Now that we (may) have a vaccine, let’s talk about what it could mean. Because it’s not all Problem Solved. We’ve had a little time to feel good, so now we get to look for monsters under the bed. They may turn out not to be there, but let’s take a look while it’s daytime. Just to be safe.
Potential monster number one: We don’t know yet whether the Pfizer vaccine will keep people who’ve been exposed to the virus from spreading it. It may, but it’s also possible that it–or any other vaccine–will keep people from getting sick but not keep them from being silent spreaders. That would mean we can’t end social distancing and can’t burn our masks.
I can’t tell if those are beady little monster eyes I’m seeing or if it’s the buttons I lost a couple of years back.
I really should clean under there more often.
Potential monster number two: If the Pfizer vaccine is the one we all go with initially, logistical problems are a certainty. It has to be kept at an insanely cold temperature–minus 70 C. That’s minus 94 F. Not even forty years in Minnesota prepared me to understand how cold that is. The worst I saw was minus 40 F., and I think that counted the wind chill. It was cold enough to freeze any thought other than How do I get indoors but wasn’t cold enough to impress this vaccine.
That’s going to be more of a problem in countries without a well-developed infrastructure and without the money for a supply of–um, what do you use to keep a drug at that temperature? Something with more insulation than your average lunch bucket.
Potential monster number three: How much of the vaccine can be produced how quickly, and at what cost. And how much of what’s produced will be available to poorer countries? Because until the virus is under control everywhere, it won’t be fully under control anywhere.
Potential monster number three and a half: Initial supplies will be limited, and the British government’s drawn up a tentative list of what sort of people will be priorities, but no country’s likely to have enough doses for all of its population. So what does that mean?
Say a vaccine protects 70% of the people who get it. (This is based on an article that came out before the preliminary Pfizer announcement of 90% protection, so the numbers will change but the structure of the problem won’t.) If 70% of the population is vaccinated, which is unlikely at first, 49% of the population will be immune.
Why 49%? Why not 49%. It’s a nice number–just off balance enough to be convincing. What it’s not, though, is enough to give us herd immunity. If the priorities for vaccination are the oldest people, the most vulnerable, and (please!) the front-line workers, that will still mean that younger healthy people need to maintain social distancing, wear masks, and generally continue to live the way we’ve been living. And people who’ve been vaccinated probably will as well if the vaccine doesn’t keep them from being contagious. Otherwise they’ll endanger both the 51% of vulnerable people who haven’t been protected. And (I know, I keep saying this) younger people are more vulnerable to this than we tend to think, so they’ll endanger them as well.
But it’s not all monsters and buttons and dust bunnies under the bed. We’ve got some potential monster-slayers too.
Sorry, I don’t mean to get bloodthirsty about this. If you’re squeamish about killing a virus, take heart: A virus is not actually alive. Or else it is. This is something microbiologists argue about. It all depends on how you define life. Either way, though, it’s them or us. It’s enough to drive even the most dedicated pacifist to sit down and have a good long think.
So, potential monster-slayer one: On a very long-term basis, it’s possible that young kids who catch the virus but don’t get sick will build up a generational semi-immunity and Covid will eventually become just another cold. It’s possible that the four coronaviruses that cause colds started out like Covid. One of the four left cattle and discovered humans around 1890–the same year as what’s been thought of as a flu pandemic but might, in hindsight, have been a cousin of Covid.
It’s possible. It’s also possible that all that is wrong. And of course most of us have to live long enough and emerge healthy enough for that to matter.
Potential monster-slayer two: More immediately, with the introduction of a vaccine, testing and tracing come into their own. They’re most effective when case numbers are relatively low–much lower than Britain has at the moment– because a country needs to track and quarantine every case. A vaccine could put us in a position to use testing and tracing well.
Of course, even if you only have three cases, you still need a competent track and trace system. I’m not sure ours is up to the challenge of three cases yet.
Early in the pandemic, South Korea used track and trace well and Joshua Gans of the University of Toronto says, “We need to all become South Korea as quickly as possible.”
That will mean ensuring that quarantine actually works. Estimates of the percentage of people in England who fully self-isolate when they’re supposed to are low (11% according to one study), and the situation isn’t helped by the lack of genuine financial support. Some people can’t afford to stay home. Others, presumably, don’t take it seriously.
One problem with testing has been that the fast tests are less accurate than the slow ones. A test that is 90% sensitive will miss 10% of positives. But don’t despair. Baffling math may save us here. “Two tests five to seven days apart are 99% sensitive in finding you positive–if you actually are,” according to epidemiologist Tim Sly.
No, don’t ask me. They’re numbers. I can’t explain why they do what they do. The main thing is not to let them sense your fear.
The recommendation is to test people frequently–frontline workers, people who fly, people who breathe. Some of the rapid tests can spot people who are actually transmitting the virus, not just people who have symptoms.
So we’re not ready to have a massive, maskless, indoor party the day after the vaccine arrives. Or maybe even the year after the vaccine arrives. Put away the confetti. Take a bite of the ice cream, then shove it back in the freezer.
But the picture is changing, and even though we have a government that’s elevated incompetence to an art form, I’m hopeful.
I’m not that naive. Being injured is (still) a good excuse not to see people too often. Besides, I just got us more masks. I’m hopeful, though, and I’m rarely optimistic.
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A bit of hope now and then isn’t going to hurt. I’m almost sure of that.
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Let us hope.
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Sometimes, when it does no harm and gets us through, yes, let’s.
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Another factor is the possible impact of the outcome of trade negotiations between the newly independent and insignificant UK (huzzah!) and the countries where the vaccine is made – I’ve seen Germany mentioned for this. Maybe I’m being unduly pessimistic, but if Johnson and his cretins have antagonised them so much I fear we may find ourselves way back in the queue. And I doubt that many forms of refrigerated transport would cope for long enough at the customs queues. Warm vaccine, anyone?
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I hadn’t even thought about the Brexit-related issues. I’d add, how much refrigeration equipment will we need to import, and from where?
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I suspect they will add an unwelcome dimension to all of this.
No doubt there is a cabinet minister with a third cousin twice removed who has a company with £5 share capital, ready and waiting for the refrigeration contract. Either that or they’ll have to get Johnson out of his fridge to make space…
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I don’t know whether to weep or laugh hysterically.
Oh, hell, I choose Option B.
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You just know they’ll make a balls-up of the vaccinations, as they have everything else.
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Like mixing up 70 below with 70 above? They really do have a track record, don’t they?
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Truly terrifying to contemplate us all becoming South Korea (a country I love by the way); it might make the other superpowers a tad nervous. And as for poor old Tim, epidemiologists are having enough trouble cutting through as it is without carrying the additional burden of being Dr. Sly.
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Another joke I missed. I must be working too quickly.
South Korea might decide it doesn’t want all of us as immigrants. I can’t say I’d blame it, We’re awkward in large numbers.
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As your Mr Churchill said “This is not the end. But it is, perhaps, the end of the beginning…”
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It’s possible. And I didn’t think he was actually mine, but it’s getting harder to know what country I belong to. Both, I guess.
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Well, his Mama was one is “US” so we can share
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Of course, there is the math of the other vaccines being developed, the therapeutics and the people who think the whole thing is a hoax. The mind boggles. I’ll leave it in your capable hands to continue figuring this mess out. Or, shove these things back under the bed.
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There’s so much under the bed that when I turn off the light it’s starting to rock. I think some of it wants out.
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The other monster slayers are the other vaccines that are being developed. Let’s hope they don’t turn out to be so delicate that they need to be kept at stupid temperatures.
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Very true.
I was listening to Radio 4 this morning and it turns out the minus 70 is the temperature of dry ice.
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So cold, but not impossibly cold.
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True. The problem, I think, will be longer-term storage: Are there enough heavy-duty freezers available, and are they in the right places?
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Indeed, but dry ice is used a lot, which means that there should be some storage to start with while new freezers are being made.
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On Radio 4, they were talking about there having been a shortage of it, which led not to a serious discussion but to speculation about sending squads out to confiscate it from nightclubs. I don’t have any serious sense of how much of a logistical problem this will be, but if anyone’s going to raid local nightclubs I’d like to stay in the background and report on it.
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We’re living in a very strange world if night clubs are going to help to save us.
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Well, it has been pretty strange lately. But since they’ve all been closed since lockdown, I doubt they have any dry ice to confiscate. Although they might have the phone number of their supplier.
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I should imagine the containers would be more important than the ice itself.
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I hadn’t thought about that. My impression is that dry ice can keep the vaccine for a few days, but that what’s really needed is freezers capable of keeping a steady, absurdly cold temperature. I’m no longer sure where I got that from, though. Possibly that Radio 4 discussion.
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If you want a conspiracy theory, apparently someone has suggested that the vaccine was ready ages ago but the announcement was delayed until after the US presidential election. Worryingly, there are probably people who genuinely believe this!
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It was probably inevitable that someone would give that a shove and start it circulating. It may not be as dangerous as the rumor that Biden stole the election (but neglected to steal the Senate).
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Yes, Sky News commented that people are questioning the validity of ballot papers including votes for Biden, but not the votes for Republican senators on those very same papers!
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They were unquestionably filled out by the same person who sent 10 Downing Street’s congratulations to Joe Biden after (sort of) crossing out Donald Trump’s name.
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I am going with the optimism angle and hoping that the Government will at least manage to accomplish the least harmful fuck-up out of all the possible ways there will be of fucking this up.
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The triumph of hope over experience, but I’ll hop in there and hope along with you. It won’t hurt anything.
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I totally agree on #3 1/2 – My family won’t see any of that vaccine for a long time … People are acting as if that was the holy grail. Germany is in partial lockdown and I’m pretty sure they just call it that so people don’t go crazy. Just yet.
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All I am going to say that other vaccine will also become available and that may well ease the issues you raise here. At least there’s light at the end of the tunnel.
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You’re right. I was so focused on one vaccine getting to this stage that it didn’t even cross my mind to acknowledge the others that are moving forward and for all we know may work as well or better.
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I think there may be issues in showing which ones work best if we rush to use the first available one.
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That was predicted, actually–that the rush may not mean we settle on the best. Today I read a discussion of whether it’ll be possible to mix vaccines. It’s could end up being the wild west out there.
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More fodder for your blog posts….
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There seems to be enough chaos to keep me going for ever. I wouldn’t mind being put out of business, to tell you the truth.
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The news circulating here in South Africa, is that Pfizer also produces Viagra… so if they can raise the dead, they should be able to cure the living.
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Thanks for making me laugh on a gray, windy afternoon.
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Find out which British minister/top civil servant/epidemologist/health boss has a relative who owns shares in Mr.Whippy and wait for the ice cream vans to come round distributing the stuff.
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Forget Mr. Whippy. It’s all about PPE, test and trace contracts, and so forth, and they seem to to trace back heavily to the tight circle around Boris Johnson and the Brexiteers. More about that soon. I was going to work on it today, but it depressed me.
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Someone has to get the vaccine to the G.P.s…who better than Mr. Whippy?
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How much dry ice does he have on hand? It turns out that dry ice is just the right temperature.
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Mr Whippy will claim he has dry ice unlimited, swallow the contract and then claim that his drivers have been given the wrong addresses.
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My question was silly. There’s been a pattern lately of giving contracts to outfits with minimal capitalization and no track record of work in whatever field the contract is for. Hence the post-Brexit ferry contract to a company with no ferries.
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At least Mr. Whippy did his rounds…..
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Our comment exchange has been echoing in my head. I don’t know the history of Britain’s social service and cousins getting contracts, but I do know that on a national scale right now it’s the politicians and their advisors who are handing out absurd–and huge–contracts to their allies and (at least former; I can’t speak to whether they’re current) business partners. The civil service is pretty well sidelined in the corruption game.
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Check the NHS procurement arm….
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Could be, but check out the privatized contracts that are bypassing the NHS–millions upon millions of pounds, no public scrutiny, no competitive bidding, and complete failure on many of the contracts.
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MD daughter says that to maintain a “typical” cold chain, 4-5C is already difficult. And she did almost a year in Africa with Doctors w/o borders. So -80C? Even in developed countries it means only certain hospitals can keep the vaccine at that temp. So, huge queues at the hospitals?
Add to that the fact that a significant number of French (damn Frogs) say they will not vaccinate themselves. How many in the UK and elsewhere?
😷😷😷
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According to one poll, 90% would accept it for themselves and 89% for their children. According to another, 36% were uncertain or very unlikely to accept a vaccine–but of those, only 9% were very unlikely. Like all polls, I’m sure it depends how you ask the question, but those two may align more than it appears at first.
The refrigeration issue, though, is going to be large. Especially with the unknowns of Brexit looming.
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Much higher than in France.
And don’t get me started on Brexit. Such a bloody shame…
Anyway, thank you Ellen for your dry sense of humour. The Clown-in-chief has been fired, though he doesn’t know it yet, that made my day/year. One moron at a time. Johnson is next. 😉
Take good care of yourself.
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Thanks, Equinoxio. I’m doing what I can in this crazy time. You do that as well, okay?
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Yep. Not much other choice…
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Great article I like your writing style. I am a US citizen living in Portugal for the past 20 years. The US is in a very bad place but Portugal has it’s problems also. When this pandemic started I told my wife that Europe and the US need to follow the South Korean example of how to stop the covid spread. They did not. The South Korean government immediately set up testing stations around the country. They also did temperature checks for everyone entering a public space. If they had a temperature they were immediately escorted to a testing center and given, first, a seasonal flu test. If positive they were sent on their way. If negative they moved to the next stage which was a scan of their lungs to check forany signs of pneumonia even if they had no symptoms. If positive they were given a covid test and held there in isolation, until the tests results were received. If positive they were sent to a quarantine center immediately and not permitted contact with anyone. The covid positive persons were either held there two weeks and retested then released if negative, or if they were ill, sent to a covid ward of a hospital. Everyone in the population was required to wear masks in public. This is the reason that South Korea got control of the virus and never had to shut down any part of their economy. The west totally dropped the ball and look at the results. Covid positives should never have been permitted to quarantine at home! Now it is too late. i have a solution to this problem and it is very simple. I will explain in my next post on solutions to stop covid so please follow me.
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That’s more detail than I’ve seen before on the South Korean approach. Britain’s approach to quarantine has been insane. At one point, it involved taking public transportation to get home, then staying there–probably. Presumably, if public transportation moves fast enough, the germs can’t keep up.
I’ll be interested to see what your approach is.
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I am hoping to finish my article today. It is a long one, (more than 3000 words),but I feel all the information is necessary to understand my point. Thanks for the follow!
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Will we still be allowed ice cream, or will all freezers have been co-opted to Mr Dyson to turn into super freezers for storing the vaccine?
I do feel the vaccine is a ray of hope, but just a little one. I’ll take it, however small, for we certainly need good news presently. But, yes, many and hurdle to leap yet and hence many risks for a trip up or two.
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I think the ice cream’s safe. There’s no way we can add together the temperatures of various freezers in the neighborhood (0 F; – 18 C, in case anyone asks) and get to – 70 C.
I’m hanging onto the ray of hope myself, and reminding myself that it doesn’t mean we can all relax and do what we want now.
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All I know is that I’m going to make sure I’m at the back of the queue to see what after-effects transpire. It’s all too quick for me…
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I mentioned your comment to my partner, who’s 82, and her take on it is that given her age she thinks waiting is the greater risk. Both decisions, I think, make sense.
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Fingers crossed.
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Indeed. Since I wrote this, I’ve heard on the grapevine that the local doctors are planning how to handle the first round of injections. They’ have to plan for a space where people can sit for 15 minutes after the shot (to make sure they don’t explode, presumably), and for enough coordination with other doctors’ practices so they can use 1,000 doses, because that’s the quantity it comes in–and they all have to go to people over 80, as far as we know. Why they’re not going to front-line workers first, I have no idea. Maybe because they have less political clout. They’re a vulnerable group and can’t self-isolate.
It turns out, though, that it can be kept at higher temperatures for something in the neighborhood of five days.
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Wow! I think any essential worker should be first. Perhaps teenagers who can’t stop partying should be next…
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Now there’s a thought.
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🙂
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