There's the expression that "it's darkest before the dawn," but that's not true. Right before dawn, it's already pretty light. There's even a term for it, The Golden Hour. It is, however, coldest before the dawn. If you've ever spent a night cold and shivering and waiting for the light to break the horizon, you know the difference between it being light and the warmth of the sun. What's worse is that there is often an early morning breeze that can take the last bit out of you.

That's where we are today. Last week we had the news we've been waiting for that an effective vaccine has likely been discovered. Last week we also hit a record for hospitalizations in the US, and the curves aren't bending at all.

We will get through this, but we're going to go through hell to get there.

Let's start with the big news, Pfizer announced preliminary results showing an incredibly effective vaccine! This is transformational news! Remember, many naysayers spoke about how we wouldn't be able to create a Coronavirus vaccine at the beginning of this. It seems they were wrong.

Specifically, Pfizer announced they believe their vaccine is 90% effective at preventing Covid infection. The Pfizer phase III has involved 44,000 people [largest ever conducted]. They expect to hit their Emergency Use Authorization [EUA] threshold by the end of November. If approved, they believe they can inoculate 20 million people by the end of the year.

This is the shout from the rooftops moment and is one of the single most incredible things you'll see in your lifetime. In the ten months since a novel virus inundated the world, one we've never been able to treat before, we've found a vaccine! Further, due to how the Pfizer vaccine works, it seems more likely that several of the other vaccine candidates will work.

As Newton would say, this vaccine happened by "standing on the shoulders of giants." The past 20 years of work done by scientists on Corona Viruses, mRNA, new imaging and sequence techniques, and more is why when the world decided to cure Covid-19, we could. This should be a reminder of the importance of basic research and why it needs robust funding. When this is all over, find a biology grad student and buy them a drink (along with doctors and other first responders).

Not only have we created a vaccine, but we also scaled up manufacturing in a way that's never done before. Pfizer says it can make 1.3 billion doses in 2021. If we get a second and possibly a third vaccine approved, it's possible that in 2021 we will vaccinate billions of people.

With just the Pfizer vaccine Operation Warp Speed expects to have 20-30 million doses A MONTH in 2021 for the US. Moderna last week announced it was analyzing the data from their first data release. They expect to report results in the coming days. If the Moderna vaccine is also at 90%+ effectiveness, then we're in an excellent position.

What does that 90% effective actually mean? In their trial, 94 people in the control group got Covid, and nine people in the vaccinated group got Covid. To put that in perspective the effectiveness of some other ones are: Measles (2 doses) - 97%, Smallpox - 95%, Chickenpox (2 doses) - 92%, Seasonal flu - 40-60%. So if I were vaccinated, I still wouldn't be jumping into a crowded bar in a high infection area. Still, it would certainly let me feel more comfortable in many places I don't right now.

Now the Pfizer vaccine does have downsides; it is the hardest from a logistics point of view. The Pfizer vaccine must be kept at -70 C, so transportation and distribution will be hard, likely starting in cities with specialized facilities as a result. Even if we only get the Pfizer vaccine, I have confidence that we will solve distribution; it's just engineering. If you went back in time and told a radar tech in the '40s that in 10 years, that tech would be miniaturized and in many homes for frozen dinners, it would have sounded crazy as well.

But before the vaccine is deployed, we need to get through the next few weeks of the surge. My worst nightmares appear to be coming true with nationwide surges in case count. Several states in the upper midwest see their hospitals hit capacity, and the death rate will soon climb. Worse still, since the surge is everywhere, there aren't extra medical personnel we can surge into the hot zones.

One incident was particularly troubling. A hospital in Utah reported that some conspiracy theorists tried to break in to "prove" that the ICU wasn't as full as claimed. The misinformation is out of control, and the fact President Trump has decided to ignore the epidemic is unconscionable.

The surge likely has a few causes. Halloween, winter pushing more people inside, and there is some evidence that dryer air lets the virus survive longer.  Thanksgiving, Christmas, and New Years will likely see it spike even further. I know we all miss our families, but this isn't the year to travel to have a big event. If we have another month of the spread at the rate we currently do, they'll be digging graves with backhoes.

For me, I'm assuming that I'll be bunkering down for a bit, pulling back on the limited outdoor socializing I was doing. We've come so far, and we're so close to the vaccine getting distributed. Let's come together and get this surge under control while the science finishes up.

Take care out there.

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