Coronavirus prep

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  • ReenieHJ
    ReenieHJ Posts: 9,724 Member
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    T1DCarnivoreRunner wrote: »
    baconslave wrote: »
    T1DCarnivoreRunner wrote: »
    baconslave wrote: »
    Gisel2015 wrote: »
    MikePfirrman wrote: »
    MikePfirrman wrote: »
    Pfizer just announced that their vaccine is testing at 90% effective. That would be fantastic.

    Also, BTW, Pfizer did not partake in Operation Warp Speed because they didn't want to obligate themselves to what taking public funds would mean. They did this pretty much on their own without help. Just in case you hear certain parties/people taking claim that "they alone" solved Coronavirus, that would be 100% false.

    In addition they will do the distribution themselves because they have suppliers already lined-up. They know how to do it, and I think that they don't trust the ability of the government to keep the vaccine as such low temperatures as it is needed.

    Word of caution: Pfizer just run what is called an interim efficacy analysis. They are still continuing with the study since not all participants have completed the second shot and the f/up vigilance phase. The company still needs to do the interim safety analysis (due toward the end of November), before they can apply for an FDA expedite approval. If everything is good.

    We got good news from the company but please people don't count your chickens until all the eggs have hatched. Disappointments are hard to swallow.

    Right.
    And it's very important to remember that they are saying they'll have enough vaccine for only 25 million people. The CDC has said that health care workers are first in line. Then the elderly. "Widespread" vaccine availability for everyone won't be until next year. Masking and distancing will remain our reality for the rest of this year and most of next. Even then everyone won't get the vaccine at once, many require 2 doses, and coverage of the populace won't be 100% b/c sadly many won't take any vaccine no matter what.

    We should all go forward knowing this will be over, but we still have quite a way to go. That's what is.

    Regardless of vaccine status, we are locked into this path right now crafted by consequences we've courted for 8 months. There will be suffering. Even if everyone started following guidelines right this moment, we would still have a rough month and a half ahead. A vaccine isn't a point-n-click solution either. And I hold out zero hopes that we'll get much better mask/distancing compliance at this point.

    There is a light!!! But the tunnel is still long. :disappointed:

    Sorry to be a downer, but like Mike said, we've had enough disappointment. Let's be real and not hurt ourselves more than the wounds we're already accruing here. I do hope at some point soon the leadership of this country, whomever that ends up being, will have this talk with the American people. IMO, we'd do better to frame this as a "war time" effort.

    The U.S. government is buying 100 million vaccines, not 25 million. Yes, healthcare workers get priority. We expected that as it was discussed months ago. Still, 100 million should be enough for healthcare workers plus some for people at higher risk. We need more for the rest of the country yet, but don't know how many more. I know some people won't take it and others won't need it because of a recent infection. At $1,950 per vaccine (this is what the federal government will pay Pfizer... they will be free for actual recipients), let's hope for a price discount on the 2nd order.

    Place where I used to live in IA is a small town with a prison. Last week's numbers showed 365 new infections at the prison... the capacity is 1,000 and I have heard they are at about 900 now, so 365 cases means about 40% got sick just on the same week. I anticipate the other 60% will be reported in the next 2 weeks. While some may not care about inmates, these are people also. They have families and friends, and some of them also have underlying health conditions to consider. I sure hope they give them masks, but am not convinced of that with how fast it has spread there.

    They may be buying 100 mil, but it will only be available for 25 million people (50 million doses, 2 each required per person) this year.

    "Pfizer has estimated it could have 50 million doses available globally by the end of 2020, enough for 25 million people." https://apnews.com/article/pfizer-vaccine-effective-early-data-4f4ae2e3bad122d17742be22a2240ae8

    That's by the end of 2020 and those 50 million doses are for the entire world. The reporting on the U.S. 100 million doses doesn't have a date attached.

    From the article you linked:
    But in July, Pfizer signed a contract to supply the U.S. with 100 million doses for $1.95 billion, assuming the vaccine is cleared by the FDA.

    But I suppose if it takes 2 doses per person, then only 50 million Americans will get it unless another order is placed. And cost is nearly $4K per patient. Either way, we are looking at several months before this becomes available to most of us.

    Right??? I'm having issues with being able to get my high risk flu shot(being over 65). I cannot imagine how this will all go down. :(
  • moonangel12
    moonangel12 Posts: 971 Member
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    Noreenmarie1234 wrote: »
    lemurcat2 wrote: »
    kshama2001 wrote: »
    So I'm a veteran (but please don't thank me for my service.) Every year I look forward to seeing the list of freebies that businesses are offering and usually get a free meal somewhere. Where I currently live, there are hardly any national chain restaurants near me, but the ones that are are only offering the discount for dine-in only. WTF? I've always gotten take out in the past. I haven't eaten in a restaurant for 10 months and have no intention of eating in one any time soon.

    Even Dunkin Donuts says "in store only." I'm sure if I went to the drive through they'd give me my free donut but I find the insistence on making me come inside the store from every place I've checked very disconcerting. (I'm also sure local chains would let me get takeout but there aren't many close enough to bother and now I'm annoyed.)

    https://news.dunkindonuts.com/news/veterans-day-2020

    https://www.blogs.va.gov/VAntage/80347/veterans-day-2020-discounts/

    If they really are in-restaurant only and aren't just wording it badly, how ridiculous. You should try the takeout just to see what they say (plus isn't DD a MA staple?). Sorry, couldn't resist!

    I'm with you that I'm not going in a restaurant any time soon, although I've tried to use takeout to support local places, and been buying a lot with pickup from my neighborhood stores (most are currently open but limited the # of people allowed within). I recently did a pickup order from a spice place and the number within were below the posted (small) limit, but the whole area (the shopping/social area of Lincoln Square) was lots of youngish adults and their kids being maskless and drinking coffee and hanging out in close proximity to each other and with zero concern about distancing from anyone else, so I think the being outside is totally fine thing might be being abused in urban areas. I'm sympathetic to the view that getting back to normal is important, and the weather here has been unseasonally great for a while until tonight, but currently cases are exploding here.

    Yes that does not make sense! I would call the restaurants and ask. I think they likely say that because they need you to come in to verify you are a vetran or else everyone would be ordering free food for pickup pretending they are a vetran.
    That’s what I was thinking - verification purposes because people would take advantage of it...
  • MikePfirrman
    MikePfirrman Posts: 3,307 Member
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    @ReenieHJ -- I hope your husband is OK.

    We should start talking more about IF you get it. I'm reading about oxygen sensors being used and the level at which you should go to the hospital.

    https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/

    Amazon has sensors as low as $17. Any other insight from people that know more than I do about science?
  • kshama2001
    kshama2001 Posts: 27,897 Member
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    AnnPT77 wrote: »
    kshama2001 wrote: »
    @kimny72 and others following vaccine research closely - how do they get that 90%? Are they exposing the test subjects? That seems unethical, but if they are not, how would they know the subjects didn't get Covid because they simply were not exposed to it?

    https://www.statnews.com/2020/11/09/covid-19-vaccine-from-pfizer-and-biontech-is-strongly-effective-early-data-from-large-trial-indicate/

    ...The companies said an early analysis of the results showed that individuals who received two injections of the vaccine three weeks apart experienced more than 90% fewer cases of symptomatic Covid-19 than those who received a placebo.

    Once there are enough numbers, they decide it's an effect, not random chance. Statistics. (It's too long since I did any advanced stats, so I'm literally incapable of explaining the details, but it's a standard protocol.)

    I don't know enough about this study to know the control/treated matching protocols (how detailed), but the answer is still statistics.

    There are some challenge studies (where people are intentionally exposed) but I don't personally know whether Pfizer did any. It's not unethical to expose test subjects who sign up for the study with full knowledge (informed consent) that they are going to be intentionally exposed to the disease. Volunteers are solicited, and brave, generous people sign up for it, in the hope of speeding vaccine availability . . . if the vaccine they're helping test pans out.
    The_Enginerd wrote: »
    From the information I've read, an independent assessor checks progress at a set number of cases in the group. From there, they can compare the number of cases in those individuals given the placebo vs. the vaccine. It seems they are actually reaching the goals earlier than expected because the spread of the coronavirus has been so widespread, and they are already over halfway through the 164 total cases targeted for final review.

    Sources:
    https://www.vox.com/21556380/pfizer-biontech-covid-19-coronavirus-vaccine-optimism-skepticism
    https://blogs.sciencemag.org/pipeline/archives/2020/11/09/vaccine-efficacy-data

    Hmm, well 100% of the people I know IRL in Massachusetts who practice scrupulous mask wearing, hand washing, and social distancing have no symptoms of the virus, so if the volunteers are doing the same, how do we know the 90% vaccine effective rate has anything to do with the vaccine?

    While it is statistically unlikely that the vaccine group is better at taking precautions than the placebo group, it seems to be a stretch to award all 90% to the vaccine if the subjects were also taking precautions.

    The Vox article and another link within it do caution that the announcement comes from a press release, not validated data, so I will reserve judgement until more is known.
  • kshama2001
    kshama2001 Posts: 27,897 Member
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    MikePfirrman wrote: »
    @ReenieHJ -- I hope your husband is OK.

    We should start talking more about IF you get it. I'm reading about oxygen sensors being used and the level at which you should go to the hospital.

    https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/

    Amazon has sensors as low as $17. Any other insight from people that know more than I do about science?
    cwolfman13 wrote: »
    I know on the Navajo reservation, they are crediting oxygen sensors for significantly brining down the mortality rate as they had doctors going door to door checking on sick people and sending them to the hospital when they dipped below a certain level when otherwise they would have been more likely to try to ride it out at home.

    I believe that is what ultimately triggered the POTUS going to the hospital.

    IIRC, a number that was being used in relationship to POTUS was "below 94%." I have a pulse oximeter myself and got it to read 94% when it was very very cold in the house. After I warmed my hands it was back up to the usual 98%.

    Good info in the link above so am reposting it:

    https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/

    @ReenieHJ - wishing the best for your husband and family.
  • Theoldguy1
    Theoldguy1 Posts: 2,454 Member
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    MikePfirrman wrote: »
    @ReenieHJ -- I hope your husband is OK.

    We should start talking more about IF you get it. I'm reading about oxygen sensors being used and the level at which you should go to the hospital.

    https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/

    Amazon has sensors as low as $17. Any other insight from people that know more than I do about science?

    This is an excerpt from a news article/interview with family about the youngest person to die of Covid in our county. She was 30 with no underlying conditions. I x'ed out names for privacy.

    Looks like a meter could be a good investment. I ordered one this morning for us, our children and a couple relatives:

    "The first sign that she had contracted COVID-19 was a loss of taste and smell. That started the Tuesday before she passed. She got tested Wednesday, which came back positive three days later.

    “Over the weekend, she was showing more symptoms. Breathing was a little bit harder, but we just thought it was something that we kind of needed to work through. I mean, it's a part of being sick. It’s just kind of got to run its course. We still weren’t all that concerned,” xxxxx said.

    Come Sunday, xxxxx said, they were starting to feel a little uneasy. They called a doctor who sent them off with some prescriptions. Still, no real red flags were raised.

    “Monday morning, we bought an oximeter, which clips onto your finger and tells you your oxygen levels in your blood. They're supposed to be about 95% typically—anything less, you should talk to a doctor. Her’s were 60%,” xxxxx said. “That's the moment it hits you that this is bad. This is not something that you should be handling on her own at home.”

    They called an ambulance. xxxxx followed his wife to the hospital. Xxxxx was admitted to the intensive care unit. Meanwhile, her husband had to leave her at the door, in accordance with safety protocols.

    Xxxxx said they put Xxxxx on a mask to help her breathe, which she initially responded well to. But things started going downhill fast that evening. Doctors put her on a ventilator that didn’t seem to be working either.

    “They tried everything they could think of and some surgeries that I'd never even heard before for trying to treat COVID,” xxxxx said. “She put up a really, really good fight. But she passed away that Tuesday morning.”

    That was less than 24 hours after xxxx was admitted to the ICU"
  • snowflake954
    snowflake954 Posts: 8,400 Member
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    Theoldguy1 wrote: »
    MikePfirrman wrote: »
    @ReenieHJ -- I hope your husband is OK.

    We should start talking more about IF you get it. I'm reading about oxygen sensors being used and the level at which you should go to the hospital.

    https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/

    Amazon has sensors as low as $17. Any other insight from people that know more than I do about science?

    This is an excerpt from a news article/interview with family about the youngest person to die of Covid in our county. She was 30 with no underlying conditions. I x'ed out names for privacy.

    Looks like a meter could be a good investment. I ordered one this morning for us, our children and a couple relatives:

    "The first sign that she had contracted COVID-19 was a loss of taste and smell. That started the Tuesday before she passed. She got tested Wednesday, which came back positive three days later.

    “Over the weekend, she was showing more symptoms. Breathing was a little bit harder, but we just thought it was something that we kind of needed to work through. I mean, it's a part of being sick. It’s just kind of got to run its course. We still weren’t all that concerned,” xxxxx said.

    Come Sunday, xxxxx said, they were starting to feel a little uneasy. They called a doctor who sent them off with some prescriptions. Still, no real red flags were raised.

    “Monday morning, we bought an oximeter, which clips onto your finger and tells you your oxygen levels in your blood. They're supposed to be about 95% typically—anything less, you should talk to a doctor. Her’s were 60%,” xxxxx said. “That's the moment it hits you that this is bad. This is not something that you should be handling on her own at home.”

    They called an ambulance. xxxxx followed his wife to the hospital. Xxxxx was admitted to the intensive care unit. Meanwhile, her husband had to leave her at the door, in accordance with safety protocols.

    Xxxxx said they put Xxxxx on a mask to help her breathe, which she initially responded well to. But things started going downhill fast that evening. Doctors put her on a ventilator that didn’t seem to be working either.

    “They tried everything they could think of and some surgeries that I'd never even heard before for trying to treat COVID,” xxxxx said. “She put up a really, really good fight. But she passed away that Tuesday morning.”

    That was less than 24 hours after xxxx was admitted to the ICU"

    We had a 21 yr old woman die of COVID three days ago, here in Italy--no pre-existing conditions.
  • gracegettingittogether
    gracegettingittogether Posts: 176 Member
    edited November 2020
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    I wonder if she had undiagnosed borderline breathing issues. Do you remember a few years back, there was a severe flu that was sending people and in particular children, to not just the hospital but the ICU?

    My niece ended up in the ICU and my son in the hospital with it. It turned out that people and especially children with undiagnosed mild asthma were hit very hard, because they didn’t know they were at risk and so didn’t recognize the warning signs and didn’t have medications or equipment to deal with breathing issues. When they finally sought help, it was catch up time, which is not good for breathing issues. The reason my son landed up admitted to the general floor and not the ICU, was because he was already diagnosed with asthma, so we knew the warning signs and had rescue medications and equipment on hand. When those stopped being effective, we knew to bring him in right away, which is why his condition never got to the point of needing the ICU.

    I’ve been wondering if the same isn’t true for those with COVID who respond unusually badly and with supposedly no underlying causes. If true, it would seem that having a pulse ox would be really helpful to be able to spot breathing issues right away and seek help.

    In fact, it probably would be good for every household to have one, just like having a thermometer. I bet a lot of lives would be saved by that.
  • lkpducky
    lkpducky Posts: 16,738 Member
    edited November 2020
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    kushiel1 wrote: »
    Even if a vaccine is available for most of us soonish and there's enough for everyone (unlikely) there's no way to know how long it will last is there? Maybe i'm missing something but the long term viability and long term effects are unable to be determined since it's hardly been long enough to really get any data.

    Pfizer/BioNTech will be following the study subjects for 2 years, so the number of people exposed is likely to increase over time, even allowing for whether they are taking precautions or not. But that is a good point - people should not be having to take precautions in the future, so I don't know how such people would respond.

    The 2-year period should give indication of how long the effects will last; if/when they'd need a second dose months later/a year later/etc.
    I got that from Look at Next Steps and Timing on this site
    https://www.pfizer.com/science/coronavirus

    And that page gives more information on the trial.

    And as far as antibody levels decreasing after a few months, the questions are as follows:
    1) Does that mean those people are back to square one as far as immune response?
    2) The next time they are exposed, will their immune response be the same? More? Faster?
    3) The immune system is complex and there are more parts that respond than just antibodies. What components/cells, if any, are still active after a few months?

    The 90% is from 86 subjects in the placebo group developing disease vs 8 subjects in the active vaccine group 28 days after the first dose/7 days after the second dose. Again, though, the researchers need to keep watching all 44,000 to see how the numbers change over time.
  • kimny72
    kimny72 Posts: 16,013 Member
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    MikePfirrman wrote: »
    @ReenieHJ -- I hope your husband is OK.

    We should start talking more about IF you get it. I'm reading about oxygen sensors being used and the level at which you should go to the hospital.

    https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/

    Amazon has sensors as low as $17. Any other insight from people that know more than I do about science?

    The This Week in Virology folks say it's not a bad idea to have one, and monitor your rate if you are sick. They aren't completely accurate obv, but if you might have covid and your normal 96 drops to a consistently lower worrisome number, it's a red flag worth getting checked out.

    I read somewhere that some hospitals in an effort to free up space were sending covid patients home with pulse oximeters and telling them to call if they got a reading under a certain number based on their stats during hospital stay.

    I got one off Amazon, picked one that was a step up from the cheapest one jic :smile:
  • kshama2001
    kshama2001 Posts: 27,897 Member
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    AnnPT77 wrote: »
    kshama2001 wrote: »
    AnnPT77 wrote: »
    kshama2001 wrote: »
    @kimny72 and others following vaccine research closely - how do they get that 90%? Are they exposing the test subjects? That seems unethical, but if they are not, how would they know the subjects didn't get Covid because they simply were not exposed to it?

    https://www.statnews.com/2020/11/09/covid-19-vaccine-from-pfizer-and-biontech-is-strongly-effective-early-data-from-large-trial-indicate/

    ...The companies said an early analysis of the results showed that individuals who received two injections of the vaccine three weeks apart experienced more than 90% fewer cases of symptomatic Covid-19 than those who received a placebo.

    Once there are enough numbers, they decide it's an effect, not random chance. Statistics. (It's too long since I did any advanced stats, so I'm literally incapable of explaining the details, but it's a standard protocol.)

    I don't know enough about this study to know the control/treated matching protocols (how detailed), but the answer is still statistics.

    There are some challenge studies (where people are intentionally exposed) but I don't personally know whether Pfizer did any. It's not unethical to expose test subjects who sign up for the study with full knowledge (informed consent) that they are going to be intentionally exposed to the disease. Volunteers are solicited, and brave, generous people sign up for it, in the hope of speeding vaccine availability . . . if the vaccine they're helping test pans out.
    The_Enginerd wrote: »
    From the information I've read, an independent assessor checks progress at a set number of cases in the group. From there, they can compare the number of cases in those individuals given the placebo vs. the vaccine. It seems they are actually reaching the goals earlier than expected because the spread of the coronavirus has been so widespread, and they are already over halfway through the 164 total cases targeted for final review.

    Sources:
    https://www.vox.com/21556380/pfizer-biontech-covid-19-coronavirus-vaccine-optimism-skepticism
    https://blogs.sciencemag.org/pipeline/archives/2020/11/09/vaccine-efficacy-data

    Hmm, well 100% of the people I know IRL in Massachusetts who practice scrupulous mask wearing, hand washing, and social distancing have no symptoms of the virus, so if the volunteers are doing the same, how do we know the 90% vaccine effective rate has anything to do with the vaccine?

    While it is statistically unlikely that the vaccine group is better at taking precautions than the placebo group, it seems to be a stretch to award all 90% to the vaccine if the subjects were also taking precautions.

    The Vox article and another link within it do caution that the announcement comes from a press release, not validated data, so I will reserve judgement until more is known.

    FWIW, another statement I can't justify with details because my stats classes were so long ago: The articles I've read about the 90% thing don't sound like the reporters really understand the statistics, and are using some key numbers from a press release and not interpreting them insightfully. (I'm sure there are better technical/statistical analyses out there, but I'm not interested enough to seek them out, and I'd probably have to haul out textbooks or something to truly "get it" at the level I'd want, if I did bother. Don't wanna. I took a lot of stats back in the day, but I didn't enjoy it.)

    So, this is from memory: Your observation is that behaviors can have differed, leading to an accidental difference in cases among the two groups: Yes, absolutely. As the numbers of cases (considered in light of the test population size) go up, the probability that the difference comes from random factors like that goes down (in the technical sense of probability). Size of the test population matters hugely, too, in how probable it is that the test subjects reflect the population.

    Kind of think of it this way: If you flip fair coins, you get heads or tails, and over many tosses, you'll get about equal numbers of each, distributed in random patterns. (Not saying that's how viruses behave: Bear with me.) In any arbitrarily long sequence of coin flips, there is a non-zero probability that ALL flips will come up heads. But the more coin flips you do, that indefinitely long (theoretically possible) sequence of all-heads becomes less and less probable to occur as you go along. At some number of flips, the intelligent person will conclude it's overwhelmingly probable that the coin is rigged, even though a very, very long sequence of all-heads is possible.

    The analogous kind of thing can happen in a more complicated test (like the analysis of the control/test populations in a virus study). The math is much more complicated, as is the underlying real-world situation, but at a certain point, the numbers can reach a point where statistics tell you pretty clearly that it's extremely unlikely that the numbers you're getting are just from sheer chance, so the overwhelming probability is that the vaccine is actually working. There's still a chance (statistically) that your conclusion is wrong, but it's very tiny.

    This is a very structured statistical decision process, IMU, not just "lotta cases here, not so many there, I think we're good". Presumably, there will've also been opportunities to compare disease incidence in both arms to disease incidence in overall populations; or, to the extent there are decent-sized cohorts of the test population in a given locale, to compare results in both arms to the population incidence. While I don't believe that would be a core method of analysis, I'd be surprised if no one was looking at other hints like that (which would be less statistically valid methods by far, but could be sort of a gut-check).

    I did enjoy statistics and do remember the coin flipping :)

    However, with coin flipping, there are just two variables - heads and tails.

    With the Pfizer study, in addition to vaccine and placebo, there is also mask usage, hand washing, and social distancing. I'm curious as to how they control for taking precautions so that the 90% efficacy doesn't include that.
  • lynn_glenmont
    lynn_glenmont Posts: 9,964 Member
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    kshama2001 wrote: »
    AnnPT77 wrote: »
    kshama2001 wrote: »
    AnnPT77 wrote: »
    kshama2001 wrote: »
    @kimny72 and others following vaccine research closely - how do they get that 90%? Are they exposing the test subjects? That seems unethical, but if they are not, how would they know the subjects didn't get Covid because they simply were not exposed to it?

    https://www.statnews.com/2020/11/09/covid-19-vaccine-from-pfizer-and-biontech-is-strongly-effective-early-data-from-large-trial-indicate/

    ...The companies said an early analysis of the results showed that individuals who received two injections of the vaccine three weeks apart experienced more than 90% fewer cases of symptomatic Covid-19 than those who received a placebo.

    Once there are enough numbers, they decide it's an effect, not random chance. Statistics. (It's too long since I did any advanced stats, so I'm literally incapable of explaining the details, but it's a standard protocol.)

    I don't know enough about this study to know the control/treated matching protocols (how detailed), but the answer is still statistics.

    There are some challenge studies (where people are intentionally exposed) but I don't personally know whether Pfizer did any. It's not unethical to expose test subjects who sign up for the study with full knowledge (informed consent) that they are going to be intentionally exposed to the disease. Volunteers are solicited, and brave, generous people sign up for it, in the hope of speeding vaccine availability . . . if the vaccine they're helping test pans out.
    The_Enginerd wrote: »
    From the information I've read, an independent assessor checks progress at a set number of cases in the group. From there, they can compare the number of cases in those individuals given the placebo vs. the vaccine. It seems they are actually reaching the goals earlier than expected because the spread of the coronavirus has been so widespread, and they are already over halfway through the 164 total cases targeted for final review.

    Sources:
    https://www.vox.com/21556380/pfizer-biontech-covid-19-coronavirus-vaccine-optimism-skepticism
    https://blogs.sciencemag.org/pipeline/archives/2020/11/09/vaccine-efficacy-data

    Hmm, well 100% of the people I know IRL in Massachusetts who practice scrupulous mask wearing, hand washing, and social distancing have no symptoms of the virus, so if the volunteers are doing the same, how do we know the 90% vaccine effective rate has anything to do with the vaccine?

    While it is statistically unlikely that the vaccine group is better at taking precautions than the placebo group, it seems to be a stretch to award all 90% to the vaccine if the subjects were also taking precautions.

    The Vox article and another link within it do caution that the announcement comes from a press release, not validated data, so I will reserve judgement until more is known.

    FWIW, another statement I can't justify with details because my stats classes were so long ago: The articles I've read about the 90% thing don't sound like the reporters really understand the statistics, and are using some key numbers from a press release and not interpreting them insightfully. (I'm sure there are better technical/statistical analyses out there, but I'm not interested enough to seek them out, and I'd probably have to haul out textbooks or something to truly "get it" at the level I'd want, if I did bother. Don't wanna. I took a lot of stats back in the day, but I didn't enjoy it.)

    So, this is from memory: Your observation is that behaviors can have differed, leading to an accidental difference in cases among the two groups: Yes, absolutely. As the numbers of cases (considered in light of the test population size) go up, the probability that the difference comes from random factors like that goes down (in the technical sense of probability). Size of the test population matters hugely, too, in how probable it is that the test subjects reflect the population.

    Kind of think of it this way: If you flip fair coins, you get heads or tails, and over many tosses, you'll get about equal numbers of each, distributed in random patterns. (Not saying that's how viruses behave: Bear with me.) In any arbitrarily long sequence of coin flips, there is a non-zero probability that ALL flips will come up heads. But the more coin flips you do, that indefinitely long (theoretically possible) sequence of all-heads becomes less and less probable to occur as you go along. At some number of flips, the intelligent person will conclude it's overwhelmingly probable that the coin is rigged, even though a very, very long sequence of all-heads is possible.

    The analogous kind of thing can happen in a more complicated test (like the analysis of the control/test populations in a virus study). The math is much more complicated, as is the underlying real-world situation, but at a certain point, the numbers can reach a point where statistics tell you pretty clearly that it's extremely unlikely that the numbers you're getting are just from sheer chance, so the overwhelming probability is that the vaccine is actually working. There's still a chance (statistically) that your conclusion is wrong, but it's very tiny.

    This is a very structured statistical decision process, IMU, not just "lotta cases here, not so many there, I think we're good". Presumably, there will've also been opportunities to compare disease incidence in both arms to disease incidence in overall populations; or, to the extent there are decent-sized cohorts of the test population in a given locale, to compare results in both arms to the population incidence. While I don't believe that would be a core method of analysis, I'd be surprised if no one was looking at other hints like that (which would be less statistically valid methods by far, but could be sort of a gut-check).

    I did enjoy statistics and do remember the coin flipping :)

    However, with coin flipping, there are just two variables - heads and tails.

    With the Pfizer study, in addition to vaccine and placebo, there is also mask usage, hand washing, and social distancing. I'm curious as to how they control for taking precautions so that the 90% efficacy doesn't include that.

    They control for hand washing, mask usage, and social distancing by having a control group that gets the placebo. The point of the placebo is so that no one knows if they got the real vaccine or not, thus their likelihood of taking those other precautions shouldn't be affected by whether or not they got the vaccine, because they don't know whether they did.
  • kshama2001
    kshama2001 Posts: 27,897 Member
    edited November 2020
    Options
    lynn_glenmont wrote: »
    kshama2001 wrote: »
    AnnPT77 wrote: »
    kshama2001 wrote: »
    AnnPT77 wrote: »
    kshama2001 wrote: »
    @kimny72 and others following vaccine research closely - how do they get that 90%? Are they exposing the test subjects? That seems unethical, but if they are not, how would they know the subjects didn't get Covid because they simply were not exposed to it?

    https://www.statnews.com/2020/11/09/covid-19-vaccine-from-pfizer-and-biontech-is-strongly-effective-early-data-from-large-trial-indicate/

    ...The companies said an early analysis of the results showed that individuals who received two injections of the vaccine three weeks apart experienced more than 90% fewer cases of symptomatic Covid-19 than those who received a placebo.

    Once there are enough numbers, they decide it's an effect, not random chance. Statistics. (It's too long since I did any advanced stats, so I'm literally incapable of explaining the details, but it's a standard protocol.)

    I don't know enough about this study to know the control/treated matching protocols (how detailed), but the answer is still statistics.

    There are some challenge studies (where people are intentionally exposed) but I don't personally know whether Pfizer did any. It's not unethical to expose test subjects who sign up for the study with full knowledge (informed consent) that they are going to be intentionally exposed to the disease. Volunteers are solicited, and brave, generous people sign up for it, in the hope of speeding vaccine availability . . . if the vaccine they're helping test pans out.
    The_Enginerd wrote: »
    From the information I've read, an independent assessor checks progress at a set number of cases in the group. From there, they can compare the number of cases in those individuals given the placebo vs. the vaccine. It seems they are actually reaching the goals earlier than expected because the spread of the coronavirus has been so widespread, and they are already over halfway through the 164 total cases targeted for final review.

    Sources:
    https://www.vox.com/21556380/pfizer-biontech-covid-19-coronavirus-vaccine-optimism-skepticism
    https://blogs.sciencemag.org/pipeline/archives/2020/11/09/vaccine-efficacy-data

    Hmm, well 100% of the people I know IRL in Massachusetts who practice scrupulous mask wearing, hand washing, and social distancing have no symptoms of the virus, so if the volunteers are doing the same, how do we know the 90% vaccine effective rate has anything to do with the vaccine?

    While it is statistically unlikely that the vaccine group is better at taking precautions than the placebo group, it seems to be a stretch to award all 90% to the vaccine if the subjects were also taking precautions.

    The Vox article and another link within it do caution that the announcement comes from a press release, not validated data, so I will reserve judgement until more is known.

    FWIW, another statement I can't justify with details because my stats classes were so long ago: The articles I've read about the 90% thing don't sound like the reporters really understand the statistics, and are using some key numbers from a press release and not interpreting them insightfully. (I'm sure there are better technical/statistical analyses out there, but I'm not interested enough to seek them out, and I'd probably have to haul out textbooks or something to truly "get it" at the level I'd want, if I did bother. Don't wanna. I took a lot of stats back in the day, but I didn't enjoy it.)

    So, this is from memory: Your observation is that behaviors can have differed, leading to an accidental difference in cases among the two groups: Yes, absolutely. As the numbers of cases (considered in light of the test population size) go up, the probability that the difference comes from random factors like that goes down (in the technical sense of probability). Size of the test population matters hugely, too, in how probable it is that the test subjects reflect the population.

    Kind of think of it this way: If you flip fair coins, you get heads or tails, and over many tosses, you'll get about equal numbers of each, distributed in random patterns. (Not saying that's how viruses behave: Bear with me.) In any arbitrarily long sequence of coin flips, there is a non-zero probability that ALL flips will come up heads. But the more coin flips you do, that indefinitely long (theoretically possible) sequence of all-heads becomes less and less probable to occur as you go along. At some number of flips, the intelligent person will conclude it's overwhelmingly probable that the coin is rigged, even though a very, very long sequence of all-heads is possible.

    The analogous kind of thing can happen in a more complicated test (like the analysis of the control/test populations in a virus study). The math is much more complicated, as is the underlying real-world situation, but at a certain point, the numbers can reach a point where statistics tell you pretty clearly that it's extremely unlikely that the numbers you're getting are just from sheer chance, so the overwhelming probability is that the vaccine is actually working. There's still a chance (statistically) that your conclusion is wrong, but it's very tiny.

    This is a very structured statistical decision process, IMU, not just "lotta cases here, not so many there, I think we're good". Presumably, there will've also been opportunities to compare disease incidence in both arms to disease incidence in overall populations; or, to the extent there are decent-sized cohorts of the test population in a given locale, to compare results in both arms to the population incidence. While I don't believe that would be a core method of analysis, I'd be surprised if no one was looking at other hints like that (which would be less statistically valid methods by far, but could be sort of a gut-check).

    I did enjoy statistics and do remember the coin flipping :)

    However, with coin flipping, there are just two variables - heads and tails.

    With the Pfizer study, in addition to vaccine and placebo, there is also mask usage, hand washing, and social distancing. I'm curious as to how they control for taking precautions so that the 90% efficacy doesn't include that.

    They control for hand washing, mask usage, and social distancing by having a control group that gets the placebo. The point of the placebo is so that no one knows if they got the real vaccine or not, thus their likelihood of taking those other precautions shouldn't be affected by whether or not they got the vaccine, because they don't know whether they did.

    I meant control for it by not awarding to the vaccine efficacy stat results that were due to taking precautions.

    If someone didn't get the virus because they weren't exposed to the virus due to taking precautions, I wouldn't want them in that 90%, because it was the mask or social distancing that was effective, not the vaccine.
  • lynn_glenmont
    lynn_glenmont Posts: 9,964 Member
    Options
    kshama2001 wrote: »
    lynn_glenmont wrote: »
    kshama2001 wrote: »
    AnnPT77 wrote: »
    kshama2001 wrote: »
    AnnPT77 wrote: »
    kshama2001 wrote: »
    @kimny72 and others following vaccine research closely - how do they get that 90%? Are they exposing the test subjects? That seems unethical, but if they are not, how would they know the subjects didn't get Covid because they simply were not exposed to it?

    https://www.statnews.com/2020/11/09/covid-19-vaccine-from-pfizer-and-biontech-is-strongly-effective-early-data-from-large-trial-indicate/

    ...The companies said an early analysis of the results showed that individuals who received two injections of the vaccine three weeks apart experienced more than 90% fewer cases of symptomatic Covid-19 than those who received a placebo.

    Once there are enough numbers, they decide it's an effect, not random chance. Statistics. (It's too long since I did any advanced stats, so I'm literally incapable of explaining the details, but it's a standard protocol.)

    I don't know enough about this study to know the control/treated matching protocols (how detailed), but the answer is still statistics.

    There are some challenge studies (where people are intentionally exposed) but I don't personally know whether Pfizer did any. It's not unethical to expose test subjects who sign up for the study with full knowledge (informed consent) that they are going to be intentionally exposed to the disease. Volunteers are solicited, and brave, generous people sign up for it, in the hope of speeding vaccine availability . . . if the vaccine they're helping test pans out.
    The_Enginerd wrote: »
    From the information I've read, an independent assessor checks progress at a set number of cases in the group. From there, they can compare the number of cases in those individuals given the placebo vs. the vaccine. It seems they are actually reaching the goals earlier than expected because the spread of the coronavirus has been so widespread, and they are already over halfway through the 164 total cases targeted for final review.

    Sources:
    https://www.vox.com/21556380/pfizer-biontech-covid-19-coronavirus-vaccine-optimism-skepticism
    https://blogs.sciencemag.org/pipeline/archives/2020/11/09/vaccine-efficacy-data

    Hmm, well 100% of the people I know IRL in Massachusetts who practice scrupulous mask wearing, hand washing, and social distancing have no symptoms of the virus, so if the volunteers are doing the same, how do we know the 90% vaccine effective rate has anything to do with the vaccine?

    While it is statistically unlikely that the vaccine group is better at taking precautions than the placebo group, it seems to be a stretch to award all 90% to the vaccine if the subjects were also taking precautions.

    The Vox article and another link within it do caution that the announcement comes from a press release, not validated data, so I will reserve judgement until more is known.

    FWIW, another statement I can't justify with details because my stats classes were so long ago: The articles I've read about the 90% thing don't sound like the reporters really understand the statistics, and are using some key numbers from a press release and not interpreting them insightfully. (I'm sure there are better technical/statistical analyses out there, but I'm not interested enough to seek them out, and I'd probably have to haul out textbooks or something to truly "get it" at the level I'd want, if I did bother. Don't wanna. I took a lot of stats back in the day, but I didn't enjoy it.)

    So, this is from memory: Your observation is that behaviors can have differed, leading to an accidental difference in cases among the two groups: Yes, absolutely. As the numbers of cases (considered in light of the test population size) go up, the probability that the difference comes from random factors like that goes down (in the technical sense of probability). Size of the test population matters hugely, too, in how probable it is that the test subjects reflect the population.

    Kind of think of it this way: If you flip fair coins, you get heads or tails, and over many tosses, you'll get about equal numbers of each, distributed in random patterns. (Not saying that's how viruses behave: Bear with me.) In any arbitrarily long sequence of coin flips, there is a non-zero probability that ALL flips will come up heads. But the more coin flips you do, that indefinitely long (theoretically possible) sequence of all-heads becomes less and less probable to occur as you go along. At some number of flips, the intelligent person will conclude it's overwhelmingly probable that the coin is rigged, even though a very, very long sequence of all-heads is possible.

    The analogous kind of thing can happen in a more complicated test (like the analysis of the control/test populations in a virus study). The math is much more complicated, as is the underlying real-world situation, but at a certain point, the numbers can reach a point where statistics tell you pretty clearly that it's extremely unlikely that the numbers you're getting are just from sheer chance, so the overwhelming probability is that the vaccine is actually working. There's still a chance (statistically) that your conclusion is wrong, but it's very tiny.

    This is a very structured statistical decision process, IMU, not just "lotta cases here, not so many there, I think we're good". Presumably, there will've also been opportunities to compare disease incidence in both arms to disease incidence in overall populations; or, to the extent there are decent-sized cohorts of the test population in a given locale, to compare results in both arms to the population incidence. While I don't believe that would be a core method of analysis, I'd be surprised if no one was looking at other hints like that (which would be less statistically valid methods by far, but could be sort of a gut-check).

    I did enjoy statistics and do remember the coin flipping :)

    However, with coin flipping, there are just two variables - heads and tails.

    With the Pfizer study, in addition to vaccine and placebo, there is also mask usage, hand washing, and social distancing. I'm curious as to how they control for taking precautions so that the 90% efficacy doesn't include that.

    They control for hand washing, mask usage, and social distancing by having a control group that gets the placebo. The point of the placebo is so that no one knows if they got the real vaccine or not, thus their likelihood of taking those other precautions shouldn't be affected by whether or not they got the vaccine, because they don't know whether they did.

    I meant control for it by not awarding to the vaccine efficacy stat results that were due to taking precautions.

    If someone didn't get the virus because they weren't exposed to the virus due to taking precautions, I wouldn't want them in that 90%.

    But there shouldn't be any more virus reduction attributable to taking precautions in the vaccine group than in the placebo control group, and the 90% efficacy stat should be based on a comparison of the vaccine group to the placebo control group.

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