Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

One for AR's frustration thesis - in my view WTF Netherlands

Dutch leaders condemn 'criminal' clashes at anti-lockdown protests
PM says violence seen in Eindhoven, Amsterdam and elsewhere at the weekend was unacceptable

Eindhoven was worst hit by the unrest on Sunday. Photograph: Rob Engelaar/EPA
Jon Henley Europe correspondent
@jonhenley
Mon 25 Jan 2021 13.58 GMT
Last modified on Mon 25 Jan 2021 14.33 GMT

Political leaders and local officials in the Netherlands have condemned as "criminals" and "scum" the rioters who clashed with police during violent protests at the weekend against the country's first nationwide curfew since the second world war.

More than 240 people were arrested as police used teargas and water cannon to disperse crowds of several hundred protesters in Amsterdam and Eindhoven on Sunday. Trouble also flared in a dozen other towns across the country.

"It's unacceptable," the prime minister, Mark Rutte, said on Monday. "This has nothing to do with protesting. It is criminal violence and that's how we'll treat it." He said the 9pm curfew introduced on Saturday was necessary and would remain in place.

Eindhoven was worst hit by the unrest, with rioters setting fire to cars, smashing windows, throwing rocks and fireworks at police, and looting a supermarket and other shops. The local mayor, John Jorritsma, said his city was "crying, and so am I".

Jorritsma called the rioters "scum of the earth", adding that he was "afraid that if we continue down this path we will be on our way to civil war". When police said the protesters were violating lockdown rules, "they took weapons out of their pockets and immediately attacked the police," Jorritsma said.

Other officials said the violence was not caused by people concerned primarily about their civil liberties. "These demonstrations are being hijacked by people who only want one thing, and that is to riot," said the Nijmegen mayor, Hubert Bruls. "This is not demonstrating. These are coronavirus hooligans."

More than 50 people were arrested in Eindhoven, police said, while in Amsterdam about 190 rioters were detained after police deployed water cannon, dogs and officers on horseback during a banned demonstration on the city's Museumplein.

Military police were sent as reinforcements to at least two towns. In the eastern city of Enschede, rioters threw rocks at the windows of a hospital, and on Saturday night youths in the fishing village of Urk set fire to a coronavirus test centre.

The police trade union, NPB, said there could be more trouble ahead as people grow increasingly frustrated with the country's months-long lockdown. "We haven't seen so much violence in 40 years," said one union official, Koen Simmers.

Rutte and his cabinet resigned on 22 January over a child benefits scandal in which more than 20,000 families were wrongly accused of fraud by the tax office, but they continue to govern in a caretaker capacity until elections scheduled for 17 March.

Schools and non-essential shops have been closed in the Netherlands since mid-December, and bars and restaurants were closed in October. The curfew was added because of fears over the more contagious British variant of the virus.

People who violate the 9pm to 4.30am curfew face a €95 fine. There are exemptions, in particular for people attending funerals or having to work, but they must present a certificate.

Besides the curfew, Rutte also announced last week a ban on flights from Britain, South Africa and South America, and lowered the number of guests allowed into people's homes to one, from the previous limit of two.

"There is absolutely no excuse" for the rioting, the overseas development minister, Sigrid Kaag, told Dutch television on Monday. "This is violence, and I hope the police track down all these people and that there are heavy punishments."

Anyone know quite what's driving this?

[Richard Hakluyt]

Cases are down a lot; the pressure will start to ease on hospitals soon and then the deaths will come down too. I hope Johnson doesn't crumple and release the lockdown too soon.

He already mentioned they might ease off next month, after which some of his press people almost broke their legs rushing in qualifying what he meant is the regularly scheduled review on the 15th, and was not promise to ease.

What a moron.

I think he literally does not understand the mathematics of the situation; though, of course, he could write a poem in Latin or ancient Greek about the pandemic 

The next worthwhile thing on the calendar is Easter which then leads into summer. I don't want laxity in February and March (never great months anyway) leading to the summer getting completely buggered-up.

[Sheilbh]

I think he literally does not understand the mathematics of the situation; though, of course, he could write a poem in Latin or ancient Greek about the pandemic 

I don't know. I've read plenty of stories when he has been on the pro-lockdown side of things and is then swayed by other members of the cabinet (especially Sunak and, I think, Gove). I think he gets it but he's weak.

He's the first PM we've had since Major where I've read numerous people say that he basically agrees with the last person he spoke to. There's been numerous stories where different people with radically different opinions have come out of a meeting with Johnson thinking he agrees with them. He's got no backbone.

[Richard Hakluyt]

Which is probably worse than him being dense or a bit of a bastard, at least when considering the pandemic. Can't stop thinking about marshmallows now 

[Sheilbh]

More riots and disturbances in the Netherlands - WTF?

[Maladict]

More riots and disturbances in the Netherlands - WTF?

It seems to be initially sincere and mostly peaceful protests being hijacked by bored/frustrated youths.
Maybe some pent-up violence that usually is unleashed at New Year's and/or football matches.

It's happening mostly in the south and east, nobody has given a very convincing explanation for that yet.
Apart from the south being scum, of course 

[Syt]

Interesting statistic:

Based on mobile phone data, mobility in Austria was reduced by 70% during the first lockdown in March 2020.

In the second lockdown before Christmas it was down by 45%, and in the current lockdown it's only down 27% at the moment, trending towards 20-25%.

[DGuller]

It's probably self-correcting.  People who are mobile during the pandemic tend to become immobile all on their own.

[Zoupa]

Gotta climb those rocks!

[Sheilbh]

Crazy story about the AstraZeneca vaccine in Handelsblatt. Last night their political correspondent had a story from anonymous sources in the coalition that the AZ vaccine was only 8% effective among the over-55s. This was then picked up by other bits of the German press.

There was a very strong rebuttal from AZ and the University of Oxford. Sources in the UK government were furious because it could undermine confidence in people getting vaccinated (while not actually presenting data just anonymous sources from within the coalition) and said it was the sort of thing they'd expect from the Russian not the German press. But running through all of these responses was a bit of bafflement about where they got 8% from because the only part of the data that referred to 8% was the number of participants in the trial in the 56-69 age group.

The German health ministry has now issued a statement denying the Handelsblatt report and it seems that someone (who was briefing reporters) did get confused about the number of 56-69 year olds participating in the trial and efficacy. Which is unbelievable that someone made that cock up and told journalists and they ran it. From the health ministry's statement (according to Jim Pickard of the FT): "At first glance it seems that the [newspaper] reports have mixed up two things: about 8% of those tested in the AstraZeneca efficacy study were between 56 and 69, only 3-4 per cent over 70 (MHRA Approval Public Assessment Report) [...] but one cannot deduce an efficacy of only 8% with older people from that. Moreover, the EMA is currently evaluating the studies.....we expect a result of the EMA's evaluation on Friday."

I think this is a really good example of when you shouldn't rely on anonymous sources. I've moaned about it all the way through the crisis but I also feel it does highlight the risk of political reporters covering covid - because what he's reporting is the decision making/thinking within the German health ministry which is legitimate and could require anonymous sources. But if it's including new information about something like vaccine effectiveness it feels like you either need someone to go on the record, or to publish the data, or at the very least have a science correspondent to verify it against the information we have rather than take a "coalition source" at face value. It just feels very irresponsible.

For what it's worth from my understanding there were not enough over 55 participants in the AZ trials (though there will be in the US Phase III trial) for them to have data on the efficacy - there weren't enough infection events, which I understand is the key trigger for assessing vaccines, in that age group. But that age group did have the same antibody response as other age groups. Sady I think 8% effectiveness is going to be one of those phantom stats that even though it's been debunked will circulate as an alternative fact now.

[The Brain]

I think this is a really good example of when you shouldn't rely on anonymous sources. I've moaned about it all the way through the crisis but I also feel it does highlight the risk of political reporters covering covid - because what he's reporting is the decision making/thinking within the German health ministry which is legitimate and could require anonymous sources. But if it's including new information about something like vaccine effectiveness it feels like you either need someone to go on the record, or to publish the data, or at the very least have a science correspondent to verify it against the information we have rather than take a "coalition source" at face value. It just feels very irresponsible.

Auntie Yi and Ma Jake want their gossip though.

[The Larch]

Crazy story about the AstraZeneca vaccine in Handelsblatt. Last night their political correspondent had a story from anonymous sources in the coalition that the AZ vaccine was only 8% effective among the over-55s. This was then picked up by other bits of the German press.

That's some seriously sloppy journalism, heads should roll, at least the ones from the journo that authored the report, for basic lack of understanding and the one from the editor that allowed it to be published.

In any case, AZ is currently under fire from the Comission for a different issue, as it seems it won't be able to supply the EU with the amount of doses it had committed to provide at rollout. Now the Comission wants to check and audit their production numbers and other dealings, to see if they've actually supplied the doses paid by the EU to other countries that paid better, and there are rumours about possible limits to vaccine exports outside the EU.

EU threatens to block Covid vaccine exports amid AstraZeneca shortfall
Bloc may receive only half of purchased 100m doses in first quarter of the year

The EU has threatened to block exports of coronavirus vaccines to countries outside the bloc such as Britain, after AstraZeneca was accused of failing to give a satisfactory explanation for a huge shortfall of promised doses to member states.

The pharmaceutical company's new distribution plans were said to be "unacceptable" after it "surprisingly" informed the European commission on Friday that there would be significant shortfalls on the original schedule.

The EU has been due to receive 100m doses in the first quarter of this year. But it is feared that the bloc will only receive half of that despite making large advance purchases ahead of authorisation of the vaccine by the European medicines agency.

In a heated call with AstraZeneca's chief executive, Pascal Soriot, on Monday, the European commission president, Ursula von der Leyen, said the company must live up to its contractual obligations. The EMA is expected to authorise the vaccine by the end of this week.

Von der Leyen's spokesperson said: "She made it clear that she expects AstraZeneca to deliver on the contractual arrangements foreseen in the advance purchasing agreement.

"She reminded Mr Soriot that the EU has invested significant amounts in the company up front precisely to ensure that production is ramped up even before the conditional market authorisation is delivered by the European Medicines Agency.

"Of course, production issues can appear with the complex vaccine, but we expect the company to find solutions and to exploit all possible flexibilities to deliver swiftly."

The EU's health commissioner, Stella Kyriakides, made a televised statement to express her frustration at the company's behaviour, warning that the answers so far provided had not been satisfactory.

Late on Monday evening following discussions with executives representing the pharmaceutical company, Kyriakides tweeted: "Discussions with AstraZeneca today resulted in dissatisfaction with the lack of clarity and insufficient explanations.

"EU member states are united: vaccine developers have societal and contractual responsibilities they need to uphold.

"With our member states, we have requested from [Astrazeneca] a detailed planning of vaccine deliveries and when distribution will take place to member states. Another meeting will be convened on Wednesday to discuss the matter further."

The development has raised pressure on the commission just as it is being criticised for the slow rollout of vaccination programmes in EU member states in comparison with the UK and the US.

The UK has administered more than 10 doses per 100 residents but according to data gathered by Airfinity, a London-based life sciences analytics company, the EU has administered just under two doses per 100 residents.

Kyriakides said Brussels would now insist on being notified of any exports of vaccines from EU sites, including that produced by Pfizer on which the UK is reliant on European laboratories for supplies, raising the spectre of export bans.

She said: "You know that AstraZeneca vaccine is currently in the final stages of approval with the European Medicines Agency. If all requirements are met, the European Medicines Agency could recommend market authorisation by the end of this week.

"But there is a problem in the supply side. Last Friday, the company AstraZeneca surprisingly informed the commission and the European Union member states that it intends to supply considerably fewer doses in the coming weeks than agreed and announced.

"This new schedule is not acceptable to the European Union. That is why I wrote a letter to the company at the weekend in which I asked important and serious questions. The European Union has pre-financed the development of the vaccine and its production, and wants to see the return."

Kyriakides said the EU wanted to "know exactly which doses have been produced where by AstraZeneca so far. And if, or to whom, they have been delivered".

"These questions were also discussed today in the joint steering board of the commission and the 27 member states with AstraZeneca," she said. "The answers of the company have not been satisfactory so far. That's why a second meeting is scheduled for tonight. The European Union wants the order and pre-financed doses to be delivered as soon as possible. And we want our contract to be fully fulfilled".

The EU has spent €2.7bn (£2.3bn) on the rapid development and production of coronavirus vaccines. Kyriakides said the commission had proposed that the member states agreed on "an export transparency mechanism be put in place, as soon as possible".

Germany's health minister, Jens Spahn, gave Berlin's backing to the commission proposal. "We, as the EU, must be able to know whether and what vaccines are being exported from the EU," he said. "Only that way can we understand whether our EU contracts with the producers are being served fairly. An obligation to get approval for vaccine exports on the EU level makes sense."

Astrazeneca said in a statement that the company's chief executive in his conversation with Von der Leyen had "stressed the importance of working in partnership and how AstraZeneca is doing everything it can to bring its vaccine to millions of Europeans as soon as possible."

[The Brain]

On TV they just step on it a few times if there's a lack of supply. Can you do that here?

[Maladict]

More riots and disturbances in the Netherlands - WTF?

It seems to be initially sincere and mostly peaceful protests being hijacked by bored/frustrated youths.
Maybe some pent-up violence that usually is unleashed at New Year's and/or football matches.

It's happening mostly in the south and east, nobody has given a very convincing explanation for that yet.
Apart from the south being scum, of course 

They've started attacking hospitals as well, I'm beyond words now 

[Sheilbh]

In any case, AZ is currently under fire from the Comission for a different issue, as it seems it won't be able to supply the EU with the amount of doses it had committed to provide at rollout. Now the Comission wants to check and audit their production numbers and other dealings, to see if they've actually supplied the doses paid by the EU to other countries that paid better, and there are rumours about possible limits to vaccine exports outside the EU.

Yeah - my suspicion is that AZ aren't in breach of their contract and that's why the EU are looking at legal measures like export controls rather than contractual remedies. But it's a huge issue that needs to be fixed.

There are also rumours that because there hasn't been a randomised trial in the over-55s the EMA will only approve AZ for use in the under-55s. I don't know about other countries vaccination plans but in the UK that would be around 50% of the vaccines we've delivered (mainly healthcare/care home workers). Obviously in the EU it'll vary from member state to member state but it may be that that decision matters more than the supply shortage because I don't think US trial on the over 55s is meant to report until April. So if you're focusing on protecting the elderly you will only be able to use Pfizer even if there's a supply of AZ.

There was a blog post on the CureVac advance purchase agreement - and if the AZ one is anything like this, it's not exactly nailed down:

For the nerdier among you with lockdown time on their hands, the CureVac APA is here (European Commisison website),  or here (US regulatory filing).

If it's all a bit tl;dr, here are are the potted highlights that may be giving AstraZeneca's legal team some comfort right now. (The extracts have been edited for brevity, without removing any vital context)

"The contractor commits to use reasonable best efforts [...] to establish sufficient manufacturing capacities to enable the manufacturing and supply of the contractually agreed volumes of the Product to the participating Member States in accordance with the estimated delivery schedule" the APA with CureVac says.

'Reasonable best efforts' are defined as ": a reasonable degree of best effort to accomplish a given task, acknowledging that such things as [...] contractor's commitments to other purchasers of the Product; [...] and any other currently unknown factors which may delay or render impossible, contractor's successful completion of the particular task, including [...] meeting delivery schedules [...] may be beyond the complete control of the contractor..."

Then there's this legal escape clause:

"In light of the uncertainties both with respect to the development of the Product and the accelerated establishment of sufficient manufacturing capacities, the delivery dates set out in this APA are the contractor's current best estimates only and subject to change."

"Due to possible delays in the authorisation, production and release of the Product, no Product or only reduced volumes of the Product may be available at the estimated delivery dates set out in this APA. In the case of delays to the anticipated availability of the Product, the contractor aims to allocate the doses of the Product fairly across the demand of doses, which the contractor has or will contractually commit to towards its present and future customers, as such doses become available."

And finally, under the section specifically referring to 'delays':

"The Parties acknowledge that there is a risk that [...] the time-line for scaling up the production of the Product may be delayed."

There is indeed a requirement to 'inform' of any delay, and give reasons. But other than that, the two sticks the commission has to enforce the agreement are cancellation - not in the EU's interest if it wants to get its hands on the vaccines - and litigation through the Belgian courts - not exactly the swiftest or friendliest of jurisdictions for potential litigants.

All of which makes sense, especially from AZ's perspective, because they can't guarantee last summer to produce x amount of a vaccine on y shcedule when they are still developing so don't know how to produce at mass - they will need some flexibility. The difference with Pfizer is Pfizer have the same sort of issues but their factory in Belgium supplies Europe so they throttle supply to all European countries including the UK.

From what I've read AZ's model was on regional exclusives - so localised factories supplying x market - India supplies India and South Africa at the minute, the UK factory is for the UK and the European factories are for the EU. And apparently under the agreement with the UK the UK factory is exclusively to supply the UK - on the one hand that might be a wise decision, flipside is if there's a similar issue in that factor then we're fucked because we face exactly the same risk. My suspicion is the EU contract doesn't have similar exclusivity provisions so Belgium can supply other regions (including, possibly, the UK) which is why they're now looking at legal measures like export controls.

It feels like the better solution would be some international coordination between customers - UK, EU (assuming it will be approved), India, South Africa - until March/April.  But I'm not sure taht will happen and instead I think we might have some vaccine nationalism which will get nasty fast (and show why, despite mistakes made by the EU, it was probably the right decision to procure on an EU level).