccine, where there's very little (if any) data on the impact on efficacy of extending the interval between doses - certainly the large trials stuck strictly to the 21d interval (there may have been problems getting some participants back in for the second dose with a few getting their second dose a day or two late but that's not going to be relevant for an extension of the interval beyond 4 weeks), the earlier safety trials and in-vitro tests may have explored different dosing regimes because there must have been some basis for selecting the 21d interval in the large trials. But, if the mRNA vaccines give >50% protection for a couple of months then from a health care resource perspective this will be sufficient to ease stress on health services from the new variant rapid spread (coupled with ongoing social mixing restrictions which will be needed for at least a few more months whatever*).
* The potential government cock-up I think is most likely is that when we get to 10% of the population vaccinated some leading politician declares the emergency to be over and starts to urge people to mix socially again (a re-run of "eat out to help out" or similar) rather than waiting for vaccination levels to reach 60-70%.
and continues listing this Government's actions (and that of the US) explaining why they are disastrous.
*Link to easier image to blow up and read
I think we all need a little light relief, and it was beautifully provided by Catherine Bennett in a spoof of Carrie's diary in the Observer.