COVID-19 treatment and vaccine update thread

[coopasonic]

Also I won't do this forever and I can only imagine I'm more patient than the average person. A year is a lot of time to give up and we're already approaching giving up a year of our lives.

Yeah, like I'm only willing to sit out 30 or 40 more years and then I've had it!

[LawBeefaroni]

We've moved on to outside healthcare workers (those not employed by our system) which means providing vaccines to independent providers' office staff, home health partners, etc. We're also set to start on the elderly and high-risk as soon as we get the go-ahead from the state. *Tap tap tap*

[hitbyambulance]

The Beijing Institute of Biological Products created an inactivated coronavirus vaccine that was put into clinical trials by the state-owned Chinese company Sinopharm. On Dec. 30, Sinopharm announced that the vaccine had an efficacy of 79.34 percent, leading the Chinese government to give it approval. The company has yet to publish the detailed results of their Phase 3 trial.

78% effective in Brazil... supposedly... https://www.reuters.com/article/us-heal ... SKBN29C1VZ

seems incredibly unlikely the US is getting any Chinese (or Russian) developed vaccine distributed within its borders at this point.

that efficacy rate was erroneously extracted from just one group, so actually

Brazil announces Sinovac’s vaccine has an efficacy of just over 50 percent.

that's... not too great, is it.

https://www.scmp.com/news/china/article ... fter-lower

[Max Peck]

That's about on par with a typical influenza vaccine. It's better than nothing, but not an option that any country that can afford one of the more effective vaccines will likely pursue.

[Paingod]

In case you all need something to read/share/post : Why you should still wear a mask and avoid crowds after getting the COVID-19 vaccine:

I'm slated to be vaccinated tomorrow by my employer (medical office) and volunteered to be dead last in line behind anyone else who might need it.

I've started wearing my mask at my desk in the corner office with no one around. While Maine has been pretty low risk, my kids have been bumped back to almost full time schooling. I figure it's only a matter of time before the school has to lock down and I'm trying to be proactive for the people who periodically pop in to ask questions.

It sounds like I'll keep wearing my mask even after tomorrow.

[hitbyambulance]

That's about on par with a typical influenza vaccine. It's better than nothing, but not an option that any country that can afford one of the more effective vaccines will likely pursue.

this makes sense, as Sinovac's vaccine uses the traditional inactivated virus technology that the influenza vaccine uses. seems likely that once mRNA technology is proven safe that flu vaccines would switch to that.

[El Guapo]

Dollar General will pay employees to get vaccinated.

Just four hours of pay (plus time off if there are any complications), so not a *ton* of money, but still, a step in the right direction.

[LawBeefaroni]

Dollar General will pay employees to get vaccinated.

Just four hours of pay (plus time off if there are any complications), so not a *ton* of money, but still, a step in the right direction.

It's enough to sway anyone on the fence. And there are a lot of them.

[Defiant]

Vaccine Tracker

Vaccinations in the U.S. began Dec. 14 with health-care workers, and so far 4.28 million doses have been given, according to a state-by-state tally by Bloomberg and data from the Centers for Disease Control and Prevention.

("Updated: January 2, 2021, 4:59 PM EST")


A previous update

Vaccinations in the U.S. began Dec. 14 with health-care workers, and so far 3.17 million doses have been given,

("Updated: December 31, 2020, 5:29 PM EST")

So approximately 1.11 million in a ~48 hour period (although it could have been reporting lag from over the holidays).

By Jan 13th at 5:41 PM 10.8 million doses had been given. So around 6.5 million doses in 11 days.

Using back of the envelope math, that's around 600K doses a day.

At a guesstimate, we need roughly (.75)(330M)(2) doses to achieve herd immunity (75% of the population getting two doses), or about 500M doses. Or about 800 days (about 2.3 years).

That assume that the rate of giving doses remains steady, which it obviously won't (for various reasons). It also ignores other vaccines entering the mix (like the J&J one which only requires one dose).

Of course, on the plus side, deaths from covid should drop significantly much more quickly as vulnerable populations get vaccinated.

[Ralph-Wiggum]

Heard on the radio this morning that SC is getting about 64,000 doses a week. With a population of around 5 million, that means we'll be fully vaccinated in only....

/takes out calculator

... three years!

[Kurth]

My folks in FL are finally getting their first dose of vaccine (Pfizer) today. They waited in line for a couple hours yesterday at their local senior center to get tickets supposedly guaranteeing them a dose today.

Happy to see this, but this whole process is still such a mess.

My parents struggled for weeks to navigate the available online portals to try to make appointments for themselves. They're in their 70s and are smart, competent and capable people, but tech savvy they are not. My son and I tried to help them remotely (we're in OR and they are in FL), but that was a nightmare.

In the end, I'm relieved they are getting vaccinated today, but this process obviously should have been handled better.

My mother kept asking me, why can't we just go to our doctors, have them tell us what priority level we fit into, have them give us a prescription for the vaccine, and then have them log on and make us an appointment for administration? I didn't have any good answer to that or some of her other points: Why isn't the process being run through doctors? Especially given the increased needs of seniors and their decreased ability (generalizing here) with technology, why aren't we making it easier for them?

Massive screwup.

[Smoove_B]

Why isn't the process being run through doctors?

It will be, eventually. For an emergency vaccination effort (make no mistake, that's what's happening), the plans don't call for finite distribution to an individual doctor. Instead, the vaccines are sent from the feds to the states. From there, the states distribute to the county / local health agencies through the established emergency network that 's been set up to vaccinate thousands and thousands of people. There really just isn't any way to disseminate (easily) down to an individual doctor level.

increased needs of seniors and their decreased ability (generalizing here) with technology, why aren't we making it easier for them?

I 100% agree. I don't really have an answer for how my state (or any state) expected people 65+ to use a website to submit information regarding their health status to get registered and put into a database for scheduling an appointment.

Massive screwup.

Absolutely - but I want to be clear here, there are a number of things at play. First, the federal government (yet again) is offering limited assistance. Our mass vaccination plans have always included funding support as we knew people would need to be temporarily hired to help set up, administer and run the clinics. That funding has not been offered.

Second - and arguably just as important - is the low prioritization most communities/states place on public health services. The 2019 data suggests that we spend about $274 per person on public health here in the U.S. on average. Private health expenditure average per person is $8000. My own state spends about $30 per person, which is shameful. This has been a long, slow death spiral for public health over the last 20 years and part of the reason our response to this has been so bad. I want to believe what's happening will change things, but after seeing how people regard public health over the last year, I'm really not hopeful much will change overall.

[Kurth]

Thanks for the answers there, Smoove, but I still don’t get why doctors are not included. The process in the initial emergency stage.

I think I get why it’s not practical at this stage to have the doctors actually administering vaccinations, but why can’t they play a role in scheduling and registering people to get a vaccine.

The way I would imagine it playing out would be, people make an appointment with their primary care doctor or even urgent care, they are told when they can get vaccinated based on current prioritization, and then the doctor or assistant logs on to whatever local website exists and makes the appointment fit the patient. Why is it any different than getting a prescription written?

Maybe it’s a patient volume thing, but that seems offset by the fact that we’re supply-limited right now. I don’t get it.

[Smoove_B]

I think I get why it’s not practical at this stage to have the doctors actually administering vaccinations, but why can’t they play a role in scheduling and registering people to get a vaccine.

The way I would imagine it playing out would be, people make an appointment with their primary care doctor or even urgent care, they are told when they can get vaccinated based on current prioritization, and then the doctor or assistant logs on to whatever local website exists and makes the appointment fit the patient. Why is it any different than getting a prescription written?

Maybe it’s a patient volume thing, but that seems offset by the fact that we’re supply-limited right now. I don’t get it.

It's absolutely a volume thing. The system isn't designed to be that responsive in "real time" where it could somehow know and guarantee vaccine availability at that granular of a level. What's happening is states are being given weekly delivery estimates and then estimates are being adjusted to actuals when they show up. When the estimates are provided, it's up to the state to then figure out how to disseminate proportional doses to each county and then the county coordinator releases them to the mass clinics and other partners (like a Walgreens or CVS). At that point, those agencies set up their own appointments and hope delivery estimates are accurate.

The further away the vaccine gets from that initial dissemination, the greater the chances of them losing track of how/when/who is getting vaccinated. It's definitely a control thing too - keeping the vaccine in a known network to make sure it's being used in the best way possible. I'd also be amazed if local / private physicians would actually want to be involved as I wouldn't expect them to be able to handle the volume and additional work (all for free) required above and beyond what they're already doing.

I can appreciate it seems counterintuitive as people have their connections and relationships with their PCP, but unfortunately in an emergency effort that;s going to be lost.

EDIT: And of course none of this addresses a local physician's ability (lack thereof) to hold/store/maintain the vaccines at the correct temperature.

[Pyperkub]

J&J vaccine could be game changer:

The two vaccines available now — one by Pfizer and another by Moderna — require two doses: a priming shot and then a booster three or four weeks later, depending on which company’s injection you get.

But another vaccine on the horizon — developed by Johnson & Johnson — would require only a single dose.

...

The vaccine is still in development, but the New Brunswick-based company is expected to release the findings of its Phase 3 clinical trial — known as “Ensemble” — later this month, the company says.

“We hope to have that information very soon,” Johnson & Johnson CEO Alex Gorsky said Monday at J.P. Morgan’s annual health care conference.

The company aims to meet the necessary benchmarks by as early as Jan. 21, according to reports. Johnson & Johnson did not respond to a request for comment regarding its timeline.

Even better:

Like Oxford/AstraZeneca, Johnson & Johnson’s vaccine also doesn’t require ultra-cold storage like Pfizer’s version does.

“The vaccine technology we’ve used can remain stable for two years at -4° F, and at least three months at 35 [to] 46° F, which is about the temperature of your home refrigerator,” Mammen said in the statement.

Many experts believe vaccines like the Johnson & Johnson and AstraZeneca doses can be more rapidly scaled up and more easily delivered, as they don’t require special freezers.

As great as it would be here in the U.S. right now, it likely has more significance for other parts of the globe in terms of delivery.

As I recall, the J&J vaccine has issues similar to the Chinese one listed on this page - a low efficacy rate, probably insufficient to get to herd immunity levels. This article (conveniently?) omits any mention of the efficacy rate.

[Defiant]

As I recall, the J&J vaccine has issues similar to the Chinese one listed on this page - a low efficacy rate, probably insufficient to get to herd immunity levels. This article (conveniently?) omits any mention of the efficacy rate.

I don't think the actual data has been released yet, but...

Initial trials of the vaccine showed that 98 per cent of participants had developed antibodies against COVID-19 nearly a month after receiving the shot.

http://octopusoverlords.com/forum/viewt ... 0#p2786720

[Max Peck]

Johnson & Johnson’s single-shot coronavirus vaccine on track for March, exec says

Moncef Slaoui, chief adviser for the U.S. Operation Warp Speed vaccine development program, said on Wednesday the vaccine could show efficacy at or above 80%.

That would be below the efficacy of about 95% achieved in trials of already authorized vaccines from Pfizer Inc with BioNTech SE and Moderna Inc, but well above the 50% benchmark for approval set by regulators.

It also has the advantage of being a single-shot vaccine, which means it can protect more people faster, and without the cold storage requirements of the other vaccines.

[hitbyambulance]

Moncef Slaoui, chief adviser for the U.S. Operation Warp Speed vaccine development program, said on Wednesday the vaccine could show efficacy at or above 80%.

in non-PR speak, that probably means '80% at best'

[LawBeefaroni]

Thanks for the answers there, Smoove, but I still don’t get why doctors are not included. The process in the initial emergency stage.

I think I get why it’s not practical at this stage to have the doctors actually administering vaccinations, but why can’t they play a role in scheduling and registering people to get a vaccine.

Capacity. Doctors only have so many hours in a day. To take the time to review and register/rx everyone who needs a vaccine would mean that they'd have almost no time for other patients and would turn them into the logjams in the vaccine rollout.

Not to mention that they'd be doing it for free (how do you bill for checking someone's age and putting their name on a list?).

[Defiant]

(how do you bill for checking someone's age and putting their name on a list?).

Uh, easily?

[LawBeefaroni]

(how do you bill for checking someone's age and putting their name on a list?).

Uh, easily?

Outside of a qualifying AHA!


I guess this could be good use of telemed but I still don't see your normal PCP being the gatekeeper to COVID vaccines.

[Anonymous Bosch]

L.A. County Supervisor Enraged Health Dept. Allows Clinics to Throw Unused Vaccines in the Trash

Update 4:27 PM PT -- We just got a call from the Dept. of Public Health. The spokesperson pointed us to this provision in the guidelines ... "Each group should be targeted with sufficient outreach and mobilization before proceeding to the next group. However, exceptions may be made in order to prevent any vaccine wastage." Here's the problem ... what exceptions? When a clinic has 800 doses at the end of the day, can a 30-year-old get a vaccine? Do they have to base exceptions on the priority lists? So, do they have to look for 800 70-year-olds before they move to the next group? It makes no sense, and there is no explanation.

The rep said the exceptions should be based on the priority groups, but that makes no sense. How are they going to find 800 70-plus-year-olds in 3 or 4 hours before the vaccines spoil? We called numerous clinics in L.A. County, and with one exception, they all said they could not give any vaccines to people who were not on the priority list. And, finally, as we reported, the Health Dept. had a closed meeting a week ago where they admitted they needed to clarify the rule and no punitive action would be taken until the rules were clarified. They have not clarified the rule at all.

---

The L.A. County Dept. of Public Health is allowing clinics to throw unused vaccines in the trash rather than inoculate thousands of residents who are desperate to get the shot, and it has enraged at least one county leader who is on a mission to reverse this insane policy.

L.A. County Supervisor Janice Hahn is reacting to a story TMZ broke last week, where a clinic administering the vaccine to health care workers ended the day with 150 unused vials of the COVID vaccine that were about to spoil ... because a huge number of people who signed up were no shows.

The clinic -- the Men's Health Foundation in Inglewood -- contacted people who were not on the priority list but desperately wanted the vaccine, and these folks got the remaining doses. Incredibly, that runs afoul of the County Health Dept's guidelines, which say ONLY people on the priority list should be vaccinated, EVEN IF THE VACCINES WOULD OTHERWISE END UP IN THE TRASH.

We worked this story for 4 days, and went back and forth with the Health Department, which never gave us an answer to our question -- ISN'T IT BETTER TO VACCINATE NON-PRIORITY RESIDENTS THAN THROW THE PRECIOUS VACCINES IN THE GARBAGE? We never got an official answer to that question, but sources who were on a call with the Health Dept. tell us they decided they would not take punitive action against clinics that replicated what the Men's Health Foundation did. But, that's a terrible solution.

Here's the problem ... the policy still says non-priority people cannot get the vaccine now, so clinics are essentially being told it's still wrong to vaccinate non-priority residents, even if the vaccines would otherwise go to waste. What's even worse, the County Health Dept. has NEVER EVEN STATED PUBLICLY THEY WOULD NOT TAKE ACTION AGAINST THESE CLINICS, so the fear is that vaccines are getting thrown in the garbage.

Supervisor Hahn is outraged, and wants the Health Dept. to get with the program and clarify this insane regulation ... IMMEDIATELY.

Fact is, the Department, led by Barbara Ferrer, has been utterly unprepared for the vaccine rollout, and folks inside her Dept. are enraged. There was no real plan for vaccinations, despite the fact everyone knew for months the vaccines were on the horizon.

To get real ... it defies common sense to throw these life-saving vaccines out rather than create a waiting list for ANYONE when there are unused vials that are no longer frozen and about to spoil.

This is probably an issue all over the country, and it must be addressed now ... as in NOW.

[gbasden]

That is absolutely insane. I'm sure there are a ton of people that would be more than happy to be on a last minute call list for vaccines. I certainly would.

[Smoove_B]

Yeah, that's what I feared would be happening everywhere. It's a result of having super-strict categories and more importantly, an inability to have an easily accessible stand-by list and quickly contact those waiting. It's pretty much unforgivable.

[LordMortis]

State opened up to 65+ on Monday and then said go talk to the counties. Wayne and Washenaw counties state that they will open 65+ soon. If you can talk to a person, they will tell you soon currently means August/September. So my hope for March for being high risk is shot. Biden is on in the background talking about the faster we can do it. The state talks about the faster they can do it but most populous counties in the state have vaccinated but a few thousand... once...

https://www.michigan.gov/coronavirus/0, ... --,00.html

https://www.washtenaw.org/ImageReposito ... ntID=18951

[LawBeefaroni]

That TMZ article is full of outrage but light of facts. Has any vaccine actually been thrown out? I get that the policy is awful but clinics seem to be ignoring it..

[disarm]

Connecticut formally announced at the beginning of the week that those administering the vaccine are encouraged to give away any 'unused' doses at the end of the day to anyone they feel is appropriate rather than throw them away. They can grab any Joe off the street as long as it keeps vaccine from being wasted.

We're actually doing a pretty good job in CT, with the announcement today that 155,000 individuals have received their first dose of the vaccine (roughly 5% of the state's population), and roughly 16,000 of those have received the second dose already. Healthcare systems in the state have offered the vaccine to all their workers at this point, and the governor announced on 1/6 that every nursing home resident in the state had been given the opportunity to be vaccinated, although they didn't disclose the percentage that accepted. Vaccine registration opened up to all residents 75 and older at the beginning of the week, a group that includes about 277k people, and some have already received their shots. Unfortunately, the state says they're currently expecting delivery of only enough vaccine to administer roughly 46,000 first doses each week, so it's going to be a lengthy process.

Interestingly, today's update from the governor also mentioned that CT would be receiving an extra 50,000 doses of the vaccine as a reward for the quality of our vaccination program. Apparently, there are incentives to states for getting their act together and getting the job done...

[Hrdina]

Thanks for the answers there, Smoove, but I still don’t get why doctors are not included. The process in the initial emergency stage.

I think I get why it’s not practical at this stage to have the doctors actually administering vaccinations, but why can’t they play a role in scheduling and registering people to get a vaccine.

Capacity. Doctors only have so many hours in a day. To take the time to review and register/rx everyone who needs a vaccine would mean that they'd have almost no time for other patients and would turn them into the logjams in the vaccine rollout.

Today my doctor's (relatively large) medical practice sent out an email on this topic. In short:

Recent eligibility changes for the COVID-19 vaccine have created a massive spike in demand for the vaccine. AT THIS TIME WE ARE NOT ABLE TO ACCOMMODATE ADDITIONAL VACCINE APPOINTMENT REQUESTS. We are working hard to secure more vaccine doses and expect that supplies will increase in the weeks and months ahead. We encourage you to check the website frequently for updates.

Because vaccine supply is so limited, we are asking all patients to follow these guidelines:
* Please do not call to schedule a vaccination
* Please do not walk in to your doctor’s office or an urgent care to schedule a vaccination
* Please do not send a patient portal message to your doctor to schedule a vaccination

The volume of appointment requests via phone and through our patient portal is limiting our ability to care for patients who need both sick and well visits.

We will contact eligible patients as soon as we are able to vaccinate you. Until then, any attempt to contact us will simply make it harder for all patients to schedule regular or critically necessary care.

[Kraken]

This is one of those 5D chess things. As Apple taught us, product shortages drive up demand.

[Defiant]

My potential worry about giving any leftover vaccines away to normally not qualified is, will they be able to get a second dose at the right time?

I mean, I would assume so, but given the incompetence currently, I don't know if I'd want to risk it (potentially getting turned away as unqualified for the second dose) until things are run better.

[LawBeefaroni]

My potential worry about giving any leftover vaccines away to normally not qualified is, will they be able to get a second dose at the right time?

I mean, I would assume so, but given the incompetence currently, I don't know if I'd want to risk it (potentially getting turned away as unqualified for the second dose) until things are run better.

Generally you get scheduled for your second dose at the time.of the first. At least that's how we're doing it.

[malchior]

I don't know what Smoove_B is seeing but NJ is a just bollixing this rollout. Everyone I have been talking to about it is either confused or frustrated by the lack of clarity about what is happening. There are multiple Phase 1 groups and now sub-groups in those groups. For example, my wife who has been working in a factory daily is group 1B but behind high-risk 1B. And it isn't clear if she is high-risk 1B or not. Even then if you are eligible the scheduling apparently is a total mess. I'm still not feeling much hope right now.

[Smoove_B]

Yeah, it seems to have descended into complete chaos. They opened the categories and now it's essentially a free-for-all with your vaccination registration/request being done on an honor system. In effect (as near as I can tell) anyone can register, claim you're in the next layer of vaccinated categories and you'll be scheduled (eventually).

Add in my County had (but it seems to have been taken down) their own COVID-19 registration page (because the D governor clearly created a registration system that punishes R county residents) that has now been turned into an appointment registration system. One of the largest hospital systems in the state is pushing *another* registration system to receive appointment notifications.

What's crazy is I suspect we're at a major bottleneck and at some point over the next few months there's going to be news article after news article about how all these staffed vaccination sites are sitting idle because no one wants to be vaccinated anymore.

We should be rolling people through these mega sites like a production line 20+ hours a day. I'm beyond frustrated.

[Defiant]

Generally you get scheduled for your second dose at the time.of the first. At least that's how we're doing it.

And that makes sense....

And hopefully that scheduling of the second dose doesn't consist of spending an hour refreshing the page to find a slot free, as it sounds like it is for the first appointment for many people.

[LordMortis]

I don't know what Smoove_B is seeing but NJ is a just bollixing this rollout. Everyone I have been talking to about it is either confused or frustrated by the lack of clarity about what is happening. There are multiple Phase 1 groups and now sub-groups in those groups. For example, my wife who has been working in a factory daily is group 1B but behind high-risk 1B. And it isn't clear if she is high-risk 1B or not. Even then if you are eligible the scheduling apparently is a total mess. I'm still not feeling much hope right now.

Wow. You sound like us. Monday "65+ should now make an appointment to get vaccinated". Tuesday. "We are in Phase 1... C... Group C... subgroup type x, if the county allows, by health care system, by availability, by appointment, by prescheduling, by predicted shipment, by what's in queue, by staff available. Do not contact your PCP. Register only by website. Registration is unavailable. 65+ will be ready soon."

Whitmer's stock is dropping. That's not good. As much as the last nine months has been blamed on the Fed, the state then shifted response to the counties and then abandoned them in the way Fed abandoned the states.

[Ralph-Wiggum]

This seems less than ideal.

https://twitter.com/drericding/status/1 ... 65089?s=21

[Defiant]

That is... terrible.

[Zarathud]

Completely foreseeable. Trump knew the disaster would be left to Biden.

Classic pump and dump.

[Smoove_B]

[LawBeefaroni]

Generally you get scheduled for your second dose at the time.of the first. At least that's how we're doing it.

And that makes sense....

And hopefully that scheduling of the second dose doesn't consist of spending an hour refreshing the page to find a slot free, as it sounds like it is for the first appointment for many people.

The vaccine clinic only does vaccines and we aren't scheduling first shots 3 weeks out yet so there are almost always open slots for the second shot. We also try to schedule at the same hour of the day to avoid creep.