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).
More from Deepti Gurdasani
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.
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.
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.
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%).
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
More from Government
BOTH @GenFlynn and #AdmMikeRogers went to Trump Tower on Nov 17, 2016.
IMPORTANT DATE to remember!!!! (THREAD)
AND Adm. Rogers arrived at Trump tower on NOVEMBER 17, 2016.... Rogers discovered @BarackObama ‘702’ Illegal Spying Operation and Briefed Trump @ Trump Tower...
THE NEXT DAY (Nov. 18, 2016) @realDonaldTrump MOVED transition meetings to private golf club in New Jersey... It was even reported in the
The following week (4 days later) POTUS tweeted, "Great meetings will take place today at Trump Tower concerning the formation of the people who will run our government for the next 8 years."
The only problem for [THEM] spying??? Trump Team ALREADY MOVED OUT OF TRUMP TOWER!!!!
This was a SETUP by #POTUS and Team because they KNEW about surveillance (From Adm Rogers/Flynn)....
(Trump later in 2017 tweeted that he "just found out" about Obama surveillance...KEK!)
🚨ITALY ON BRINK OF DOWNFALL OVER CENTRAL INTELLIGENCE DIVIDE
@GenFlynn @GeorgePapa19 @PatrickByrne @JovanHPulitzer @SidneyPowell1 @Capezzone @Sadiso @realDonaldTrump @CarrollQuigley1 @We_Have_Risen @KanekoaTheGreat @JudgeJeanine @
The FIRST story to break out of Italy, by Cesare Sacchetti
The second story from Sacchetti is BONKERS! ⬇️
Maria Zack, founder of https://t.co/IaftMj8cs0 on January 6th broke this story which corroborates Sacchetti's claims.
Ex CIA operative, Bradley Johnson, is the third source corroborating both Zack and Sacchetti.
Lacking adequate government emergency services, many seek help from aid groups.
Border Patrol routinely obstructs these efforts. 🧵⬇️
Families often receive urgent calls from loved ones who are lost and in distress in the U.S.-Mexico borderlands, or from an eyewitness who was with them in the desert.
These calls can contain crucial details regarding the person’s location and medical condition.
Faced with an inadequate and discriminatory emergency response system controlled by Border Patrol, family members take on the monumental work of acting as emergency first responders.
Here’s a partial list of actions family members have taken to locate their missing loved ones...
1. Repeatedly calling police, Border Patrol, ICE offices, hospitals, detention centers, morgues, immigration attorneys, non-profits, and news outlets.
2. Taking out missing persons ads, putting up posters, searching and posting on the Internet, in hopes of hearing word of their loved ones whereabouts.
Then I asked, how many of your children were involved in the Ibadan killings today? SILENCE!
Then one of my "Comrade" himself and his wife are always jumping from @channelstv to @ARISEtv. I asked him, aside your television rounds, have you ever handled an AK47? Simple question, he called me a bastard.
I asked will your Ibadan radio station host 100 Eso's? SILENCE!
Then another one, he was Afenifere lackeys, during the Ajegunle crisis, the same one who chopped money meant for young Yoruba who were defending their streets, mane died needlessly. I asked when last he visited Eso zones across Yoruba land. SILENCE! He kept ranting Fulani bla bla
Then practical questions to another, do we have a list of our vulnerable settlements? Any attempt to activate our fighting organisations so that all manner of people don't go about attacking innocent non Yoruba. SILENCE!
That one pretended he had poor network. No answer!
Then another one, he said I had 'changed'. I told him, you cant have witnessed a wicked Yoruba ruling elite, hype up sons and daughters of the poor and personally attended the burial of many of those unsung heroes and not call for extreme caution and the need to truly be prepared
You May Also Like
This limitation, which is still found in the very latest Windows 10, dates back to BEFORE STAR WARS. This bug is as old as Watergate.
When this was developed, nothing had UPC codes yet because they'd just been invented.
Back when this mistake was made, There was only one Phone Company, because they hadn't been broken up yet. Ted Bundy was still on the loose. Babe Ruth's home run record was about to fall.
When this bug was developed, Wheel of Fortune hadn't yet aired. No one had seen Rocky Horror. Steven Spielberg was still a little-known directory of TV films and one box-office disappointment. SNL hadn't aired yet. The Edmund Fitzgerald was still hauling iron ore.
WHEN THIS STUPID MISFEATURE WAS INVENTED, THE GODFATHER PART II HAD JUST OPENED IN THEATERS.
So, why does this happen? So Unix (which was only 5 years old at this point) had the good idea of "everything is a file" which mean you could do things like write to sockets, pipes, the console, etc with the same commands and instructions.
Reliable source tells me Withdrawal Deal text contains
- No unilateral exit from backstop
- Large annexe on level playing field
.... after reporting this on @SkyNews I get a call from a different senior source that this is “spot on” and further that the Attorney General Geoffrey Cox has not pulled his punches in confirming in legal advice there is “no unilateral exit” from backstop ...
... furthermore I’m told (and this chimes with excellent Times splash this morning re Weyand) that the future partnership then takes its starting point as the activated backstop - ie UK-wide customs union-style arrangement and level playing field.
Understand that a ministerial briefing on the draft Withdrawal Agreement meant to drum up support from some trade organisations due tonight has now been postponed
It's an assault on facts and reason. It's an assault on good governance. It's an assault on the bureaucracies that are being discounted. It's an assault on science and history. But it is also an assault on one of the underpinnings of democracy.
We live in a system that is grounded on the idea of collaborative government. Leaders may have a final word but even then, there are typically checks and balances. Hopefully, in this case, such checks and balances may work. But they also are being tested.
The president's position that he is smarter than all the world's scientists, than the entire intelligence community, than experts who have studied any issue all their lives, is, of course, asinine. But his belief that government turns solely on his opinion, is monarchic.
Louis XIV reportedly said, "L'etat est moi." That he was the state. Trump asserting that he knows better than all, discounts all advice, that his brain is enough to chart the course for America alone, is essentially saying the same thing.