People just love it when something that has been nearly a vice can be portrayed as an virtue. — ssu
800th time, a vaccine doesn't have to be perfect to be relevant.
— Cheshire
:up:
A good 250 pages in, I wonder how many times repetitions have been posted. — jorndoe
Why is it placing the whole burden of responsibility on the people? — baker
Other than the critical policy mistakes of abandoning containment in the early stages of the pandemic (which every country that made a competent effort succeeded in doing), if things do go wrong with the vaccine, we can note the further policy disaster of allowing vaccine developers to issue press releases on their data and work with their media sycophants to create such a hype train that governments basically had to approve the vaccines (not only because they too are sycophants but, in addition, due to the overwhelming pressure and belief created in the media that "over 90% effective and the pandemic will soon be over with these vaccines!! woweee").
Governments should have designed and mandated new trial protocols appropriate for the situation (much larger with much better experimental design and carried out by third parties), and corporations should have been gag-ordered to provide zero information to the press so that review and approval processes were not affected by public opinion and media hype. Simply accelerating the old normal process was not a reasonable policy because phase 3 is not usually followed by massive deployment of a new pharmaceutical, but there is phase 4 of post market surveillance, that is usually many years of "seeing what happens" and only a small percentage of the population gets the intervention every year (i.e. the risk of something being missed isn't so great because few people get the new intervention for many years). A competent medical professional would want a new trial design that would seek to get some of the same insights as phase 4 in an accelerated time line, which (if it is statistically impossible to do) then want direct challenge experiments (exposing trial participants to the virus deliberately, including known mutations) would be the only reasonable course of action; the benefit obviously outweighs the harm in this pandemic situation, and the only reason direct challenge experiments weren't used to get much, much more certainty about efficacy and side-effects in humans is because policy makers and their corporate donors preferred not to know, but to rather roll out a multi billion dollar gamble in a statistical haze.
The die is cast now though, so we'll see what happens.
And if you think policy makers aren't disastrously idiotic and corrupt, just look at the pandemic up until this point in the places rushing to be first to deploy the vaccine. Although past stupidity and corruption doesn't guarantee future stupidity and corruption, I wouldn't personally bet against it. — boethius
There isn't really a basis for this belief. No vaccine trial, vis-a-vis covid, is designed to prove actual effectiveness at changing the course of the pandemic. Different experimental design would be needed for that and very likely different targets of efficacy.
Generally, there is healthy skepticism in the evolutionary biologist community whether a vaccine that cannot irradiate the disease is a good investment, as the obvious prediction based on science is the disease will simply evolve to defeat the vaccine. Vaccines of this kind also have the potential to simply shift harm profiles around without reducing total harm, which is difficult to capture in trials which may easily a confuse looking at a shift at one part of the harm profile and conclude a general reduction of harm can be inferred when there is no basis for such a conclusion (vaccines that reduce disease severity for most people, may increase transmission while significantly increasing the severity for a sub population; for instance, that a sub population has severe over-reaction of the immune system). So, we will find out, but there is no reason to have higher confidence than a skilled gambler down on his luck on this particular issue.
However, considering the harm the pandemic has already had on the global community, we can already conclude that vaccine technology does not protect public health from negative infectious disease outcomes, and investments in vector control, better outbreak protocols, treatment capacity, but most importantly simply public health in a general sense (preventing preventable diabetes, obesity, lung harm from bad air etc.) are more effective investments. In particular, investments in public health in the sense of healthy people is not even a cost but pays for itself many times over.
And yet, public health policy of the last decades has been based on under-investing in healthy foods, healthy city design, healthy habits, and healthy air -- which turns out to benefit fossil and food corporations -- and over-investing in medical technologies that "fix problems post-fact" -- which turns out to benefit pharmaceutical and other medical corporations. Certainly only coincidence and these policy failings will be swiftly corrected going forward. — boethius
You think those billions now poured into various vaccine programs by major countries won't have an effect?
— ssu
Maybe, but there is currently no evidence that they will. In my version of science I believe things when there is evidence to believe it. The experimental design of the current covid related vaccine trials, do not seek to answer the question of whether the pandemic will be significantly curtailed in one way or another, and the scientists running these trials do not make such a claim.
For instance, if the virus simply evolves to defeat the vaccine (how evolution works) the scientist will simply point out that their experimental design did not seek to provide any insight on this issue.
The reason I mention evolution is that in an exponentially expanding new virus there are many evolutionary paths available and with 7 billion people there are many hosts available in which those evolutionary events can take place. There are already now a diversity of strains of the virus, a vaccine developed against a certain strain may already not be effective against strains that already exist, which will of course then come to dominate once the conditions are such that they have an advantage. The virus has simple maths on its side. The long amount of time it usually takes to make an effective vaccine, for good reasons, means simple math is not on its side.
But my main point seems to be lost on you, which is that obviously vaccine technology cannot possibly be relied on to intervene to prevent major harms from infectious disease ... because those major harms have already occurred in the case of Covid, for basically the reasons you state.
Vaccine technology is simply not a reliable basis for protecting public health from infectious disease generally speaking and the disastrous consequences of a pandemic. You may say "But of course! Vaccines take time and aren't meant to intervene to strop a pandemic before there is already major health harms and economic disruptions! dum dum", but, of course, my response is simply to repeat, that for exactly that reason, "Vaccine technology is simply not a reliable basis for protecting public health from infectious disease generally speaking and the disastrous consequences of a pandemic". There do exist other policies that can have a much bigger consequence.
Other policy measures do not have this problem, and in the case of public health in terms of "healthiness", actually pay for itself. Therefore, focus should be first investing in policies that both intervene at all stages of a pandemic such as we are experiencing and moreover pay for themselves. Ultimately, relying on vaccine technology to control infectious disease was lazy thinking by the medical community. Does that make them idiots? I'm sure you are already confident my answer is yes, yes it does make them idiots. However, it was not a consensus; many experts predicted exactly this scenario and pointed out more effective investment strategies to protect global health against the inevitable "high impact" event we are seeing. — boethius
Anyone who ever said that the vaccine totally prevents Covid is wrong. — EricH
The vaccine does not prevent a person from getting Covid. The vaccine significantly reduces the odds that you will catch it - and if you do catch it the vaccine significantly reduces the odds that you will have a serious case. — EricH
Most victims are people who refused to get a simple vaccine that would keep them safe. — EricH
And yet every day we hear things like, "If so and so would've gotten the vaccination, he'd be safe and well." — baker
The glint of a few pence off the tax bill. It's really not that hard to explain why Italy was so unprepared. It costs money to be prepared and people were not willing to pay it.
But hey you can stick to your narrative of the big bad virus coming out of nowhere with no-one to blame for its spread but the tinfoil-hat wearing anti-vaxxers. I'm sure the pharmaceutical industry will be along soon on their white chargers to save us all, and then we can get back to business as usual... killing 22,000 children a day from poverty and no-one giving a shit because they're not white middle class taxpayers. — Isaac
No, my point was firstly, that a rushed vaccine based on new technology may be either falsely effective, have unexpected side effects (already we're getting allergic reaction that was not anticipated), or too expensive to help poorer countries.
And secondly that a huge proportion of the deaths are in poor communities coupled with poor healthcare services. Investing in core service provision and community healthcare is a far more efficient as it helps not only this pandemic, but also future ones. I've previously cited papers showing how proper ICU care more than halves the mortality rate. The overlap with poorer communities and existing health issues is well documented, but I can cite some if you like.
Thirdly, investment doesn't spring out of nowhere. It's taken from other budgets. I've just cited figures for TB excess deaths which result from only a fractional drop in the availability of frontline services.
Basically if you've already decided that the solution is an expensive vaccine then the investment is great. If your aim is to increase the number of vaccines in the world then this is a big score. If, however, your aim is to look after the immediate and future health of the population with the scarce resources we have available then the fact that a few rich countries have used up years of healthcare investment on a luxury vaccine is hardly the Holy Grail. — Isaac
...besides which, as I understand baker's position, it has nothing to do with the significance of the reduction and everything to do with the heartless abandonment of the poor sods for whom it doesn't work, or worse. — Isaac
the heartless abandonment of the poor sods for whom it doesn't work, or worse.
At this forum, not once have I seen that a pro-vaccer said that people should get vaccinated for their own sake.
Not once has anyone who has told me to get vaccinated said that I should do it to protect my health.
Not once. Not a single time. — baker
At this forum, not once have I seen that a pro-vaccer said that people should get vaccinated for their own sake.
Not once has anyone who has told me to get vaccinated said that I should do it to protect my health.
Not once. Not a single time. — baker
The vaccine significantly reduces the odds that you will catch it - and if you do catch it the vaccine significantly reduces the odds that you will have a serious case. — EricH
refusing vaccination has basically saved government from further scrutiny — boethius
That's why mandatory vaccination could be a last resort. It would force the government to act more transparently and to take at least a part of the responsibility for the safety and efficacy of the vaccine.
The only problem is that with covid in particular, the "effectiveness" of the vaccine would be about the same as the course of the disease without the vaccine, and then the government could take the credit and make vaccination mandatory indefinitely. — baker
In which case, the likely situation is still not "good". The current vaccine programs are too little and too late to affect this winter season; coronavirus has demonstrated strong seasonal tendency and so will anyways go down in the spring and it will be difficult to know if the vaccine is working or not, and if we will be hit by a third wave next season anyways, whether due to the vaccines not working or new strains defeating the vaccine. — boethius
Do you think there is some magical spell that stops the virus?
It's about stemming the tide, containing, tracking, learning.
Some of your comments can't be differentiated from paranoia.
Next time I have a fat guy on the stretcher having a heart attack I will make sure to let him know that Banno says he should have hit the gym and eaten more salad; now accept the responsibility of your choices fatty, and die with dignity. Same with the alcoholics, people that get in car accidents if they were driving too fast... — Book273
It's an odd question.On what basis then? — Isaac
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