Daviewolf83 said:

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Some updates on vaccinations and vaccine development:

1. On Face the Nation this morning, Dr. Fauci Dr. Anthony Fauci said the Biden Administration's vaccination goal is 100 million "shots in arms within 100 days" and not 100 people vaccinated. He estimated this will mean 67 million people will be vaccinated. Some will be fully vaccinated and some will have received one dose.

Personally, I believe the 100 million doses in 100 days is not a new goal, since we were already tracking to this number prior to President Biden taking office. It is basically "sleeves out of his vest", since it is an accomplishment that would have likely occurred without any additional action on his administration's part, beyond what is already being done to ramp up vaccinations. A more aggressive goal would be 150 to 200 million vaccine doses in 100 days. There are indications we will have enough vaccine supply to achieve a higher goal and the states are starting to show significant improvements in vaccination rates.

As I have indicated before, I am tracking against this target, both for the US and NC and will provide updates starting next week with regards to how we are doing in meeting this goal.

2. Reports indicate the Johnson and Johnson vaccine trial could be close to concluding and there could be a read-out in the next couple of weeks. This was actually expected by some this past week, but it appears the reports are not ready yet. Dr. Fauci said a couple of days ago that we could have the J&J vaccine approved by mid-February. It might be possible if J&J submits their data and EUA to the FDA the first week of February, but it will be tight. A J&J board member said they may have 100 million doses available this Spring by end of April, but other reports I have seen indicate this may be difficult. Hopefully, we will get more clarity on supply in a couple of weeks when the EUA is filed. Two advantages of the J&J vaccine are that it does not need to be kept at super-cold temperatures (refrigerator temps are fine) and it only requires one dose, so supplies do not need to be reserved for a second dose.

3. For the AstraZeneca vaccine, it is still going through trials in the US. It was approved for use in the UK in December and Brazil in January. The AstraZeneca vaccine is a vector vaccine, like the J&J vaccine. However, it will require two shots to be fully effective, unlike the one-shot J&J vaccine. The trial results for the US and other countries have been a little confusing, but it appears efficacy could be around 70%. While good, this is not as effective as the Moderna and Pfizer vaccines. The AstraZeneca vaccine could be submitted for EUA by the end of March.

4. The Novavax vaccine entered Phase 3 trials in December and they are enrolling 30,000 participants in the US and Mexico. The vaccine requires two doses, given 21 days apart. Novavax expects to have results for this trial by early first quarter of this year.

5. There was a very good article posted yesterday on Operation Warp Speed and how well it worked in getting Covid-19 vaccines developed. I encourage everyone to read it. It was written by someone I have followed on Twitter for months - Alicia Smith. She has been on top of the vaccine development news for months. You can read the article at the following link:

Operation Warp Speed's Success

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Nice. This was a very interesting and enlightening listen regarding development of the vaccine, from one of the main scientists:

https://www.thisamericanlife.org/727/boulder-v-hill

The virus info is in Act2, but I found the whole show to be a good listen (as almost every episode of TAL is)

Civilized said:

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Biden raises the bar on vaccines and suggests US will get to 1.5 million a day

Good call. The bar needed to be raised from 1M/day. In early December, when we were only vaccinating around 300K/day, 1MM/day seemed like a reasonable goal but by the time Biden took office we weren't far off from averaging 1MM/day already. It wasn't a very ambitious goal anymore once we got to mid-Jan.

Will be interested to see how far they can push the envelope, and how many are getting vaccinated per day in 3 months.

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I agree. We are doing over 1M a day now and as supply improves, it is not unreasonable to think 150M is very attainable. I think 150M should be a goal and 200M should be an aspirational goal. We should have supply to support up to, if not more than 200M by May.

Some not so good news is coming out on the AstraZeneca vaccine. Some reports appeared today that suggest the vaccine's efficacy for 65+ is only 8%. If so, it is very possible that it will only be approved for younger people. This is apparently how it is being approved in Germany. Of course, AstraZeneca is saying the reporting is in error, but people who have seen the data that is being reviewed in Germany say the reporting is accurate. I guess we will find out soon.

That's really quite bad, do you know how big the sample size is?

statefan91 said:

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That's really quite bad, do you know how big the sample size is?

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No mention of the details. The data is coming from people who reportedly have seen the data, but the full data has not been released to the public yet.

Today's vaccination updates for the US and NC, per Bloomberg. For some reason, the CDC did not update their numbers today:

US Vaccinations
Total Doses Available: 41,418,325
Total Doses Administered: 23,461,494
% of Available Doses Administered: 56.6%

NC Vaccinations:
Total Doses Available: 1,246,600
Total Doses Administered: 676,037
% of Available Doses Administered: 54.2% <== significant improvement in usage in the past several days

If you have not seen the news today, it is being reported that many people in NC who had appointments to get the vaccine have had their appointments cancelled. This apparently is being caused by:

1. Reserving vaccine doses for people who will need their second dose
2. Reallocating supply to sites in the state that are performing more large-scale vaccination events. For example, in Charlotte they are doing vaccinations at Charlotte Motor Speedway and due to how effectively they are getting shots in arms, more of the supply is going to this site.

The good news is the reallocation will help to expedite getting shots in arms. However, some of the rural counties (and even some like Wake Co) will see their supply cut, since they have not scheduled any large events or do not have the ability to conduct these type of events.

Daviewolf83 said:

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Civilized said:

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Biden raises the bar on vaccines and suggests US will get to 1.5 million a day

Good call. The bar needed to be raised from 1M/day. In early December, when we were only vaccinating around 300K/day, 1MM/day seemed like a reasonable goal but by the time Biden took office we weren't far off from averaging 1MM/day already. It wasn't a very ambitious goal anymore once we got to mid-Jan.

Will be interested to see how far they can push the envelope, and how many are getting vaccinated per day in 3 months.

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I agree. We are doing over 1M a day now and as supply improves, it is not unreasonable to think 150M is very attainable. I think 150M should be a goal and 200M should be an aspirational goal. We should have supply to support up to, if not more than 200M by May.

Some not so good news is coming out on the AstraZeneca vaccine. Some reports appeared today that suggest the vaccine's efficacy for 65+ is only 8%. If so, it is very possible that it will only be approved for younger people. This is apparently how it is being approved in Germany. Of course, AstraZeneca is saying the reporting is in error, but people who have seen the data that is being reviewed in Germany say the reporting is accurate. I guess we will find out soon.

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The AstraZenica info alligns with what my brother was saying a few weeks ago. He told me bluntly that if he had a choice, he wouldn't even consider getting the AZ vaccine because of the information that they had on it at that time. Said it had to many side effects and wasn't very reliable.

Daviewolf83 said:

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Today's vaccination updates for the US and NC, per Bloomberg. For some reason, the CDC did not update their numbers today:

US Vaccinations
Total Doses Available: 41,418,325
Total Doses Administered: 23,461,494
% of Available Doses Administered: 56.6%

NC Vaccinations:
Total Doses Available: 1,246,600
Total Doses Administered: 676,037
% of Available Doses Administered: 54.2% <== significant improvement in usage in the past several days

If you have not seen the news today, it is being reported that many people in NC who had appointments to get the vaccine have had their appointments cancelled. This apparently is being caused by:

1. Reserving vaccine doses for people who will need their second dose
2. Reallocating supply to sites in the state that are performing more large-scale vaccination events. For example, in Charlotte they are doing vaccinations at Charlotte Motor Speedway and due to how effectively they are getting shots in arms, more of the supply is going to this site.

The good news is the reallocation will help to expedite getting shots in arms. However, some of the rural counties (and even some like Wake Co) will see their supply cut, since they have not scheduled any large events or do not have the ability to conduct these type of events.

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Yeah, I don't like the "redistribution" aspect of this post... the supply should be distributed in the same percentages as population in each county.

Cone had to reschedule over 10,000 people due to the reallocation to Charlotte. Wake County expected 3000 and got less than 1000. But for some reason Alamance County was expecting 975 and got about 2000. How are they supposed to schedule the vaccinations when the state does this?

PackMom said:

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Cone had to reschedule over 10,000 people due to the reallocation to Charlotte. Wake County expected 3000 and got less than 1000. But for some reason Alamance County was expecting 975 and got about 2000. How are they supposed to schedule the vaccinations when the state does this?

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That's been a mess here. Your question is the same thing cone is asking itself.

Wow! Didn't they just stop those (elective surgeries) yesterday?

Great news from you Drs/ healthcare workers. It appears we are finally getting over the holiday spike. That's why things were so bad... you had Thanksgiving, then a few weeks later Christmas, then New Years. It takes a few weeks to finally get over all that. Hopefully numbers continue to improve. Next uptick will probably be first of Spring, or maybe around Easter.

Some vaccine supply info this morning.

1. According to Moderna, they have supplied approximately 30M doses to the US. If accurate, this means 30 of the 42M doses available in the US are Moderna. I am a little surprised by this number, since they were approved later than the Pfizer vaccine. The advantage is the Moderna vaccine does not require the ultra-cold storage during shipping and prior to injection.

Also, Moderna has confirmed they are on track to supply a total of 100M doses by the end of March and 200M by the end of June.

Last, Moderna has seen a reduction in the neutralizing effects of their vaccine on the UK/S. African strain of the virus (B.1351 strain), but they think the neutralizing effects are still high enough to be effective in protecting against the new strain. Regardless, Moderna has begun development of a vaccine specifically targeted against the new strain.

2. J&J is saying they could release data on the efficacy of their vaccine next week. If accurate, it means the US could see approval of the vaccine by the third week of February- assuming it is deemed safe and effective. If so, it will go a long way in insuring the US has 200M total vaccine doses by April.

I'm getting the Moderna vaccine. They will also be giving the Pfizer vaccine where I'm getting mine, but I'm getting the moderna. Not due to my preference or planning. Just luck. That's the one I preferred so it worked out nicely.

Mormad said:

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Yep. With the R0 3 wks ago they were predicting 350 admitted by feb1. We were just under 300 a week ago. So 3 wks ago they planned the shutdown. We're now down to like 220, and only 20 in the unit and 10 tubed. Things are looking up. And until this week, every day I'd walk in to round there'd be a line around the corner of folks waiting in line to roll up their sleeves.

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That's great to hear! Thanks for the update.

Good news from you, too, PackPA!

Daviewolf83 said:

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If you have not seen the news today, it is being reported that many people in NC who had appointments to get the vaccine have had their appointments cancelled. This apparently is being caused by:

1. Reserving vaccine doses for people who will need their second dose
2. Reallocating supply to sites in the state that are performing more large-scale vaccination events. For example, in Charlotte they are doing vaccinations at Charlotte Motor Speedway and due to how effectively they are getting shots in arms, more of the supply is going to this site.

The good news is the reallocation will help to expedite getting shots in arms. However, some of the rural counties (and even some like Wake Co) will see their supply cut, since they have not scheduled any large events or do not have the ability to conduct these type of events.

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Yep, my inlaws (live in Charlotte) are in the 70-75 range, so were 2nd wave - and their initial appts thru the Meck Health Dept was mid-April, just one day after that site opened the window for that range.
Thru a friend, they heard that BofA Stadium was going to be offering, and were able to move their appts up to early FEB.

I'm guessing all that came at some other area - likely rural -- demise.

Mormad and PackPA - Thanks for the update on hospitalizations in your areas. This is definitely encouraging information and mirrors what I have begun to see in the hospitalization data I have been collecting. It appears the virus may be following the influenza curves we have seen for the past several years. This seems to imply that the increases we saw over the past few months is related to seasonality effects with respiratory viruses.

The good news in the graph below is the percentage of active cases hospitalized is now approximately 3.5% and this is the lowest it has been in months.




Additionally, the percentage of hospitalized Covid-19 patients in ICU is also continuing to fall and the 30-day average is down 1% from a couple of weeks ago when I published the chart below.

Have you seen predictions of an incredibly large surge in approximately March when the COVID variant surges in the US?

I read a couple articles from various epidemiologists that are worried about another surge then. Some are reporting that this may be the largest surge since the pandemic began.

Mormad said:

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Israel is reporting a 60% reduction in hospitalizations in those over 60 23 days after vaccination.

Haven't read the study, but Canada has been looking at colchicine since March and they're saying it has been effective in reducing hospitalizations and mortality.

Here, the curve has flattened so quickly, they are rolling out a plan by this afternoon to ramp up elective surgeries again. Great for the community we serve.

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Fantastic news.

To my layperson interpretation, we're currently at around 25 million who have been infected (or tested positive anyway) and 25 million who have been vaccinated. If we get to 100 million vaccinated in the next three months with similar increase in infection over that time, we will have more than a third of the population that has either been exposed or vaccinated, and even higher if we reach the possible earlier stated goal of 150 million vaccinated. With that amount of the population having ostensibly some resistance to the virus, including hopefully a large percentage of those most at risk, and since it has been stated that the vaccine seems to provide that even for the new strain, I don't see how a surge in that time frame could be worse than anything we've experience so far. I think that the summit is in sight, though I'm sure this is something we will be dealing with for the foreseeable future, and certainly the myriad of other secondary effects of the virus and lockdowns for many years to come.

wilmwolf80 said:

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To my layperson interpretation, we're currently at around 25 million who have been infected (or tested positive anyway) and 25 million who have been vaccinated. If we get to 100 million vaccinated in the next three months with similar increase in infection over that time, we will have more than a third of the population that has either been exposed or vaccinated, and even higher if we reach the possible earlier stated goal of 150 million vaccinated. With that amount of the population having ostensibly some resistance to the virus, including hopefully a large percentage of those most at risk, and since it has been stated that the vaccine seems to provide that even for the new strain, I don't see how a surge in that time frame could be worse than anything we've experience so far. I think that the summit is in sight, though I'm sure this is something we will be dealing with for the foreseeable future, and certainly the myriad of other secondary effects of the virus and lockdowns for many years to come.

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According to the CDC, only 3.4M have been fully vaccinated at this point. The goal of vaccinating 100M (shifting to a 150M doses administered goal) is based on doses and not actual people vaccinated. As I mentioned a couple of days ago, 100M vaccines administered translates to approximately 67M people vaccinated. Some of these will be fully vaccinated and some will only be a single dose. This would equate to approximately 20% of the US population. I believe we will need to get through the end of Summer before we will see substantial reduction from natural and vaccine-induced herd immunity and this seems to be what people like Dr. Fauci are suggesting as well.

I do think getting the LTC facilities fully vaccinated and significant numbers of people over the age of 65+ will have a positive impact in lowering overall mortality by late February and into early March. I do hope the vaccine will help to keep the chances of a major surge from the new strain lower than anticipated.

Even those with a single dose are showing some signs of resistance to the virus, correct? So reword my post as needed. Regardless of the nuances of the numbers, I'm simply speaking to the fact that I don't see how a surge in March would be worse that anything we've seen so far, as those numbers of people with at least some sort of resistance increase substantially, and presumably a large number of those people are the most at risk.

wilmwolf80 said:

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Even those with a single dose are showing some signs of resistance to the virus, correct? So reword my post as needed. Regardless of the nuances of the numbers, I'm simply speaking to the fact that I don't see how a surge in March would be worse that anything we've seen so far, as those numbers of people with at least some sort of resistance increase substantially, and presumably a large number of those people are the most at risk.

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I hope you are right, but we do not know yet. As I mentioned earlier, the mRNA vaccines do seem to be effective against the new strain, but the data I saw reported this morning indicates both shots might be required to provide effective neutralization. It is not clear yet if the single dose will provide enough margin with regards to antibodies that were induced by the first injection. Let's hope it does and the data will eventually reflect this to be the case. I really hope the worst of the peak is over and we will see nothing but falling cases and deaths from this point forward.

The podcasts I've listened to lately (NPR mostly) have made it sound like many modelers think we have peaked for this current wave, though the CDC has not agreed to that yet. However, the variant's and their higher level of infectivity are unknowns.

https://fortune.com/2021/01/06/covid-pandemic-recession-unemployment-mortality-rate-increase/amp/?__twitter_impression=true

https://www.nejm.org/doi/full/10.1056/NEJMcibr2032888

Info on the variant

https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-modeling-5c156686a64b

Really good article explaining how models predicting the effects of mitigations are often misleading to the public.

Good articles, thanks!