The last week has been the worst for the pandemic by any measure in the US. On average, 2,400+ people died every day of Covid, and that's likely an undercount due to the Christmas holiday. A new, likely more contagious strain has been identified in the UK and South Africa. There is hope on the horizon; the rollout of the vaccines is going well.
California is in full crisis right now. Large parts of the state have no room in the ICU's, and there are more active infections than any other time in the epidemic. In the last 48 hours, it looks like we may be peaking, but I'm skeptical. Between Christmas gatherings and delays in reporting, it's probably going to get worse before it gets better.
Now is not the time to have a New Years' party. Now is not the time to hang outside your bubble. Now is the time to bunker.
Let's talk about the new variants. First off, mutations are expected in viruses, even more so when tens of millions of people are currently infected. There is a worry that both of these mutations came from long-duration infections in immunocompromised patients. Basically, if the virus has a long time to exist in a single body before it is fought off or kills the host, it will start to evolve in response to the immune system.
These new variants, known as B.1.1.7 for the British one and 501Y.V2 for the South African, show early indications that they may be more contagious. There is no evidence that they are more deadly nor evidence that the current vaccines won't work.
It's unknown if either variant is currently in the US, but it's likely already here. One gap in our monitoring system is detailed genetic analysis. The UK does the most genetic analysis in the world, and that's how they discovered theirs.
Modern sequencing/modeling is a marvel. We know exactly what changes the new variant has and have theories on why it would be more contagious. The vaccine experts have looked at the new sequences and don't believe that it will have a significant impact on efficacy. Your body mounts what's called a polyclonal antibody response to the vaccine, which means it targets various parts of the spike protein.
The analogy would be if the cops were looking for a suspect and one set of cops looked at the fingerprints, one facial recognition, and one looks at footprints. If the suspect changed one thing, like their fingerprints, they would still get caught by the other cops. This is what your immune system does; it builds a set of antibodies to various parts of the virus so it can't get away; it's incredible.
Obviously, the bad news is that we might have a more contagious strain on our hands; the good news is that nothing changes how we fight it. Masks, testing, and distancing still work.
Today AstraZeneca / Oxford CEO stated that their vaccine is very effective and expects it to be approved in the UK this week. The scientists I follow on Twitter continue to hold reservations about this one. If you catch a student cheating on a paper, you tend to read the rest of their work a little closer, and that's where we are with AZ. In today's press release, the CEO gave minimal data. It does not appear to have been evaluated by any outsiders. I'm thrilled that the FDA requires AZ to do a separate trial in the US and independently review the data.
With AZ, I'm also worried about the pressure cooker they're under is the perfect storm to cause people to commit fraud. AZ was supposed to win; it was supposed to be the first. The UK and Europe bet big on AZ, and now they look like fools. No one else thought Moderna had a chance. The Germans are livid that the Pfizer vaccine's core tech is from Germany, and they didn't buy in to get the first doses!
Governments may lose their elections, and the CEO could lose their job over their failure. That's why after the selective release of their first data, which on deeper investigation threw a ton of red flags, it's even more concerning they're going for certification with basically no further public release of data.
Contrast this to the FDA. The FDA made Moderna enroll thousands of more people, slowing them down when they felt the cohort didn't have enough minorities. The FDA made Pfizer push its first checkpoint to a higher number because they were concerned they wouldn't have enough data to make statistically relevant conclusions. The FDA isn't going to approve AZ without ample data showing they did their trial correctly.
The AZ vaccine may work and be incredibly effective, but given their track record, they need to bring data to show that it is.
This was the first week for two vaccines being in distribution. Over 2 million people in the US have now received their first shot! That's amazing! A couple million more will get theirs this week!!
Out of those two million doses, there has been a minimal number of allergic reactions. Some have been in people with previously known reactions like this. There are a few cases they are still investigating. Still, they suspect it's related to a cosmetic filler that those patients had. Overall this is an extremely safe vaccine; the medical staff quickly and safely treated the allergic reactions.
Some people have expressed concerns about the logistics of the rollout. The closest event we have is the annual flu vaccination in the US. In the 2019-2020 flu season, 48.4% of adults got the flu vaccine. That's about 170 million doses went out in the 2018-2019 season. The Covid rollout logistics aren't that much harder, and it's obviously a much higher priority.
This week the US bought an additional 100 million doses of the Pfizer vaccine, due by July 31st. We also have 200 million doses of the Moderna one on order to be delivered before June. With that, we can vaccinate 200 million people, plus by June, tragically, probably 100 million people will have caught it naturally. That's enough for herd immunity.
We did the hard thing; we developed and rolled out a vaccine in under a year. Let's band together and crush this current wave, and then we let the vaccines do their job. The end of this is in sight.
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