Coronavirus Sars-CoV-2/Covid-19 Megathread

[Jacob]

BB's proposition is that the lesson to be learned is that we need to create such obligations.  But who would put their faith in what the US or China agreed to do after witnessing the last few years.

Much better to have robust domestic capability.

I mean, I think we should do both. Create the obligations and the framework for cooperation, and build sufficient domestic capacity (or the ability to quickly ramp it up) in case the cooperation fails. That will, of course, have some cost in terms of capital and efficiency, but IMO that's the best way forward.

But yeah, Trump has amply illustrated that US reliability is less than it used to be, and China is of course shitting the bed completely in terms of their reputation.

[crazy canuck]

BB's proposition is that the lesson to be learned is that we need to create such obligations.  But who would put their faith in what the US or China agreed to do after witnessing the last few years.

Much better to have robust domestic capability.

I mean, I think we should do both. Create the obligations and the framework for cooperation, and build sufficient domestic capacity (or the ability to quickly ramp it up) in case the cooperation fails. That will, of course, have some cost in terms of capital and efficiency, but IMO that's the best way forward.

But yeah, Trump has amply illustrated that US reliability is less than it used to be, and China is of course shitting the bed completely in terms of their reputation.

I agree with that.  The point I was rejecting was the notion that we should rely entirely on the word of other governments that they will do certain things in the future, when we have just lived through four years of the US doing exactly the opposite.

[Jacob]

I concur.

[Sheilbh]

Look at who's furthest in vaccination efforts right now. The US and the UK, both of which have banned export of vaccines (de iure or de facto). Whereas the EU, which has not, or Canada, which lacks capacity, face months of delays coming out of the pandemic in comparison.

But that's just not true about the UK - for a start it's part of the Pfizer supply chain. The agent that delivers the vaccine is manufactured in the US and Yorkshire. And from my understanding the majority of the EU's exports have been Pfizer where it's always been the alternative base for manufacturing and as mentioned is part of a global supply chain.

With AZ the UK has only received 30-50% of what it's ordered - just like the EU. It's got a stricter contract and it invested in a domestic supply chain including setting up a factory in April last year before it was the AZ vaccine (the UK's investment - excluding purchases - in vaccine manufacture and research on a per capita basis is equivalent to the US and about 7 times the size of the EU's non-purchasing investment). Both of those things were options for the EU and the UK wasn't stopping any of that from happening.

Also UK regulators have inspected and approved non-European factories so AZ can make up the shortfall from non-European factories, from my understanding they've also made that offer to the EU but the EU has not as yet inspected or approved any non-European factories - and those factories are supplying countries all over the world. India is producing a lot of vaccine of which about 40% are being exported though they've just started the domestic vaccine program (2% inoculated so far).

That's not an export ban - and I think it's still worth noting that the IP in the AZ vaccine has been globally licensed to manufacturers all over the world and is provided at cost. 

Edit: Incidentally I have a lot of sympathy for the Commission - I think they were between a rock and a hard place on this. But I sort of wonder if the EU wouldn't have done better if the Inclusive Alliance of France, Germany, Italy and the Netherlands who were all willing to put up more money up front and earlier hadn't made purchases on behalf of the EU that the EU could then distribute which I think was the initial strategy.

I was talking about Trump pulling stuff like trying to buy that German vaccine researcher/ manufacturer for US use only, shitting on WHO cooperation, and generally go all in on the everyone-for-themselves approach. I think that set the tone and undermined a good deal of potential cooperation.

Although - weirdly that may have jump-started things. According to the long read in Politico EU it was that attempt to buy Curevac that prompted EU states to really start putting money into vaccines. And at the same time it caused the UK government to block the University of Oxford-Merck deal because Merck wouldn't agree to establish a UK supply chain. Without Trump's hamfistedness everyone might be relying on the US and hoping Biden would lift restrictions - but, then, he wouldn't.

[Richard Hakluyt]

The vaccination squabbles with the EU are helping me to move on from Brexit 

I wonder if that is a common response amongst remainers?

[Sheilbh]

The vaccination squabbles with the EU are helping me to move on from Brexit 

I wonder if that is a common response amongst remainers?

A huge part of it is simply luck - you know, the UK is at the back of the queue for Moderna and J&J vaccines. If they'd been authorised first, we'd be in the opposite position because I don't think we're getting any of them until end of April/May. In part that may reflect good work done by Kate Bingham. In the interview with La Repubblica etc she said when they were prioritising which vaccines to order the first test was whether there was a realistic chance it could be developed and approved in 2020. But I think the nature of Brexit means whatever happened both the EU and UK would inevitably be drawing comparisons with each other and that would shape the context for how we viewed our own relative success or not. I think if it was just Israel or the US both the UK and the EU would find reasons why those comparisons aren't applicable. And in the wider context I think in this pandemic the UK government has done four things well (testing since the summer, vaccines, gene sequencing, economic support) and everything else very badly which is why we have one of the highest death rates in the world

But as I say, it turns out the two vaccines that came first were both ones the UK had ordered a lot of and I think there may also be an element of luck in the make-up of the basket. The UK program so far is 50/50 Pfizer and AZ, so even if all of the AZ vacines manufactured in the UK went to Europe it would be an extra 10 million doses (the bigger impact is member states taking quite a strict approach and not delaying the second dose v the riskier decision made by UK CMOs). Given that Pfizer have cut everyone's deliveries by the same amount at the minute, the UK receive 8 million Pfizer doses in February, so far the EU has had 30 million Pfizer which suggests to me that either they've ordered a smaller amount (and possibly higher amounts of other vaccines) or they had less aggressive delivery schedules - which again is a contract issue.

But I also think there's been a lot of incorrect information, especially about the AZ vaccine, from sources in the EU to avoid responsibility/blame someone else - and after 5 years of British governments doing Brexit, it's a pattern of behaviour I think we've become quite good at spotting

[Sheilbh]

Two papers into new treatments. One in Brazil that showed strong reduction in mortality:
https://twitter.com/julienpotet/status/1369936620833624064

And separately GSK is applying for authorisation for a new experimental treatment that reduced mortality in hospitalised patients by 85%. Also J&J vaccine approved by the EMA.

I still find it surprising that we got multiple vaccines before we got lots of therapies/treatments. I don't know if that's just because of the focus of funding by governments etc but in my head I always thought that vaccines would be more difficult and slow to develop.

[The Larch]

EMA has just approved the J&J/Janssen single dose vaccine.

[Berkut]

I still find it surprising that we got multiple vaccines before we got lots of therapies/treatments. I don't know if that's just because of the focus of funding by governments etc but in my head I always thought that vaccines would be more difficult and slow to develop.

This actually does not surprise me.

Vaccines, in some ways, are "simpler" to developer then treatments. I know people who have worked on vaccines in the past - and it's very "pure" science. You go into a lab, and you work. It's complex of course, but it is "simple" complex. You are doing science, and testing, and more science with a bunch of other scientists.

Developing treatments for an ongoing pandemic is messy as all hell. You have LOTS of different people trying all kinds of shit, you are inindated with data, most of it sontradictory, and just trying to understand what information is legit and what is bullshit is nearly impossible. People are operating largely by the seat of their pants. If you are trying to coordinate and validate treatment innovation, how do yo do that? It's super messy.

There have been a LOT of effective treatments developed. I am good friends with someone who is a nurse specializing in respiratory technicians - she works pretty much exclusively now treating COVID patients in the hospital. They know a LOT more than they used to for sure. But sifting through all that data, much of which is not much better then Trumps "Cant we use bleach?" has to be a nightmare for whoever is responsible for coming up with approved recommendations for new treatments.

[Tamas]

So, I am seeing some reports of heavy blood-clogging triggered by the AZ vaccine, couple of cases in Austria, another in Denmark, is this, like, an issue or just odd cases?

[Sheilbh]

So, I am seeing some reports of heavy blood-clogging triggered by the AZ vaccine, couple of cases in Austria, another in Denmark, is this, like, an issue or just odd cases?

The EMA published a statement on it:

COVID-19 Vaccine AstraZeneca: PRAC preliminary view suggests no specific issue with batch used in Austria Share
News 10/03/2021

The Austrian national competent authority has suspended the use of a batch of COVID-19 Vaccine AstraZeneca (batch number ABV5300) after a person was diagnosed with multiple thrombosis (formation of blood clots within blood vessels) and died 10 days after vaccination, and another was hospitalised with pulmonary embolism (blockage in arteries in the lungs) after being vaccinated. The latter is now recovering. As of 9 March 2021, two other reports of thromboembolic event cases had been received for this batch.

There is currently no indication that vaccination has caused these conditions, which are not listed as side effects with this vaccine.

Batch ABV5300 was delivered to 17 EU countries and comprises 1 million doses of the vaccine. Some EU countries have also subsequently suspended this batch as a precautionary measure, while a full investigation is ongoing. Although a quality defect is considered unlikely at this stage, the batch quality is being investigated.

EMA's safety committee PRAC is reviewing this issue; it is investigating the cases reported with the batch as well as all other cases of thromboembolic events, and other conditions related to blood clots, reported post-vaccination. The information available so far indicates that the number of thromboembolic events in vaccinated people is no higher than that seen in the general population. As of 9 March 2021, 22 cases of thromboembolic events had been reported among the 3 million people vaccinated with COVID-19 Vaccine AstraZeneca in the European Economic Area.

PRAC will continue its assessment of any potential issue with the batch as well as its review of thromboembolic events and related conditions.

EMA will further communicate as the assessment progresses.

[mongers]

I'd like to see the Brazilian P1 variant renamed the 'Bolsonaro virus', as his anti-Covid polices have provided the ideal 'breeding ground' for it and possible future variants.

[crazy canuck]

So, I am seeing some reports of heavy blood-clogging triggered by the AZ vaccine, couple of cases in Austria, another in Denmark, is this, like, an issue or just odd cases?

Better not to spread groundless rumours 

https://www.bbc.com/news/world-europe-56357760

[Zanza]

The vaccination squabbles with the EU are helping me to move on from Brexit 

I wonder if that is a common response amongst remainers?

The fallout from Brexit will still be there when the pandemic is over. It's perpetual poor relations and economic damage.

[Richard Hakluyt]

The vaccination squabbles with the EU are helping me to move on from Brexit 

I wonder if that is a common response amongst remainers?

The fallout from Brexit will still be there when the pandemic is over. It's perpetual poor relations and economic damage.

Like Norway and Switzerland then?