Coronavirus COVID-19 (2019-nCoV) Thread - 2021 Breaking News

Rather than simply continue the other thread until it breaks, I’ve started a new thread for this new year.

When I update tonight I’ll use the stats I posted in the old thread but here are the stats as I found them at 12:01am on 1 January 2021:

83,842,646 total cases
1,826,373 dead
59,345,329 recovered

In the US:

20,445,654 total cases
354,215 dead
12,125,806 recovered

That’s 1 year from the announcement of the discovery of this new virus: from zero to this.

Thank you.

From the old thread:

Wasn’t there a SURPLUS of ventilators a very short time ago? Left over from the push to manufacture boatloads of them back when COVID first hit?

Turned out ventilators weren’t the go-to thing for people in trouble, other therapies worked better in many cases.

I was perhaps not clear. I know they’re having equipment shortages involved with treating COVID, couldn’t remember which equipment, and jumped to ventilators. And now I look like an ass for assuming. :wink:

Not at all. A person who admits looking like an ass is by definition, not an ass. :slightly_smiling_face:

MSNBC is reporting that almost all hospitals in LA county are diverting ambulances in one way or another, and that patients arriving often wait in the ambulance for up to 8 hours. Patients are being treated in chapels, gift shops, and even in the ambulances. They’re short of O₂ and PPE, but mostly they’re short of trained staff. Cedar Sinai is releasing videos of nurses describing how dire the situation is. One nurse says that they are admitting patients faster than the patients are being discharged.

There are more than 7,646 COVID patients in hospitals. Mortuaries and private funeral homes are turning families away because they are out of room for bodies.

There is some very odd stuff going on in the UK regarding vaccination schedules - specifically the gap between the first and second injection of the Pfizer vaccine.

The Pfizer vaccine was authorised for emergency use with the two doses being given 21 days*apart
The A-Z vaccine was authorised for emergency use with the two doses being given 4-12 weeks apart

When the A-Z vaccine was authorised, the timing was changed for the Pfizer vaccine doses thus:

The Joint Committee on Vaccination and Immunisation (JCVI) has subsequently recommended that as many people on the JCVI priority list as possible should sequentially be offered a first vaccine dose as the initial priority. They have advised that the second dose of the Pfizer/BioNTech vaccine may be given between 3 to 12 weeks following the first dose…

Source

OK, so this expedites rollout (a good thing, obviously), but is it supported by the data?

The following is from Information for Healthcare Professionals on Pfizer/BioNTech COVID-19 vaccine

In Study 2, approximately 44,000 participants 12 years of age and older were randomised equally and received 2 doses of COVID-19 mRNA Vaccine or placebo with a planned interval of 21 days. The efficacy analyses included participants that received their second vaccination within 19 to 42 days after their first vaccination.

Source. My bold.

So it wouldn’t be unreasonable to ask, where’s the data to support 12 weeks then? Just like this:

Plaid Cymru has called on the Welsh Government to ask the UK government to publish evidence to justify increasing the period between the two doses of the Pfizer-BioNTech vaccine from 21 days to 12 weeks…

…He added there were “very real concerns” that a longer delay between doses “could significantly decrease the effectiveness of the vaccine”.

Source

At this point, I’m left wondering what Pfizer would have to say about it. Fortunately, Reuters has reported it:

Pfizer sounded cautious on the prospect of shifting the schedule of its second dose, noting it had not been evaluated on different dosing schedules.

“There are no data to demonstrate that protection after the first dose is sustained after 21 days,” it said in a statement, adding that the implementation of alternative schedules should be closely monitored.

j

(*) - it may have been at least 21 days - I can’t access the documents as originally published

PS: Bloomberg also report Pfizer’s concerns. Their report also includes this:

Anthony Fauci, the top U.S. infectious disease expert, also weighed in on the U.K.’s decision in an interview on NBC’s Today Show on Thursday. Spreading out the two doses is “under consideration,” he said, though he didn’t specify by who.

“I still think, if done properly, you can do a single dose, reserve doses for the second dose, and still get the job done,” Fauci said. But he added “you can make an argument, and some people are, about stretching out the doses and giving a single dose across the board and hoping you’re going to get the second dose in time to give to individuals.”

LA hospitals are running out of sedation medications, and today a doctor tweeted that patients who experience OOH (out of hospital) arrests (cardiac events, strokes, etc.) that cannot be resuscitated in the field should be pronounced dead at the scene and not transported to hospitals, because they do not have room or personnel in the hospitals to treat them.

Hmmm. Further down the thread I learn this has been the standard of care in much of the country for decades. Is this new to LA, then?

There is no specific evidence, for the only two COVID vaccines now authorized in the U.S. and Canada, concerning the best interval, or even whether there should be a second dose — except for historical data concerning other vaccines. But we do know that no one who got sick more than ten days after getting the first dose has needed to be hospitalized.

I’m much more concerned that the Camden County NJ web site says that my 94 year old mother can’t get any vaccine until, at the earliest, Feb. 20. The mantra needs to be — don’t make the perfect the enemy of the good.

So when should we see any level of statistical effect in numbers due to the vaccine in the world and in America in particular? I know the rollout (here, at least) is slow and it needs two doses over a month and this hasn’t rolled out to the general population yet, so I was wondering.

There still are no hospitalizations for anyone more than ten days after the first dose. Second doses won’t affect those numbers, or deaths, but may bring down mild case numbers.

In the few states like W. Va. where they did nursing homes first, I think there should be a drop in new hospitalizations this coming week.

People who work in hospitals don’t have a high rate of illness anymore, so the U.S. states where their workers went first won’t see as quick a drop.

About 25% of hospitalized are age 75+. Almost half are 65+. If you tell me when they will be offered a jab, I can tell you more.

P.S. If the U.S. rollout had been handled well, you already, today, would have EMT’s telling TV news that they were seeing fewer COVID calls.

Every hospital in Central Alabama is on diversion.

Is that happening in the UK where they started almost 2 weeks earlier?

84,382,650 total cases
1,835,391 dead
59,641,739 recovered

In the US:

20,617,346 total cases
356,445 dead
12,175,841 recovered

Yesterday’s numbers for comparison:

Doesn’t look like it: They also have supply not being used:


Ministers urged to strip away red tape to hit UK vaccine rollout target: Doctors say 24/7 vaccine centres and recruiting retired health workers could help reach goal

Lack of rollout planning sounds all too similar to what I read in the New York Times about the U.S.

True . But medicines regulators authorise medicines on the basis of the available evidence. The Pfizer pivotal study was based on two doses with a 21 day interval between them (though in real life, the interval varied somewhat). That worked well and that was what was authorised. What we are now seeing is a group of “experts” (JCVI) recommending that the vaccine be used differently, and indeed in a manner that was never even investigated. Weird. Better hope it works.

j

We can view this as a variant of the “off label” use of existing meds. Sometimes those off-label uses are later found to be effective, and at other times they’re later shown to be a crock.

But in each case the beginnings of off-label use are based on the hunches of individual practioners or based off small exploratory studies.


It's also the case that we're all watching the borderlands between personal health and public health morphing before our very eyes. Which is certainly understandable in the face of an emergency this large.

Collectively we will be taking some individual risks with any vaccination. That confers public health benefits with concomitant possible private health disadvantage. War sucks. And this is a war.


I’m not tuned in enough to handicap these particular decisions by these particular decision makers. But the above are the sorts of considerations that should legitimately be included in that mix.