Wuhan Coronavirus Resource Thread

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vera_k
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Re: Wuhan Coronavirus Resource Thread

Post by vera_k »

Posting this here as the FDA's approval for Aduhelm based on a surrogate endpoint (reduction of plaques) sounds exactly like how Covaxin was approved based on Phase 2 data. Wish similar procedures were used to approve Covid vaccines a few months sooner than they eventually were.

FDA Grants Accelerated Approval for Alzheimer’s Drug
Accelerated approval can be based on the drug’s effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients, with a required post-approval trial to verify that the drug provides the expected clinical benefit.
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Re: Wuhan Coronavirus Resource Thread

Post by sankum »

Dean,
Nobody thought the second wave will be so lethal so as to overwhelm the medical system.
It's no use analysing what should have been done. The whole sarkari system needs reforms pending for decades so that we are to developed nation standard and among them.
Best was made out of the prevailing circumstances. Even now if we get 50 % of population vaccinated will be a big deal and by September when vaccine production is expected to reach 43 Cr doses I suspect we will to export the surplus doses.
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Re: Wuhan Coronavirus Resource Thread

Post by Sachin »

What is the new time lines for vaccinating the entire population? Is it end of the year? Or it would be more like a multi-year program? Many corporates have now started vaccination campaign for its staff (and dependents) which means that they are also aware of additional supplies coming in soon.
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Re: Wuhan Coronavirus Resource Thread

Post by vera_k »

Entire population will be next year. The announced timeline for most adults is this year. Of course much depends on vaccines that are not currently approved. Without additional vaccines, vaccinations for adults will not be completed this year.
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Re: Wuhan Coronavirus Resource Thread

Post by sankum »

Expected production.
June 12 Cr
July 17 Cr
August 30Cr
September 43 Cr
October 43 Cr
November 43 Cr
December 53 Cr
Roughly by year end total 266 Cr doses to vaccinate entire population. On expectation COVAXIN and nasal drops are used to vaccinate below 18 years children. Vaccine hesitancy is there ,even if 70% vaccination it will be a good achievement.
If 70% vaccinated then 70 Cr doses will have to be exported by year end if all planned vaccines are on time.
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Re: Wuhan Coronavirus Resource Thread

Post by Zynda »

There is a possibility that a 3rd booster shot will be introduced (in Western countries, they are targeting fall to end of fall I think, perhaps end of year in India)...assuming 70% number, it will be around 900 Million additional doses and not to forget that 2nd dose itself is pending for a lot of folks. Even if we start exporting, I hope it will be in limited numbers and/or to fulfill contractual obligation.
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

Deans sir, what you posit may very well be true, ie the govt could have ordered a few more doses ahead of time. But one thing we seem to be missing is, what was the available production capacities of SII and BB at that time, based on their internal constraints and supply availability? If either of them had surplus production capacity ready in the Nov-Dec timeframe, then sure, GoI erred in not placing a larger order. But we don't have this info in the public domain as far as I can tell. Given the close co-ordination between GoI and the manufacturers, and that this is the first question anyone might ask, I assume the manufacturers would have indicated their ramp-up roadmap and the govt would have placed orders accordingly, with an indication that they will buy a lot more as and when happen and production ramped up.
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Re: Wuhan Coronavirus Resource Thread

Post by Deans »

sankum wrote:Dean,
Nobody thought the second wave will be so lethal so as to overwhelm the medical system.
Best was made out of the prevailing circumstances. Even now if we get 50 % of population vaccinated will be a big deal and by September when vaccine production is expected to reach 43 Cr doses I suspect we will to export the surplus doses.
I agree, the magnitude of the 2nd wave was not predicted by anyone. The problem it created (more people willing to be vaccinated) was exacerbated by allowing the 18-45 age group from 1st May, when it was known there was shortage even for the 45+ age group.
I believe its enough if we vaccinate 50% of the population above 45% (95% of deaths). Adding FLW & Health care, that's 260 million people (260 million doses with 50% opting for it). We will reach that number within a week.
50% compliance is more like 70% urban and 40% Rural. (adding the number who contracted covid and not vaccinated, we would have 75% coverage of vulnerable groups in urban areas. In my city, Bangalore, known Covid cases are 1.2 million, out of an adult population of 7 million.
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Re: Wuhan Coronavirus Resource Thread

Post by A Deshmukh »

Deans wrote: My submission is that taking the decision in Nov to ramp up capacity on a war footing, might have resulted in our having a capacity of 80 million
units in April, instead of June. I understand that govt had an intent to do so in Nov, I'm just questioning if our system displayed the seriousness of purpose in executing. We had pre-ordered stock of only 50 million from SII and 10 from BB (another 50 million for SII was added later).
If we had additional pre-orders of 50 million from SII (BB would have taken longer to ramp up) and higher capacity in place 2 months earlier,
we could have administered an additional 102 million doses between March and end May. This assumes a limitation of 100 million doses a month
that the health system can administer and a stock of 10 million doses on 1st June.
I don't think these numbers are unreasonable.
This sounds correct in the hindsight of second wave and the size of second wave.
Considering the vaccine hesitancy, the govt plan would have worked well.
The size of the second wave has increased the demand for vaccines.

Also, we know in hindsight, that both Covaxin and Covishield works well for the strains found in India.
What if, they had not worked?

what if, God forbid, these vaccines do not work against the third wave?
then the same proactive orders work against the govt. "why did the govt order so many vaccines without knowing if they worked?"
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Re: Wuhan Coronavirus Resource Thread

Post by Deans »

arshyam wrote:Deans sir, what you posit may very well be true, ie the govt could have ordered a few more doses ahead of time. But one thing we seem to be missing is, what was the available production capacities of SII and BB at that time, based on their internal constraints and supply availability? If either of them had surplus production capacity ready in the Nov-Dec timeframe, then sure, GoI erred in not placing a larger order. But we don't have this info in the public domain as far as I can tell. Given the close co-ordination between GoI and the manufacturers, and that this is the first question anyone might ask, I assume the manufacturers would have indicated their ramp-up roadmap and the govt would have placed orders accordingly, with an indication that they will buy a lot more as and when happen and production ramped up.
Arshyam Sir. I have the same concern. Let's assume orders were placed based on the known capacity of SII/ BB.
The Govt in Jan, repeatedly stated that its objective was to vaccinate 300 million people i.e. 600 million doses by end July. At this time all production was to be from Covshield and Covax only.
The most we are likely to complete by end July is 400 million.
Either SII or BB should be held accountable for the shortfall, or GOI made a unbelievable error in its calculation.

My earlier post argues that we could have done 100 million more doses (not 200) but that was ok, because vaccine compliance among the vulnerable groups would realistically have been 50%
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Re: Wuhan Coronavirus Resource Thread

Post by IndraD »

Jharkhand

https://timesofindia.indiatimes.com/cit ... 267544.cms

Negligible covid spread in rural Jharkhand.
out of 1,86,509 people identified as suspects, only 920 have tested + (which means rural JH is still susceptible to covid), vaccine team going to Daltonganj and jungle areas are returning w/o giving single jab as no one turns up specially in tribal areas
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

Deans wrote:
arshyam wrote:Deans sir, what you posit may very well be true, ie the govt could have ordered a few more doses ahead of time. But one thing we seem to be missing is, what was the available production capacities of SII and BB at that time, based on their internal constraints and supply availability? If either of them had surplus production capacity ready in the Nov-Dec timeframe, then sure, GoI erred in not placing a larger order. But we don't have this info in the public domain as far as I can tell. Given the close co-ordination between GoI and the manufacturers, and that this is the first question anyone might ask, I assume the manufacturers would have indicated their ramp-up roadmap and the govt would have placed orders accordingly, with an indication that they will buy a lot more as and when happen and production ramped up.
Arshyam Sir. I have the same concern. Let's assume orders were placed based on the known capacity of SII/ BB.
The Govt in Jan, repeatedly stated that its objective was to vaccinate 300 million people i.e. 600 million doses by end July. At this time all production was to be from Covshield and Covax only.
The most we are likely to complete by end July is 400 million.
Either SII or BB should be held accountable for the shortfall, or GOI made a unbelievable error in its calculation.

My earlier post argues that we could have done 100 million more doses (not 200) but that was ok, because vaccine compliance among the vulnerable groups would realistically have been 50%
Please, no "sir" :)

Let's not forget the fire in SII that slowed down their efforts to increase capacity. Though the fire did not affect the unit producing Covishield, IIRC, the area that burned down was supposed to accommodate an existing production line, so the freed up space could have been used for Covishield. I can't find the reports that discuss this, but I recall reading something to this effect on this thread itself. There also were reports that the fire caused a loss of ₹1000 crores, which if true, would impact any company's cash flow and production capability.

BB has the BSL-3 constraint, but apart from that, it was impacted by the US trade action as its adjuvant was being imported from Kansas, USA. I recall wondering about their ability to ramp up on this very thread, and around that time they announced that they had indigenized the ingredients needed and would ramp up production henceforth. We should note that this was a small company at that time - BB before Covid made a few different vaccines from a single plant, and did not have the scale of SII. Their flagship Rotavirus vaccine had a production capacity of 200m per year, which translates into 16m/month. So we can imagine the challenges in ramping up production to Covid scale for a new vaccine within a compressed time-frame that requires BSL-3 facilities, while securing supplies from a worldwide supply chain that was subject to trade action by other countries.

In either case, both companies could have publicly called out these constraints, but they didn't do so for reasons unknown to me. Neither did the GoI. All we have are some media reports alluding to these issues.

Lastly, the production shortfall could have been a simple case of not being able to ramp up this quickly while maintaining quality. Maybe the intention was to meet the GoI-specified target, but they weren't able to do so due to a lack of experience in such a fast ramp-up. Nothing unique to SII or BB on this, all manufacturers worldwide have had these issues. Some even went to extent of mixing up raw materials, which, thankfully didn't happen in India. Per Occam's razor, this is the most likely explanation I am comfortable with.

[Edited to add links]
Last edited by arshyam on 08 Jun 2021 20:24, edited 1 time in total.
arshyam
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

And, right on cue :mrgreen:

Union Government Places Fresh Order For 44 Crore Covid-19 Vaccine Doses From SII And Bharat Biotech - Swarajya
The Narendra Modi led Central government today (8 June) placed a fresh order of 44 crore Covid-19 vaccination doses from Serum Institute and Bharat Biotech to ensure universal vaccination against the virus.

In a follow-up of Prime Minister Narendra Modi's announcement of changes to the national Covid-19 vaccination program guidelines, the Union Health Ministry has placed an order with Serum Institute of India for 25 crore doses of Covishield and with Bharat Biotech for 19 crore doses of Covaxin.

An advance to the tune of 30 per cent of the cost of total order has been released to Serum Institute of India and Bharat Biotech.

This decision comes after the centre took over the entirety of Covid-19 vaccination management by reverting back to the pandemic management system which was followed till 30 April.

As a result, the centre will take back the 25 per cent control which states were given over the vaccination drive. Prime Minister Modi also added that the centre will provide free vaccines to the states for the vaccination of all citizens aged above 18.

Henceforth, the centre will procure 75 per cent of the Covid vaccines and provide it to the states free of cost. The remaining 25 per cent vaccines will be procured by private players.

Today's 44 crore dose order is is in addition to 30 crore doses ordered from Hyderabad based vaccine manufacturer Biological-E. These vaccine doses will be manufactured and stockpiled by Biological-E from August-December 2021.

The COVID-19 vaccine of Biological-E is currently undergoing Phase-3 clinical trial after showing promising results in Phase 1 and 2 clinical trials. The vaccine being developed by Biological-E is a RBD protein sub-unit vaccine.
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

^^ So that's an order book of 740 million doses across 3 manufacturers and 3 vaccines. I assume this is excluding the existing orders which are currently being fulfilled by SII and BB.
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Re: Wuhan Coronavirus Resource Thread

Post by A Deshmukh »

arshyam wrote:^^ So that's an order book of 740 million doses across 3 manufacturers and 3 vaccines. I assume this is excluding the existing orders which are currently being fulfilled by SII and BB.
do we have orders on Sputnik?
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

A Deshmukh wrote:
arshyam wrote:^^ So that's an order book of 740 million doses across 3 manufacturers and 3 vaccines. I assume this is excluding the existing orders which are currently being fulfilled by SII and BB.
do we have orders on Sputnik?
From GoI? Not that I know of.
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Re: Wuhan Coronavirus Resource Thread

Post by Deans »

arshyam wrote:
In either case, both companies could have publicly called out these constraints, but they didn't do so for reasons unknown to me. Neither did the GoI. All we have are some media reports alluding to these issues.

Lastly, the production shortfall could have been a simple case of not being able to ramp up this quickly while maintaining quality. Maybe the intention was to meet the GoI-specified target, but they weren't able to do so due to a lack of experience in such a fast ramp-up. Nothing unique to SII or BB on this, all manufacturers worldwide have had these issues. Per Occam's razor, this is the most likely explanation I am comfortable with.
That's my view too. There was clearly a difference between what GOI thought would be produced and what actually happened.
I'm sure there were all kinds of problems in ramping up. My concern is that I've not seen any statement by SII/BB on their inability to meet targets, or help they required (until April) - nor did GOI express concern until the 2nd half of April. BB's lack of capacity was well known even in 2020. Why would it not be possible for GOI to spare no effort or expense to have a BS-3 plant ready in April (if they acted in Nov) to produce Covax - especially when they were less dependent on an imported supply chain. A BS-3 facility would be a national asset. My feeling (and this is only conjecture) is that when GOI did put pressure on SII, Poonawalla went to the UK. Since we had no alternative to SII, GOI had no leverage.

If supply was an insurmountable problem, the vaccines should have been rationed. The 18-45 age group should not have been offered the vaccine until now. It would have taken only 85 million doses to fully vaccinate 2/3rd of Health and front line workers (the rest have not opted for it) and 60% of the urban population above 60. Another 90 million doses would have meant that 50% of the population from 45-59 would have got their first dose by end May. These categories account for over 90% of our deaths.
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Re: Wuhan Coronavirus Resource Thread

Post by Suraj »

Looking at the data, my view is that even if the Govt believed there would not be a significant 2nd wave, it should have, as per its stated plan,
vaccinated all HCW, FLW & those over 60, by end April. These are 150 million people, or 300 million shots. This should have been covered.
I don’t understand how you can state supply requirement numbers as the argument in favor of doing things sooner. Everyone knows the number of people and the requirement. It does not magically make the production volume rise.

You spend too much time using strange terms like “war footing”. It sounds very MBA like. What part of the efforts so far across the world does not seem war footing like to you ? There’s been no crisis in modern history like Covid and India is fortunate to have some of the most significant vaccine production lines on the planet, far beyond the level of countries in our income group.

Pfizer had a 3 month head start in terms of Ph1/2 results and yet they struggled badly with yield scaling. Do you realize that the US death toll was almost continuously 3000 odd a day for months from Oct-Nov thru March ? All their wealth, power and technological capability could not make them produce vaccines faster than 16 million per month in January.

When using fancy terms like “should have done his on war footing” please normalize this against what everyone has tried to do and what they’ve managed .

India despite its meager resources has fostered two vaccine candidates and produced an imported one at a scale larger than any Pfizer plant to date.

The US despite its enormous resources watched a months long wave ravage them and there was nothing their wealth, power and dominance over tech could do to hurry things up. Nothing.

China, despite allegedly having a vaccine last year and production capability, didn’t ramp up the kind of scale India estimates to reach this summer, until April.

Fancy MBA terms are alright, but you’re fundamentally focusing on stating conclusions. First demonstrate your understanding of - as Amit Shah said please understand chronology, and normalize what’s been accomplished vs the best others have been able to accomplish.

There are several detailed posts on how much effort it takes to scale up vaccine production. Covaxin involves growing live Covid viruses in large batches. They take months to grow - AFTER you have a safe facility in place. You cannot hurry this any more than you can have a child in one month by marrying nine women.

Twitter had some great posts on the problems every single vaccine type faces while scaling. The challenges are a near black art. Two plants, same ingredients, one producing much more. Same plant, tries to double production and yield falls badly. When such things happen they dig until they find what precise temperature or other factor caused this, then try to fix and restore level of output.

Your posts betray an incredible disconnect from reality, presuming that the central basis for lack of more vaccines today is inaction today or prior. I’m giving you evidence to the contrary and you are willfully ignoring it. Why ?

Neither India nor countries with far more wealth , manufacturing power or access to vaccine IP have been able to scale up production any faster. We are not a laggard - we are on par with US and behind China in production volume . That’s all they’ve managed despite their resources. And yet what we’ve managed is a failure for which the Mudi shud rejine.
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

Deans wrote:Why would it not be possible for GOI to spare no effort or expense to have a BS-3 plant ready in April (if they acted in Nov) to produce Covax - especially when they were less dependent on an imported supply chain. A BS-3 facility would be a national asset.
This statement is not correct - it was BB that needed the BSL-3 facilities and depended on the imported adjuvant, which was later indigenised with CSIR help.
Deans wrote:My feeling (and this is only conjecture) is that when GOI did put pressure on SII, Poonawalla went to the UK. Since we had no alternative to SII, GOI had no leverage.
Poonawalla went to the UK after the vaccination was opened up to states and private sector. GoI pressure would have been there from early in the year itself, whereas he chose to leave soon after Apr 1, and blamed "chief ministers" and "business leaders" after reaching the UK. The MHA had announced additional (Y category?) security for him just around that time - so clearly GoI was also in the loop here. One can read between the lines of his statement as to who he blamed, it didn't sound like GoI per se.
Deans wrote:If supply was an insurmountable problem, the vaccines should have been rationed. The 18-45 age group should not have been offered the vaccine until now. It would have taken only 85 million doses to fully vaccinate 2/3rd of Health and front line workers (the rest have not opted for it) and 60% of the urban population above 60. Another 90 million doses would have meant that 50% of the population from 45-59 would have got their first dose by end May. These categories account for over 90% of our deaths.
Two factors you'd need to take into account here: a) the incessant propaganda by the opposition and media to "decentralize" the vaccine procurement, and b) the vaccine hesitancy that kept a large portion of the 60+ at home, though they were eligible since March 1 (all the elders in my family across multiple cities reported practically empty vaccination centres when they took their shots). During this period, there was no report of shortage of vaccines anywhere, the shortage was in the people showing up (or lack thereof). The same trend continued post April-1, though the second wave convinced a lot of these fence sitters to make a beeline, and the supplies started getting used up. By May 1, the stockpile was quite low, and it was clear the new decentralized strategy won't help, but as Modi said, the states wanted a say and so GoI obliged.
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Re: Wuhan Coronavirus Resource Thread

Post by darshan »

This western concept of vaccine hesitancy needs to be stopped from being peddled. There were not enough people wanting to not take vaccine to overcome supply demand equation. There were no reports of people waiting to vaccinate and no one showing up.

There was a pause with onset of wave and it should not be misinterpreted.

At many places, politicians and Abrahamics were running systematic anti vaccine campaigns and that should not be counted as hesitancy.

Real hesitant people would not have made a big difference.

There has to have had real data that says that supplies were idle and no one was coming to get vaccinated. GoI started on March 1 and the threat had not sunk into minds of people till few weeks later to sign up for each slot available. The Incorrect risk assessment can't be interpreted as hesitantcy. The whole wave started with the population believing that the virus has been defeated. If that wasn't the case then the wave would not have been bad as masks would have been on the face and people would have been following protocols. The same with putting priority on getting to the booth to get a vaccine shot. The fear wasn't there to make it a number one priority for many. Well to do people not deciding to vaccinate themselves doesn't translate to the whole India where everyday's earnings matter.
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Re: Wuhan Coronavirus Resource Thread

Post by Uttam »

COVID-19 Vaccination Update- Day 144
Cumulative Vaccine Coverage exceeds 23.88 Crore
More than 25 lakh Vaccine Doses administered today till 7 pm
Day 144 - Day 143 = 23.88 - 23.59 = 29 lakhs
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Re: Wuhan Coronavirus Resource Thread

Post by Uttam »

There has been a lot of discussions about what the govt. could've and should've done to order vaccine. However, one more important factor missing from the equation is vaccine hessitancy. Look at the most recent data on vaccination. Today 11940 HCWs and FLWs 70968 received their first vaccine. These people have been eligible to receive their vaccine for over 5 months now. Should the govt. had done more to reduce vaccine hesitancy?

Agreed that Jaychands of India created a lot of confusion about vaccines. Should the govt. anticipated it and worked harder to reduce the misinformation? I don't have an answer, just questions.
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Re: Wuhan Coronavirus Resource Thread

Post by darshan »

There's no excuse for restricted phases people not getting vaccinated and still allowed to be in public. That should be termed as failure and vaccine hesitantcy. The same can't be applied to 60+ and others. Having plenty of opportunities and education but still choosing not to get vaccine is a different crime. And crime it's as we don't know how many people they got infected and helped cause the wave. 60+ hiding in their homes without vaccine didn't cause wave.

GoI needs to fight misinformation campaigns on WhatsApp not only for this issue but many issues. Yes, competent bureaucracy should have been monitoring where vaccines will fly off the shelf and where it will not because of active misinformation campaigns.

For example, GJ state government didn't put in any effort to tell people that there's no connection to vaccine and being positive. Many that got vaccines on the first week ended up as positives two weeks later. This put in pause for many. Not because that they were anti vaccine people but didn't know what the hell is going on here and wanted to be safe.

For many 60+, vaccines have to go to them compared to them going to vaccines. India isn't a rich country with 60+ having lots of resources.

Vaccination drives coincidentally started with the wave and effects of this are being termed as hesitantcy.
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Re: Wuhan Coronavirus Resource Thread

Post by disha »

darshan wrote:This western concept of vaccine hesitancy needs to be stopped from being peddled. There were not enough people wanting to not take vaccine to overcome supply demand equation. There were no reports of people waiting to vaccinate and no one showing up.
Please check out TN vaccination numbers and also please check out on field evaluations by front line health workers. Vaccine resistancy is big. Very big.
There has to have had real data that says that supplies were idle and no one was coming to get vaccinated.
Data is there, you only need to look at it.
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Re: Wuhan Coronavirus Resource Thread

Post by darshan »

Can one look at those numbers and separate by causes?

My definition of vaccine hesitation is that someone rejected vaccination with all options, resources, and education available. Like one would in let's say US.

Lot of states are suffering from misinformation campaigns. Should I really term them as vaccine hesitation?
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Re: Wuhan Coronavirus Resource Thread

Post by Deans »

Suraj wrote: I don’t understand how you can state supply requirement numbers as the argument in favor of doing things sooner. Everyone knows the number of people and the requirement. It does not magically make the production volume rise.

You spend too much time using strange terms like “war footing”. It sounds very MBA like. What part of the efforts so far across the world does not seem war footing like to you ? There’s been no crisis in modern history like Covid and India is fortunate to have some of the most significant vaccine production lines on the planet, far beyond the level of countries in our income group.

Pfizer had a 3 month head start in terms of Ph1/2 results and yet they struggled badly with yield scaling. Do you realize that the US death toll was almost continuously 3000 odd a day for months from Oct-Nov thru March ? All their wealth, power and technological capability could not make them produce vaccines faster than 16 million per month in January.

When using fancy terms like “should have done his on war footing” please normalize this against what everyone has tried to do and what they’ve managed .

India despite its meager resources has fostered two vaccine candidates and produced an imported one at a scale larger than any Pfizer plant to date.

The US despite its enormous resources watched a months long wave ravage them and there was nothing their wealth, power and dominance over tech could do to hurry things up. Nothing.

China, despite allegedly having a vaccine last year and production capability, didn’t ramp up the kind of scale India estimates to reach this summer, until April.

Fancy MBA terms are alright, but you’re fundamentally focusing on stating conclusions. First demonstrate your understanding of - as Amit Shah said please understand chronology, and normalize what’s been accomplished vs the best others have been able to accomplish.

Your posts betray an incredible disconnect from reality, presuming that the central basis for lack of more vaccines today is inaction today or prior. I’m giving you evidence to the contrary and you are willfully ignoring it. Why ?
Suraj ji, I don't disagree with your points, Indeed I make several of them in my own discussions, when uninformed critics (I try not to be one) take pot shots at India, for everything from vaccine shortage, to overflowing crematoria. My earlier posts mention the achievements of developed countries being no better than ours. Given the Anti vaccine /Anti Modi/Rush to SC, tactics of the opposition and the performance of State govts they control, I don't believe any other govt would have done better.

My discomfort is that the points you so eloquently make, should have been much more widely publicised from the outset. It is lack of information that leads the opposition to float their own ideas and for SC to ask what our vaccine policy is. This was exacerbated in May, when demand peaked - partly from reduced vaccine hesitancy following a surge in cases and because it was extended to the 18-45 age group.

Could the govt not say in Jan (preferably earlier) that the available vaccine capacity is X /month and with that capacity, this is how we are going to cover the population ? At that stage they could have addressed issues like production constraints of Covax and why they are giving priority to
certain groups ahead of others. I would have been happy if the country was told at the outset that (for e.g.) our expected rate of vaccination will suffice to protect all FLW and senior citizens by the end of May - which it was.

By `war footing' I had in mind mind - Modi ji telling the nation that making anti-vaccine statements is no different from siding with the enemy in a time of war and they would be guilty of culpable homicide of all those who died because they chose not to get vaccinated. Nor would he allow HC to sanction the culling of our senior citizens, by saying the young should get priority because the old have lived their lives.
Secondly, ask SII and BB (in Nov) what they would need to scale up to the desired level. Give it to them, let the country know what is being done and make sure capacity is available on schedule.

The one MBA jargon (since I am one) I do want to look at, is accountability. The reason for my angst was that we are falling 200 million doses short of the number Govt had committed (400 million in July vs 600 million target). I'm not clear why. Who will be held responsible if 2.16 billion doses (the latest target) are not delivered by the end of Dec ?
It would have been more realistic if the govt had said that 320 million doses would be achieved in June but that would suffice to protect the overwhelming majority of the vulnerable - it would be a higher proportion of those above 60, than the US or EU.
darshan
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Re: Wuhan Coronavirus Resource Thread

Post by darshan »

What's vaccine hesitancy here and what's internal security matter here?
Stalin and other DMK leaders are responsible for vaccine hesitancy in Tamil Nadu: BJP state chief L Murugan | Chennai News - Times of India
https://m.timesofindia.com/city/chennai ... 147219.cms
vera_k
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Re: Wuhan Coronavirus Resource Thread

Post by vera_k »

IMO, Central government should plan to put out a paper on its pandemic planning to detail what the plan was, what changed and what was achieved.
Looking outside in, it appears that the role of variants was not fully understood and baked into the plan, but hard to know for sure.

SII's own statements from Sept 2020 were that it would take until 2024 for most people to be vaccinated given available manufacturing capacity around the world. Granted that this statement extends to the population of the entire planet, however it was also stated that 50% of vaccine production in India would be exported. Which means that even in the best case, vaccinations were planned at a somewhat leisurely pace.
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Re: Wuhan Coronavirus Resource Thread

Post by Suraj »

Deans wrote:My discomfort is that the points you so eloquently make, should have been much more widely publicised from the outset. It is lack of information that leads the opposition to float their own ideas and for SC to ask what our vaccine policy is.
Then learn the details instead of effectively letting them play you. Do you not realize that you're being a played by them by turning around and making conclusions ? "Govt should have done this before, so opposition had no chance to complain" .

This is such a basic weakness - you're easily rattled. All I would do from the other side is throw all kinds of sh*t out and let the other guy get rattled and start shooting at his own leadership. This is stupid.

Gain a command over the facts and articulate them. When you lack data, avoid concluding or reacting. Without a command over the details, it's more or less guaranteed your conclusions will be nowhere near the mark.

Your conclusions have been wildly off the mark so far. I've patiently addressed them in a quantitative manner, but at this point you're simply derailing the thread. Please take your further whines on politics to the politics thread. Further arguments here will be deleted.
Deans wrote:Could the govt not say in Jan (preferably earlier) that the available vaccine capacity is X /month and with that capacity, this is how we are going to cover the population ?
No. I've literally just explained this in the prior post. In January, Pfizer was struggling to get just 4m doses out each week. They now manage that each day. Ask *any* vaccine maker in Dec/Jan to estimate month on month production and you'll find none of them able to do that. Not because they're incompetent, but because scaling up production takes time to stabilize.
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Re: Wuhan Coronavirus Resource Thread

Post by sankum »

News reports say 25 crore covisheild, 19 crore COVAXIN and 30 crore biological e for total of 74 crore till December 2021. Government order is for roughly half of expected production in August Dec time period of covisheild and COVAXIN nearly all the production of biological e. May be waiting for BB nasal drops.
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Re: Wuhan Coronavirus Resource Thread

Post by Suraj »

Those are not the orders for up to December. They are simply the regular orders that Govt has been making every 4-6 weeks.

mid March: 120m doses (100m SII, 20m BB)
late April: 160m doses (110m SII, 50m BB)
early June: 740m doses (250m SII, 190m BB, 300m Biological-E)

There will be more orders in July/Aug, and I expect Zycov-D and Sputnik will see orders in the near future too. The govt has so far collaborated with the companies to help them to the point of clearing regulatory processes and development, even paying for Phase 3 trials. Once the vaccine looks like it's ready for use, they make orders.
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Re: Wuhan Coronavirus Resource Thread

Post by Prasad »

Tried to collate some information on the supply-chain challenges that countries and companies faced in setting up and increasing production. Very long thread. And also has information on how pfizer etc struggled to increase production until Jan 21. Despite large orders very early in July 2020 itself. And what goi did in Nov 2020.

How did countries undertake vaccine manufacturing supply chain management? When did orders come in? What were the bottlenecks? Did production meet projections? Is current and future projected mfg rate enough? Questions without consolidated answers. So, thread -
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Re: Wuhan Coronavirus Resource Thread

Post by vijayk »

Uttam wrote:COVID-19 Vaccination Update- Day 144
Cumulative Vaccine Coverage exceeds 23.88 Crore
More than 25 lakh Vaccine Doses administered today till 7 pm
Day 144 - Day 143 = 23.88 - 23.59 = 29 lakhs
Hope it crosses 4M mark by Wed/Thu

They are actively pushing in Hyd.

KIMS is going to apartment building and vaccinating 700-800 people on weekends. In B'lore too, lot of folks getting it now.

Cab drivers are getting message from Telangana Transport dept to come and get vaccinated. Hope we move fast
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Re: Wuhan Coronavirus Resource Thread

Post by Amber G. »

For the record - Posting some graphs, as posted before, for trend etc.
There are five countries, India, US, Canada, France and UK (personal choice)

Daily confirmed cases per million. (India was relatively doing well before the second terrible wave)
Image

Same as above (Confirmed cases) in absolute numbers:
Image

Confirmed deaths per million.
Image

Confirmed deaths in numbers.
Image

Daily vaccinations per 100 people:
Image

Daily vaccinations in numbers:
Image

Here is number of people who received at least one dose of vaccine:
Image

The above as a percentage of population
Image

Final two graphs: CFR
Image

Estimate of R
Image
vera_k
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Re: Wuhan Coronavirus Resource Thread

Post by vera_k »

Brazil says Russian Covid vaccine carried live cold virus
Tainted batches of Russia's Sputnik V Covid vaccine sent to Brazil carried a live version of a common cold-causing virus, the South American country's health regulator reported in a presentation explaining its decision to ban the drug's import.
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Re: Wuhan Coronavirus Resource Thread

Post by Pratyush »

I have been reading with interest the demands for doing things sooner about the procurement of vaccines. However, IMO this is ignoring the real world restrictions on export of vaccine raw materials by the US in Feb and March. Unless that issue was resolved production of vaccines could not have ramped up. Which is what was accomplished in case of SII by mid April. In case of BB the issue was resolved with the addition of BSL3 facilities by GOI.
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

Vaccine hesitancy was real. Multiple experiences were documented on this very thread, especially from the side of daily wage labourers and others in lower economic strata. Anyone dismissing it as some western fad is missing the wood for the trees, to put it mildly. Yes, the hesitancy was not for the same reasons as the anti-vaxers in the west, but the end result was the same - empty vaccination centres for more than a month, which, had they been used properly, would have made a big difference to the second wave. That the bulk of deaths in the second wave came from the 45+ group is telling.

Code: Select all

Age group(years)  1st wave   2nd Wave

Infections
---------
40-50                 17.16%      17.50%
50-60                 14.80%      15.07%
60-70                 9.01%       9.99%
70-81                 4.17%       4.19%
80+                   1.31%       1.28%
-----
Total (40-80)         46.45%       48.03%


Deaths
-------
40-50                 11.98%     10.82%
50-60                 23.29%     21.23%
60-70                 28.76%     28.21%
70-80                 19.99%     22.17%
80+                   7.82%       9.81%
-----
Total (40-80)         91.84%       92.3%
Two points to note:
1. % by age group by itself usually would not be useful without taking into account population by age group. Or we should normalize it to per million population. But since we are comparing across waves here, it's fine - the same population set is compared against itself.
2. Death rate being significantly higher shows how deadly this disease is for aged people. Nothing we didn't know, but this data confirms the same pattern in both waves.

Conclusion: The fact that the infection rate, as well as the death toll for the aged category hardly dropped (it increased slightly, actually) in the second wave shows how little impact the vaccination had. Couple this with the rate vaccinations during Mar-Apr (multiple reports of empty centres) shows the problem was not with ineffective vaccines, rather was that of not enough eligible people taking it. In my mind, that's hesitancy, irrespective of whatever wordplay we want to come up with.

Source: Union health secretary Rajesh Bhushan's press conference as reported by https://science.thewire.in/politics/gov ... -ministry/

---------

Added l8r: This also partially answers one of Deans sir's concerns about needlessly high impact of the second wave - if people simply didn't show up, there is not much advance prep could do. Yes, a greater availability means we could have opened up to additional age groups earlier, but given the hesitancy among the most vulnerable (elderly) people, I doubt the youngsters would have given it that much more importance. Given the death toll was skewed so much in favour of the elderly, youngsters, even if they had chosen to show up, would not have impacted the death toll that much. Yes, this is mostly conjecture, but that's one of the pitfalls of trying to go back in time and try to see "what could have been".
Deans wrote:The incremental 140 million doses would have saved 60,000 lives.
Last edited by arshyam on 09 Jun 2021 10:32, edited 1 time in total.
arshyam
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

From the same source as above, the data is for the really young is heartening, maybe this is why experts are now saying there is no evidence that the next wave would specifically be hard on kids. Hope it stays true.

Code: Select all

Age group(years)  1st wave   2nd Wave

Infections
---------
< 10                4.03%         2.97%
10-20               8.07%         8.50%
-----
Total (0-20)        12.10%      11.47%

Deaths
-------
< 10                0.27%         0.34%
10-20               0.53%         0.31%
-----
Total (0-20)        0.80%         0.65%
arshyam
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Re: Wuhan Coronavirus Resource Thread

Post by arshyam »

For example: 'No Data To Show Children Will Be Seriously Infected In Subsequent COVID-19 Waves': AIIMS Director Dr Randeep Guleria - Swarajya
All India Institute of Medical Sciences (AIIMS) Director Dr Randeep Guleria on Tuesday (8 June) said that there was no data available either in India or globally which could suggest that the subsequent COVId-19 waves are going to cause severe illness in children.

“It is a piece of misinformation that subsequent waves of the COVID-19 pandemic are going to cause severe illness in children. There is no data - either from India or globally - to show that children will be seriously infected in subsequent waves.” Dr Guleria said during a media briefing on COVID-19, held at Press Information Bureau's National Media Centre in Delhi.

Dr Guleria said that 60 to 70 per cent of the children who got infected and were admitted to hospitals during the second wave in India, had either comorbidities or low immunity. Healthy children recovered with mild illness without need for hospitalisation, the AIIMS Director said, according to a Ministry of Health statement.

He also urged people to follow COVID-appropriate behaviour to avoid future waves of the pandemic, as one of the main reason behind a wave can be human behaviour.

“Whenever cases increase, there is a fear in people and human behaviour changes. People strictly follow COVID Appropriate behaviours and non-pharmaceutical interventions help break the chain of transmission. But when unlocking resumes, people tend to think that not much infection will happen and tend to not follow COVID appropriate behaviour. Due to this, the virus again starts spreading in the community, leading potentially to another wave," Dr Guleria said.
More details in the PIB article linked in the above:

https://pib.gov.in/PressReleasePage.aspx?PRID=1725366
Ministry of Health and Family Welfare

“No data to show children will be seriously infected in subsequent COVID-19 waves”
To avoid future waves, aggressively follow COVID Appropriate Behaviour: Dr. Guleria

Posted On: 08 JUN 2021 5:52PM by PIB Mumbai

“It is a piece of misinformation that subsequent waves of the COVID-19 pandemic are going to cause severe illness in children. There is no data - either from India or globally - to show that children will be seriously infected in subsequent waves.” This was informed by Director, All India Institute of Medical Sciences (AIIMS) Delhi, Dr. Randeep Guleria, during a media briefing on COVID-19, held at National Media Centre, PIB Delhi today.

Dr. Guleria cited that 60% to 70% of the children who got infected and got admitted in hospitals during the second wave in India, had either comorbidities or low immunity; healthy children recovered with mild illness without need for hospitalization.

COVID Appropriate Behaviour is Key to Preventing Future Waves

Director AIIMS explained why waves occur in any pandemic. Waves normally occur in pandemics caused due to respiratory viruses; the 1918 Spanish Flu, H1N1 (swine) flu are examples, said Dr. Guleria. “The second wave of 1918 Spanish Flu was the biggest, after which there was a smaller third wave.”

And as we know, SARS-Cov-2 is a respiratory virus.
1. Multiple waves occur when there is a susceptible population
When a large part of the population acquires immunity against the infection, the virus becomes endemic and infection becomes seasonal – like that of H1N1 that commonly spreads during monsoon or winters.

2. Waves can occur due to change in the virus (such as new variants)
Since new mutations become more infectious, there is a higher chance for the virus to spread.

3. One of the reasons behind a wave can be human behaviour
Dr. Guleria cautions: “Whenever cases increase, there is a fear in people and human behaviour changes. People strictly follow COVID Appropriate behaviours and non-pharmaceutical interventions help break the chain of transmission. But when unlocking resumes, people tend to think that not much infection will happen and tend to not follow COVID appropriate behaviour. Due to this, the virus again starts spreading in the community, leading potentially to another wave.”

The Director said that if we have to stop subsequent waves, we need to aggressively follow COVID appropriate behaviour until we can say that a significant number of our population is vaccinated or has acquired natural immunity. “When enough people are vaccinated or when we acquire natural immunity against the infection, then these waves will stop. The only way out is to strictly follow COVID appropriate behaviour”.
darshan
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Re: Wuhan Coronavirus Resource Thread

Post by darshan »

arshyam wrote:Vaccine hesitancy was real. Multiple experiences were documented on this very thread, especially from the side of daily wage labourers and others in lower economic strata. Anyone dismissing it as some western fad is missing the wood for the trees, to put it mildly. Yes, the hesitancy was not for the same reasons as the anti-vaxers in the west, but the end result was the same - empty vaccination centres for more than a month, which, had they been used properly, would have made a big difference to the second wave. That the bulk of deaths in the second wave came from the 45+ group is telling.
Still not classifying it as hesitancy. One can term it as illogical decision to not open up vaccination to all or divert to employees. Though not hesitancy. Can you decouple causes for empty centers based on aggregated numbers alone while at the same time the wave is happening? Throw in politically charged environment with elections on the line. Can I overlay or filter based on additional metadata associated with who's getting vaccine and who's avoiding it? When one's dealing with Abrahamics, BIF, anti Modi, etc. Where is hesitancy?
In what world, are you expecting day laborers to line up for vaccination without lot of groundwork and incentives?

Call it anything you want other than hesitancy. That allows real culprits to walk free of their crimes.
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