Coronavirus

[bkp_duke]

This "eligibility criteria" is bull-sh!t. We are to the point where if someone in CA wants a vaccine, just let them get the damned thing.

Meanwhile . . . the virus doesn't stop propagating for anything except immune individuals. It doesn't take days off, it doesn't debate the "pros and cons", it just replicates and mutates.

 

[EVNow]

In King county (Seattle metro) looks like the case count has flattened. Unfortunately with each flattening, the count is higher. See the lowest points in June, October and now in March. With statewide reopening of businesses, spring break etc - looks like we are headed for the 4th wave unless vaccination rate picks up - its a race. In Europe looks like the vaccination rates being low lost out to the new wave.

Infact the low point now is about the same as the high point in April and August !

 

[AlanSubie4Life]

Avg BMI for San Diego is 27.8. Do you have different eligibility criteria for different cities/counties in CA ?

Yep. Yes, it appears so. San Diego appears to be one of the more open counties for vaccination, as of yesterday.

This "eligibility criteria" is bull-sh!t. We are to the point where if someone in CA wants a vaccine, just let them get the damned thing.

I mostly agree, though if there is still a shortage of vaccine (which there is), I do think it should still be targeted, primarily by age. It doesn't make a lot of sense to vaccinate overweight people in their 20s and 30s, if they aren't frontline workers of some sort. (Mild obesity/overweight status is not a major risk factor.)

And we need to push vaccine into disadvantaged communities. From what I've seen in other states, you'll see low socioeconomic status communities with much less vaccine coverage in those over age 55. Those people should get vaccines before I do (though I don't mind being on a wait list and getting vaccine that is going to be thrown away). Just keep pushing it into those who are moderately old.

I would have much preferred them to lower the age limit to 50, and expand to people with serious medical conditions (many of which don't actually elevate risk), rather than basically open it up to everyone.

That calculus changes if there is a shortage of demand. But right now, in San Diego, it seems clear to me that at the moment, there is no shortage of demand (even before opening up the criteria). Now there won't be a shortage of demand for weeks. Which I guess is fine, though non optimal.

It's like the 80% solution - we gave ample time to vaccinate those over 65 (who make up 80% of the deaths), though we still haven't really gotten good coverage of all of those people (due to socioeconomic factors I suspect). So we mostly did it right...just kind of jumped the gun by 2-3 weeks, I feel.

At some point, after you hit the vulnerable, it does make sense to open it up to those who are at high risk of infection. I guess maybe that was part of the thinking in this new strategy.

I don't think any of this debating is slowing the rate of vaccinations or resulting in us "taking days off." It's just an optimization problem regarding who is "best" to immunize (either to reduce spread, or reduce mortality/hospital loading).

 

[EVNow]

This "eligibility criteria" is bull-sh!t. We are to the point where if someone in CA wants a vaccine, just let them get the damned thing.

Meanwhile . . . the virus doesn't stop propagating for anything except immune individuals. It doesn't take days off, it doesn't debate the "pros and cons", it just replicates and mutates.

Depends on the situation. If a lot of spots are not being booked makes sense to open it up. Until recently here - it was basically not possible for seniors to get an appointment without help.

But its an open question as to whether seniors should have been vaccinated first or people in service industry who come into contact with a lot of people. Our cleaning lady is still not eligible, for eg. Neither are the ladies in the salon - after 3 DIY haircuts at home, I'm ready for a professional haircut !

 

[EVNow]

And we need to push vaccine into disadvantaged communities. From what I've seen in other states, you'll see low socioeconomic status communities with much less vaccine coverage in those over age 55.

Here's the latest poll. Plurality of white Republicans don't want to get vaccinated. We'll soon be going from supply constrained to demand constrained.

White Republicans are more likely to reject the COVID-19 vaccine than any other group in America

According to a recent poll, 56% of white Republicans said they were either unsure or would not take a COVID-19 vaccine if it were available to them.

news.yahoo.com

https://civiqs.com/results/coronavirus_vaccine?annotations=true&uncertainty=true&zoomIn=true&trendline=trueendline=true

 

[AlanSubie4Life]

Plurality of white Republicans don't want to get vaccinated

That's not correct. 45% of White Republicans want to be vaccinated (or are), while 42% do not. (13% undecided)

Another thing to observe is that young White Republicans dominate the NOs. I suspect they are just acting tough, and when the vaccine is available to them, their resistance will partially crumble. Not completely, of course. But enough. (You also have to keep in mind that there's probably a decent portion of this population who have already had COVID-19. They should have added that crosstab!)

Thankfully, this group is only 29% of the population. So we can probably get away with 60% coverage of that group, which seems like it could be attainable with a small attitude shift, and that's not even taking into account 80% protection from reinfection of a portion of the group who have already had COVID-19.

 

[bkp_duke]

Depends on the situation. If a lot of spots are not being booked makes sense to open it up. Until recently here - it was basically not possible for seniors to get an appointment without help.

But its an open question as to whether seniors should have been vaccinated first or people in service industry who come into contact with a lot of people. Our cleaning lady is still not eligible, for eg. Neither are the ladies in the salon - after 3 DIY haircuts at home, I'm ready for a professional haircut !

See my previous post (weeks ago) about how inefficient the delivery of vaccines was here in SD county.

Literally, as a 1st year pediatrics resident I ran vaccine clinics that put what the county did to shame.

 

[GbrilliantQ]

Find COVID‑19 vaccine locations near you

Vaccines.gov helps you find clinics, pharmacies, and other locations that offer COVID‑19 vaccines in the United States.

vaccinefinder.org

For folks still wondering how, where and when.

 

[AlanSubie4Life]

See my previous post (weeks ago) about how inefficient the delivery of vaccines was here in SD county.

Literally, as a 1st year pediatrics resident I ran vaccine clinics that put what the county did to shame.

It certainly got off to a rocky start (inexplicably not prepared), and that probably cost a few lives, but right now the county has administered 93% of the vaccines delivered, so it's not clear how much of an impact this is really having at this point. So not clear that criteria need to be widened as much as they were yesterday, to increase demand.

You could argue that a less restrictive policy early to get better initial vaccination rates would have cost more lives than what actually happened (by reducing doses to the vulnerable).

 

[bkp_duke]

It certainly got off to a rocky start (inexplicably not prepared), and that probably cost a few lives, but right now the county has administered 93% of the vaccines delivered, so it's not clear how much of an impact this is really having at this point. So not clear that criteria need to be widened to increase demand.

You could argue that a less restrictive policy early to get better initial vaccination rates would have cost more lives than what actually happened (by reducing doses to the vulnerable).

The county only orders as many vaccine doses as they think can administer. Keep that in mind. So of course the % administered is going to be 90+% of what was ordered. It's a self-fulfilling prophecy.

During the weeks when 75% of the country was under snow/ice, large batches of vaccine could have been diverted to CA and FL for them to ramp up administration, since other locations were cancelling vaccine administration clinics. But that didn't happen.

If governor numb nuts had deployed the national guard like other states to assist with vaccination efforts, we could have at least 50% more shots in arms than we do now.

 

[AlanSubie4Life]

The county only orders as many vaccine doses as they think can administer. Keep that in mind.

Can you provide the link showing that is what is happening?

I'll ignore any lags in reporting which may exist.

135.8 million total doses delivered in the US so far.

SD County population: 3.34 million
US Population: 330 million.

Expected allocation: 3.34/330*135.8million = 1.37 million.

Actual allocation: 1.34 million.

Seems pretty close to expectations.

During the weeks when 75% of the country was under snow/ice, large batches of vaccine could have been diverted to CA and FL for them to ramp up administration, since other locations were cancelling vaccine administration clinics. But that didn't happen.

My understanding is shipments of Moderna in particular were delayed to San Diego County during that cold snap due to logistical problems. Not only did they not ramp up administration, they actually had to shut down vaccination sites (including Petco) because vaccine was not able to be delivered due to circumstances that I understand were out of San Diego County's control.

I do not know the nature of the logistical problems. If surface transport were involved it would make a lot of sense for there to be delays of course.

So of course the % administered is going to be 90+% of what was ordered.

California has only administered 75% of its doses or 87% of their doses depending on whether you count the pharmacy program (totally not clear if administrations of those doses are being counted - seems like they aren't (might be tracked completely separately, it's all extremely unclear and not easy to determine...), so probably the number is about 87%). So I like how SD County is doing so far.

Covid-19 Vaccines

covid19.ca.gov

 

[bkp_duke]

Can you provide the link showing that is what is happening?

I'll ignore any lags in reporting which may exist.

135.8 million total doses delivered in the US so far.

SD County population: 3.34 million
US Population: 330 million.

Expected allocation: 3.34/330*135.8million = 1.37 million.

Actual allocation: 1.34 million.

Seems pretty close to expectations.

I was mentioned on a SD County physician's society zoom call. I didn't record it.

But the county only requests as many doses as they think they can get into arms. Same for the rest of the state.

 

[Dave EV]

It's like the 80% solution - we gave ample time to vaccinate those over 65 (who make up 80% of the deaths), though we still haven't really gotten good coverage of all of those people (due to socioeconomic factors I suspect). So we mostly did it right...just kind of jumped the gun by 2-3 weeks, I feel.

Yeah, I agree. While the Overweight BMI category seems suspect to me to open up (Obese I have no issue with), it sure does seem like an easier approach would be to simply go by age.

To target certain areas / demographics with low vaccination rates, another easy method would be to lower the age threshold by zip-code. Live in a zip-code that hasn't vaccinated many old people? Lower the age threshold. People who live in that zip code are more likely to come into contact with those older, unvaccinated people, so it makes sense to vaccinate as many people as you can in that area.

Another group to prioritize - anyone who works public facing retail (already have food sector workers eligible). And then anyone who can't work from home. This one is harder to enforce, so maybe by the time you get here, just go back to age.

But the county only requests as many doses as they think they can get into arms. Same for the rest of the state.

Vaccine sites have been shutting down for periods the whole time due to lack of supply - all the drug stores (CVS, RiteAid, etc) are also booked solid. Is that because they can't vaccinate any faster, or is that because of lack of supply?

 

[EVNow]

During the weeks when 75% of the country was under snow/ice, large batches of vaccine could have been diverted to CA and FL for them to ramp up administration, since other locations were cancelling vaccine administration clinics. But that didn't happen.

Not sure that would have worked. In WA we didn't get any vaccines for a week because of snow related disruptions - even though we were snow free.

 

[EVNow]

That's not correct. 45% of White Republicans want to be vaccinated (or are), while 42% do not. (13% undecided)

I didn't want to get into details - but among people not yet vaccinated "Nos" dominate.

If you look at overall numbers - we have 43, 23, 10 for Yes, No & unsure. 25% are vaccinated (atleast one dose).

Just as some of those Nos and Unsures will get vaccinated, so too will some of the Yes drop out. We may reach > 60% vaccination by end of this year - but next 25% will be lot harder than the first 25% - and rest will be even harder.

Heres an interesting focus group by Luntz.

Trump Voters Hesitant About COVID Vaccine Won't Be Swayed by Ex-President

Nearly half of Trump's supporters aren't interested in getting vaccinated against COVID-19.

www.newsweek.com

 

[bkp_duke]

Yeah, I agree. While the Overweight BMI category seems suspect to me to open up (Obese I have no issue with), it sure does seem like an easier approach would be to simply go by age.

To target certain areas / demographics with low vaccination rates, another easy method would be to lower the age threshold by zip-code. Live in a zip-code that hasn't vaccinated many old people? Lower the age threshold. People who live in that zip code are more likely to come into contact with those older, unvaccinated people, so it makes sense to vaccinate as many people as you can in that area.

Another group to prioritize - anyone who works public facing retail (already have food sector workers eligible). And then anyone who can't work from home. This one is harder to enforce, so maybe by the time you get here, just go back to age.




Vaccine sites have been shutting down for periods the whole time due to lack of supply - all the drug stores (CVS, RiteAid, etc) are also booked solid. Is that because they can't vaccinate any faster, or is that because of lack of supply?

Drug stores are totally a different animal. They have their own supply (i.e. CVS Caremark, etc.) and run their own distribution that they get upstream (i.e. at the state level). Sometimes it's because of supply upstream, sometimes it is due to their own distribution network (probably serviced by the state, but I'm not 100% sure on this).

It's the county-run sites that make requests directly to the state for allocation. There have been some times where there have been vaccine run out at these sites, and those always make the news. What DOES NOT make the news, are all the days when the giant vaccine centers in Petco Park and North County have excess and about 2:30-3:00 PM tell people on social media to "call anyone you know that is in the age criteria" to come get a dose, otherwise it will go to waste. I see these posts 1-2 times per week.

 

[EnergyMax]

Santa Clara county is starting to play games with who gets the vaccine ( they don't want to join the state wide "myturn" program). So instead of waiting forever, I just signed up and got my first pfizer dose last Sat ( I'm not really in any of the categories). I had to drive to the location for a few hours, but it was worth it. Really, if anyone wants to get it, I think it's possible at this point.

 

[FoverM]

GA lowered the age minimum last week. We now, ahem, qualify

Getting our first shots tomorrow. We've talked to several people who have had the shots and they reported no symptoms afterwards (other than pain at the injection site). Hopefully, we'll continue the winning streak.

 

[scottf200]

Hmmm ...

Germany and France become latest countries to halt use of AstraZeneca COVID-19 vaccine over blood clot concerns

Published1 day ago
Title: Covid-19: Evidence does not suggest AstraZeneca jab linked to clots, MHRA says

Covid-19: Evidence does not suggest AstraZeneca jab linked to clots, MHRA says

The drugs regulator says people should still get their Covid vaccine, as some countries suspend using it.

www.bbc.com

The Medicines and Healthcare products Regulatory Agency [MHRA] said evidence "does not suggest" the jab causes clots.
The Netherlands has become the latest country to suspend use of the jab following reports of serious clotting.
But the World Health Organization says there is no reason to stop using it.
Dutch officials said the move was precautionary following reports from Denmark and Norway about side effects including blood clots.
Manufacturer AstraZeneca has said there is no evidence of a link between the two.

 

[AlanSubie4Life]

I meant Pfizer here. Moderna not expected to ramp until end of month. Pfizer was supposed to be at 13 million or so mid-March but seem to be lagging. New allocations will publish tomorrow (allegedly, but looks like it already updated) so hopefully we will see the promised step change. They are at just 9 million. Big shortfall vs. commitments (though could be a lag from factory to gov’t warehouse).

View attachment 644860

Moderna doing nothing interesting, steady 6.5 million per week:
View attachment 644861

This did update today and Pfizer is now officially 4 million doses short of what was expected at this point (9.2 million per week rather than 13 million). So unless there are doses going somewhere else that aren’t accounted for in the graphs, they seem behind expectations.