When will this shit end?

[ErnestWorthing]

35 minutes ago, xxialac said:

Thank you for such a balanced view. Refreshing to read.

Of course the UK excels in some things. But the UK is a very small country and will have increasingly less relevance on a world stage now dominated by China and its periphery and the US.

Being part of an influential block was by far our best hope to have influence globally...and we've given that up. Getting vaccinations completed a couple of months early won't begin to make up for the far lower global influence, soft power and the inevitable weaker economy through inefficient and lower volumes of trade with the people we want to trade with most.

 

We're going off topic here but we have a permanent seat on the UN security council, we're a member of the G7 and NATO, we're the 6th largest economy in the world.  Let's not pretend we're an irrelevance on the world stage.

[Hannibal Schmitt]

10 minutes ago, steviewevie said:

yeah, I expect trust was pretty low anyway, now they may as well give up with the AZ one.

It`s rather complicated. Countries like Germany won`t loose so much time as their vaccination campaign is building up more on the Biotech/Pfizer, they will get to their goal late summer with or without the AZ. Other countries like ours are building up on both, the AZ and Biotech and others in the EU are only building up on the AZ. These will really have a problem now with the German, French and others decisions. So the EU/EMA (this is what our health minister said yesterday as approving the continuation of the AZ till probably Thursday) should make a clear and very fast statement on countries and the use of the AZ, giving confidence to the people, because the stopping of the AZ was done by individual countries and should have been coordinated the the EU.

[HalfAnIdiot]

34 minutes ago, xxialac said:

It takes some considerable skill to earn a negative community rating after 12,000 odd posts so people on here don't agree.

I guess it depends what is important to you. 

This place is an echo chamber, particularly evident on this thread. The 'community rating' only reflects that. 

[HalfAnIdiot]

15 minutes ago, steviewevie said:

oh god, hope that doesn't happen to me.

Best to unplug the toaster now, just in case. 

[xxialac]

13 minutes ago, ErnestWorthing said:

 

We're going off topic here but we have a permanent seat on the UN security council, we're a member of the G7 and NATO, we're the 6th largest economy in the world.  Let's not pretend we're an irrelevance on the world stage.

I wasn't commenting on our position today.

I was making the point that our position as a global power is massively under threat and we are invariably going to become less and less relevant.

Leaving the EU will only accelerate that trend.

And incidentally there's not much to separate the size of the 5th-15th largest economies. Individually we are all minnows behind China and the US. And other emerging economies are just going to grow and grow.

Edited March 16, 2021 by xxialac

[stuie]

23 minutes ago, steviewevie said:

oh god, hope that doesn't happen to me.

Maybe unplug it just in case 

[JoeyT]

Cases are falling on a day by day basis. Much to be positive about! All being well we could drop below 4K tomorrow...

 

[zahidf]

Mental

[eFestivals]

2 hours ago, zahidf said:

Well

Of course it's political the wrong decision comes back on the politicians.

 

[DeanoL]

1 hour ago, Barry Fish said:

I also think there a lot of marginal gains to be made across the whole economy.  Just in general productivity vs other countries.   Lots of small gains equal big returns.

I LOVE working from home and it suits me well but many others really want / need the office back.  I could do with the office couple of times a week some weeks.  You can't beat that around the white board meeting sharing ideas.  Its much more restrictive over zoom.  

We are service based economy and the more productive those services are the better they will compete on a global market.

I agree with that, I just don't think the difference in productivity from opening up a few months ahead of the rest of the world will really make an impact. Are people really going to choose a UK supplier over a European one because the UK team can have real life meetings over a whiteboard?

Especially as in many parts of the world offices have reopened already anyway, even though they're still in a form of lockdown.

[Hannibal Schmitt]

EMA Press conference today 2pm CET, decision expected latest on Thursday.

Most likely outcome after reviewing the AZ=defining high risk thrombosis groups which should not get vaccinated with the AZ.

Meanwhile Reuters reports Germany seems to be legally bond to make the decision because they would have had to fear  complaints about bodily harm at court (7 serious cases of sinus vein thrombosis out of 1 Mio. vaccinated are reported).

[xxialac]

35 minutes ago, Barry Fish said:

Domino effect...

Someone said how is this an EU issue - well there you go...

Learn something every day.

I had no idea the following countries were in the EU:

- Norway

- DRC

- Thailand

- Indonesia

- Iceland

And Switzerland hasn't approved it either.

Oh and Sweden has suspended a vaccine from an, er, Anglo-Swedish company for political gain.

 

[Ozanne]

 

[zahidf]

@Toilet Duckjust a coupel of wuick questions if thats ok

1. Is fatigue a month after a Covid 19 normal?

2. If someone just takes the one dose instead of 2 for AZN, would that mean they'd have no protection at all ? ( Not me, an elderly relative being a bit dim)

[xxialac]

57 minutes ago, Barry Fish said:

Its actually an overstated possibility.

If you look at the reality the global picture has been very stabled for a very long time.

https://en.wikipedia.org/wiki/List_of_countries_by_largest_historical_GDP

We have had talk about the emerging economies growing and over taking the traditional economies for a very long time and there is very little real world evidence of it actually happening.  Its been talked about for as long as I can remember.

India is the most likely to do very well and China are already here.  After that though its unlikely we going to see major movements.

No, that's not right. 
Emerging economies, particularly in Asia, are growing far more rapidly than the UK.

It's just that they are starting from a lower base.

My point is that they will be catching up every year and more importantly the gap from the UK to China/US will continue to widen such that we need to be part of a bigger union to not get bullied.

[xxialac]

Just now, Barry Fish said:

I agree with your last point.  Brexit was madness and we have to work hard to replace it.

Yes, agreed. 

Sorry for clogging up the thread with this. I'll hibernate.

[MrHew]

14 minutes ago, zahidf said:

@Toilet Duckjust a coupel of wuick questions if thats ok

1. Is fatigue a month after a Covid 19 normal?

2. If someone just takes the one dose instead of 2 for AZN, would that mean they'd have no protection at all ? ( Not me, an elderly relative being a bit dim)

I'm not Toilet Duck but

1. It's certainly fairly common. It's over 5 weeks since I tested positive and I'm still fatigued. I'm up to 4 hours work a day now and that shatters me out.

2. They would still have some protection but TD would probably be able to give you more detail. 

[Ryan1984]

2 hours ago, Zoo Music Girl said:

When the easing was announced I thought we'd be super busy that Easter weekend with both our families wanting to do stuff, but I think it's going to be a bit more slow and steady for us. With it having to be outside and just for a day visit, it was pointed out to me that traffic is likely to be a nightmare that weekend (due to bank hol and lockdown easing) so seeing relatives that live a fair bit away won't be that easy. My family also aren't keen to meet outdoors if cold! 

So at the moment I think I'm definitely seeing one mate for a park visit and maybe a couple more that weekend, but we may well hold off most of our socialising until later in the month, being led by what others want to do. 

Good point about the traffic. Also doesn’t appear like we have the same kind of warm days ahead as this time last year.

I think letting people who want to have the Big Bang of socialising first go out and do it and then going a week or two later is for the best.

[JoeyT]

 

[Zoo Music Girl]

Just now, Ryan1984 said:

Good point about the traffic. Also doesn’t appear like we have the same kind of warm days ahead as this time last year.

I think letting people who want to have the Big Bang of socialising first go out and do it and then going a week or two later is for the best.

Yeah the weather definitely could do with picking up a bit! Sure it was a lot nicer this time last year (although that was something of a fluke).

[eFestivals]

27 minutes ago, xxialac said:

Learn something every day.

I had no idea the following countries were in the EU:

- Norway

- DRC

- Thailand

- Indonesia

- Iceland

And Switzerland hasn't approved it either.

Oh and Sweden has suspended a vaccine from an, er, Anglo-Swedish company for political gain.

 

Norway and Iceland are EFTs, EEA rsthrer than EU.

[philipsteak]

2 minutes ago, Zoo Music Girl said:

Yeah the weather definitely could do with picking up a bit! Sure it was a lot nicer this time last year (although that was something of a fluke).

Think it was just before Easter last year when it started getting consistently nice. At least it was around here anyway

[Toilet Duck]

So...OX/AZ, blood clots, suspension of vaccinations, politics, vaccine hesitancy, convoluted data, PR problems, Brexit, EU procurement naivety, poor logistics, national identity...there’s an awful lot of things getting embroiled here!

What’s going on? 

Basically, Oxford, building on decades of prior research, made an excellent vaccine in record time that is easy to distribute and, at the behest of their VC, will provide it to the world at cost price while we are still in a pandemic. Sounds amazing. And it is. 

But...the initial trials were designed by academics. They were designed to test lots of different things, and in reality, they produced an exceptionally rich dataset that allowed the best way to use their vaccine to be determined. However, politics and business meant that others denigrated this approach and pointed to lean, clean efficient trials from competitors and suggested that it was somehow inferior. This is where OX/AZ’s PR problem came from and it was compounded by AZ stating an average efficacy in their press release in an effort to keep up with competitors.  By the time the regulators looked at the data, how the vaccine should be used to gain comparable efficacy to their competitors had been worked out, but it was too late in some places, the narrative had already been established (normally, people aren’t that interested, the academics write their paper, the regulators review the data, it gets approved and the drug company promotes it to professionals, but doesn’t give worldwide press conferences before the data is properly examined...but we’re not in normal times!). That bad PR was perpetuated by idiotic comments from some European politicians who were playing politics with a global public health issue (they weren’t the first, nor will they be the last). 

After efficacy in trials, the next important metric in terms of disease control is effectiveness (how it performs in real world use). On this front OX/AZ has matched or outperformed Pfizer & Moderna...and in some places this has been noted and has changed how the vaccine is used, in others, they have yet to change, not really because they doubt the vaccine, they just don’t have that much of it and have alternatives that they can deploy. 

The next issue with the use of the vaccine is safety. In the trails, as they built through the phases, greater and greater numbers of participants got the vaccine. Adverse events were noted and were almost entirely mild to moderate. Few required medical intervention. Trials were paused to investigate serious events, but deemed to be unrelated to the vaccine, so they continued. In the end, 10s of 1000s of participants got the vaccine and no serious side effects were noted. So far so good. The next phase of safety assessment is the post-authorisation surveillance. This occurs for all medicines and is how we pick up really rare things that you might not see when only a few thousand people get the shot compared to millions or billions. Safety signals for really rare things usually don’t stop a vaccine being used, but they do help identify who should not take it (and if there is an alternative, then they can take that instead). 

Which brings us onto the blood clots. So far in the UK, DVT and other clotting events have been what has been observed. They have occurred at a rate that is no greater than would be expected randomly in the population. Therefore, the conclusion is that they are not related to the vaccine. That is entirely correct. What has happened in Europe over the last week is that a rarer form of clotting has happened in a bunched up way (within a short time post-vaccination). Random stuff can cluster (I used the lotto numbers example before), but it still requires investigation. The next part of the concern is the depletion of blood components associated with these clotting events. This is not usual and, again, needs to be investigated.

I’ll heavily caveat the next part as completely speculative (and indeed, I could be missing key information) but it does maybe give an understanding of why regulators in some countries want an answer...

The genetic vaccines work by delivering the instructions for the spike protein into our cells. The machinery in our cells makes the spike, and we mount an immune response to it. Because it is made in our cells, it is displayed on their surface for our immune system to recognise. This is good in terms of the complexity of the response elicited (we activate T-Cells that teach our B-Cells how to make antibodies to the spike and we also make T-Cells that directly kill the “infected” cell. Next time we encounter the real thing, the entire force of our immune system can be mobilised). It’s an elegant solution and by all evidence, works very well...now, here’s where the possible biological explanation is that needs to be fully answered. Which cells make the spike from the instructions is really important. The aim is that it happens in our muscle cells at the site of the injection. Where the vaccine goes after injection is tested by biodistribution studies during development. In the approval of the Pfizer vaccine, the results of these pre-clinical studies are shown (using a light generating reporter instead of the spike gene so it can be visualised). Light is detected in the muscle cells for about 6 days after injection, suggesting that the muscle cells are making protein for under a week, then it returns to baseline. Light is emitted from the liver for 48 hours after injection, suggesting rapid systematic clearance of any vaccine that gets into circulation. So far so good (rapid clearance prevents our immune system from causing damage elsewhere in our bodies in this case). However, the biodistribution studies for the OX/AZ vaccine weren’t fully completed when the approval was granted (in the approval it says they will be done by end Feb 2021). There are preliminary studies that follow the same pattern as the Pfizer vaccine, but it is a different delivery mechanism and you can’t completely extrapolate (this is the part that I could be missing something on, but I couldn’t find the data in any of the approvals...there’s also years of data on IM administration and systemic distribution to fall back on, so the regulators were probably happy). So, if the vaccine can get into circulation and be taken up by endothelial cells (the cells that line our blood vessels) or platelets (small cells that help our clotting mechanisms among other things), then if they were to make the spike protein and display it on their surface, the immune response would be the same, but the cells destroyed by the T-Cells that were stimulated would be the very ones that are missing from the patients who have had these rare clotting events (though rapid clearance would prevent this). 

Again, this is all conjecture, when I thought of it, I went back to look at the pharmacokinetic and Pharmacodynamic studies that made up the approval submissions for all the vaccines and was generally relieved to see that these things had been looked for, but the final piece of the puzzle was missing for OX/AZ. They may have it by now, the approval was submitted last year, but it would be good to know.

So, how come this isn’t more widespread? Nobody knows. It could just be random (and none of the above happens). Or, the people involved could have a very rare underlying genetic trait that makes them prone to this...normally, 48h would not really be enough time for cytotoxic t-cells and other parts of outer adaptive immune system to be made in order to destroy platelets or endothelial cells. But if these individuals don’t clear the vaccine as quickly, then we don’t really know what happens. The biodistribution studies are generally done in animal models, so it’s possible that there are some really rare slow metabolisers of the vaccine out there that are at risk of this happening...or it could be a manufacturing issue. But that’s exactly what needs to be untangled.

The next thing to note is the difference in approval for OX/AZ in the UK vs Europe. In the EU, under their CMA, AZ are on the hook for any problems. Not so in the UK (the government are). So, AZ will vigorously deny any connection to the vaccine in the EU as they are liable if there is a problem. So, it’s important for the regulators to examine independent data when making sure the vaccine can be safely used. We can’t entirely take AZ’s word for it if they say there is no problem as they have a conflict of interest.

Further to that, OX/AZ is not the principal vaccine is use in much of the EU, so pausing to untangle this poses less of a risk than it would in the UK and elsewhere. That’s partly down to supply, partly down to poor EC procurement, partly down to 27 different Healthcare systems having different capacities and a bunch of other things, but it undoubtedly has played a role in the decision making.

Finally, as has been noted, these are very rare events. Even if it does turn out to be an issue, the vaccine will still be used as the benefits still outweigh the risks. However, I think public confidence in vaccines in general would be harmed by not taking a rigorous approach to safety. I know we are still in a pandemic, but cutting corners does nobody any favours in the long run. There remains a massive amount of communication to be done on the safety of this and other vaccines and that is strengthened by being able to say, we take every event seriously and investigate it and only allow it to be used when we are fully confident it can be done without putting people at risk (and we will mitigate the risk of pausing vaccination by continuing to protect high risk Individuals with other vaccines).

I won’t get into Brexit, the UK/EU relationship, AZ commitments (though you know how I feel about that!), national identity, politics or any of the other aspects that have been dragged into this as I don’t really know much of anything about them.

 

TLDR: the vaccine has been safely used in millions of people. Very rare events are causing some concern. These should be checked and either ruled out as vaccine-related or looked for during future use. We will still use the vaccine as the benefits greatly outweigh the risks.
 

 

[onthebeach]

Yeahhhh - 3 weeks today I had my first jab so those lovely antibodies and T cells should now be at a good level.

I am embarrassed to say that I was a little disappointed that it was Pfizer after being so invested in the Oxford-AstraZeneca development but gave myself a good talking to for being so privileged to just have the opportunity for any vaccine.

However, it’s certainly not going to change my behaviour at the moment. No illegal raves for me - not that I’m up to it anyway! I’m sticking with the current lockdown easing. I’ve only got one gig lined up in late July and if it’s still on I’ll certainly be going. Lots of UK campervan trips booked and planned also.

What it has really helped at this point in time is with my young son. My other half had his jab 5 weeks ago and with me now at 3 weeks it has taken so much anxiety away from him. He lives with us and has been working in an engineering company throughout with positive cases. He has been so concerned about catching it and bringing it home. Not so worried about himself but more about us. We’ve reassured him throughout that he would in no way be responsible if he did catch it - s**t happens.

So relieved that he can now relax more and enjoy meeting his friends in the garden/organised football games on the 29th March and outdoor pubs/restaurants on the 12th April 

 

[Hannibal Schmitt]

EMA PR here https://audiovisual.ec.europa.eu/en/ebs/live/2