2019 Novel Coronavirus Covid-19 Discussion

Forums › Health and fitness › 2019 Novel Coronavirus Covid-19 Discussion

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Ultimate Geek

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#2630575 5-Jan-2021 11:41

Batman: It's not that simple.

In medicine there is this thing called dose response curve.

Not a binary yes no.

You're absolutely right. What I'm saying is that information may not exist at this point in time. Therefore, people who know what they are talking about will look at all of the available data (medical, and social) and make a decision one way or another.

It will always have an element of politics involved, and it will be impossible to separate that element from the medical aspect due to the situation the world finds itself in.

That doesn't make it a conspiracy.

Batman

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#2630576 5-Jan-2021 11:43

And we are very early into data collection as iirc the phase 3 trial actually hasn't concluded, this is emergency approval.

mkissin

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#2630577 5-Jan-2021 11:44

tdgeek:

So its not good science, as the better outcome is the correct dose. Using the rampant failures in USA and UK is no reason to give low doses. You would consider a proper lockdown, for once, which after 2/3 of a year, ENG is now doing.

Is that still true accounting for the poor distribution situation within the USA in various states? Where some doses are expiring because they're not able to follow the plan they initially put in place.

I don't have the answer. But you also don't.

A quote from the article I linked...

“Here is the alternative. We know that for the Moderna vaccine, giving half the dose to people between the age of eighteen and fifty-five—two doses, half the dose, which means exactly achieving the objective of immunizing double the number of people with the doses we have—we know it induces identical immune response to the hundred microgram dose and, therefore, we are in discussion with Moderna and with the FDA.

Edit: The best case, I agree, would be a full lockdown followed by proper vaccine distribution. However we both know that's not going to happen, so what's option 2?

tdgeek

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#2630622 5-Jan-2021 11:52

Batman: It's not that simple.

In medicine there is this thing called dose response curve.

Not a binary yes no.

And this dose response curve applies to a population of people, not technically to a single person.

who said it was a yes/no?

tdgeek

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#2630627 5-Jan-2021 12:18

mkissin:

Is that still true accounting for the poor distribution situation within the USA in various states? Where some doses are expiring because they're not able to follow the plan they initially put in place.

I don't have the answer. But you also don't.

A quote from the article I linked...

“Here is the alternative. We know that for the Moderna vaccine, giving half the dose to people between the age of eighteen and fifty-five—two doses, half the dose, which means exactly achieving the objective of immunizing double the number of people with the doses we have—we know it induces identical immune response to the hundred microgram dose and, therefore, we are in discussion with Moderna and with the FDA.

Edit: The best case, I agree, would be a full lockdown followed by proper vaccine distribution. However we both know that's not going to happen, so what's option 2?

I never said I have the answer. If the half dose is "we know it induces identical immune response to the hundred microgram dose" why isnt that the regular dose? One minute we have a two dose method, now the magic solution is giving people half the dose , which laughingly is now quoted as identical to the full dose

ENG is introducing a full lockdown, till end Feb. SCO a lesser period IIRC. USA is a dead duck so not relevant

mkissin

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#2630629 5-Jan-2021 12:29

tdgeek:

I never said I have the answer. If the half dose is "we know it induces identical immune response to the hundred microgram dose" why isnt that the regular dose? One minute we have a two dose method, now the magic solution is giving people half the dose , which laughingly is now quoted as identical to the full dose

ENG is introducing a full lockdown, till end Feb. SCO a lesser period IIRC. USA is a dead duck so not relevant

I think you're mischaracterizing the understanding of the effects of the half-dose immunization. It appears to me that it's more a case of: we're not 100% sure what happens, but it's almost certainly better than no dose, which may be the only other option.

The tests to date had (with one exception, IIRC, and that was done in error) only one dosage used, which is therefore the only solid datapoint anybody has.

I don't want to make it appear that I think reducing/splitting/changing the doses is The Right Decision. Rather, that internet forum people (including myself) are operating on, at best, limited knowledge and understanding. Therefore, the experts (including politicians) will make a decision that they believe is correct and which is based at least partially on guesswork. That decision may well be indistinguishable to internet people from a conspiracy, but that doesn't make it one.

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#2630641 5-Jan-2021 12:42

Damn

England has lost trying to stay ahead again. full stay at home for a month

https://news.sky.com/story/covid-19-boris-johnson-announces-new-national-lockdown-for-england-which-is-expected-to-last-until-mid-february-12179371

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#2630642 5-Jan-2021 12:45

mkissin:

I think you're mischaracterizing the understanding of the effects of the half-dose immunization. It appears to me that it's more a case of: we're not 100% sure what happens, but it's almost certainly better than no dose, which may be the only other option.

The tests to date had (with one exception, IIRC, and that was done in error) only one dosage used, which is therefore the only solid datapoint anybody has.

I don't want to make it appear that I think reducing/splitting/changing the doses is The Right Decision. Rather, that internet forum people (including myself) are operating on, at best, limited knowledge and understanding. Therefore, the experts (including politicians) will make a decision that they believe is correct and which is based at least partially on guesswork. That decision may well be indistinguishable to internet people from a conspiracy, but that doesn't make it one.

As I see it, two doses is required. All brands decree that. If you wish to half the dosage, you double the people dosed, and an unknown downside. Why not make it a 1/4 dose and cater for four times as many people? If thats a bad or silly idea then a half dose is half as bad and half as silly. I dont see it as a conspiracy, just using one easy method to downplay the promised but underdelivered vaccines.

tdgeek

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#2630645 5-Jan-2021 12:49

Oblivian: Damn

England has lost trying to stay ahead again. full stay at home for a month

https://news.sky.com/story/covid-19-boris-johnson-announces-new-national-lockdown-for-england-which-is-expected-to-last-until-mid-february-12179371

Yes, damn, but I support that. Has it started? Be better if they gave everyone time to stock up, so compliance will be better. At least mid Feb too. It works

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#2630646 5-Jan-2021 12:50

Yes, a quasi full-lockdown as people who can't WFH can go out - unlike New Zealand where everything stopped really:

From now, people across the whole country must now stay at home apart from five exceptions:

• for work, if people cannot work from home, such as those in the construction sector or key workers
• to shop for necessities such as food or medicines
• to exercise once per day at a local location. This can include with one other person from outside someone's household or support/childcare bubble
• to provide care or help to vulnerable people
• to attend medical appointments, get medical care or a coronavirus test, or to flee the threat of harm or violence.

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#2630648 5-Jan-2021 12:54

tdgeek:

Oblivian: Damn

England has lost trying to stay ahead again. full stay at home for a month

https://news.sky.com/story/covid-19-boris-johnson-announces-new-national-lockdown-for-england-which-is-expected-to-last-until-mid-february-12179371

Yes, damn, but I support that. Has it started? Be better if they gave everyone time to stock up, so compliance will be better. At least mid Feb too. It works

Yes, immediate effect.

mkissin

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#2630653 5-Jan-2021 13:07

tdgeek:

As I see it, two doses is required. All brands decree that. If you wish to half the dosage, you double the people dosed, and an unknown downside. Why not make it a 1/4 dose and cater for four times as many people? If thats a bad or silly idea then a half dose is half as bad and half as silly. I dont see it as a conspiracy, just using one easy method to downplay the promised but underdelivered vaccines.

That's just a reductio ad absurdum fallacy. There's an entire continuum in there that you've waved away. Why not give people 6 doses? 12 doses? 1 million doses! Those are all likely to confer "more" immunity.

At the end of the day, you don't need perfect immunity, you just need to get R below 1. There are potentially many roads to that victory.

Moderna, AstraZeneca, and Pfizer all require two doses, but there are many others in development that are undergoing trials with only a single dose needed:

Covid-19 Vaccine Tracker: Latest Updates - The New York Times (nytimes.com)

tdgeek

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#2630712 5-Jan-2021 13:18

mkissin:

That's just a reductio ad absurdum fallacy. There's an entire continuum in there that you've waved away. Why not give people 6 doses? 12 doses? 1 million doses! Those are all likely to confer "more" immunity.

At the end of the day, you don't need perfect immunity, you just need to get R below 1. There are potentially many roads to that victory.

Moderna, AstraZeneca, and Pfizer all require two doses, but there are many others in development that are undergoing trials with only a single dose needed:

Covid-19 Vaccine Tracker: Latest Updates - The New York Times (nytimes.com)

You're making things up. 12 doses, one million does, that is not the same as you know. If various brands say two doses, and one says one dose, do the math. Follow the directions as described by experts and the designers of the drugs. If you take half you take half. Why take just a half dose? Because of the rampant virus activity at the moment? Because of lack of supply and lack of vaccination numbers? Its not dissimilar to most of the lockdowns. Half doses, seemingly ended up as a liability.

mkissin

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#2630717 5-Jan-2021 13:30

tdgeek:

You're making things up. 12 doses, one million does, that is not the same as you know. If various brands say two doses, and one says one dose, do the math.

That's a weird response when the various vaccines work differently. They're not just two companies producing equivalent generic drugs.

tdgeek:

Follow the directions as described by experts and the designers of the drugs. If you take half you take half. Why take just a half dose? Because of the rampant virus activity at the moment? Because of lack of supply and lack of vaccination numbers? Its not dissimilar to most of the lockdowns. Half doses, seemingly ended up as a liability.

Without exception, they all worked to lower R. The problem arose in that they either did not lower it enough, or were stopped too early, or were not combined with enough other effects to lower R even further.

What I'm saying is that it's a big grey area, and a set of interconnected tradeoffs - both medical and social. If you cannot get to perfect (full lockdown, with the "proper" vaccine dosage) for whatever reason then your second choice may be something that looks a bit strange to non-experts and come along with all sorts of high-level disagreement as people argue the tradeoffs. Which is what we're seeing. Very few people (arguably, probably nobody) has enough information at the moment to make what would be, with the benefit of hindsight, the correct decision.

tdgeek

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#2630725 5-Jan-2021 13:45

mkissin:

What I'm saying is that it's a big grey area, and a set of interconnected tradeoffs - both medical and social. If you cannot get to perfect (full lockdown, with the "proper" vaccine dosage) for whatever reason then your second choice may be something that looks a bit strange to non-experts and come along with all sorts of high-level disagreement as people argue the tradeoffs. Which is what we're seeing. Very few people (arguably, probably nobody) has enough information at the moment to make what would be, with the benefit of hindsight, the correct decision.

Its probably not so grey for the drug designers. the dose size, whether its one or two, etc etc etc isn't a guess. Is it 100% known and documented? No. For the many weeks these vaccines have been discussed, new ones are created, its has built towards active vaccinations. Now its ok to dilute the dosage as a worthwhile tradeoff. Ok.

Given that as you say no one knows everything yet, so we cant make the correct decision. Why risk diluting the dose? It may well be that the full dose is not enough, so we make it worse by guessing that its ok to halve it. Do you design something and test it, then dilute it? As I said its like most lockdowns. If its called a lockdown, thats good enough, but as we know, the diluted lockdowns many countries had did more harm than good

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