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.
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.
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).
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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%).
Questions have to be asked about the evidence Jenny Harries gave to the Education Committee today about the risk to teachers.— Adam Hamdy (@adamhamdy) January 19, 2021
Was she aware of this data?
If not, why wasn\u2019t she properly briefed?#COVID19 #schools https://t.co/4wa1PyAJld pic.twitter.com/eqFjaA1zYC
data shows *both* primary & secondary school teachers are at double the risk of confirmed infection relative to comparable positivity in the general population. ONS household infection data also clearly show that children are important sources of transmission.
Yet, in the parliamentary select meeting today, witnesses like Jenny Harries repeated the same claims- that have been debunked by the ONS data, and the data released by the @educationgovuk today. How many lives have been lost to these lies? How many more people have long COVID?
has repeatedly pointed out errors & gaps in the ONS reporting of evidence around risk of infection among teachers- and it's taken *months* to get clarity on this. The released data are a result of months of campaigning by her, the @NEU and others.
Rather than being transparent about the risk of transmission in school settings & mitigating this, the govt (& many of its advisors) has engaged in dismissing & denying evidence that's been clear for a while. Evidence from the govt's own surveys. And global evidence.
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.
To recap - NHS capacity is critical in many places. Hospitals have reported oxygen shortages, and doctors are talking about having to choose who to put on ventilatory support. We have rapidly rising case numbers, >50,000 daily reported cases & 981 deaths reported yesterday.
Let's remember that the impact of socialising over christmas hasn't even begun to show in our numbers yet. And that hospitalisations are indicative of infections that happened ~2-3 wks ago (since then we have been seeing exponential rises in cases).
This means even if we act today, and bring R to below 1 right now, hospitalisations will continue to rise for another 2 wks or so - in line with exponential rises in cases over the past 2 weeks. And deaths will continue to rise for 2-4 wks after we act.
Given current doubling periods, this means very conservatively, 20-30,000 deaths over the next 4 weeks or so, which we sadly can't do anything about now, because most of those who will die during this period have already been infected.
Cases have been rising exponentially in England- much of the increase being attributed to the South, although declines have slowed even in the North following easing of lockdown. Much of this is anticipated, and expected, given the behaviour of the virus. 2/N
SARS-CoV-2, like any other viruses mutates as it multiplies (albeit slower than influenza). Mutations occur randomly and most are 'neutral' - i.e. have little to no effect on transmission, ability to evade the natural or vaccine-related immune response
Having said that, few mutations have been shown to be less likely to be neutralised by plasma from patients infected by the usual (wild-type) virus. Whether this translates to a lower response to vaccines or higher risk of re-infection is unclear at the moment.
Also worth noting that just because a variant becomes more frequent in a region doesn't necessarily mean it offers a fitness advantage to the virus. Many mutations rise to different frequencies in different regions due to random processes. The frequency of strains varies globally
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This. Is. 🔥🔥🔥🔥🔥🔥🔥
Everyone pray for Lin and his family.
As background to tweets I am about to post, you should read this article carefully. I ask that you read each of my tweets carefully & decide if the information conveyed demands that Patriots rise up so that every lie will be revealed.@realDonaldTrumphttps://t.co/9KIX4DEtha— Lin Wood (@LLinWood) January 4, 2021
"The Chinese leadership knows China is a dying country and that explains their aggressive behavior. It is an attempt to save China through expansion before the clock runs out. The environmental damage that industrialization has cause Chinese cannot be underestimated."
"A secret Chinese study conducted 4 years ago laid out a grim future for the country. Currently only 23
% of China`s water is safe. Over 50% of the land is poisoned and air pollution is creating such destruction over 40% of the population has lung poisoning and..."
"...the figure is rising. The biggest danger in the short run is the damaged caused by the insane population polices of limiting families to small sizes. This has created havoc with the population demographics and basically China is an aging country with..."
"...the wrong mix that is creating a disaster with too many old people. The most telling sign though was the Xi visit to Trump in the first year of his presidency. American intelligence bugged Xi`s plane and on his stop in Alaska on the way back to China Xi declared to..."
"Voters don\u2019t care about how the D\u2019Hondt system works or about how you\u2019d geographically carve up a regional assembly... They want results.\u2070"@spellar on why Labour should stop obsessing over constitutional issues: https://t.co/W0zsire5xI— LabourList (@LabourList) February 11, 2021
The state of our constitution is a bit like the state of the neglected electric wiring in an old house. If you are moving into the house, sorting it out is a bit tedious. Couldn’t you spend the time and money on a new sound system?
But if you ignore the wiring, you’ll find that you can’t safely install the new sound system. And your house may well catch fire.
Any programme for social democratic government requires a state with capacity, and a state that has clear mechanisms of accountability, for all the big and all the small decisions that in takes, in which people have confidence.
That is not a description of the modern UK state.
It fashioned every law it could to advantage Republicans, gerrymandered at a bionic level & stymied popular efforts to increase voter participation such as restoration of felon voting rights.
During that same time, the FL GOP poured MILLIONS into turning the state party into a sophisticated, permanent, well-funded voter contact machine.
This gave GOP candidates two massive advantages: 1) they didn’t have to spend on selling the GOP position, 2) all of
in-state messaging got backed up by the RNC, and most importantly, the constant drum beat of Fox News.
There is no biological way to overstate the advantage that Fox News gives to Republicans in red states. MSNBC is NOT the opposite of Fox News.
MSNBC does not structure its programming around whipping up white grievance and fear. Whereas Fox News is the propaganda arm of the RNC, MSNBC is the left leaning version of CNN, not the DNC.
So when I say that Fox News is a huge advantage for the GOP, I know of what I speak.
In FL, Dem candidates spend a inordinate amount of time debunking Fox News lies, even to died in the wool Dems.
Because GOP candidates at every level do not have to spend on messaging, and so not have to spend on attacking Dem policy, they spend almost exclusively on 2 things:
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Christianity and islam may be the largest religion of today’s world but Sanatan dharm has the largest religious monument in the world in the form of Angkor wat. It is situated in combodia and spread across over 400 acres / 1.6 km².
It was listed as a UNESCO World Heritage Site in 1992, which encouraged an international effort to save the complex.
It was originally built as a Hindu temple dedicated to the god Vishnu. In Khmer, the Cambodian language, Angkor means "city" and Wat means "temple grounds".
So Angkor Wat means "Temple City". Its original name was Vrah Vishnuloka or Parama Vishnuloka, meaning the sacred dwelling of Vishnu in Sanskrit.
But, it gradually turned into a Buddhist temple towards the end of the 12th century & is still used for worship today.
Angkor Wat was initially designed and constructed in the first half of the 12th century, during the reign of Suryavarman II, as the king’s state temple and capital city. It was built without the aid of any machinery, as there was no machinery available at that time.
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1. People's Justice Courts to be set up worldwide
2. Citizens' arrests of all Identified Suspects
3. Lab Inspections
3. Harsh interrogation using MKULTRA
4. Public Show Trials video streamed live
5. Cross Questioning of suspects via Twitter & Zoom
A growing list of suspects to be interrogated
Foul Traitors, Charlatans, Frauds, Bat Molesters! Frankensteins, Well Poisoners, Plotters, Deceivers!
Dr. Shipmans, Saboteurs, Devils in White Coats!
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The divine abode of Mallikarjuna Swamy (Jyotirlinga) and Devi Brahmaramba (Shaktipeeth).
When Ganesha was married before Kartikeya, he left in anger to Kraunch mountain. Shiva and Parvati also followed him there.
Shiva assumed the form of Jyotirlinga and resided on the mountain by the name of Mallikarjuna. Mallika means Parvati while Arjuna is another name of Shiva
It is also said that once, a princess Chandravathi, saw a cow shedding milk on a rock resembling a shivlingam.
She started praying to the lingam daily and used to offer jasmine (mallika pushpam) daily. Pleased Shiva appeared before her and agreed to wear jasmine garland (mallika pushpmala) on his head permanently. Since then, Shiva became known as Mallikarjun Swamy.
At this place, Shakti took the form of Bhramaram (bee) to kill Arunasur and settled as Bhramaramba Devi. The place is a Shakti Peeth as the neck portion of Devi Sati fell here.
It is said that by merely seeing the hill, one is emancipated from all his sins and worries.
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