Essentially ponied you by a nose, though your reference is helpful.
No but it means you can tolerate some risk that the second dose might be delayed a bit. It sounds like theyâre literally holding all the second doses in a warehouse somewhere in case all vaccine manufacture stops tomorrow. That seems overly cautious. Pick the 95% confidence interval and deal with it if the 5% disaster happens.
Reduce spread and minimizing mutants are only good insofar as they reduce death.
Folks with significant long term effects are a small minority. And COVID hasnât even been around long enough to know if these âlong termâ effects are actually long term. Sure, theyâre bad, but Iâm far more worried about death.
Probably to minimize the time to be able to safely reopen things to the point that mask mandates are no longer necessary, subject to the constraint of not overstressing the health care system. Iâm not trying to minimize deaths, just keep them to a manageable number. Thatâs the same view I have towards what the current restrictions should be.
I made this post a few days ago. At some point, they were down to fewer than 10,000 first doses on hand, although I donât have a screenshot of that.
Since then, they have received some additional supply, and they had about 53,000 first doses on hand as of this morning, which would last for less than two days at peak demonstrated throughput.
Iâve been following the situation in New York very closely. The main problem is lack of supply, but a secondary problem is that until recently the Federal government wasnât telling the states what their allocations would be in advance, and they even reduced allocations without notice one week. This lead to a wave of appointment cancellations and postponements in New York, and a new policy that distribution centers canât schedule appointments anymore until they know what their allocation will be.
The Biden administration recently committed to letting states know their allocations three weeks in advance, so that should smooth out appointments going forward, but it probably hasnât worked its way through the system entirely.
Itâs also been pretty cold here today, so I wouldnât be surprised if there were some no-shows on that account.
But bottom line is that there recently hasnât been a lot of slack in the system. NYC has already shown it can distribute >40k doses per day, and that is before bringing online new mass distribution sites in the Bronx and Queens. Weâll know things are going well moving forward if inventories of first doses remain low and if the cumulative number of second doses starts matching first doses with a 3 to 4 week lag. If that doesnât happen, then weâll know thereâs a problem.
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Iâm pretty sure that vaccination strategies that are the most aggressive about minimizing death will fulfill all of these other goals pretty well. And we get the least death on top of that.
Yeah, this had been the meta-summary of the data posted in this thread, but itâs nice to see a single conclusive analysis about it all in one place, and from a source that a lot of people will pay attention to.
There are a lot of mom & pop restaurants by me that I have no idea how theyâre staying open doing like 10 takeout orders a night. Iâm sure theyâd like this to be over as soon as possible as well.
Iâm generally not aggressive as a default strategy and like to plan things through.
I also think that a âjust do itâ strategy is going to end up being biased against the poor and minorities and I want to think through how to roll out the vaccine in a more equitable manner. I wouldnât mind prioritizing communities that rely on mass transit over the general population in places such as car-centric suburbia.
The more I think about it, the more I think the most efficient way to vaccinate would be based on geography, so that parts of the country can reopen sooner rather than every state reaching herd immunity levels of vaccination at the same time.
These are all fine ideas but none are directly related to whether we should be more or less cautious about holding second doses in reserve.
Also to be clear, when Iâm talking about minimizing death as being paramount, Iâm talking specifically about vaccination strategies. I could be convinced that when it comes to other mitigation strategies (e.g. social distancing, OFB), then minimizing death above all else may not be the way to go.
If polls showed no state was likely to hit herd, would you change your strategy?
I would consider forced vaccination.
New variants would seem to drive the % required for herd immunity to levels out of reach for many countries, if they were unlucky enough to encounter one
Ultimately, though, it is hoped that mass vaccination will result in Britain developing herd or population immunity. This will be achieved when a mix of natural and vaccine induced immunity drives the R rate of the virus below one, meaning the epidemic falls away to little or nothing.
Original calculations suggested that at least 60 per cent of the entire population would need to be vaccinated to achieve this, says Danny Altman, a professor of Immunology at Imperial College London.
But the arrival of highly infectious new variants has changed the maths. âWith the higher R0 value with B.1.1.7 circulating, that gets pushed to nearer 80 per cent,â he says.
ok, substitute âsufficient levels of vaccination to justify reopeningâ instead of herd immunity.
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I donât think we can say significant minority. Where is that coming from? Arenât long haulers more common than deaths? Low single percent vs tenths of percent???
I think we are splitting hairs here. I think immunizing the most risk for immediate death is #1. Then how you do the next batch vs using spread to limit death is next. And it gets very complicated. If you allow a high amount of spread you do run increased risk of mutants that cause big problems for those already immunized (natural or vax).
I doubt there is enough knowledge to make that determination.
So practically get the front line workers, olds and comorbidities done first and then just get the damn thing distributed as fast as possible.
Coming up with some complex formula seems to be gumming up the plan in several places already.
Iâve had this thought as well. Politically very difficult.
That article points out that a virus that prevents severe outcomes but doesnât provide herd immunity still reopens society to mostly normal life, just with endemic COVID. So not sure it would change the hypothetical vaccine program strategies described above. I think we have too much travel within the US to make that strategy work, but donât think variants would change the merits either way.
Not even that, as long as immunity keeps lasting like it has been, we eventually hit herd immunity levels.
I meant significant minority of all COVID cases.
I havenât seen any good stats on long-haulers? Have you? Also itâs not clear what the definition is. For example if you havenât got your sense of smell back from COVID 6 months ago, are you a long hauler? What about someone who has asymptomatic myocarditis? And does it make sense to include them in the same category as someone who literally canât walk?
Any analysis of long haulers is tough. Everyone doesnât necessarily mean the same thing, and COVID hasnât been around that long.
But for the most part I think that anything that minimizes death is going to give is similar benefits in terms of long haulers (however one defines them), so I donât think about them that much. I just figure if I focus on death, Iâll solve that problem pretty well too.
And as far as focusing on death, I would more or less agree with the plan you outlined.
And with these more transmissible variants, weâll get there even quicker!