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

Oh this makes me scream. NO THEY’RE NOT! I hope this doctor is better at doctoring than he is at statistics, because he knows nothing of confidence intervals or of statistics. The chance that this vaccine has no effect is, to a first approximation, zero.

This is just wonderful news. It works in older people and it prevents serious disease. This is fantastic.

Because the Moderna vaccine is an mRNA vaccine too, and because we’ve already seen great preliminary results, we can expect it too works well.

I am getting a lot of bang for my buck of the local paper subscription!

https://www.seattletimes.com/business/fda-allows-1st-rapid-virus-test-that-gives-results-at-home/

However, that Lucira at-home quick test costs $50, so it may be too expensive for many people to use as a daily check before going to work, grocery store, etc…

The Lucira test is also prescription only. A good development, but we still aren’t close to being there on testing.

Oxford said their vaccine is soon to be out too.

Hopefully these all will work and we can start engaging offensively against Covid putting an end to it, or at least getting it significantly better.

I feel for those who catch it these next few months and don’t make it or have lifelong effects. It feels like we could be so close to the end.

This test is intended to be used for at home diagnosis. Not intended as a daily check at all; it is supposed to cut down on clinic or test center visits or sample shipping back to the lab (for home administered sample collection). Of course it has to be prescribed and then sample collection has to be observed remotely to make sure there is no sample swapping.

This is not an antigen test; this is a first at home test based on NAAT - but performed without any thermocyclers or fluorescence detectors. This EUA appears to be a major confirmation of the technology. As far as I can tell, the trick is in the enzymes that run the reaction. Hope this tech works as advertised.

Do any of you know whether there is a lot of effort being put into developing a cheap rapid test? I am not a scientist and have NO IDEA whether this would be easy to do or not, but here we are with a vaccine imminent.

Without getting political, it seems like a failure of leadership to not press for more testing options, no? Our local hospital was unable to get tests at all a few weeks ago. That seems criminal, this far into this situation.

Which will get there first, wide spread vaccines or convenient testing? Once vaccines become widely administered, would testing be needed much?

From the AMA (American Medical Association) this morning:

Patients with SARS-CoV-2 may present with only symptoms of delirium, study indicates

Modern Healthcare (11/19, Castellucci, Subscription Publication) reports researchers found “patients with coronavirus – particularly those over 65 – may present to health care settings with only symptoms of delirium rather than well-known signs of the virus like fever and shortness of breath.” The findings were published in JAMA Network Open.

STAT (11/19, Cooney) reports that in the study, “more than one-fourth of older patients…arrived at hospital emergency rooms with delirium, and 37% of these patients had no typical COVID-19 signs, such as fever or shortness or breath.”

Yes we still need testing, especially if many people don’t choose to get the vaccine and/or if the vaccines are not sterilizing (a vaccinated person might harbor the virus in their nose and still be able to spread it).

Also, the vaccines don’t work for everyone and when you are talking such large numbers, many people could still be infected. So, if 100 million got the vaccine, at 95% efficacy, 5M vaccinated people would still become infected (hopefully with limited severe cases).

We need a high proportion of the entire population to take the vaccines, and right now no company is testing their vaccine under 12 year olds. Only Pfizer is testing in 12-15 year olds (don’t know what happened to 16 and 17 year olds) and today’s EUA filing includes data from 100 people in this age group…we will see if this vaccine gets approved in this age group based on that scant data, or not. Moderna will be for 18+ only.

https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-submit-emergency-use-authorization

That may very well be but the necessity of tests is greatly diminished with the vaccine that is as good as 95% efficacy. This thing about people not getting the vaccines is overblown. I predict most people will get it. 95% efficacy also helps. For younger under 12 group, efficacy may not be as high as 95% but it will still help. It is also easier to pressure under 12 to be vaccinated through school requirement. Celebrate this great news.

Of course having vaccines is good news. But there is still so much we don’t know…such as can vaccinated people still spread the disease if infected, for how long a vaccine confers protection, how much supply we will have, how distribution will work, etc. Say for instance vaccines protect for one year…vaccinated people will need their second annual injections before everyone has had their first vaccinations. Remember both Pfizer and Moderna vaccines require two shots, 3-4 weeks apart.

I don’t know how many people will ultimately choose to be vaccinated, all we have to go by are the polls, and historical vaccination rates.

We still need good testing to be able to open up (back to work/school, events, etc). These vaccines will likely not change the need to mask and socially distance for a while.

People tend to think on absolute terms. Everything has to be 100%. It isn’t 100% taken care of but given 95% efficacy,I think we can bring the threat level to that of flu pretty soon. Everyone will have to find their own good enough and not insist on 100%. The adm miserably failed in containing but in vaccines and preparing for its distribution, they were working on the logistics for a while and are better prepared than people expect them to be.

This vaccine is fascinating. it is totally new technique. I would think all other vaccines can be reinvented. Could there even be a super vaccine that vaccinates against everything including future disease?

@dragonmom , what strong side effects did your daughter experience with the vaccine trial?

@Iglooo i disagree with your comment that this thing with people refusing to get a vaccine is overblown. I know a lot of folks who say they are going to refuse for several years (like 5-10) because they want to see how other people do first , and still believe their risk is low because they are under 70 and don’t have any comorbidities. And I know some who intend to refuse altogether. It would be interesting to me to see a demographic study of who refuses, because although I know a very wide group of folks, the ones I know who are saying this are well educated and well off financially. I would have thought it would have been the folks I know who view this as really only affecting the very old folks and being overblown for political purposes; surprisingly those folks are more willing to get a vaccine. Of course this is just my limited experience, but it it seems the opposite of what I would have expected.

I think it’s critically important from a public health standpoint that we figure out who doesn’t want to get a vaccine and what their reasoning is, so we can work on getting out messaging that will reach these folks and convince them to do it, not just for their own sake, but for the sake of others. I hope someone is working on that.

A University of Michigan townhall for engineering suggests we will be wearing masks to some extent through 2022. They suggest there will be more viral outbreaks of some form or subforms. Not wearing a masks in crowded places etc is just going to be foolish.

Gallup did a survey on “If an FDA-approved vaccine to prevent coronavirus/COVID-19 was available right now at no cost, would you agree to be vaccinated?” during 10/19 to 11/1: https://news.gallup.com/poll/325208/americans-willing-covid-vaccine.aspx . Note that the survey was done before the Pfizer / BioNTech and Moderna preliminary vaccine results press releases.

Overall 58% yes.

More willing groups:

61% Men
62% 18-44
63% 65+
63% College degree
69% Democrats
61% White adults
66% Northeast
62% West

Less willing groups:

54% Women
49% 45-64
55% No college degree
49% Independents
49% Republicans
48% Non-White adults
55% Midwest
52% South

Of those who said “no”, the reasons:

37% Concerns about rushed timeline
26% Want to wait to confirm if it is safe
12% Don’t trust vaccines generally
10% Want to wait to see how effective it is
15% Other reason

(Demographic breakdowns for those who said “no” also given.)

In looking at the timeline phases for how the vaccine will be distributed to various groups, can anyone explain to me why the 18-30-year-old cohort will be receiving it before the 30-65-year-old cohort? The schedule looked reasonable to me other than that. Undoubtedly because that is the group I am in - lol.

Do you have a link describing the timeline phases in question?