I’m so old, I remember just a few months back when the media heralded Germany as a country that did “everything right” and was doing so much better than other countries in controlling Covid-19.

Germany will go into a “hard” national lockdown, starting next week and continuing through the Christmas period, German Chancellor Angela Merkel said Sunday, after agreeing to stricter measures with state governments to stem a wave of coronavirus cases.

Source: Germany Covid: Nation to go into national lockdown over Christmas to stem rise in cases

Update: South Korea also – I’m so old I remember when South Korea was THE poster country for having “done everything right”:

SEOUL, Dec. 14 (UPI) — After a weekend that saw record numbers of daily COVID-19 infections, South Korea amplified its efforts to control the spread of the virus with measures that include closing schools and opening 150 additional testing sites in the greater Seoul area on Monday.

On Sunday, South Korea recorded 1,050 COVID-19 cases, its highest-ever daily total, forcing health authorities to scramble to contain a third wave of the virus.

It’s as if public health mitigations – given the time dimension – eventually fail. It’s tempting to blame Trump but he’s not actually the leader of Germany.

• 15 days to flatten the curve!
• Oh, may be a month
• Two months
• Okay, at least 3 months
• Well, until a vaccine is available
• Wait, we do not trust vaccines – need to evaluate it ourselves, says Oregon
• It is a mystery why people say they will not get vaccinated…

(Basic idea for that was originally seen on social media.)

Public availability of vaccines not likely until 2021.

“Experts” say life may not return to normal until Fall of 2021 or even the end of 2021.

Easy to see why public health has lost credibility – they have repeatedly “over promised” and “under delivered”. Months ago, they were saying 300 million doses of vaccine to the U.S. by end of December. Hah hah. Perhaps by now they are under promising with an expectation of over delivering in 2021 – we hope.

“15 days to flatten the curve” has evolved into 18 to 21 months.

Making false assertions and promises leads to “Never Cry Wolf” – where no one believes public health anymore. And how do you address this?

Most public health and media reports say the pandemic only ends when 60-70% of the population has been vaccinated. Based on existing schedules, that implies fall of 2021.

But that is not a very good metric for determining the end. Ultimately, the pandemic ends when the spread of the disease has fallen dramatically. In other words, R-0 is well below 1.0 and stays well below 1.0.

This can occur without vaccinations. Indeed, all past pandemics have eventually ended on their own, without vaccines, as people contract the disease, develop subsequent antibodies and the virus runs out of targets to easily spread.

Many scientists have suggested this type of ending may come before the vaccination thresholds are reached.

• Dr. Scott Gottlieb, formerly FDA Commissioner, thinks these effects will occur as soon as the end of 2020. (“Effects” means we see a slowing spread, not that the virus is gone.)
• A prominent researcher at University College London thinks the pandemic falls to an endemic level in “early 2021”. That basically means it falls to low level remaining present in the background.
• A data scientist has a model (for whatever that is worth) and concludes the pandemic is over in the May/June 2021 time frame.
• Several scientists at prestigious research groups have made similar comments.

Of course no one knows with certainty. The above are all mostly expert opinion. Seems inline with my hypothesis from last September.

While vaccination programs may move the goal line up by a month or two or three, the pandemic may very well end of its own accord – not because of vaccines.

The only thing we can predict is that new politicians in 2021 will take full credit for having ended the pandemic even though all of the things that lead to a pandemic ending were in place before they took office.

Reminder: I am an idiot with no health care experience and my comments are strictly for Entertainment Purposes Only.

Public health and media reports are setting an unrealistic expectation for vaccine availability. Those age 65+ are probably in line in March to April time frame. The general public is probably out to summer of 2021 to start receiving vaccinations.

UPDATE FEBRUARY 19, 20201

Biden says general availability of vaccines should be by August of 2021. With at least 1/3d of the adult population then eligible, it would likely take up to 3 months s after that to reach everyone. Would not be surprised if, considering the timing, that priority then shifts to K-12 students before the rest of the adults under age 65.

UPDATE FEBRUARY 15, 2021

UK says general availability in “Autumn of 2021”.

Also, some indications the US might have to make vaccine appointments available to all in the spring of 2021, certainly by early summer. It becomes impossible to determine who is eligible and who is not – meaning it just becomes more effective to open this up to everyone once more dosages are available.

UPDATE JANUARY 27, 2021

Pfizer will delivery 200M additional doses (2-doses per person) by May 31st instead of July 31st.

UPDATE JANUARY 8, 2021

Oregon Health Authority Director Pat Allen said today that it will be fall of 2021 before vaccines are likely to be available to the general public.

UPDATE DEC 20, 2020

Based on Dec 20, CDC ACIP meeting recommendations, there is new information for Phase 1a, 1b and 1c. The new information implies no general vaccine availability until likely mid-summer (late July) of 2021.

Please go here for the full update, including numbers, dates and potential wild cards to this information.

UPDATE DEC 23, 2020

The US government announced it has reached an agreement to purchase doses for an additional 50M people by July 31, bringing the total to 200 M.

The US has a contract with Johnson and Johnson for 100 million doses of its single dose vaccine, but no date of delivery has been announced.

The US has a contract with AstraZeneca for doses for 150 million people, but no delivery date has been announced.

From Schwab’s daily update for Dec 23:

On the COVID-19 vaccine front, Pfizer Inc (PFE $38) said that it has struck a deal with the U.S. government to provide 100 million more doses of its inoculation co-developed with BioNTech SE (BNTX $98). The new order, which is expected to be delivered by the end of July, brings the total number of doses provided by the firms to 200 million.

At this time, the US has publicly announced contracted delivery of doses for 185M people by June 30th, and 200 M total by July 31st. The US has contracted also with J&J and AstraZeneca, but there are no delivery dates published. The US also contracted with NovaVax and Sanofi, but both are significantly delayed – probably until 2H 2021, even late 2021.

These numbers are confirmed by the Director of the NIH in this video clip. He is optimistic that the AstraZeneca and Johnson and Johnson vaccines can be manufactured rapidly “at scale” and that the US may have enough vaccine doses for everyone by early summer.

In fact, an early December news report confirms that plans for vaccinating everyone in the U.S. were dependent on AstraZeneca and Johnson and Johnson vaccine deliveries, which are delayed until the spring of 2021 at the soonest. There are hints that neither vaccine has achieved the same 94-95% efficacy of the first two – which also implies that those of us at the end of the line might receive less effective vaccines. But we will not know until official trail data is released in perhaps Q1 2021.

Here is the TL;DR Summary

• Prioritized groups will be underway by the end of 2020.
• The consensus of “expert opinion” is for vaccines to go first to health care workers and other prioritized groups, which may include very elderly in group homes.
• The consensus of expert opinion is that those age 65+ might be able to begin receiving vaccinations in the February – March time frame (that means “start” tor receive as it will then take some time).
• The consensus of expert opinion is that more people in the workforce will then begin to have access in March to April time frame.
• Only after that will vaccines be available to the general public. The expert consensus is that is likely to be in the summer of 2021 (June to September) – updated January 8, 2021: Oregon says it will be FALL OF 2021 for general public access.
• As trials have not yet been conducted on children, it is likely that vaccines will not be available for children until summer of 2021.
• Wildcards: Perhaps demand for vaccines will be less than expected. The pandemic might mostly die out on its own during 1H 2021, and that may lower demand for vaccinations. Vaccines contracted for U.S. and other nations’ delivery might be redirected to other countries (see below) delaying availability to the general public.

As vaccine distribution is not yet predictable, there are a wide range of estimates from “experts” and from the available public data.

We can look at the different “expert opinion” projections and do a Delphi-like “crowd wisdom” estimate of when the vaccine is available to the general public (rather than prioritized groups only).

We can also look at limited public data on contracted vaccine deliveries.

Both lines of evidence point to general availability beginning in the summer of 2021, with up to a few months to reach everyone who may wish to be vaccinated.

Read on for the list of “expert opinions” and contracted delivery information.

Continue reading When will you get a vaccine? →

Source: Covid 19 Risk Tool from Johns Hopkins University

The online calculator uses data to estimate your  mortality risk, based on data for people with similar health situations as you, in your community.

My mortality risk, they calculate, is in the lowest possible category at 4.4 per 100,000 individuals. According to the CDC, influenza has a death rate of 3.4 per 100,000 individuals.

I am over 60 and have 2 health conditions (lifelong exercise induced asthma, and elevated blood pressure) that are factors in their calculation.

Their calculated estimate is significantly different than what earlier reports have led me to think was my risk.

 

 

It’s so tempting to blame leadership, but each country has its own leaders – and the same outcome is occurring in each country. The problem is flawed public health science and strategies.

Europe is in meltdown again as daily Covid death tolls reach record highs and countries scramble to expand testing and rescue hospital systems that are buckling under the pressure.

….

Russia and Germany reported record daily Covid-19 deaths on Friday, and October was Russia’s deadliest month in a decade. Stockholm’s intensive care units hit 99% capacity as Sweden proposed a spring “pandemic law” to potentially force closures of certain public spaces. And France said its lockdown would not be eased as planned on Tuesday after daily case numbers rose on Thursday compared with last week.

Source: Covid in Europe: Death tolls soar and hospitals struggle as containment unravels

Earlier this year, many of these countries were said to be “doing everything right”. But then the time dimension caught up with them. It is apparent that “everything right” does not work well.

Public health needs new ideas, new approaches and massively improved public communications. Everywhere.

Update as of December 3, 2020: The model used to generate influenza in-season preliminary burden estimates uses current season flu hospitalization data. Reported flu hospitalizations are too low at this time to generate an estimate

Source: 2019-2020 U.S. Flu Season: Preliminary In-Season Burden Estimates | CDC

Obviously, this could change later in the winter. Should tag this for a revisit in a couple of months.

Today, I wrote our state public health officials and called them out for the lack of an effective strategy. We need new thinking and new approaches. With cases ten times higher than 4 months ago, it is brutally obvious their existing mitigation policies have failed. But I am just a citizen idiot and they probably won’t even read the first sentence of the letter I sent.

I just ran across this paper in The Lancet, published a few weeks ago. It says much the same, in regards to the UK.

On Sept 21, 2020, the Scientific Advisory Group for Emergencies (SAGE) advised the UK Government to institute a circuit breaker in England to suppress the epidemic. Instead, the government opted for several weeks of ineffective local tiered restrictions, and cases continued to rise exponentially. Finally, on Oct 31, 2020, the government announced a 4-week national lockdown commencing on Nov 5, 2020.

Lockdowns are last resort measures that reflect a failure of the pandemic control strategy. They have massive impacts on the population and the economy. To avoid repeated lockdowns and their impacts, we need a sustainable COVID-19 public health strategy. Here, we make seven evidence-based recommendations (a schematic representation is available in the appendix).

Source: The UK needs a sustainable strategy for COVID-19 – The Lancet

Like duh.