Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

What is so appalling is that no other country on the earth is doing this.

The UK demands priority - but the AZ vaccine is being exported from the UK.

The EU has no export controls - which is why its vaccines are being sent all over the world.

I don't think the AZ vaccine is being exported from the UK. From my understanding, the UK, because of its contract with Oxford and AZ, has minimum deliveries from UK factories before those factories can provide doses to other customers. So far AZ has only managed to hit 30-50% of the delivery schedule. But there is no export ban so the UK is part of vaccine supply chains for, for example, European production of Pfizer. There are also plants in the UK that will be manufacturing Curevac, Novavax and Valneva - which are all looking very promising right now and they should all be approved in the next few months (I think Novavax is very close and has published really good results). I imagine those will largely be exported.

But the Oxford/AZ model is not like Pfizer or Moderna who have said they want to supply everyone from one or two large manufacutring bases - I think GSK and J&J have a similar approach. A condition of Oxford licensing their vaccine to AZ is that it is licensed globally and manufactured at cost. So there is one manufacturer in the UK, two (huge) manufacturers in India, one in Australia, two in the EU - I believe there's also a few in the US and possibly Japan and South Africa. It should be noted that AZ aren't actually manufacturing much of this it's basically in charge of licensing and supply chains but the actual manufacturing is largely sub-contracted, from what I've read this is because AZ basically has no experience in manufacturing vaccines so don't have the expertise to make it (unlike, say, Pfizer, Merck, J&J etc).

I'd add that the UK is from what I understand one of the largest per capita contributers to Covax and has already announced that it will be providing most of its surplus vaccines to Covax (because, like most rich countries, we ordered a lot of doses from a lot of manufacturers because no-one knew what would work - so I think we have four times as many ordered as neede to vaccinate the entire UK population).

Edit: And in terms of impact the UK has from my understanding manufactured about 10-12 million AZ vaccines - I think there's some impression we're swimming in it. We've imported a similar amount of Pfizer from the EU (which is about 10% of Pfizer's European production) so an equivalent amount would be 1-1.2 million AZ vaccines which would not really make much difference to the EU's program.

The single biggest difference - and I think the best decision from UK decision makers (in this case the Chief Medical Officers) was to go for a delayed second dose strategy. I understand some provinces in Canada have adopted it, I think Denmark and Germany have with the AZ vaccine, but for three months it doubles the number of people you can vaccinate. And there's now data supporting it (there always was for AZ). I don't understand why this isn't being adopted more widely or there's no pressure to consider it.

[Sheilbh]

Tests show that the "British" B1.1.7 mutation is currently 90% of all cases in Vienna and similar in much of Eastern Austria - one of the reasons numbers have been rising again. It's also leading to hospitals filling faster compared to similar infection rates in autumn.

That's expected but grim to hear

There is growing evidence that it is more lethal as well as more transmissible. I think you - and most of Europe - will end up having national lockdowns a bit like we have if this variant gets to a dominant position. Because if it starts spreading it gets exponential quickly.

[Grey Fox]

I'd kind of forgotten how languish could get

Berkut still types really, really fast. I can't keep up when using a KB & here I was trying to quote his wall of texts on my phone.

[Admiral Yi]

I'd kind of forgotten how languish could get

Feel like disappearing for another five years? 

[Barrister]

I'd kind of forgotten how languish could get

[Berkut]

Oh yes, it is all Berkuts fault for pointing out that bigotry against America, while satisfying and delicious, is still rather stupid.

I provided facts. Actually, I didn't even provide them, I pointed out the actual facts in the articles YOU guys provided.


It really is amazing how mad people get when you challenge their cherished love of being mad at some other group.

[Jacob]

I don't see how that could be - I think Tamas is correct that inherent in the very notion of a nation-state is that it will prioritize the lives of its own citizens first. One can critique a world system based on that form of organization but it's hard to argue that the implication doesn't follow.

I think there's a pretty broad range of possible responses in pursuit of the national self interest.

IMO, Trump started out with his typical "fuck everyone, it's all about my ego and about me being number 1" and proceded in a way that was destructive to international co-operation and efficiency.

Biden's current stance of blocking exports is a reasonable if unfortunate consequence of that. He needs to be seen as going all in on getting the situation under control in the US, and doesn't want to open himself up to "he cares more about foreigners than Americans" lines of attack. It sucks, but it is what it is. And I think the "we're loaning you AZ vaccines" move is an attempt to maintain that public America First line, while being a little more constructive than that, which I appreciate.

However, I believe that if Covid had happened under Biden - or under any pre-Trump American president - the US response would have been to step in and help shape and co-ordinate - or even lead - the international effort. I expect that the US would still get plenty of vaccines, and would in fact be further ahead than everyone else - but I expect traditional allies would be better off as well. And I expect the discussion would be calmer and more rational.

IMO, it could be argued that it's in the US national interest includes maintaining and building soft power, and maintaining and improving the system of international trade and trust that it has built over the years. Especially if this can be done without significantly setting back other priorities.

If, say, the tenor of the discourse had been calmer and less "us vs them" (at least inside the group of traditional US allies), then the US could do something like keep 90% of the vaccines, export 10% (or whatever proportion, but putting yourself first but still being helpful to your allies) without making a big fuss about it domestically or internationally (it'd all be the various CEOs taking the blame).

You'd still be way ahead, but instead of talking about how events have shown that it's foolish to rely on the US when push comes to shove, and how international supply chains are a national risk, we'd be talking about how great it is that the US has such massive pharmaceutical production capacity, how - in spite of some hiccups - the system kind of works, and how the US is a great ally to have.

That's my perspective. I don't think the current situation was inevitable, and I do think things could've been managed better and produced better outcomes. And I don't think that would've required the repudiation of the underlying principle of the idea of the nation-state to achieve that.

[HVC]

I'd kind of forgotten how languish could get

He's not as fiery as he used to be. But he does type quickly, like GF said.

[Jacob]

I'd kind of forgotten how languish could get

Feel like disappearing for another five years? 

I'm definitely curating my posting more tightly this time around 

I think that's a strategy you've followed for a long time.

[Berkut]

OK, so Canada, seriously - STFU.

Take a look at this article:

https://www.nature.com/articles/d41586-020-03370-6

Most of this capacity is already spoken for. The 27 member states of the European Union together with five other rich countries have pre-ordered about half of it (including options, written into their contracts, to order extra doses, and negotiations that have been disclosed but not yet finalized). These countries account for only around 13% of the global population.

If six other leading vaccine candidates are included, the total number of doses for which disclosed deals are in place rises to 7.4 billion, with expansion options or ongoing negotiations accounting for another 2.9 billion doses, according to Airfinity's calculations. When these other vaccines are included, the total number of doses secured by the same five countries and the EU remains at around half of the total, because those wealthy enough to place bets on a number of candidates bought up broad portfolios of products early in the pandemic.

Canada is actually on track to have more doses per capita then any other country in the world. I am sure that is so they can promptly ship them off to Africa.

If you actually have a MORAL argument to make here, it isn't about the US screwing over the other ultra-rich countries, it should be about all the rich countries fucking over everyone else, as usual.

But that isn't nearly as satisfying and signalling, now is it?


Looking at the graph in the article, most of US production isn't even the critical path anyway - the US is producing about a billion doses, I think, and that is going to cover the US and then start shipping elsewhere. AZ alone has like 4 times that amount (not sure exactly, since I cannot tell how much of Pfizer is produced in the US versus the EU).


So the idea that the US is somehow the bogeyman is ridiculous. The US is doing the same thing everyone is doing - getting as much for its citizens as it can, under the various and complex agreements and priorities that the world is operating under. The idea that the "rest of the world" is somehow doing some noble sacrifice for the greater common good is utter horseshit. If that were true, we would see a hell of a lot less vaccine in the rich countries, and a lot more in the poor ones.

[alfred russel]

There are a lot of critical scarce resources in the world economy. Us first worlders are used to be able to get access to them through our wealth, and more or less ignore the poor countries that do without. Some of the countries that suffer malnutrition or lack of access to medicine or energy supplies or whatever are even our allies!

Then a situation comes along where access to scarce resources involves more than just money, and the first worlders that can't buy their way to the supplies they want are unhappy about it. 

[Jacob]

My understanding is that Canada's pre-order numbers are so high because our initial set of pre-orders got a "yeah, you may have pre-ordered, but you're not actually getting these vaccines for a long time" - so we've gone out and pre-ordered a whole bunch of more vaccines in the hope that some of them will get delivered.

If you look at the number of vaccines distributed per capita, Canada sits at roughly 9.5% with the US at roughly 34.5%, the UK at 40.7%, Germany at 12.2, Mexico at 3.8%.

But, Berkut, fair point about the rich countries screwing over the poor ones - and yeah, Canada is definitely part of that. IMO, better international coordination, cooperation, and leadership could've helped. That boat has kind of sailed, but it'd be great if we could somehow mitigate that.

[Jacob]

There are a lot of critical scarce resources in the world economy. Us first worlders are used to be able to get access to them through our wealth, and more or less ignore the poor countries that do without. Some of the countries that suffer malnutrition or lack of access to medicine or energy supplies or whatever are even our allies!

Then a situation comes along where access to scarce resources involves more than just money, and the first worlders that can't buy their way to the supplies they want are unhappy about it. 

But yeah, it's a wake up call for sure.

[PDH]

I don't know what you guys are fighting about.  I got my 2 doses of the vaccine and, really, isn't that what it's all about?

[HVC]

I don't know what you guys are fighting about.  I got my 2 doses of the vaccine and, really, isn't that what it's all about?

Stop flaunting your old man privilege!