Corona Virus: It's a Marathon, Not a Sprint

[$iljanus]

Well I think we're going to see how quickly they can design and synthesize new sequences for vaccines because the Brazilian variant has now been found in Minnesota in a person who just had to travel to Brazil.

https://www.washingtonpost.com/health/b ... story.html

Fortunately (as I understand it) the mRNA vaccines are easily customizable. Unfortunately, if we can't stomp these suckers out before they're widespread, we might end up needing a melange of different vaccines. Viruses evolve fast.

I thought the South African variant was the most worrisome of the moment.

Yeah since they're basically nucleic acid sequences they can program the synthesizer with the new sequence. I'm sure they have some candidate sequences since variants were a possibility. But playing wack a mole with spike protein sequences can be laborious after a while.

[malchior]

These calculations are why I'm wondering why we don't invoke the Defense Production Act and give the vaccines to other companies and say "here, make this." There are other facilities besides the three that have viable vaccines that are theoretically capable of producing them given the technique.

I have no doubts they're looking at everything, but at the end of the day, vaccine manufacturing isn't set up for pandemic response. The EO he signed last week was all about trying to remove the additional limiting factors that in theory could slow down production (syringe components, vial production, etc..)

While there might be other facilities that could add to the overall production I really have no idea what's involved in re-configuring them to make the mRNA vaccines.

The best analogy I could think of is if you had a machine that could make pizza dough starters and we needed to ramp up production to make 10x the amount (because aliens were invading and they like to eat pizza), maybe we could reconfigure machines that make donuts but how long that takes and how effective they can be is another story. They seem similar (both involve the creation of dough), but the ingredients and actual process will differ enough that it's not a 1:1 translation of similar equipment. Sure, every bit helps, but we're in a raging inferno right now; this should have been done last March.

FWIW its a bit worse than that. I happened to do some pharma OT work in the last 2 years for 3 of the big players. Most of it was manufacturing name brand pharmaceuticals and some OTC stuff. All FDA regulated though based on the actives, etc. However, I was involved in Business Continuity Planning risk assessments and tech stack security assessment for them. I'll steer clear of anything specific but the obvious issue is the qualification process and supply chain issues that impact ability to manufacture. I'd assume 80% of what I know is applicable but it might even be higher.

We looked at the time to spin up new capacity and it is a lengthy process and has several dependencies/blockers. The qual. process probably could be sped up with help of the FDA especially if they pitch in waivers. They probably won't because if word got out...it'd be bad. Still government involvement pushing them would probably get the qualification process down to a minimum period. It'd be relatively safe to ballpark that in the 'several months' time frame. The blockers are the doozy. That's *if the equipment was available* and it probably won't be. It's all custom machinery - safe to assume since almost all drug manufacturing uses high precision equipment -- and has long lead times plus every nation is probably hording whatever they have. Also *they need enough 'factory' space* which is always an issue. Maybe they could steal floor space from another drug but I imagine that'd require some thought obviously because people rely on those drugs. This is probably the lesser issue but it requires a clean room and the environment is qualified so it isn't something you just throw together either.

That said the government is a perfect actor for this using the DPA. They alone can walk the supply chain end-to-end and demand information. The pharma companies are customers or competitors and can't get the real deal raw information about who/what/where/when and how expensive things really are. I agree with what you that this should have been started long ago. It is really aggravating that we've seen a more competent response in days - a year into this thing - than the whole Trump administration showed us.

[hitbyambulance]

Gov. Jay Inslee today announced progress toward the state’s goal of administering 45,000 vaccine doses a day. As of Monday, the state’s current seven-day rolling average was 23,960 doses administered.

The governor also announced a record number of COVID-19 vaccines administered in a 24-hour period, with around 40,000 doses reported as of Monday. Washington also officially passed 500,000 vaccine doses administered and reported.

Inslee and Secretary of Health Dr. Umair A. Shah issued the vaccination goal last Monday at a press conference. On Thursday, the state reported the previous week’s average being 16,000 doses a day. Today’s numbers mark an 8,000 increase in the average number of COVID vaccines going into Washington residents’ arms across the state every day.

“We have taken action, we expanded our distribution and infrastructure and it is working,” Inslee said Monday. “We still have a long way to go, but if Washingtonians have proven anything throughout this pandemic, it is that we are up to the task. We have taken action, and we will continue to improve until we meet and exceed our goals.”

doesn't mean a lot if the vaccine supply runs out, but well. it's a start

[Daehawk]

Was emailing my bud today that I started gaming with in the early 90s and he was in the hospital with a stroke. I asked if I could bring him anything....figured I could hand it off to staff and they'd deliver it. He said due to Covid only 1 person visit per 24 hours.

I find it surprising they still allow people in a hospital to visit at all.

[Paingod]

I find it surprising they still allow people in a hospital to visit at all.

It's likely through a plexiglass window, and it's one person at a time for space constraints.

Loneliness has got to be almost as lethal as COVID for the people being isolated. I can't imagine what they're going through in there.

[Smoove_B]

Coming out of the CDC, look at that:

Preventing transmission in school settings will require addressing and reducing levels of transmission in the surrounding communities through policies to interrupt transmission (eg, restrictions on indoor dining at restaurants).

NOTE: I'm not saying we shouldn't address what this means for the restaurant industry, but to deny the connection between what's being encouraged right now is insane.

[El Guapo]

Coming out of the CDC, look at that:

Preventing transmission in school settings will require addressing and reducing levels of transmission in the surrounding communities through policies to interrupt transmission (eg, restrictions on indoor dining at restaurants).

NOTE: I'm not saying we shouldn't address what this means for the restaurant industry, but to deny the connection between what's being encouraged right now is insane.

What's your reaction to the CDC report in general? Seems like the headline is that they're saying that schools should generally be open as long as masks and social distancing can be maintained (though some school activities, like indoor sports, should remain closed), but that indoor dining and the like should be shut down. Which seems generally sensible?

[Smoove_B]

Yeah, I think it's something that should have been prioritized last year and if this message came from the CDC and was pushed by the federal government, maybe things would be different now. Not completely perfect or ideal but better.

Having kids in school (K-6 in particular) slipped so quickly down the priority scale as the bar and restaurant industry (entertainment industry in general) dominated the conversation right as school was ending and the summer was starting. It's *insane* right now that indoor dining is happening in any capacity, anywhere but that ship has long sailed.

Sports can clearly be done (SEE: NFL) but I think engaging in sports while there's a raging pandemic and high levels of community spread is also undercutting the effort to get kids back in school. The biggest exposure problem we saw at my daughter's high school happened because of the football team. In other words, non-academic school related activities resulted in possible exposures for 14+ students and staff. We've been half-measuring our way through this since last year and things are still a complete mess.

As I keep pointing out, we're collectively 4-6 weeks from driving transmission rates down to manageable levels - if there was political will to pay people to stay home *and* the average American willingly agreed to it. Instead we've pinned everything on vaccinating our way out of the mess we've created and that solution is still 6+ months away, if ever.

[Daehawk]

If everything shut down. If everyone stayed home. If everyone wore a mask. If everyone did the right thing....Id guess we could be over it in a month and half IF no one or nothing was allowed into the country at all.

But this will never happen. Cant happen. So Covid may be here forever.

[ImLawBoy]

Coming out of the CDC, look at that:

Preventing transmission in school settings will require addressing and reducing levels of transmission in the surrounding communities through policies to interrupt transmission (eg, restrictions on indoor dining at restaurants).

NOTE: I'm not saying we shouldn't address what this means for the restaurant industry, but to deny the connection between what's being encouraged right now is insane.

What's your reaction to the CDC report in general? Seems like the headline is that they're saying that schools should generally be open as long as masks and social distancing can be maintained (though some school activities, like indoor sports, should remain closed), but that indoor dining and the like should be shut down. Which seems generally sensible?

Unfortunately, we're going to get people spouting half of the recommendations (Schools should be open!) without paying heed to the other half. I'm not sure the first part is quite so safe if we're not doing the second part.

[Zaxxon]

Coming out of the CDC, look at that:

Preventing transmission in school settings will require addressing and reducing levels of transmission in the surrounding communities through policies to interrupt transmission (eg, restrictions on indoor dining at restaurants).

NOTE: I'm not saying we shouldn't address what this means for the restaurant industry, but to deny the connection between what's being encouraged right now is insane.

What's your reaction to the CDC report in general? Seems like the headline is that they're saying that schools should generally be open as long as masks and social distancing can be maintained (though some school activities, like indoor sports, should remain closed), but that indoor dining and the like should be shut down. Which seems generally sensible?

Unfortunately, we're going to get people spouting half of the recommendations (Schools should be open!) without paying heed to the other half. I'm not sure the first part is quite so safe if we're not doing the second part.

Exactly my thought when I read that report earlier this afternoon.

[YellowKing]

I'm really getting tired of the media decrying Biden's 100 million shots in 100 days as "lacking ambition" and in the same breath calling his forecast for 400,000 doses by the end of the summer as "politically risky." I'm looking at you, CNN. The last administration did absolutely nothing, do we really have to start attacking this one's every positive move?

Come on, man!

[Kurth]

Vaccinated People Are Going to Hug Each Other: The vaccines are phenomenal. Belaboring their imperfections—and telling people who receive them never to let down their guard—carries its own risks.

When Americans began receiving coronavirus vaccines last month, people started fantasizing about the first thing they’d do when the pandemic ends: go back to work, visit family, hug friends. But the public discussion soon shifted. One news article after another warned about everything that could go wrong: Protection isn’t immediate; vaccinated people can still transmit the virus; vaccinated people might get mild infections that could become chronic; vaccines might not work as well against new coronavirus variants. “COVID-19 Vaccine Doesn’t Mean You Can Party Like It’s 1999,” one headline admonished. Can vaccinated people at least hang out with one another? Nope, masks and distancing are still required. “Bottom line,” another article concluded ominously: “You will need to wear a face mask after you’re vaccinated until COVID-19 cases become nearly nonexistent.”

The gist of this article -- that this kind of "better safe than sorry" messaging carries its own risks -- seems on point to me and in line with what I was suggesting earlier about the need to balance risk mitigation with incentivizing people to get vaccinated:

Vaccines provide a true reduction of risk, not a false sense of security. And trying to eliminate even the lowest-risk changes in behavior both underestimates people’s need to be close to one another and discourages the very thing that will get everyone out of this mess: vaccine uptake.

The take away for me is simple:

health is more than the absence of disease.

As my parents and in-laws struggle to figure out whether, post-vaccination, they'll feel safe enough to travel to visit their grandchildren, this looms large in my mind.

[Smoove_B]

It's a good article - I mean to post it earlier.

As my parents and in-laws struggle to figure out whether, post-vaccination, they'll feel safe enough to travel to visit their grandchildren, this looms large in my mind.

My parents live next door - literally, I can throw a rock and hit their house. They've not been closer than 6' to their granddaughter since March of last year. To suggest it's been tough is an understatement. I am hoping when all the adults are vaccinated things will be better, but I still don't have faith in my fellow humans to submit to vaccination at high enough levels. In fact, I'm going to guess sooner than later the news stories aren't going to be about vaccination center bottlenecks and people unable to get vaccinated but instead centers that are open, full of staff and completely empty of visitors.

[malchior]

It's a good article - I mean to post it earlier.

As my parents and in-laws struggle to figure out whether, post-vaccination, they'll feel safe enough to travel to visit their grandchildren, this looms large in my mind.

My parents live next door - literally, I can throw a rock and hit their house. They've not been closer than 6' to their granddaughter since March of last year. To suggest it's been tough is an understatement. I am hoping when all the adults are vaccinated things will be better, but I still don't have faith in my fellow humans to submit to vaccination at high enough levels. In fact, I'm going to guess sooner than later the news stories aren't going to be about vaccination center bottlenecks and people unable to get vaccinated but instead centers that are open, full of staff and completely empty of visitors.

I hope not but I'd like for them to solve the preposterous shadiness we are seeing in NJ at least. I'm really thinking hard about how long we are going to remain here. This year was tough for a lot of reasons but NJ did little to help me this year and a lot to harass me - not just COVID stuff. I've said it in the past but I'm ready to leave. I just have to convince the wife.

[Smoove_B]

Yeah, I spoke to some people today and it's dire. So much frustration and confusion that could have been easily avoided had the state maintained control.

Another good article that popped today - vaccines alone will not end the pandemic:

In many parts of the U.S., case numbers are finally in decline. However, though they are lower than they were several weeks ago, they are not actually low; in fact, cases remain higher than throughout most of 2020. States are anxious to relax restrictions, at least where restrictions have been implemented in the first place. Transmission is occurring at levels too high to be countered with vaccination alone, given the issues with supplies and distribution. This week, a model by scientists at Columbia University predicts that vaccination alone will not be sufficient to control spread, even if vaccine distribution and uptake were substantially improved. The lag in vaccine availability in the face of rising transmission was predicted in a policy paper authored by Walensky and colleagues last fall. Relying exclusively on vaccines is like throwing a ball of wet yarn at a raging forest fire. Even if we could magically untangle the myriad knots in the vaccine distribution and supply knot, it will do nothing to extinguish the encroaching flames.

...

But we also can’t sugarcoat reality: While these vaccines are the greatest scientific triumph of my lifetime, we are at a critical juncture. Without continued vigilance and increased dedication to reducing transmission as we resolve the existing vaccine distribution and supply issues, we are destined to fail in our efforts to bring the pandemic to heel. We must remember that risk reduction is additive: Whenever possible, we should focus on masking, social distancing, staying home when leaving the house is not essential, avoiding gatherings outside our household, avoiding enclosed spaces, ventilating when possible, washing our hands, and disinfecting high-touch surfaces. We must persist in this struggle just a few months more.

[malchior]

Yeah, I spoke to some people today and it's dire. So much frustration and confusion that could have been easily avoided had the state maintained control.

Yeah - I'll point that the RWJ megasite registration for the Edison location is a black box. You register and get no confirmation. No idea where you are in line. Nada. And then we hear people who somehow jumped the line. People who are sitting at home while my wife goes into a fucking factory nearly everyday. I'm beyond aggravated.

[hitbyambulance]

Vaccinated People Are Going to Hug Each Other: The vaccines are phenomenal. Belaboring their imperfections—and telling people who receive them never to let down their guard—carries its own risks.

When Americans began receiving coronavirus vaccines last month, people started fantasizing about the first thing they’d do when the pandemic ends: go back to work, visit family, hug friends. But the public discussion soon shifted. One news article after another warned about everything that could go wrong: Protection isn’t immediate; vaccinated people can still transmit the virus; vaccinated people might get mild infections that could become chronic; vaccines might not work as well against new coronavirus variants. “COVID-19 Vaccine Doesn’t Mean You Can Party Like It’s 1999,” one headline admonished. Can vaccinated people at least hang out with one another? Nope, masks and distancing are still required. “Bottom line,” another article concluded ominously: “You will need to wear a face mask after you’re vaccinated until COVID-19 cases become nearly nonexistent.”

The gist of this article -- that this kind of "better safe than sorry" messaging carries its own risks -- seems on point to me and in line with what I was suggesting earlier about the need to balance risk mitigation with incentivizing people to get vaccinated:

Vaccines provide a true reduction of risk, not a false sense of security. And trying to eliminate even the lowest-risk changes in behavior both underestimates people’s need to be close to one another and discourages the very thing that will get everyone out of this mess: vaccine uptake.

The take away for me is simple:

health is more than the absence of disease.

As my parents and in-laws struggle to figure out whether, post-vaccination, they'll feel safe enough to travel to visit their grandchildren, this looms large in my mind.

and just from today:

https://www.npr.org/sections/goatsandso ... rom-brazil

"So I can imagine that we'll be doing something similar with [the] coronavirus. Eventually we'll need to design different vaccines that are targeting different parts of the virus — ones that the virus finds harder to change."

This process is going to cost the world a great deal of money — and take time, Gupta added. "I don't think there's going to be a single solution that just comes along in 2021 that says, 'That's it, we're done.'

"The coronavirus is going to cause a long-term disruption."

[Default]

My ex teaches for Philly. They want to send them back with no vaccinations and the assumption that young children aren't transmitting Covid. Much. USPS is complete radio silence on the subject. Jiving myself that the Johnson & Johnson will be available and give us another option.

[Kraken]

If there's one thing the past four years have reinforced -- it's to always expect the worst. Then, if it doesn't happen, you're pleasantly surprised. I haven't had many pleasant surprises since 2017.

I hope we can go spend a weekend or longer in the Berkshires come fall...see a play, visit a couple of museums, have some nice meals out -- you know, like we do every year -- but I'm not planning on it. Right now, I'll be happy if we can go back to dining outdoors again next summer.

[hitbyambulance]

https://www.washingtonpost.com/health/2 ... -guidance/

man, i do not want to have to start purchasing and using single-use disposables. won't layering two cloth ones be 'good enough'?

[Blackhawk]

The kids school has been on hybrid since last fall (the student body is divided in half, with each half attending alternating days) with the line-in-the sand being that if we went to red status, it would be all remote. Three or four weeks ago we went to red status (Indiana has green-yellow-orange-red per county based on severity and spread, updated weekly.) The school decided that, gosh, hybrid was good enough after all. By last week, they didn't have enough teachers who weren't sick to conduct in-person classes at all, so they were forced to go fully remote. This week they had a couple of teachers back, so they went back to hybrid, still in red status.

The status update yesterday took us out of red and back into orange, the second most severe. The school responded by announcing that they were going to fully reopen the schools, all grades, all in-person, starting Monday. Masks are still required, but there is no extra ventilation, and there is no possibility of distancing with the full student body in the classrooms.

And there is absolutely *zero* that can be done about it, as the county is packed full of halfwit rednecks who are cheering the superintendent on for not listening to the lib propaganda.

[Grifman]

The newly discovered Covid stain that is highly infectious could be an even bigger disaster for public health. Because it is more infectious, it soon becomes the dominant strain with the following implications:

Another, Adam Kucharski, PhD, an associate professor at the London School of Hygiene and Tropical Medicine who specializes in the math of infectious disease outbreaks, says the math shows the infectious strain will be more deadly.

Kucharski recently compared how many people would die after 10,000 new infections over the course of a month. With the current situation, with a virus that sees each patient infect an average of 1.1 others and kills .08% of everyone it infects, you’d predict 129 deaths over a month of spread. With a virus that’s 50% more deadly, you would expect to see about 193 deaths over a month of spread. With a virus that’s 50% more contagious, you end up with 978 more deaths over a month of spread -- or five times as many deaths.

https://www.webmd.com/lung/news/2021010 ... life-again

[Zaxxon]

US vaccination rate has stabilized in the past couple of days at about 1.2M/day. That's... not gonna cut it. Hopefully supply ramps and the J&J news expected imminently is good.

[Blackhawk]

https://www.washingtonpost.com/health/2 ... -guidance/

man, i do not want to have to start purchasing and using single-use disposables. won't layering two cloth ones be 'good enough'?

How does one even sort the profiteering junk from the quality masks? Amazon lists 7,000 options.

[Smoove_B]

How does one even sort the profiteering junk from the quality masks? Amazon lists 7,000 options.

You need to cross reference the list provided by the FDA; it's searchable.

[gilraen]

https://www.washingtonpost.com/health/2 ... -guidance/

man, i do not want to have to start purchasing and using single-use disposables. won't layering two cloth ones be 'good enough'?

I'll just buy filters to stick in my 2-layer cloth mask.

[Blackhawk]

How does one even sort the profiteering junk from the quality masks? Amazon lists 7,000 options.

You need to cross reference the list provided by the FDA; it's searchable.

Talk about a wild goose chase. I was able to find three of the brands listed, and none of the models. One was a non-disposable, so that doesn't help. This and this were listed companies, but different models. None of the top brands Amazon is selling are listed at all.

[Smoove_B]

I have these, but the price has jumped significantly in the last ~3 weeks. I'm only using them when I'm forced into an indoor environment - like picking up takeout food. If I'm outdoors (picking up curbside groceries), I just use a layered fabric mask and maintain my aura of "stay back".

[pr0ner]

I'm looking at you, CNN. The last administration did absolutely nothing, do we really have to start attacking this one's every positive move?

You know the answer to this!

[Kraken]

Today's grocery run will be my first double-masked foray. I'll wear a disposable surgical mask under my cloth one. Or maybe over it. Depends on which combo fits better.

[El Guapo]

Today's grocery run will be my first double-masked foray. I'll wear a disposable surgical mask under my cloth one. Or maybe over it. Depends on which combo fits better.

Does it matter which one goes on top vs. the bottom? I've done this a couple times lately, and mostly I've been putting the disposable one on top, somewhat arbitrarily.

[Kraken]

Today's grocery run will be my first double-masked foray. I'll wear a disposable surgical mask under my cloth one. Or maybe over it. Depends on which combo fits better.

Does it matter which one goes on top vs. the bottom? I've done this a couple times lately, and mostly I've been putting the disposable one on top, somewhat arbitrarily.

One tip I read (here, maybe) is that the paper mask can be worn more than once if it's on the outside. They only cost me 20 cents apiece, so not a big consideration. They do get pretty swampy after an hour or two on the inside. The important thing is to try for a good seal all the way around, so I'll go whichever way looks tighter.

[malchior]

Today's grocery run will be my first double-masked foray. I'll wear a disposable surgical mask under my cloth one. Or maybe over it. Depends on which combo fits better.

Does it matter which one goes on top vs. the bottom? I've done this a couple times lately, and mostly I've been putting the disposable one on top, somewhat arbitrarily.

I don't think it matters. Comfort wise I find disposable is more 'painful' attachment-wise. It can be held in place by the more comfortable mask.

[Paingod]

At what point should I get better filters for my woodworking mask and just start wearing that around? It's got a pretty good seal around my face and only clean air can be inhaled through the filters.

I absolutely don't want to come across as anti-mask, but I'm having trouble understanding why two is so important now. One stops my breath from spewing out in a cone, and I keep distance from everyone else - masked or not.

[Daehawk]

Its really changed Scooby Doo

[Defiant]

One thing I've heard is that you want the one that's a higher grade (eg n95 or surgical) on the bottom. Or the one that is a better fit and forms a tighter seal.


The other advice I've heard is that if you have a mask that uses some technology to kill the virus, you may want that on the outside (top), because it'll help to prevent the inner mask from becoming a biohazard.

[wonderpug]

I absolutely don't want to come across as anti-mask, but I'm having trouble understanding why two is so important now. One stops my breath from spewing out in a cone, and I keep distance from everyone else - masked or not.

Two is more important now because we have a more contagious strain going around now and two masks work better than one. If it's an option, you could also just wear a better mask. The overall point is to protect yourself even more now, if possible. Same reason eye protection is being recommended more now. Infection avenues that were smaller risks before are now larger risks.

[Daehawk]

Need a space suit.

[Smoove_B]

Hopefully this doesn't get lost in the chatter (I just had a 20 minute discussion with my parents about layering masks and I'm dizzy), but Slate has a primer on mask layering:

But, more broadly, it is important to remember that whatever you are doing right now in your effort to mask—if you are wearing a mask, if you are looking into ways to make that mask fit and filter better—is helping keep you and others safe. Volckens has a whole interactive chart on how good bandanas are versus gaiters versus two-ply masks, and on and on. What is clear looking at it is that any face covering is much better than no mask. Improvements from there are useful, and good, and worth pursuing. It is especially worthwhile for people with the power to work on getting us, as a country, better masks. But what’s not useful is if we shut down over how very hard it is to find the perfect setup and give up. “Cruddy cloth masks still offer a good degree of protection,” says Volckens.

For what it’s worth, the Centers for Disease Control and Prevention, is recommending a mask that is at least two-ply and hugs your face. While that’s less than what everyone I spoke to suggested, right now, many people are still trying to personally be better at this health thing than the CDC. It is a lot to do!