igor67

I would argue BTN would be a good match for something different.

I would imagine waiting for any kind of preliminary analysis/ announcement until after the election was an entirely deliberate and appropriate decision. Pfizer is getting positive PR like crazy out of this, and they know it. The amount of money they make directly off the vaccine is almost certainly going to be very modest. But after years of getting hammered for this that or the other thing, being first (or tied for first) to get this vaccine out to people. I would do everything I could to distance myself from anything election related.

I'd love to see that there was some level of coordination. Given the increased difficulty of distributing the Pfizer vaccine it makes sense with Moderna likely to be a viable alternative that Pfizer goes for the bigger population centers and Moderna spreads out a little more. The details are always going to be a lot more involved, and certainly targeting hotter spots makes sense in the prioritization as well but that is going to be a little bit of a moving target, when speed also is going to give a big boost on impact. With the seeming consistent efficacy of these mRNA type vaccines I really find myself wondering how much this new technology may end up completely revolutionizing vaccines going forward

I watched Walz's announcement last night and I was very intrigued as they shared some of their data on where 'outbreaks' are happening and they were using that to make decisions on what to rollback. I think the patterns also tell something of an understandable story. 1) Retail was pretty low risk 2) Bars and restaurants were intermediate 3) Salons were low risk 4) Youth sports high risk 5) Schools were low to intermediate (not specifically addressed) 6) In person anything high Salons in particular are a big test of masks because there is no significant social distancing possible. The bigger story though I think is one of compliance. Classrooms I think are able to be lower risk because schools are used to enforcing rules. Athletics though leads to a lot of breaks in those rules (and I have observed the inconsistency very directly). Salons again despite some close contact are able to really control the environment. Bars not so much and certainly the going maskless for periods of time contributes. My experience with the MN retail business and peoples behavior is that they do pretty good with combining social distance and masks. Wisconsin not so much, people have picked on Kwik Trip there is also a certain hardware store that spent the entire summer running obnoxious anti-mask adds. Again it's not specifically about the masks its about being able to combine the layers of protection and follow the rules. I would imagine MN efforts would have worked even better if it wasn't literally surrounded by states where things were raging out of control.

Time for a football analogy 12 million recorded cases, go with the standard and assume twice that number of undetected asymptomatic people gets us to 24 million out of 331 million or 7.25%. Let's round all the way up to 8% just to be generous and we are talking 4.8 minutes of the way through a football game. If one wants to get together with family there are very safe ways to do that in person, like getting tested or isolating prior to meeting. Unfortunately despite the higher risk side of my family seemingly having escaped with mild cases our other side that we were making those preparations to meet has suffered an outbreak.

There are important questions still on the table, but the news is pretty big and positive. 1) It just increases the raw number of doses available in the short term. 2) A well executed plan could funnel the Pfizer vaccines to the higher population centers and the Moderna vaccine to more rural parts to help maximize the distribution (I'm sure there a plenty more details but in broad strokes that is very helpful). 3) Since the mRNA type vaccines are new seeing very similar results in 2 separate studies run without and without direct government oversight is very comforting.

This article fills in some more details on the cold storage needs: https://www.bbc.com/news/technology-54889084 It appears that compared to a lot of my experience with cold storage samples the Pfizer and Moderna vaccines are rather sensitive to the simple act of opening the door. It reminds me why I avoided projects involving RNA, always such a pain to work with compared to DNA or proteins (in general).

I don't have any direct experience with hospital labs, I would just be surprised given the research tie-ins for Mayo's central hospital to not have substantial lab space, the same with UW hospital and U of M. Other hospitals I'm not really sure.

I would have to agree with Machu that there is something off about the statement concerning Mayo. You would need comparable storage for freezing eggs for IVF for example, and molecular biology research labs typically have freezers that are that cold. I would guess it is more of a question of capacity and location. The freezer space to store enough vaccines and in the right location for their clinics makes more sense. If your curious to go shopping https://www.fishersci.com/us/en/browse/90106033/ultra-low-temperature-freezers

It certainly is, though I think it is still close to a month wait before distribution would actually be able to start, that is potentially quite a few more cases between now and then.

I could go super long on a school post that has been bouncing around in my head for awhile, but the short version is that MN has had a tiered statewide plan for schools for months. Individual schools opted for a number of strategies under that plan, we decided to be cautious and not risk bouncing kids around a bunch of times in between models (distance, hybrid, in person). Our conversations with other schools that opted to try hybrid was that despite the advantages of some in person time the reality was that dealing with the monitoring and quarantining of students and staff they were pretty universal in saying they could have gotten as much or more learning done in distance. As a pragmatist I understand people will say they support education, but in reality may have any number of other conflicting attitudes about the purpose and role of school aside from actual learning. So I have a question (since I actually have some responsibility in deciding what learning mode our school uses). As a parent would 2 or 3 days a week of in person be that valuable to you knowing that at any moment you may have to switch back to quarantine for 2 weeks? This is not arbitrary one of our comparison schools has kept track and in 2 months (keep in mind the case counts here have been noticeably lower in MN) about half their teachers and 20% of the students have had to miss time for quarantining. On a separate note one of my in-laws tested positive back in Wisconsin with a high likelihood another family member already has it and I would assume his entire household will contract it eventually. Unfortunately, it is hitting the highest risk parts of my close family. None of them are flagrant deniers (or particularly close to that category). With 1 exception even with pre-existing conditions they have decades of life expectancy left. [Our grandparents and aunt hit 90+ with many of the same conditions when that was a lot harder to do]

Vitamin D has some sophisticated interactions that put it on the short list of things where supplements may have some health benefits for 'normal' people. Which is a short way of saying most people with any kind of remotely normal food intake get plenty of what they need and supplements are a waste. That said I would be shocked if vitamin D was more than a footnote in terms of risk factors or strategies. That said the UW has made a ton of money over the years from drugs derived from vitamin D. https://biochem.wisc.edu/highlights/2016/highlights-vitamin-d-21st-century Proud Badger all the way.

Something else I thought of while driving. Since the Lancet paper was doing a regression analysis and only reported statistically significant effects, there is a huge sample size difference between number of cases and number of deaths. Which definitely is going to make it easier to show a significant impact on overall case numbers compared to death numbers.

First sorry the link got all messed up to the lancet paper https://doi.org/10.1016/j.eclinm.2020.100464 I wasn't surprised there wasn't a linkage in a multiple regression analysis between lockdowns and the mortality numbers because it was so early. Countries initial responses and initial impacts certainly would be heavily impacted by already existing conditions. The paper also did not attempt to correct for any under counting of deaths in that critical early period which is a pretty big confounder in the data. Add into the mix the how much of a lagging indicator deaths are and I can certainly see how any number of other factors would have dominated the reasons for early deaths. I hope that clarifies.

Late to the party here I dove in to nate's article's a little more, and there some deeper warning flags and problems with them than what Peavey identified. For example https://www.medrxiv.org/content/10.1101/2020.04.24.20078717v1 not only is the article somewhat old, it was submitted by a scientist way outside their field to what is called a pre-print server. Typically these articles will be posted with the expectation they are going to a journal for actual peer review. I haven't seen any sign that ever happened, along with a title that does not sound like a publication and it being a single author. Looking at the methods it reads as a math proof, not a statistical analysis of data. The AIER is also incredibly problematic since again it provides no statistical analysis. Just a series of bar graphs. Followed by 1 off comparisons trying to look for correlations. Unsurprisingly for a complex problem when they make no attempt to control for these complications they can't find correlations of effectiveness of different policies (none of which were terribly well defined in the paper). I had a brief look at the wallstreet journal articles before the paywall went up, but it was enough to track down link to one of there citations. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30208-X/fulltext What was particular troubling was that it was clear the wall street journal article fixated on this sentence from the paper :Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people. " Which sound really supporting of Nate's point until you read the full article. The following is far more representative of the authors data and conclusions then the WSJ rather bad reading job. "We built a country-level model, incorporating data from 50 different countries, to assess country-specific socioeconomic factors and healthcare capabilities on COVID-19-related outcomes such as new case burden, critical cases, and mortality. Our country-level model demonstrated that travel restrictions and containment measures put in place up till 01 May 2020 may have an impact on the total number of COVID-19 cases in a given country, but there was no observed association between public health policies and the number of critical cases or mortality. Importantly, low levels of national preparedness in early detection and reporting, limited health care capacity, and population characteristics such as advanced age, obesity and higher unemployment rates were key factors associated with increased viral spread and overall mortality." Of particular note is that all the data only goes up to May 1st, so I personally find it less than surprising that most mortality in that timeframe was driven more by pre-existing risk factors than the ability to decrease the infection rates (which did happen)

I'm not sure what any of the specific companies policies are, but even while I understand they have made some efforts to clean things up it's not feasible to stop either on the up front filtering from certain locations (too many ways to work around that temporarily at least) and on the backside no automated filtering can accurately (100%) detect misinformation given the lack of precision in human language. Even operating with purely truthful facts one can absolutely mislead. Even something as being provocative induces emotional responses that decrease logical reasoning (this is a very well established bit of neuroscience).

I'm not 100% sure that HIPAA is the biggest stumbling block, but certainly the contract tracing for Covid is less invasive to an individual than the contract tracing for STDs and I would agree an exemption should be up for discussion. I do wonder after reading the article as well if melding cell phone data with over the phone interviews could improve efficiency? Now is rather late in the game almost, but some exemptions to try and use that data might help a great deal as well.

Some nice informational reporting on how the vaccine trials are being reviewed. https://www.propublica.org/article/who-decides-when-vaccine-studies-are-done-internal-documents-show-fauci-plays-a-key-role A really long look at the unknowns about Sturgis https://www.washingtonpost.com/health/2020/10/17/sturgis-rally-spread/?utm_campaign=wp_main&utm_medium=social&utm_source=twitter

As would be terribly easy to demonstrate epidemiologists easily recognized the probability of increases in infection rates with the fall. The fact that this is happening all over in Europe is not proof of a lassie faire attitude. Very much the opposite Sweden deaths' as of Oct 12 5899 Denmark 674 Finland 346 Norway 277 Yet all are still grappling with resurgence. Just Denmark, Norway, and Finland have thousands more citizens who are still alive because of their earlier decisions. https://www.statista.com/statistics/1113834/cumulative-coronavirus-deaths-in-the-nordics/ The numbers are less stark, but there are significant signs that treatment is already substantially better today than April and this is without any huge breakthrough. That's a relative benefit to getting sick today vs. April as an additional reason for having mitigated (and there are any number of studies demonstrating the relative values of various mitigation strategies (https://connect.biorxiv.org/relate/content/181). We're not trading any kind of permanent loss of freedom, we're talking about incremental trade-offs of quality of life for quantity of life on a timescale of months.

As a follow-up to my post last week all of these activities carry some level of risk, and it is important to consider both the intrinsic risk of the activity on a per-event or per person basis as well as the number of people doing the activity. Probably more importantly based on years of education research we know that humans are really bad at estimating those types of problems. Ideally consistent public health messaging could help deal with our inherent awfulness at solving these problems ourselves. Instead we are wallowing in the classical grammar/ statistical mistake that the plural of anecdote is anecdata. Putting that aside I do think it is helpful to be mindful of pigeonholing posts or even the news. It's too easy to over read into a short post extreme positions. Even introverts want to see other people, and thinking Trick or Treat could go doesn't mean your a shill for Big Dentist. Remember back to ~2017 when we started to see how crazy good social media was at presenting us with super distorted versions of reality. I avoid most of that but after clicking just 1 story about school uniforms I still get links to other ridiculous stories advocating positions I've never heard an actual human say. Obviously I stopped reading those after awhile recognizing them as crazy and not remotely representative of anything but for awhile the insistence of that type of story sure made it seem like there was a substantial amount of will towards that nonsense. I suspect that absent any kind of cues that answering one way or another suggests allegiance to a group or cause 90+% of people would agree that the goals of any pandemic policy would be make things as normal as possible and save as many people as possible.

Thanks for the catch, yes the classic copying the number straight off the calculator kind of typo.

There are levels of risk, and I would strongly suspect that the actual risk posed by activities also depends on the current number of infections. As far as I am aware there isn't anything magical about minute 15 of close contact compared to minute 13 or 14. So the number really should be thought of as representing a high enough increased risk to justify scarce contract tracing resources. Put another way I will currently shop Menards in MN, but I would not in WI. For some context using only reported cases the statewide prevalence is 0.005%. So using a simple probability model the odds of walking into a Menards in WI with a total of 50 employees and customers gives a 77% chance no one in the store has Covid. at 75 people it is 68% and 100 people has the chance of nobody having it down to 61%. Using MN number I'm getting 90% chance with 50 people and still at an 80% chance with 100 people. There are all sorts of issues with that simple of a model, but the general point is that the increase in cases for whatever reason has pretty dramatically changed how risky some activities are. I think that fits some of the narrative an initial pulse driven significantly (but not only) by college students led to other kinds of community spread and now a big chunk of people are catching it doing things they had been doing for awhile.

A big wrinkle in the vaccine distribution process is going to be what is the effectiveness of the first vaccine or 2 approved. While there are so many vaccines in development the odds of at least one being useful is pretty high, it is also unlikely that the first ones across the finish line have the same type of effectiveness we see in other approved vaccines. This could definitely lead to a situation with a need to administer a second round at some later point to bring things down to acceptable levels. That isn't intended to be pessimistic, as even an imperfect vaccine distributed to high needs groups might not enable everything back to normal, but a lot closer.

The data is rather surprising, but it is somewhat early. I know the MN data had started to show noticeable increases in the second half of September for example. Just as important though is that I can confirm everything turborickey said. There big barriers some fiscal, but pure space issues, staffing, and other logistics that make keeping schools from being superspreading locations a huge ongoing issue.

In the spirit of genuine discussion I think FV was using these CDC stats Number of deaths for leading causes of death: Heart disease: 647,457 Cancer: 599,108 Accidents (unintentional injuries): 169,936 Chronic lower respiratory diseases: 160,201 Stroke (cerebrovascular diseases): 146,383 Alzheimer’s disease: 121,404 Diabetes: 83,564 Influenza and Pneumonia: 55,672 Nephritis, nephrotic syndrome and nephrosis: 50,633 Intentional self-harm (suicide): 47,173 But that would suggest lumping in Chronic lower respiratory deaths which I am sure includes all kinds of things, which is an interesting comparison. I think more crucially looking at all of the top 10 list there means that covid went from not existing to being number 3 on the list for causes of death. That is pretty dramatic. For some additional context there were only 16,214 murders in the US in 2018. With cancer sitting at 600,000 I don't think covid will chase that number down given the forecasts out there, but a final tally once some of the adjustments can be made for early undercounting might get uncomfortably close.