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I’m skeptical that vaccine production and distribution will in the US will scale that well. I certainly hope that it will happen, but given that the country has

I’m skeptical that vaccine production and distribution will in the US will scale that well. I certainly hope that it will happen, but given that the country has failed on just about every other pandemic related front tempers my perspective.

maxerickson 6y ago
The cold chain for the Pfizer vaccine is tougher, but otherwise it's not radically different than flu vaccination (we do ~150 million of those each year in the US). The production estimates are coming from the vaccine companies also, so less likely to be victims of the administrative decline.
- claudeganon 6y ago
  Even achieving something comparable to prior year’s flu vaccination would not bring us anywhere close to the herd immunity threshold though. I’m not as concerned with production of the vaccine itself as the logistics involved. I find it hard to believe that a country that otherwise can’t deliver the basic protective necessities to frontline workers is suddenly going to pull out a logistical miracle out of their hats.
  - maxerickson 6y ago
    Something like 5 or 10 million people are acquiring natural immunity each week right now (it's maybe not that high, but there are 1 million+ positive tests each week, with quite high positivity rates, which indicates testing isn't sufficient to find all cases). It's a grim statistic, but the raging spread of the virus is accelerating the timetable for reaching herd immunity. 140 million vaccinated (approx the number of flu vaccinations administered last year) + tens of millions with natural immunity does put us close to the herd immunity threshold (the number of people that have immunity from an infection has big error bars of course, and there will likely be overlap)
    - Pfhreak 6y ago
      Test positivity does not map one to one with people. If someone takes two tests, you get two positives. Also, acquired immunity might not be forever. Could be possible to get reinfected. And you have a very optimistic understanding of how many vaccines can be manufactured and distributed, I would guess.
      - maxerickson 6y ago
        The 14.5 million are cases that have been identified with a positive test. There are certainly more people that have been infected than that, the only question is how many. Distributed, probably so. I don't see any reason to doubt the manufacturers statements yet, and I'm not including the potential/likely J&J vaccine. And while we don't know how long acquired immunity lasts, it's pretty clear that it lasts a good while (it's still a freak occurrence when someone tests positive after recovering from a first infection).
        tertius 6y ago
        It seems right now we're at 10-15% positivity on PCR. And I think that probably maps onto society... So there's a vague guess how many will test positive with PCR. Unfortunately a PCR result at a 35 cycle threshold (which the vast majority of tests in the U.S. are) does not prove that a person was infected and has immunity, only that there was exposure that is detectable. It may never even have entered the bloodstream. Only antibody testing will show if there was a immune response and if there is immune memory. We're not doing that at scale.
runawaybottle 6y ago
It’s not going to scale at all. There were three hour lines just this month to get the rapid test, and we’re months into this. Unless the federal government gets real with it, and releases an app that leverages scheduling systems to mass coordinate a roll out, this too will be a clusterfuck. The healthcare administrative staff (your standard hospital/clinical administrative staff) is not innovative enough at the moment to adapt to the challenge.

maxerickson 6y ago

The cold chain for the Pfizer vaccine is tougher, but otherwise it's not radically different than flu vaccination (we do ~150 million of those each year in the US). The production estimates are coming from the vaccine companies also, so less likely to be victims of the administrative decline.

claudeganon 6y ago
Even achieving something comparable to prior year’s flu vaccination would not bring us anywhere close to the herd immunity threshold though. I’m not as concerned with production of the vaccine itself as the logistics involved. I find it hard to believe that a country that otherwise can’t deliver the basic protective necessities to frontline workers is suddenly going to pull out a logistical miracle out of their hats.
- maxerickson 6y ago
  Something like 5 or 10 million people are acquiring natural immunity each week right now (it's maybe not that high, but there are 1 million+ positive tests each week, with quite high positivity rates, which indicates testing isn't sufficient to find all cases). It's a grim statistic, but the raging spread of the virus is accelerating the timetable for reaching herd immunity. 140 million vaccinated (approx the number of flu vaccinations administered last year) + tens of millions with natural immunity does put us close to the herd immunity threshold (the number of people that have immunity from an infection has big error bars of course, and there will likely be overlap)
  - Pfhreak 6y ago
    Test positivity does not map one to one with people. If someone takes two tests, you get two positives. Also, acquired immunity might not be forever. Could be possible to get reinfected. And you have a very optimistic understanding of how many vaccines can be manufactured and distributed, I would guess.
    - maxerickson 6y ago
      The 14.5 million are cases that have been identified with a positive test. There are certainly more people that have been infected than that, the only question is how many. Distributed, probably so. I don't see any reason to doubt the manufacturers statements yet, and I'm not including the potential/likely J&J vaccine. And while we don't know how long acquired immunity lasts, it's pretty clear that it lasts a good while (it's still a freak occurrence when someone tests positive after recovering from a first infection).
      - tertius 6y ago
        It seems right now we're at 10-15% positivity on PCR. And I think that probably maps onto society... So there's a vague guess how many will test positive with PCR. Unfortunately a PCR result at a 35 cycle threshold (which the vast majority of tests in the U.S. are) does not prove that a person was infected and has immunity, only that there was exposure that is detectable. It may never even have entered the bloodstream. Only antibody testing will show if there was a immune response and if there is immune memory. We're not doing that at scale.

runawaybottle 6y ago

It’s not going to scale at all. There were three hour lines just this month to get the rapid test, and we’re months into this. Unless the federal government gets real with it, and releases an app that leverages scheduling systems to mass coordinate a roll out, this too will be a clusterfuck. The healthcare administrative staff (your standard hospital/clinical administrative staff) is not innovative enough at the moment to adapt to the challenge.