Inside Medicine. What Are You Seeing? [COVID-19 medical news]

Dr Fauci revised his earlier opinion today, and said he thinks the vaccine will be available to “most Americans” by the end of March. This Pfizer announcement is huge… the other manufacturers using MRna will have similar results. Pfizer is not even in operation warp speed so that money has gone to other manufacturers, which means we’re likely going to have enough for more than 25 million people by the end of the year (Moderna has been manufacturing). Good news all around.

@suzyQ7 End of March. Whoa. But, for these vaccines anyway, people need two doses. I don’t remember how far apart though. Can’t wait to see how this plays out. What social limitations change and in what order? How will it be decided that we go to the grocery store or the mall without a mask?

I don’t think that there’s any evidence as of yet that the vaccines will prevent transmission – the trials essentially only measuring the impact on symptomatic cases of Covid. So I think that masks will be here for a while. Also, keep in mind that the vaccines are not being trialed as of yet in children, so kids will still be a source of potential transmission for the near future.

Yeah I don’t agree. Time after time, I have heard Fauci say “back to normal” when vaccine widely available. He said he’d be playing pick up basketball without a mask. And the college presidents I’ve heard talk about “after vaccine” time are also saying back to normal. I get how the vaccine works and what it does but I’ve heard absolutely no one say we are in masks and socially distanced until we have some way to stop transmission.

To be 100% accurate - he said April. Sorry, I misspoke.

“Fauci says vaccine could be available to all by April
Dr. Anthony Fauci tells CNN’s Jake Tapper that a coronavirus vaccine could be available to all Americans by April, 2021”

https://www.google.com/amp/s/amp.cnn.com/cnn/videos/health/2020/11/10/fauci-coronavirus-vaccine-availability-timeline-tapper-intv-lead-vpx.cnn

I think Fauci, like the rest of us, is shocked and delighted by the 90% effectiveness rate. This changes alot of the other projections they had made for “normalcy” by end of 2021. 90% changes everything.

I’m not sure if it only measuring the impact on symptomatic cases. If you are in the trail, you are supposed to go about your normal life, and that may include asymptomatic testing. Like for work or school or because you’ve been in contact with an infected person.

“I’ve heard absolutely no one say we are in masks and socially distanced until we have some way to stop transmission.”

There’s a lot yet unsaid. And for various reasons. One careful step at a time.

"I’m not sure if it only measuring the impact on symptomatic cases. If you are in the trail, you are supposed to go about your normal life, and that may include asymptomatic testing. "

I am sure, because I read Pfizer’s protocol. They do not do routine asymptomatic testing of participants. They are not measuring asymptomatic transmission, nor are they measuring asymptomatic infection.

So, are you all saying that keeping people from contracting Covid is not enough? If someone has been vaccinated and still ends up asymptomatic, so what? Is there some big worry that asymptomatic people will have some health issues down the line? That’s not the immediate problem. The immediate problem is people being symptomatic, getting very sick and/or dying. This vaccine will stop that if people get vaccinated.

If a vaccinated person ends up asymptomatic and still gives the virus to someone who chose not to get a vaccine then that person could get very sick. It’s up to each person to get vaccinated. If there are parts of the country where a majority of people want to turn away a vaccine, that’s their problem. Sounds like there will be enough vaccine to go around. That shouldn’t keep the rest of us from getting vaccinated and getting back to normal.

One thing is… 90% of people is not 100%, and we don’t know whether the vaccine works less well in older people, as many vaccines do.

So if the vaccine works to prevent disease in almost all younger people but doesn’t prevent transmission, but doesn’t work well in people over 75, then it wouldn’t be preventing many deaths.

I think you should go on CNN. You seem to know more than every expert I’ve seen. Not sure why no one nationally is picking up in all of your concerns.

I was trying to find them but didn’t (study protocols). So if someone in the study gets tested (routine surveillance testing or because of possible exposure) Pfizer is not tracking or measuring that? Say someone in the placebo group tests positive - outside of Pfizer’s process, will that count as a positive? Or on the other side, if a vaccinated person tests negative- won’t they take tha to into account? Are they doing surveillance testing themselves within the study?

In the general population, something like 40% of positives are asymptomatic and only know they have it because of testing. It’s hard for me to believe that Pfizer is ONLY counting/tracking symptomatic people who test positive.

@calmom Depends what you mean by kids, this trial is covering tweens and teens: https://www.nbcnews.com/news/us-news/meet-youngest-participants-covid-19-vaccine-trials-teens-tweens-n1244957

According to the Pfizer protocol, they’re not doing surveillance testing. If a participant in the study develops symptoms, they’re supposed to call the study people, who will test them. I don’t know what happens if a study participant is tested outside the study and is positive, but doesn’t have any symptoms.

But as I’ve repeated several times here, the study is counting people who develop symptoms. That’s the evaluation criterion: does the vaccine prevent disease? Discovering that a participant tested positive but didn’t have any symptoms wouldn’t be of much use to the people running the study, because they’re not counting up people who test positive but don’t have symptoms.

Seems to me that some are focusing only on the positive bits- which may include some calculated spin.

Asymptomatic only means you don’t show symptoms of a disease. Not “normal” hunky dory. Not safe. Getting your own shot doesn’t mean you can go out like Typhoid Mary. And then say to the next guy, “Hey, you could have gotten a shot too. Tough luck.”

Sometimes, rather than focus on the “bits” of good news, recognize this is just the tip of the iceberg. Much left for consideration and exploration.

Ethics and proper scientific principles will apply.

A few things. The study results came back “OVER 90%”. When Bourla (Pfizer CEO)was interviewed on CNBC and one of the anchors said something about it being 90% effective, he quickly corrected them, with an adorable gigantic Cheshire Cat grin, and emphasized the “over”. So we will know the official number when the data set is in, but I’m interpreting that as 91%-99.9% for this interim data. In my head, I’ve chosen 95% as the midpoint as a reasonable estimate.

As for the older people, it is true that they have not segmented the data for us yet. BUT, older people were a very significant part of the data set. We know 94 participants tested positive. Let’s say 88 of the participants who tested positive got the placebo, and 6 got the vaccine. We would have then expected 88 who got the vaccine to test positive if it was ineffective, but only 6 did, so it prevented 82 transmissions in that case. I can’t remember where I read the proportion of the 44,000 participants who were older adults, but it was WAY higher than just 6/88 of the group. So even without seeing the fine-tuned details on the impact on older adults, you’d have to be oddly pessimistic to be overly concerned that this is not effective on the older adults. With over 90% effectiveness, you’d have to be pretty pessimistic to waste energy worrying about ANY group (sex, race, age cohort, etc) not being helped by the vaccine who was included in data set (obviously we don’t know about the under 12 set yet). OVER 90% is HUGE.

On the point about whether it prevents transmission or merely sickness, while it will be awesome if it does both, that is not necessary for this to still be AWESOME news. According to the experts I’ve read/listened to, if it does both that will accelerate us getting to the point of suppression. But even if it doesn’t we will still get to suppression, but will need more people to get inoculated.

Pfizer has already started enrolling 12 year olds-16 year olds a month ago. They started with 16 to 18 year olds the month prior The CEO said they will continue enrolling even younger age groups going forward in increments like that, I believe. By the time they are ready to vaccinate children (presumably not before February at the earliest), they should have ample safety data on children.

It will be interesting next spring to learn if there are any groups of people who are ineligible to take the vaccine. Let’s just say that anyone with a particular disease can’t safely take it, or anyone aged 30-50 with the name Joe, or whatever. Like posters above, once everyone has been offered the vaccine here, I for one will ditch my mask that I wear so willingly now (unless I have the sniffles, because now we know how to easily prevent ourselves from passing on any sort of respiratory illness, so I expect to always wear a mask in the future if I have sniffles), I will not worry about the crazy anti-Vaxxers one bit (well, I would care about the poor children of anti-Vaxxers, but luckily children are at very low risk). UNLESS there are large swaths of the population ineligible to take the vaccine due to a disease or their name is Joe or whatever. Then I will still feel the need to inconvenience myself to protect them. But if it’s their own stupid choice, I honestly won’t care enough about them to wear a mask just for the sake of willful anti-Vaxxers. I’d be curious if someone can convince me otherwise—I’m open to arguments on that! Maybe for an extra month or two if it helps accelerate true suppression of covid which is for the sake of everyone, but I wouldn’t do it JUST for the sake of anti-vaxxers…

Of course one of the key steps in the coming months is a major communication plan, led by scientists (but maybe supplemented by movie stars or other influencers, who knows?) to accurately communicate the process, the safety, the importance of vaccinating not just for your own sake but for the sake of humanity, etc. That will come as the data comes in. The leaders are aware of the importance of this PR needed, fortunately.

I myself was on chemo for 12 looong months, and have a decent shot of going back on. I can say that I never wanted other people to inconvenience themselves for my sake, though, when my immune system hit the floor. So if certain groups like people undergoing chemo can’t take the vaccine, I would still think it’s reasonable for everyone else to go back to normal life, and the people on chemo to work extra hard to protect themselves. I do not think 99% of the world should have to tiptoe for my sake if I’m in a tiny group of people who can’t take the vaccine. Cheers to normal life in 2021!!!

Anything positive is better than nothing positive, but I plan to remain a skeptic until there is more data available. It surprises me how many folks jump on preliminary results, but I probably shouldn’t be surprised. It happens all the time when the media prints headlines, esp if folks really want the news to be true.

Heck, a good number of people believe masks don’t help because they want that news to be true and have found someone who will say it for them. They can ignore the masses saying otherwise.

That said, I’m glad the preliminary results are positive vs not. I just don’t consider them the be all, end all. There “may” be a light at the end of the tunnel and if 90% were indeed true, it sure beats 50%.

These preliminary results are not so very, very preliminary. The final data set will be based on 165 of the 44,000 testing positive, and this data already includes 94 of the 165. Almost there! The outside body of experts said there were no significant safety concerns. Yes, I suppose it’s possible for a skeptic to think of the remaining 71 people we need to wait for to test positive, the results for them will be wildly different from the results of the first 94 (???), but that’s really an odd thing to expect. And even if the results for the remaining 71 people aren’t over 90% like the first 94 people were, let’s say they experience just 70% effectiveness in that next group, there would still be over 80% effectiveness in total—HUGE. What negative info are you anticipating, Creekland and LookingForward, that would drastically change this preliminary data? To me, the only bad news would be if all of a sudden there was a major safety event. But the way this platform works, the scientists have no reason to expect a late safety effect, and 44,000 people (giant trial!!) have already taken the vaccine.

Media prints headlines and then people believe they are true? I don’t think you can compare this “headline” to one saying that masks don’t work. One is scientific info and the other is blatantly false.

I’m pretty good at sniffing out fake news and reading the whole story before “believing” a headline. Do I want it to be true that an effective vaccine (or vaccines) could be available in the next six months? You bet. Who doesn’t? I don’t want to shed my mask because I want to go to bars or sporting events. For me, this is almost exclusively about our kids. I want to see D21 graduate in our high school’s traditional ceremony. I want her to have a prom. I want S19 to be able to have an internship in person this summer. And I want both of them to be on campuses in the fall taking advantage of everything their colleges offer.

I just think it’s odd that some posters are basically saying that these vaccines aren’t enough until we have one that keeps people from catching the virus. I have read this opinion no where but here (maybe that’s my fault?). Where are all of the stories saying that a vaccine that prevents Covid-19 isn’t good enough?