Covid Update - 21 Feb 2021

There's an apocryphal Churchill quote of "America will always do the right thing, after they've tried everything else."

We crossed 500,000 deaths in America due to Covid this week. A crushing, awful milestone that's hard to fathom. Our government [at all levels] failed us, and a cities worth of Americans are dead. After spending a year rejecting facts and logic, the efforts put into science have paid off.

Our scientists have created two of the most effective vaccines we've ever produced. After a bit of stumble out of the gate, we are now one of the world leaders for vaccination. This week brought us massive news about the increase in production and inoculations. Just as it was hard to fathom how bad the last year would be, I expect it's hard to understand how fast things will get back to normal.

The infection maps are mostly orange instead of solid red. For the first time since December, the seven-day average for deaths has dropped below 2,000 people per day.

Based on the current infection rates and hospitalization, I expect this to continue to drop dramatically. By no means are we entirely out of the woods; New York and Florida, in particular, still have relatively high base levels, but the trend lines are clear.

Case counts nationwide and worldwide continue to be in free fall. This is likely due to several factors: immunity from large amounts of people infected, vaccinations, and seasonality of the virus. This is incredibly important because the fewer people currently infected, the less chance we give the virus to mutate and evade our vaccines.

On the topic of mutations, the 351 variant continues to be the one I'm tracking closest. Still, I continue not to be that concerned. Pfizer did some lab studies using the blood of people who had been vaccinated against a 351 stimulant. They found reduced antibody effectiveness but that there was still a protective effect. It's challenging to precisely predict the real-world knockdown based on these types of studies. Israel should give us some real-world data on this in the next few weeks. I expect we'll get boosters for a variant or two in the fall. It still seems likely that the vaccines are good at preventing hospitalizations for 351.

We need to help prevent more mutations from arising, and the best way to do it is to lower the infection level.

As Dr. Angela Rasmussen put it on Twitter, "I'm sick of stupid SARS-CoV-2 winning evolutionary Powerball all the time." Me too. So let's stop selling it tickets."

This week our daily inoculation rate dropped due to the disaster in Texas. Not only did it prevent TX from continuing their vaccinations, and they were doing 100k per day, but it also disrupted supply chains across the midwest. As of today, it looks like we're back to where we were.

States will begin getting 13.5 million doses of mRNA vaccines each week -- up from 11 million currently. The feds will be distributing an additional 2 million doses per week directly to pharmacies. That's excellent news. We now have dialed in our distribution strategies at the local level. The current blocker is the amount of vaccine.

Pfizer expects to double the number of doses it provides in the coming weeks, going from 5 million to 10 million doses a week. They expect to deliver 200 million doses by the end of May, about two months ahead of schedule. Moderna also expects to deliver 200 million doses by the end of May.

Let that sink in. By the end of May, we'll have 400 million mRNA doses delivered, enough for 200 million people. That doesn't include anything else we get from J&J or Novavax. In the coming weeks, the projections show we'll double the weekly doses to over 3 million. Things are going to get better, faster than you can imagine.

Pfizer also had two other significant announcements this week. First, after more study, they are applying to change the storage requirements to a regular freezer instead of a deep freezer. They were overly cautious in their first filing and now have the data to show it. The deep freezer requirement was a significant limitation on one of our two vaccines. The other announcement is that they are starting a study on vaccinating children 5-11 years old and expect results in the fall.

Moderna announced some huge news this week that they have early results showing that a half dose is as effective as a full dose. When they were developing the vaccine, they erred on the side of caution and went with the higher dose due to time pressures. If approved by the FDA, this will double (!) the capacity of all the factories.

On top of all the excellent availability news, we got our first study on whether the vaccine prevents transmission. To recap, all the studies have been to determine how effective the vaccine is at preventing you from getting sick. In some pathogens, your immune system prevents you from getting sick, but you can still transmit it to others. Well, the data is in, and these vaccines are incredibly effective at preventing transmission, nearly 90%. So while not quite full sterilizing immunity, it's pretty close and will significantly contribute to how fast we'll get it all under control.

Today, the US has secured 600 million doses [300 million peoples worth] of mRNA vaccines on track to deliver before the end of July. There are only 250 million American adults and 80 million kids. In the late summer, we will get data on the various studies on children to dose them correctly.

As of now, the US has reservations for an additional 500 million doses between AZ, J&J, and Novavax. I expect we'll donate almost all of those reservations. We might keep the Novavax ones if they spin a dose that is a multi-strain response, or we might use mRNA boosters in the fall. Either way, we erred on the side of caution and have more than we can use, and the world will benefit from the overage.

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