What is the basis of this?
I've been seeing a lot of discussion around the dosage gaps recommended by government for the Astra/Oxford & Pfizer/BioNTech vaccines. My thoughts on the potential benefits & risks of such an approach, and the need for much greater transparency around these decisions. Thread.
What is the basis of this?
1) the first dose is likely to confer some degree of protection against disease, so better to roll this out as fast as possible, and
2) that for Oxford/Astra efficacy may be higher when the gap between doses is greater.
Vaccine efficacy among 18-55 yr olds SD/SD dosing was 59% vs LD/SD dosing at 90%.
Is this due to dosing, or differences in gaps between doses?
Differences in gaps don't appear to impact efficacy in this analysis.
https://t.co/9yaSAyHcKR
It looks like the first dose prevented all severe disease (although numbers were small) in the SARS-CoV-2 vaccine group compared to vaccine control after the first 21 days of vaccination, and <14 days after the 2nd dose.
https://t.co/966V4EYw13
U.S. is now considering idea of a single vaccination shot, delaying shot #2 until months later. Last wk, I thought that was a bad idea \u2013 the trials that found 95% efficacy were 2 shots; why add extra complexity & a new curveball. But facts on the ground demand a rethink. (1/7)
— Bob Wachter (@Bob_Wachter) December 31, 2020
1. Resources for roll-out are limited & fixed & we need to optimise how best to use them within limitations
2. There isn't significant decline in immunity after the 3 wk mark
3. Later dosing will not affect overall efficacy
A key part of the rationale appears to be a bottleneck in vaccine supply (rather than roll-out).
https://t.co/mccavkBGeb
The reasoning is public now https://t.co/ZkO1k0yqlL.
— Volker Schulz (@portefeuillefun) December 31, 2020
More from Deepti Gurdasani
This is the exact problem with our government's thinking & response- despite this strategy of 'tolerating deaths' and half-way measures having spectacularly failed, it's quite amazing that our govt still hasn't learned anything, & continues to promote a policy of death. Thread
Had we adopted an elimination strategy early on, rather than one of tolerating a certain level of infection, we wouldn't be here now. The reason we're here is because the govt never committed to elimination.
We eased lockdown in May when infection levels were much higher than when other countries in Europe did this. The govt was warned about this, but did this to 'help the economy'. Not only did this lead us into the 2nd wave, the need for further lockdowns harmed the economy further
It's very clear from global evidence that we cannot 'tolerate a level of community transmission' and maintain 'R at or just below 1', which has been our governments policy for a long time. This isn't sustainable & very rapidly gets out of control, leading to exponential rises
Coupled with late action to contain these surges, not only does this lead to many more deaths, and much more morbidity with Long COVID, it also creates a fertile ground for viral mutations to accumulate with a greater risk of adaptation, which is exactly what happened in the UK
U.K. needs to confront
— Esther McVey (@EstherMcVey1) January 2, 2021
\u2018The challenge that faces us is to decide - are we going to try to pursue the elimination of Covid-19 regardless of the costs or decide on a tolerable level of deaths (like we do with the flu) in order to return to a normal life?\u2019
https://t.co/9hWbHIPJUq
Had we adopted an elimination strategy early on, rather than one of tolerating a certain level of infection, we wouldn't be here now. The reason we're here is because the govt never committed to elimination.
We eased lockdown in May when infection levels were much higher than when other countries in Europe did this. The govt was warned about this, but did this to 'help the economy'. Not only did this lead us into the 2nd wave, the need for further lockdowns harmed the economy further
It's very clear from global evidence that we cannot 'tolerate a level of community transmission' and maintain 'R at or just below 1', which has been our governments policy for a long time. This isn't sustainable & very rapidly gets out of control, leading to exponential rises
Coupled with late action to contain these surges, not only does this lead to many more deaths, and much more morbidity with Long COVID, it also creates a fertile ground for viral mutations to accumulate with a greater risk of adaptation, which is exactly what happened in the UK
Brief thread to debunk the repeated claims we hear about transmission not happening 'within school walls', infection in school children being 'a reflection of infection from the community', and 'primary school children less likely to get infected and contribute to transmission'.
I've heard a lot of scientists claim these three - including most recently the chief advisor to the CDC, where the claim that most transmission doesn't happen within the walls of schools. There is strong evidence to rebut this claim. Let's look at
Let's look at the trends of infection in different age groups in England first- as reported by the ONS. Being a random survey of infection in the community, this doesn't suffer from the biases of symptom-based testing, particularly important in children who are often asymptomatic
A few things to note:
1. The infection rates among primary & secondary school children closely follow school openings, closures & levels of attendance. E.g. We see a dip in infections following Oct half-term, followed by a rise after school reopening.
We see steep drops in both primary & secondary school groups after end of term (18th December), but these drops plateau out in primary school children, where attendance has been >20% after re-opening in January (by contrast with 2ndary schools where this is ~5%).
I've heard a lot of scientists claim these three - including most recently the chief advisor to the CDC, where the claim that most transmission doesn't happen within the walls of schools. There is strong evidence to rebut this claim. Let's look at
The science shows us that most disease transmission does not happen in the walls of the school, but it comes in from the community. So, CDC is advocating to get our K-5 students back in school at least in a hybrid mode with universal mask wearing and 6 ft of distancing. https://t.co/dfvJ2nl2s4
— Rochelle Walensky, MD, MPH (@CDCDirector) February 14, 2021
Let's look at the trends of infection in different age groups in England first- as reported by the ONS. Being a random survey of infection in the community, this doesn't suffer from the biases of symptom-based testing, particularly important in children who are often asymptomatic
A few things to note:
1. The infection rates among primary & secondary school children closely follow school openings, closures & levels of attendance. E.g. We see a dip in infections following Oct half-term, followed by a rise after school reopening.
We see steep drops in both primary & secondary school groups after end of term (18th December), but these drops plateau out in primary school children, where attendance has been >20% after re-opening in January (by contrast with 2ndary schools where this is ~5%).
Thread on the recent report on the possible risk of increased death associated with the new UK variant (B117)- with a discussion of the evidence around this, and what this means.
First, there is strong evidence to support increased transmissibility of B117 - current estimates of increased transmissibility range between 30-70% - from epidemiological evidence examining the differential rate of growth of B117 with respect to other variants & increase in R
There is also evidence from PHE contact studies that the risk of transmission from those carrying the B117 variant is ~50% greater than with other non-B117 variants.
Increased transmissibility, even if a variant has the same fatality rate can increase deaths substantially, because the rate of growth of cases is higher- & more cases means more deaths.
Increased fatality rates also increase deaths- but do so
So how was risk of death with the variant studied?
We don't routinely sequence all samples for the virus. We've found that the variant has a particular deletion which means that some PCR tests on samples with the variant give a different read-out when the variant is present.
First, there is strong evidence to support increased transmissibility of B117 - current estimates of increased transmissibility range between 30-70% - from epidemiological evidence examining the differential rate of growth of B117 with respect to other variants & increase in R
There is also evidence from PHE contact studies that the risk of transmission from those carrying the B117 variant is ~50% greater than with other non-B117 variants.
Increased transmissibility, even if a variant has the same fatality rate can increase deaths substantially, because the rate of growth of cases is higher- & more cases means more deaths.
Increased fatality rates also increase deaths- but do so
How dangerous are the B.1.1.7 and 501Y.V2 hyper-transmissible strains?
— Eric Topol (@EricTopol) January 11, 2021
by @AdamJKucharski @CFR_orghttps://t.co/aycWMN3b5h
h/t @Karl_Lauterbach pic.twitter.com/JlaFzzP06t
So how was risk of death with the variant studied?
We don't routinely sequence all samples for the virus. We've found that the variant has a particular deletion which means that some PCR tests on samples with the variant give a different read-out when the variant is present.
More from Government
Labour Grandees are listed in Sir Keir Starmer's colleague Jeffrey Epstein's ''Little Black Book''; Blair, Mandelson and Alastair Campbell. COINCIDENTLY, Keir Starmer and some of the same people have connections to ANOTHER of the worlds most prolific peadophiles. #StarmerOut
Starmer failed to bring charges against Jimmy Savile for paedophilia. The decision was made despite the Crown Prosecution Service receiving substantial evidence of his crimes from witnesses and victims several years before Savile died in 2011. #StarmerOut https://t.co/PNyX5uSAkw
With a past like hers, Margaret Hodge might show a bit more humility.
In the Eighties Hodge was aware of previous child sex abuse in the care homes for which she was responsible, and did nothing about it. #LabourLeaks #StarmerOut
As leader of Islington Council, a post she held from 1982-92, Margaret Hodge was aware of previous, horrendous child sex abuse in the care homes for which she was responsible, and did nothing about it. #LabourLeaks #StarmerOut #CSA
She was guilty of rather more than a casual failure of oversight. In an open letter to the BBC after it investigated a range of monstrous abuse (child prostitution, torture, alleged murders), Hodge libelled one of its victims as “seriously disturbed”. #LabourLeaks #StarmerOut
Starmer failed to bring charges against Jimmy Savile for paedophilia. The decision was made despite the Crown Prosecution Service receiving substantial evidence of his crimes from witnesses and victims several years before Savile died in 2011. #StarmerOut https://t.co/PNyX5uSAkw
With a past like hers, Margaret Hodge might show a bit more humility.
In the Eighties Hodge was aware of previous child sex abuse in the care homes for which she was responsible, and did nothing about it. #LabourLeaks #StarmerOut
As leader of Islington Council, a post she held from 1982-92, Margaret Hodge was aware of previous, horrendous child sex abuse in the care homes for which she was responsible, and did nothing about it. #LabourLeaks #StarmerOut #CSA
She was guilty of rather more than a casual failure of oversight. In an open letter to the BBC after it investigated a range of monstrous abuse (child prostitution, torture, alleged murders), Hodge libelled one of its victims as “seriously disturbed”. #LabourLeaks #StarmerOut
If you're curious what Trump's defense will look like, all you have to do is turn on Fox News. My latest at @mmfa
The tl;dr is that for years right-wing media have been excusing Trump's violent rhetoric by going, "Yes, but THE DEMOCRATS..." and then bending themselves into knots to pretend that Dems were calling for violence when they very, very clearly weren't.
And in fact, this predates Trump.
In 2008, Obama was talking about not backing down in the face of an ugly campaign. He said "If they bring a knife to the fight, we bring a gun."
https://t.co/i5YaQJsKop
That quote was from the movie The Untouchables. And there's no way anybody reading that quote in good faith could conclude that he was talking about actual guns and knives. But it became a big talking point on the
In 2018, Obama-era Attorney General Eric Holder was speaking to a group of Georgia Democrats about GOP voter suppression. He riffed on Michelle Obama's "When they go low, we go high" line from the 2016 DNC.
The tl;dr is that for years right-wing media have been excusing Trump's violent rhetoric by going, "Yes, but THE DEMOCRATS..." and then bending themselves into knots to pretend that Dems were calling for violence when they very, very clearly weren't.
And in fact, this predates Trump.
In 2008, Obama was talking about not backing down in the face of an ugly campaign. He said "If they bring a knife to the fight, we bring a gun."
https://t.co/i5YaQJsKop
That quote was from the movie The Untouchables. And there's no way anybody reading that quote in good faith could conclude that he was talking about actual guns and knives. But it became a big talking point on the
In 2018, Obama-era Attorney General Eric Holder was speaking to a group of Georgia Democrats about GOP voter suppression. He riffed on Michelle Obama's "When they go low, we go high" line from the 2016 DNC.
