Here in Europe, articles are coming out complaining that the slow vaccination could be harming the economy which, well, fucking duh. (https://www.brusselstimes.com/news/belgium-all-news/154626/c...)
Fast rollout. Involve pharmacies. Involve the army. Distribute widely and efficiently. Prepare for months before the vaccine is here. Follow-up campaign to convince vax holdouts. A real War Effort.
There's barely any calls for volunteering here in Belgium. Hospitals and vaccination centers will complain to the government that they are understaffed but you seldom hear them urgently asking for new volunteers to assign to COVID teams and vaccination centers. We spent a ton of time debating whether the social bubble should be 2 or 3 large, whether kids should be 12 or 14 before they count for it, etc etc and those spending that time were the same people who didn't prepare for the eventuality of a vaccine, and started doing so in late December.
Sorry this has veered off topic. The number of articles that can be summed up to "Vaccines work, are good, and israel is doing it right" frustrate little european me. :(
> Israel feels like the only nation taking the importance and urgency of vaccination seriously.
It's a mixed situation here.
* Israel supposedly paid 3 times more than others per shot (but if it works, it's cheaper than the economy losses).
* Israel has free public health care.
* All public health care databases are connected.
* Pfizer gets very detailed annoymized dataset.
* centralization means the health care also hospitalization covered by health care and connected to database.
* Israel is a small country. I can easily cover it by 7hrs drive bottom top.
All those helped get enough jabs.
There's enough population that don't social distance / comply to basics such as wearing a mask (even indoor!). Some population even did huge events during lockdowns with zero enforcement.
Hope this gives some proportion.
Instead they were de prioritized in the list.
More than that even, closer to a factor of 10.
$47 / head!
VS closer to $5 in other countries.
It's not that likely that a comparable investment from the US would have accelerated vaccine availability to the same extent as happened with Israel, which was able to get substantial shipment in part because the US invested a lot in the mRNA vaccines, and in part because the EU waffled about making orders.
To put that into context: the US has a population ~36x the population of Israel.
Given the better efficacy, I think the comparison doesn't boil down to a single number very well.
- modernas main bottleneck is filling. They applied weeks ago to fill the same bottles with 15 doses instead of 10. The FDA has still not approved it.
- the us prioritizes second doses over first doses. This creates a ton of cascading issues, including the fact that many places are storing half the doses for 28 days. Many people have reported getting the same lot number for the second shot.
- the FDA takes 3 weeks to schedule approval meetings (after having reviewed the data enough to believe an EUA is warranted).
-the FDA hasn't approved Astrazeneca, one of the last countries to do so.
-our prioritization system is a mess. It's really hard to figure out who is eligible. "Healthcare workers" (which was supposed to be the first group) is vague, so of course what happened is what you would expect. I know about 100 people personally who have gotten the vaccine as healthcare workers. Only 1 works with COVID patients. Most of the others have less contact with people than grocery store workers. They should have just done covid ward workers first (<1M people) then go by age only. Super easy to know who is eligible. Our local hospital sat on doses from late Dec to late Jan because they didn't know who to give them to. After sitting on them for almost 30 days, they realized if all the doses went bad it would be a scandal so they just gave it to everyone on the property first come first serve.
Their is a real supply shortage. Israel Can and did secure enough vaccines for all its people. The us cannot, there’s not enough supply.
Because of the lack of supply the us has been focusing its efforts on using the supply it has to go to the groups most likely to face complications from covid, and the folks supporting said group.
The US is leading the world when it comes to total vaccines given.
As for the second shot prioritization. The feds screwed up distribution with there being no strategic reserve. What you have already is what you’ll have. Anything else is not gaurenteed.
If 15 doses lead to issues compared to 10, then you jeopardize all those vaccines which are slow and difficult to make. You also give people false sense of hope and possibly either get lower effectiveness or build public distrust. These are tough balancing acts.
Israel, UK and USA procured large amount of doses ahead of time, and now EU is having trouble getting enough doses for their population.
That was my understanding.
US has fourth fastest vaccination rate per capita, behind Israel, UAE, and UK.
That’s huge when you realize manufacturing capabilities don’t come online overnight. The us secured the large majority of supply.
There's vaccination centers set up all around the country which are being utilized at 1-5% capacity, just waiting for vaccines to arrive.
They are upgrading the infrastructure even more despite that, anticipating being able to vaccinate 10% of the population per day.
If you wait until Q3, you can get a proven vaccine for $3 per person, so $90m instead, so going early is going to cost you ... $3.1bn? So that's still 10% of GDP ish. Not sure that's an easy sell.
I was very impressed. I am looking forward to seeing how it continues. If there is a way to improve supply I have no doubt they could go even faster.
As a side note; The side effects to the Oxford jab was less than ideal. Bad chills (on an already very cold day) and a cracking headache. Feel much better now but I wasn't expecting it to be so bad! I had had COVID before, although it was mild, and I've heard this can make the reaction a bit worse than normal. So maybe that was why.
There are vaccine centres in London (certainly the one I attended) having to close early because a lot of people in group 1-4 are refusing to take up their appointments. I believe that so they can make use of their supply they've had to transition to lower groups a lot sooner than planned.
0: by which of course I mean strong institutions like the NHS, apolitical and well-organised army, regional councils, and the civil service
So I'm not sure it's only a supply issue.
My pet theory is, that someone looked for a scapegoat why German vaccinations are so low. AZ was a welcome one, especially after the question of whether AZ had to use its UK factories for EU orders. After that stunt, I have the impression AZ is somewhat pissed.
The EMA allowed the use of AZ for patients over 65 (because they guess that it'll probably be effective), but the STIKO and other government institutions of the various EU countries restricted it.
I don't think it'll make a huge difference, since more than a third of german vaccine doses were used based on occupation, where AZ can be used. The obvious scapegoat for slow vaccinations is that AZ cut deliveries by a large amount, which might not be AZs fault, so the different scapegoat wasn't needed.
The most important thing to remember is that both the UK and EU pre-paid for AZ to manufacture their vaccine pre-approval. The date of regulatory approval and the manufacturing schedule are supposed to be completely decoupled.
It's true that the UK got their vaccine order in first and nobody is denying that. That's why the UK was getting shipments from AZ back in December. When the EU finally signed their contract they were told that their deliveries could start in February.
While I doubt the EMA is going to comment publicly on the timing of their decisions, I don't think it's a coincidence that their approval of AZ was done in late January. They already knew that the meaningful supplies were starting in February so they simply collected as much data as they could before making the "go/no-go" decision.
So while the "feckless EU bureaucrats screwed it up" storyline is forever popular (both in the UK and EU press) they seem pretty blameless on the issue of AZ approval. They just had to get it approved before the manufacturer was ready to start deliveries and they managed that.
What kicked this into a crisis is that AZ announced that their February deliveries to the EU would be less than half of the expected amount. The EU's position is that the UK and EU should be treated equivalently at this point: they both pre-paid for certain quantities to be delivered in February, so any production shortfall should be shared. Needless to say, the UK sees it differently and doesn't want any UK-based manufacturing to go to the EU. Hence we got this ugly diplomatic standoff.
Israel simply paid more and bought a larger amount of vaccines delivered earlier. Which is smart but it's not a strategy that all countries can replicate, not because we cannot afford it but simply because there is a bottleneck in production. There is not enough vaccines for all no matter how much we pay, so we would end up competing in price for no real speed up.
Now some states _are_ close to 100%. Some are close to 60%. Investigating the differences in approach that lead to those differences in numbers mostly comes down to whether states prioritize vaccinating people or creating complicated rules and sticking to them.
When combined with things like this from https://www.theguardian.com/global-development/2021/feb/14/w... : "Instead we have a patchwork of approvals and I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April.", it sure seems like a large part of the apparent supply bottleneck is self-inflicted. Some basic "if it's approved in another G-8 country (or whatever criterion you want to pick) we should auto-approve it here" logic would probably significantly help with this sort of thing....
Anyway, getting the first vaccines is always going to be zero-sum for the same reason getting first-row in a concert is zero sum.
Actually you can. When dealing with a pandemic causing the level of disruption we've seen, you throw money at propping up production of every serious vaccine candidate, hoping that at least one of them works out.
Every additional day of lockdown probably costs as much as the entire production lifecycle of a vaccine, including distribution.
I think the EU economy contracted at least 5% in 2020. The EU GDP was $18.3 tn, so 5% is about $915bn. That's $2.5bn per day (!). And that's just the direct impact, the whole psychological, PTSD, etc. longer term impact probably makes that higher, I'd be shocked if the total cost isn't something like $3bn per day.
They should have been throwing money at every reputable vaccine producer, including burning all red tape to make sure that excessive production capacity will be ready before the final approval is even given.
To be clear, I agree that the return on investment of a quick and successful vaccination campaign is so big that it makes sense to aggressively bet on it. But I also think the evidence shows we have bet quite aggressively on it, at least to unprecedented levels.
What I cannot comment on is how much better we could have done, the supply chain and logistics of producing 1 x (world population) for each candidate vaccine in the hopes at least one of them works and we can roll-it out quickly are so ridiculously complicated I don't know how it could have been made to work. I fear I would just be misdirecting my frustration with the current situation and an incomplete understanding of the problem from the comfort of my armchair.
My 81-year old grandparents will get their first dose of vaccine on February 28, while other countries are already vaccinating much younger people.
Maybe I missed it, but you'd think with something so devastating we'd just make a bunch of candidates, get them out to the clinics for storage, and as soon as we thought a given candidate was effective start injecting everyone?
And if a given drug doesn't work, what's a few billion?
The truth is just that mass-manufacturing of a brand new vaccine is a hard problem. The fact that we're only a couple months from the very start of vaccinations and the world is already nearing 200 million doses delivered is, frankly, amazing. The only problem is that due to the severity of the crisis we wish we had a magic wand that gave us 10x the supply right this instant.
The good news is that manufacturing continues to ramp up dramatically. It just feels like it's slow because we're all so eager for it to improve. If you look at the month-on-month growth, though, it's clearly ramping up fast: https://covidvax.live/
The site you linked is really nice! Not sure where they get the numbers from, but regardless a great resource.
One of the more interessting metrics in there is "daily doses per mil", as it shows the difference between the vaccination campaigns. Would be even better if the also shwed when each campaign started.
I can't personally vouch for its exact accuracy -- every government reports their metrics on a different schedule and I guess they're building realtime estimates based on that. Certainly seems reasonable enough to look at for the broad trendline.
If you look at https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... and scroll down to "U.S. Vaccination Campaign" you will see that in the US 74.5% of the vaccine doses that have been delivered have actually been used.
This could happen for a combination of two reasons, as far as I can see: either delivery is ramping up so fast that most of the delivered doses were delivered very recently, or because people are doing a terrible job of using doses that get delivered.
My impression is that the latter is a larger factor than the former, so far, based on the wide variation by state in the "Supply used" column. West Virginia has used ~96% of their supply. D.C. and Rhode Island have used only 60% (and it's not like their populations are larger or more spread out than West Virginia's!). And I should note that I can imagine various poverty-and-social-whatever issues D.C. might be facing, but they don't obviously apply to Rhode Island in the same way.
Things like http://www.arnoldkling.com/blog/virus-update-3/ item 3 are pretty common: crazy vaccine-distribution setups meaning people who want vaccines can't get signed up to get them, while vaccines are getting thrown out due to spoilage.
Things like https://www.nytimes.com/2021/02/10/us/houston-doctor-fired-c... are, I hope, not common, but you can bet that case will have a chilling effect on efforts by doctors to avoid wasting vaccines.
https://www.theguardian.com/global-development/2021/feb/14/w... includes this incredible from a major vaccine manufacturer: "Instead we have a patchwork of approvals and I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April."
Does that sound like a manufacturing supply constraint to you?
Similar is https://marginalrevolution.com/marginalrevolution/2021/01/ap... where we have a vaccine, and a factory that can produce it, and the vaccine is approved in the UK, but it's not approved in the US. This is also not a supply constraint.
I don’t think this is true. Rhode Island has tremendous wealth disparity.
And just to be clear, right behind DC and Rhode Island we have Alabama (OK, maybe poverty). Then just a few % above them New Hampshire, Kansas, Alaska, Pennsylvania.
These are all quite different from each other on various socio-economic and geographical axes.
And of course the states with the most successful vaccination campaigns in the US (with ~98% of vaccine supply used) are West Virginia, North Dakota, and New Mexico. Which are also quite different from each other in various socio-economic ways.
So it's hard to blame the socio-economic angle for the state-by-state disparities here, though I would be quite willing to look at data showing otherwise.
The US for all the criticism it can take, closed this negotiation in weeks. We spent a whopping 3 months arguing with pharma companies about price and liability before closing these contracts.
There are people dying avoidable deaths while we allowed for this inertia. There are no serious media outlets pushing the European Comission for answers on this failing. There will be no hearing to find a cause for this failing. As a very pro-european citizen this made me very bitter, there could have been a strong EU wide vaccination programme and EU transnational solidarity but instead we see this blunder that will set us back for months probably +1 year of these lockdowns and economic damage.
No pharma exec wants to be the one that killed the golden goose.
The issue is the EC went on a panel wide long discussion to then get to more or less a carbon copy of the initial german contract. Those were 3 months wasted that could have made a difference in ramping up vaccine manufacturing.
The EU's economy is roughly the same size as the US's, but the EU has roughly a little over 445 million citizens compare to the US's ~330 million.
I would imagine that EU countries paying for the healthcare of 445 million citizens would be considered as quite a large "customer" for pharmaceutical companies and could strike a good deal.
How does the US get an edge in negotiations over the EU? It feels that military power wouldn't factor here, but I'm having trouble coming up with other ideas. What else could it be?
I agree that in Belgium things are not as well organized as they should, as usual. They should for months they were preparing and plans would be ready and working by the beginning of January. But it turned out nothing was ready, debates about who to give the vaccine first were only starting instead of being started many months before. But at this point none of that really matters: it's simply not the bottleneck. Vaccination centers are ready for thousands of people per day, but only get 100 doses.
By the way I've read and heard about calls for volunteers for hospitals and vaccination centers. Vaccination centers don't really need many people now though because of the low supply.
That's why they did digitize - every resident has a digital medical file, and healthcare providers can easily track and report back to Pfizer and the ministry of health on side effects and efficacy (i.e. it's easy to look up who got the vaccine and when, when they get admitted to a hospital with COVID).
But you're presenting that as somehow being bad, while it's actually better than what a lot of other countries have.
And as somebody who currently resides in USA, I am well aware that it's better compared to local state of affairs
This is a huge, enormous screw-up which can be almost entirely pinned on promoting people that have achieved nothing but failures into EU offices, the latest and most egregious case of which is Ursula von der Leyen. Guess what, when you're promoting an incompetent moron who failed at every job so far into an office with actual power and responsibility, they're going to fuck things up. Previously they'd only promote idiots to Commissioner level or so, which was already pretty bad if you ask me, but not this bad. Not "billions worth of economic and innumerable social damage"-bad.
Israel is specifically suited to treat COVID as a test-run for a biowarfare attack. A real War Effort, because it is one.
I don't think the military was involved yet, and religion was in fact working against vaccination efforts as a few anti-vax rabbis drove sectors of the Haredi population off.
EDIT: Saw another comment about a person in uniform doing the immunization so I might've been wrong about the army's involvement. But either way most comments referring to military involvement mean i.e. wartime levels of involvement, military handing out gas masks door-to-door etc. We're not at the level that the army is a sizable force, from what I can tell. (Except immunizing their own soldiers of course)
Rapidly distributing materials to the population is absolutely within the ability of the IDF and their civil counterparts. Vaccines fall into these categories. It also doesn't hurt that most of the over 18 population have been in the military and know how to follow orders. For those of you who would attribute the successful roll out to the latter, don't. It all starts with anticipating black swan events and being prepared for them.
2) Generally, the Palestinian Authority can do a better job allocating its resources, uh, you know, to prepare for these sorts of events https://en.wikipedia.org/wiki/Palestinian_Authority_Martyrs_... . Of course, it goes without saying that the terrorist run enclave of Hamas-land in Gaza is another story completely, yet for the purposes of this discussion fall under agreements with the PLO, see point 1.
> The Palestinian Authority has not commented on the news. But up until the latest announcement, no vaccines had reached Palestinians except those living in East Jerusalem or working in the Palestinian hospitals there.
> Palestinians expect first large vaccine shipments in March
> The Palestinian Authority expects to receive its first shipments of independently-procured vaccines in March.
> Yasser Bouzia, a Palestinian Health Ministry official, told CNBC that the PA is currently finalizing a bilateral agreement with AstraZeneca for 2 million doses of its U.K.-developed vaccine. It expects to receive another 2 million vaccine doses through COVAX, a global scheme that was established to ensure equitable vaccine access globally.
> “That will cover almost the majority of the population. And after that we will look for other sources to have another almost 1 million people to be vaccinated, because we are aiming to vaccinate almost 5.2 million people,” Bouzia said.
> Until then, infections are still spreading, despite government-imposed restrictions.
Israel is vaccinating the Palestinian residents of east Jerusalem since they are part of the Israeli medical system.
Needless to say that the Arab citizens of Israel (20% of Israel’s population, many of whom identify as Palestinian) have full access to vaccines.
Israel is vaccinating Palestinians who are Israeli citizens. It actually runs special promotion campaigns (including the PM visiting Nazareth) because some in Arab population are reluctant to take it.
It does not vaccinate Palestinians in the Palestinian controlled areas as it has no authority to do so. Furthermore, Abbas and the PA leadership make a point of not allowing their citizens access to Israeli healthcare (though they did make sure to get vaccinated themselves).
Some time ago my wife was involved in an effort to provide life saving medical care to a Palestinian child in an Israeli hospital. The hospital waved all costs and the treating surgeon was in daily touch with her. The PA refused to allow the child entrance into Israel to receive that care. This wasn't an isolated case, it's PA policy.
And sure, as a fellow Jew I'd like to believe we're better than everyone else, but hey, we're not. I guess maybe better than some.
The complexity of the Palestinian/Israeli conflict can't be reduced to these simplistic terms. Anyone can take some specific incident or piece of data out of context and make their case around it, and all sides take every opportunity to do so while at the same time refusing to accept any responsibility to how they got to where things stand today.
I do hope that once Israel has finished vaccinating its population it will extend the additional vaccines to the PA and to Gaza, I think it's in their own interest and it's the right thing to do.
Searched for the well written article I've seen, to link it here, but I'm only getting SEO bullshit.
It's complicated. Right now there are vaccines that have been purchased and produced but not delivered due to regulatory approval issues (70 million from just one manufacturer, according to https://www.theguardian.com/global-development/2021/feb/14/w... ), vaccines being delivered but not used (see https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... "Supply used" statistics), and so forth.
Blaming supply constraints is a great cover for these organizational and regulatory failings, though. "We don't have enough vaccine" sure sounds better than "we've only bothered to use 60% of the vaccine we got our hands on" (hello, Rhode Island and D.C.).
Sure, Israel did a great job negotiating for vaccines, but it's a zero-sum game so only a few countries could have pulled this off.
Given claims like "I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April." from https://www.theguardian.com/global-development/2021/feb/14/w... it seems like claiming that the bottleneck is production needs some serious caveats....
I'm curious where these 70M doses are bought but not approved. As far as I can tell, AstraZeneca is approved all over Europe.
So it's entirely possible that the specific vaccines approved in Europe are supply-constrained, while other vaccines are in the situation described in the article. All that means is that saying that "the problem problem is production" is very specific-vaccine and specific-regulatory-unit dependent and needs to be evaluated carefully.
The story right now is one of the entire industry ramping up production as fast as they possibly can with money being no object.
The production is going very slow, and therefore the rollout it's super slow...
It's very likely that europe failing to supply us is saving the jobs of other politicians who failed to organize us better.
Who could have guessed that paying the right price would guarantee the supply of a rare commodity everyone would want? :)
Manufacturing capacity at the continental AZ facilities have been hit by teething issues. There were also teething issues at AZ's UK facilities, but the impact was less because the order was placed three months earlier in the UK.
Like I said in another reply: if you're ahead of schedule when your supplier is dry, your schedule is awful. Isn't it? It makes no sense otherwise.
If we had 1 million vaccines to distribute right now, we couldn't. We have 150 "vaccination centers", all of which are converted testing centers but which makes only 10 percent or so of them full time; most of them are open a couple days a week. If you crunch down the numbers you end up very optimistically at the ability to distribute 250-350k vaccines per month... In a country roughly the same population as israel.
Edit: i don't even sort of understand why I'm getting downvoted for sharing plain numbers.
In Israel, where everyone has received a military training and is ready to organise, the IDF is of course very involved in the vaccine rollout though the Home Front Command. The supply of the vaccine is also controlled by the government, not private healthcare providers.
But my point was not even this. It was about how to consider the pandemic and its potential consequences as part of the internal government's discussions on how to respond and then the capacity to act quickly. I have no doubt that Israel has deemed Covid a very serious threat to national security and has thus mobilised accordingly using their experience of the de facto continuous state of war or at least high alert to organise and act quickly and effectively.
In addition to nurses employed by the health plans, supplemental staff were recruited from the Home Front Command of the Israel Defense Forces (IDF), private companies, and others.
In the current vaccination campaign, the Home Front Command of the Israel Defense Forces (IDF) is playing several vital roles. It is responsible for ultra-cold storage of the vaccines in a central location, transporting those vaccines to a large number of vaccination sites, and also organizing vaccination sites in small localities 
IDF facilities have also provided 50% of all covid tests.
It is percent of population that matters not absolute number of vaccinated people. Israel is near 70%, while India is only 0.5% .
CFR per capita, while looks good (113.97 deaths per million) is not actually good compared to Mongolia (0.62 deaths per million). You know, who else is doing well - Belarus (195.31 deaths per million). I don't believe Belarus numbers as all countries around are burning (500+ deaths per million). Could it be that India is faking it as well? Based on corruption index  it is even worse than Belarus.
Which is more commendable considering the vastness of the land itself. Israel == Delhi and surrounding reasons.
Given the economic parameters of the country, it has better CFR than US, Italy, Germany and UK. Thats pretty amazing considering the health expenditure and wealth of US, Italy, Germany, UK is enormously high than India.
As when number fudging that is not happening.You can look at data from independent foreign houses stationed in India.
* Average age in India 26.8
* Average age in countries you are comparing with is 38+
And about independent foreign houses: sources please :)
By this rate, people won't be vaccinated by 2021.
The dashboard for Germany: https://impfdashboard.de/
This is objectively untrue though
What some describe as smart moves by Israel is also rather selfish. It’s made possible by the fact that they are a rather small country that has a large support by major powers for historical reasons, but they made a pact with the devil here: They simply outbid everyone so the vaccine goes to them INSTEAD somewhere else (including Palestine). They sold all kinds of patient data on top in order to get where they are now.
Vaccinating the 100x larger EU is simply a different beast. If the EU had been as "smart" as Israel here and bid as much, don‘t forget we‘d all be stuck at 5% vaccination speaking in absolute numbers of vaccine availability.
I think there was a lot of skepticism in Europe initially regarding the vaccine while in Israel the demand was very high from the get-go.
The numbers are falling all over the western world; probably because the policy response is largely same and maybe also because the virus' natural cycle is at the same stage.
Given how much further Israel is, one would have expected it to stick much more out in the statistics.
But it does not?
There a three big points to make:
1 - There is a delay. While now we have more and more vaccinated people, much of the current cases in the hospital got infected before that.
2 - It changes from community to community but in general we have many people that are really not "disciplined". Either they believe coronovirus does not exist or it won't get them or that god will save them or the herd immunity is high enough (when it isn't)... excuses all over
3 - The vaccinations are not evenly distributed in the population (for lack of demand, supply is there). While in some places you have 70% in other communities you have 2%. (and those with 2% act like there's no coronavirus, see point 2)
I've come to notice this over the last year. We now effectively live in two completely diverged realities. In one, coronavirus is a serious danger that affects our behavior and dominates every aspect of life, where we follow the news of new vaccines and declining case numbers with gratitude and relief, hoping to god that life can return to normal some day. In the other reality, COVID is just a flu. Maybe you might get it but it's not a big deal. Life goes on as normal and you are happily taking advantage of deals on travel, low crowds, and you get annoyed at being reminded to wear your mask. Meeting with friends, going to church, eating at restaurants. All of this is fine because you've convinced yourself it's no big deal.
It's bizarre, and it has torn many of my personal relationships apart. I'm not sure how we ever fix this.
However, I can also appreciate that in aggregate, the medical impact is higher than a normal flu. Hospitals have been overwhelmed (in Italy most famously, but here in Iceland it was also dicey for a bit around the peak). In that sense, I see it as being socially irresponsible not to take low-cost/low-effort preventative measures (mask/sanitizer).
Where it gets murkier for me is in the shutdown of businesses. I'm not sure I really have an opinion one way or the other on that. On one hand I can appreciate it sucks hard for those impacted. On the other, Iceland's second wave originated from an outbreak in a bar, so some kind of precautions are clearly needed. On the other other hand, at that time life was back to normal, so even normal precautions were completely ignored, so maybe we could have kept businesses open but just with precautions, which is the path we're taking now which seems to be working so far, though right now we're quite strict on international travel.
And though I've been drawing observations from anecdotes in Iceland, Iceland's numbers have never been very high because there just aren't that many people. Maybe the optimal approach is different in a higher-density location like New York.
IMO the solution to merging the realities is to humbly admit although we have statistics, none of us have all the answers. There is no one-size-fits-all solution.
Also, IMO, relationships are far more important than politics, especially politics as transitory as pandemic response. I argue with family about our differing perceptions of the pandemic, but at the end of the day I still believe they're doing the best they can and how wrong I think they are about some things is totally irrelevant to the relationship.
So it's not an "alternate" reality (that's usually used as pejorative), it's a different situation to your own.
You can take case of yeshivas (religious schools): some have 80% of infected and recovered students. So when authorities come to the head of the school with a story about deadly virus, they don't understand each other. And examples of 90 years old elders dying from COVID-19 are meet with question "What you expected them to do instead at this age?"
The major holidays in Judaism were 5 months ago, just when the lockdowns started.
Probably the latter. Mortality doesn't seem to be affected by (covid specific) policy:
(there are lots of studies like these, I just picked three more or less at random)
Lockdown started in November, and relaxed on Jan 15 or so.
... the curves look pretty similar to that of many other countries. There was apparently (according to Wikipedia) one between Nov 23rd and Dec 15th but that appears to have made no real difference, in fact, numbers per million were stable during those dates when they had previously been falling.
What they have found, according to our news sites at least, is that it is causing a lot more of the under 65 group to become severely ill.
Some groups are more affected than others (for instance they are seeing that a relatively large amount of women who are in their late term of pregnancy are hit hard by this variant)
Making matters a bit worse is that the anti-vaccine propaganda has been quite successful in some areas, with some anti-vaxxers going as far as to book appointments only to intentionally not show up so that the vaccine is wasted.
In Hebrew, but interesting to look at if you want to follow the vaccination campaign
Unfortunately the anti-vaxxers in Israel are extremely aggressive and they use a lot of fear tactics and deceptive “marketing”. An approximate translation of the largest anti-vaccine group in Israel’s Facebook page title is “Vaccines, an educated choice”.
I do think that more recently the tide has turned against them as Facebook has become much more aggressive in hiding their propaganda.
Personally, I hold the opinion that anti-vaxxers are more of a natural product of their environments than anything else. You can clearly see the distinction along the religious and educational boundaries, for example. Limiting the freedom of speech in attempt to silence them is not going to work, like it's not working in stopping any other kind of speech you don't like. Censorship is dangerous: it alienates people and prevents communication, effectively radicalizing those affected.
Whether it’s the right choice is obviously subject to debate.
Conflating the vaccine hesitant with the radicals you mention is done on purpose of course, but there’s a real cost. You are alienating and further radicalizing fence sitters. Censorship of open discussion can also be seen as confirming their possible view that vaccine manufacturers are ”hiding something“.
The Haredi population is acting like covid doesn’t exist and has insanely high numbers of cases.
I suspect that despite the vaccine working well on your everyday science-trusting Israeli, the Haredi population is throwing off the average significantly.
Source: I have family there.
Recently the police tried to enforce the lockdown Bnei Brak (a city with a lot of Haredis). The Haredi rioted against this, yelled “Nazis” at the police, and burned down a bus.
What is significant is that they live in much more densely populated areas with much larger families. Every infection is amplified by the number of people who come in contact with that infected person and this is likely what we are seeing with the heredi population. In the heredi community it is not unusual for 10+ people to live under the same roof.
It has absolutely ravaged their older populations with one study estimating that 1 in 73 of the heredim over the age of 65 have died from COVID. Unfortunately among some of their communities the anti-vaccine propaganda has been very effective, but this is something the government is actively working to counter.
What about the weddings and funerals involving 1000s of people?
Just this past weekend the police shut down two nature parties/raves around the town I live in. This happens every weekend. Does that mean the “seculars” are breaking the rules on a larger scale than anyone else? Of course not. You and I do not have enough information to know who is and who is not breaking the rules.
Calling the Haredim out on their behaviour is not anti-semitic.
Complaining or commenting about downvotes is not regarded well on HN.
I wonder if all the people who upvote this would take offense to the same statement applied to black people or whatever identity you want to swap in.
African Americans are not ignoring lockdown en masse. They are avoiding the vaccine, but that’s less problematic.
This is the sort of mentality that 2000 years of diaspora creates. Their way of life is now defined by choosing to be the outcast, by wearing outcast uniform, by fearing and hating those that don't wear the uniform.
Their leadership is just aweful.
Also, name calling authorities you don’t like is a not even a national sport, it’s a global one.
There’s a lot of good arguments against them, but they require more nuance.
I would say, less than 80 years old. In most normal countries this kind of behavior would be called "destructive totalitarian sect".
I very much believe in vaccines in general and me and my whole family are vaccinated according to calendar, but getting injection of something that is still at phase 2 trials, created using technology never used before without information on long term effects is something else.
Your comment actually creates more doubt about long term effects than it assuages. “There aren’t any long term effects. Because uh, there is no such thing as long term! Hah hah! It’s certainly not because they weren’t studied long enough.”
Try posting a study that backs up the nonsense you’re spouting because you don’t seem trustworthy.
So long-term effects should really be called short-term effects?
We still have a fair way to go before all vulnerable groups have had two jabs.
I guess to the extent that people are actually following the lockdown rules, that substitutes pretty well for a vaccinated population. The advantage of vaccination (at least in theory) is that you can maintain those rates without being locked down.
The vaccination rate at younger individuals is far lower than elder ones, also the vaccine created a false sense of safety for everyone.
It turns out that almost all people that get sick are the people that were not vaccinated.
> "Israeli study finds 94% drop in -> SYMPTOMATIC <- COVID-19 cases with Pfizer vaccine"
Asymptomatic cases still spread the virus.
Also, see the sibling comments about the difference between asymptomatic and pre-symptomatic.
But a large scale study in Wuhan found no cases of asymptomatic transmission, and the same findings have been found elsewhere. NB: there is a difference between asymptomatic and pre-symptomatic. The latter sometimes can transmit.
It's now younger people in the ICU: the vaccine started going out as the more contagious (and harmful) British variant started spreading in Israel.
From this article:
>Researchers at the Weizmann Institute of Science, who have been tabulating national data, said on Sunday that a sharp decline in hospitalisation and serious illness identified earlier among the first age group to be vaccinated - aged 60 or older - was seen for the first time in those aged 55 and older.
>Hospitalisations and serious illness were still rising in younger groups who began vaccinations weeks later.
Here is an overview of an Israeli study that was finding a more realistic effectiveness of 70% https://dalewharrison.substack.com/p/israeli-vaccination-dat...
If anyone has a link to the actual study, please post it! It is really annoying to see news articles posted about studies that don't link to them or even provide any basic information to find the study.
If half of population responsible for 90% of deaths is vaccinated it should affect death-per-case ratio.
Edit: Also, when you look at the JHU data (e.g. via google), it shows a peak at Jan 15th in the number of cases followed by a steady decline. The number of deaths peaks on Jan 28th, followed by a similar, steady decline. Which is as expected, so I would say we are already seeing the effects on the number of deaths.
Sorry that I didn't look at the data earlier before replying.
My hypothesis (it's not mine but I agree with it): if population with high death risks is disproportionately vaccinated, at the level it can make visible effect on case count for this population, it should have effect on case fatality rate. Of course, multiple factors can reduce/slow down the decline, but it should be there. Reducing death probability by half for the 60+ people without changing anything else should significantly reduce case fatality rate.
Yet the data does not support it:
The case fatality rate peaked at the end of November, slightly declined until mid-January, then grown a bit and is almost constant in last three weeks.
So, the options I see are: either no effect at all can be seen yet behind the noise (it's hard to believe for me), or there is some factor compensating for the case fatality rate reduction (I can think of what could increase fatality that much and exactly compensate the effect), or the hypothesis is wrong (I can't see why either)
So I would argue that we do see the CFR being lower than the peak we would expect without working vaccinations.
The vaccination also does no good if you are already infected, and with the spike in infections in Israel coinciding with vaccination ramp up, those will be tricky to separate out.
If you vaccinate more people, you would expect that the cases that present at a physician will be selected to be the most severe. If the vaccine reduces most infections to very mild or asymptomatic cases, they will not be counted in the statistics at all.
So it would make sense that introducing a broadly effective vaccine would increase the case fatality rate. (You would also expect fewer severe cases, which is the whole point.)
A functioning vaccine should affect the CFR by changing the denominator of measured cases.
I am reminded of an analogy from improvements in battlefield medicine. As battlefield protocols (on-site treatment, rapid evacuation, etc.) have become more effective, battle fatality rates have fallen. But they have been replaced by a rise in severe chronic injuries like amputations.
Most of cases both before and after vaccinations are not severe. Moreover, the share of severe cases seems to stay the same or even increase ( https://datadashboard.health.gov.il/COVID-19/general , I hope it can be google-translated or something).
As I explained in other reply ( https://news.ycombinator.com/item?id=26142482 ), I expected change in fatality rate due to disproportional vaccination of the group with most of the fatal cases. For 60+ fatality rate is very high, and many of them are vaccinated. For everyone else, the opposite. I agree that if only severe cases were registered, we should've been looking at case number instead (which would be more stable since almost all of those would be registered).
I can't read the dashboard, but as I indicated this is what you would expect if you have a vaccine that broadly works at controlling the most severe forms of the disease. Vaccinated people whose infections manifest as nothing or a day or two of lethargy are not going to get counted in the statistics.
> I expected change in fatality rate
your expected change in the fatality rate needs to take into account that the real-world denominator has changed and that will not be apparent if you just divide number of fatalities by number of cases. (Because vaccinated people may be more likely to be asymptomatic, and we expect them to not get sick enough to ever present as a case.)
It's important to look at the number of people hospitalized or dying.
This reduces the number of cases.
A good explanation is that the vaccine is not working. ( people are in denial)
I looked at the Pfizer numbers and my conclusion is the it's doing nothing.
So you’d expect hospitalizations to lag 18-26 days or so. Also the chart is not saying all those groups had vaccines: those under 60 largely haven’t been. The labels could have been clearer.
It’s just a chart of change in hospitalization by age from a starting date.
Why didn't they use that label then?
So 0-59 late vaccinated means some vaccines but later in time and fewer in number.
This is what I gathered from the abstract anyway: https://www.medrxiv.org/content/10.1101/2021.02.08.21251325v...
Apologies for original error.
Of course, you're also correct that another important factor is that some of the cohort are not yet fully protected.
The definitions are here:
In order to distill the possible effect of the vaccinations from other factors, including a third lockdown imposed in Israel on January 2021, we compared the time-dependent changes in number of COVID-19 cases and hospitalizations between (1) individuals aged 60 years and older, eligible to receive the vaccine earlier and younger individuals (0-59 years old); (2) early-vaccinated cities compared to late-vaccinated cities; (3) early-vaccinated geographical statistical areas (GSAs) compared to late-vaccinated GSAs;
At what point does common sense risk to reward ratio come into play for young people?
> Serious question: How do we know any of this reporting is true?
> There's no data sources provided, no way to check follow up health (i'e. what if these people all dropped dead a week later), no way to prove the data isn't a complete fabrication, etc. Also, they make sure to use dynamic terms so we can't be sure these numbers have any valuable meaning at all (e.g. were Covid tests with drastically different cycle counts used?). Not to mention all of this reporting is praising a single vaccine producer in a billion dollar industry.
> I just read "How to Lie with Statistics" by Darrell Huff and this whole thing is the epitome of a manipulatable situation.
Combine the two and you no longer look "hey lets make sure people aren't lying to us," you just look like you have your own agenda.
So if you can lie with statistics, you can certainly lie even more with claimed anecdotes...
(The point of a vaccine is to trigger and train the immune system. The immune system revving up can cause symptoms of its own. If you get the fever of the immune system responding, without the lung damage cause you don't have the original actual virus, that's a huge win!)
If you toggle the 'relative' button you'll see the actual numbers - basically, hospitalization count for vaccinated elders is is decreasing, and the hospitalization of unvaccinated non-elders is slightly increasing.
Hard to not comment this cynically. That is bad.
Early vaccinated patients over 60 have 40% improvement. Keep in mind that the group older 60 is smaller in size compared to under 60, and the effect is smaller that adverse response in younger. Net negative.
It does not explicitly discriminate between vaccinated people or non-vaccinated, only possibly by proxy of age.
People under the age of 35 were previously not included in the vaccination scheme.
At the same time, the two more infectious variants are spreading.