The COVID-19 pandemic

[tomh009]

The AstraZeneca/Oxford vaccine that was announced today is pretty promising, doesn't need super-cold storage and is much less expensive, maybe a tenth of the cost of an mRNA shot. But even fewer details are available, on storage and side effects, for example.

Their trial size was only about 11,000 people, and of those, half got the placebo (meningitis shot), (maybe) a quarter got the COVID in two full-size inoculations, and (maybe) a quarter got it in a half-size and then full-size. The full/full was 62% efficacy and half/full was 90%, but effectively those are now quite small trials, each with fewer than 10,000 people (details not provided). In comparison, Moderna's trial has 30,000 people and the Pfizer/BioNTech has 39,000.

It's still good news, but I really want to see more details.

[danbrotherston]

The AstraZeneca/Oxford vaccine that was announced today is pretty promising, doesn't need super-cold storage and is much less expensive, maybe a tenth of the cost of an mRNA shot. But even fewer details are available, on storage and side effects, for example.

Their trial size was only about 11,000 people, and of those, half got the placebo (meningitis shot), (maybe) a quarter got the COVID in two full-size inoculations, and (maybe) a quarter got it in a half-size and then full-size. The full/full was 62% efficacy and half/full was 90%, but effectively those are now quite small trials, each with fewer than 10,000 people (details not provided). In comparison, Moderna's trial has 30,000 people and the Pfizer/BioNTech has 39,000.

It's still good news, but I really want to see more details.

Do you know why the trials were so different in size? Is there not a standard stage 3 study size?

[tomh009]

Do you know why the trials were so different in size? Is there not a standard stage 3 study size?

There isn't really a fixed minimum trial size. The trial size will, though, factor into the confidence level for the results and the regulators are more likely to approve a vaccine that had a large trial population, given similar results, as the confidence levels will be much higher (just as with polling).

10,000 is fairly low as far as stage 3 trials go, some go up to 100,000 people, but the 30-40,000 for Pfizer/BioNTech and Moderna is pretty much mid-range. Here is a chart from NIH that shows a number of vaccine trials with the stage 3 trial size on the x-axis (vaccine cost on the y-axis but that's a different discussion).

   

[danbrotherston]

Do you know why the trials were so different in size? Is there not a standard stage 3 study size?

There isn't really a fixed minimum trial size. The trial size will, though, factor into the confidence level for the results and the regulators are more likely to approve a vaccine that had a large trial population, given similar results, as the confidence levels will be much higher (just as with polling).

10,000 is fairly low as far as stage 3 trials go, some go up to 100,000 people, but the 30-40,000 for Pfizer/BioNTech and Moderna is pretty much mid-range. Here is a chart from NIH that shows a number of vaccine trials with the stage 3 trial size on the x-axis (vaccine cost on the y-axis but that's a different discussion).

Is there a reason to use a smaller trial though? I wouldn't think cost would be that big a factor, and recruiting participants should be easy right now.

[tomh009]

Is there a reason to use a smaller trial though? I wouldn't think cost would be that big a factor, and recruiting participants should be easy right now.

One factor might be the trial location -- if AstraZeneca did their trial in the UK, and Pfizer/Moderna did it in the US, they would only have one fifth of the population to draw from.

That's pure speculation, though. Normally you would use a smaller trial size to speed up the process and reduce the costs, but, as you say, that shouldn't be the major factor here.

[danbrotherston]

Is there a reason to use a smaller trial though? I wouldn't think cost would be that big a factor, and recruiting participants should be easy right now.

One factor might be the trial location -- if AstraZeneca did their trial in the UK, and Pfizer/Moderna did it in the US, they would only have one fifth of the population to draw from.

That's pure speculation, though. Normally you would use a smaller trial size to speed up the process and reduce the costs, but, as you say, that shouldn't be the major factor here.

Ironically, the US studies probably have better data on efficacy (but not safety) as a result of the US's record breaking COVID rates.

[tomh009]

One factor might be the trial location -- if AstraZeneca did their trial in the UK, and Pfizer/Moderna did it in the US, they would only have one fifth of the population to draw from.

That's pure speculation, though. Normally you would use a smaller trial size to speed up the process and reduce the costs, but, as you say, that shouldn't be the major factor here.

Ironically, the US studies probably have better data on efficacy (but not safety) as a result of the US's record breaking COVID rates.

Quite. That's about the only positive (that I can think of) from the massive growth in new cases there.

[tomh009]

MONDAY 2020-11-23

Waterloo Region reported 62 new cases for today (18.1% of the active cases).  3125new cases for the week (+11), averaging 13.4% of active cases. 363 active cases (+8 in the last seven days).

Next testing report on Tuesday.

Ontario reported 1,589 new cases today with a seven-day average of 1,429 (+20). 1,484 recoveries and 19 deaths translated to an increase of 86 active cases, and a current total of 13,004. +174 active cases for the week, and 134 deaths. 37,471 tests (primarily Saturday testing activity) resulted in a 4.24% positivity rate. The positivity rate is averaging 3.68% for the past seven days, as compared to 3.86% for the preceding seven.

1,589 is a new record, but only barely, one more than on Saturday. Overall, the number of cases for the past seven days is up only 1% over the previous seven days. Will it last? Will there be another surge from the past weekend's shopping frenzy?

ICU bed count is up to 156 (+9).

• 535 cases in Peel: 35.7 per 100K population
  
• 336 cases in Toronto: 11.6 per 100K
  
• 205 cases in York: 18.5 per 100K
  
• 61 cases in Hamilton: 11.5 per 100K
  
• 56 cases in Windsor-Essex: 14.3 per 100K
  
• 53 cases in Halton: 10.5 per 100K
  
• 41 cases in Durham: 5.8 per 100K
  
• 40 cases in Ottawa: 4.0 per 100K
  
• 30 cases in Wellington-Dufferin-Guelph
  
• 25 cases in Simcoe-Muskoka: 4.4 per 100K
  
• 24 cases in Niagara: 5.0 per 100K
  
• 83 cases in Waterloo: 12.8 per 100K (based on provincial reporting, one day behind the region)[/color]
  

Ottawa is looking good. York, Windsor and Waterloo, on the other hand, are trending toward a lockdown.

[jeffster]

Ottawa is looking good. York, Windsor and Waterloo, on the other hand, are trending toward a lockdown.

I think it was predicted with Diwali that numbers would be increasing 7-14 days later.

But yeah, out numbers certainly makes it look like we're headed to another lockdown.

[Coke6pk]

Looking at these numbers, why is Windsor staying in the Orange zone? I mean, the mayor isn't doing them any favours....

(https://www.cbc.ca/news/canada/windsor/w...-1.5812980)

Coke

[ac3r]

Data error means Ontario reports just 1,009 new COVID-19 cases, almost half in Toronto: https://www.msn.com/en-ca/news/canada/da...r-BB1bjNy8

Meanwhile in Toronto, rednecks defy indoor dining ban in order to cram themselves into a BBQ joint run by a conspiracy theorist to super spread the virus and listen to country music: https://twitter.com/jpags/status/1331256737442242562

Edit: Seems like the police and bylaw left without charging him or doing anything. Now there is a crowd of anti-lockdown protestors ordering takeout and congregating. What is the point in a lockdown if literally hours after it went into practice, the authorities give zero fucks if people openly break them and risk public health? Seriously...this is just getting frustrating: https://twitter.com/KamilKaramali/status...4027065348

[Rainrider22]

Data error means Ontario reports just 1,009 new COVID-19 cases, almost half in Toronto: https://www.msn.com/en-ca/news/canada/da...r-BB1bjNy8

Meanwhile in Toronto, rednecks defy indoor dining ban in order to cram themselves into a BBQ joint run by a conspiracy theorist to super spread the virus and listen to country music: https://twitter.com/jpags/status/1331256737442242562

I am not sure what you mean by "Rednecks".... and you make it sound like it is wrong  to listen to country music?  You choose to use your unconscious bias to see it one way.  What about this view point.  A desperate business owner watching his livelihood disappear in front of him with no ability to pay back his debt without claiming bankruptcy. Perhaps he has a family at home to feed and is scared he doesn't know how he will do it now...  I don't know this is the case, I am saying perhaps we shouldn't be so quick to judge.

[ac3r]

Data error means Ontario reports just 1,009 new COVID-19 cases, almost half in Toronto: https://www.msn.com/en-ca/news/canada/da...r-BB1bjNy8

Meanwhile in Toronto, rednecks defy indoor dining ban in order to cram themselves into a BBQ joint run by a conspiracy theorist to super spread the virus and listen to country music: https://twitter.com/jpags/status/1331256737442242562

I am not sure what you mean by "Rednecks".... and you make it sound like it is wrong  to listen to country music?  You choose to use your unconscious bias to see it one way.  What about this view point.  A desperate business owner watching his livelihood disappear in front of him with no ability to pay back his debt without claiming bankruptcy. Perhaps he has a family at home to feed and is scared he doesn't know how he will do it now...  I don't know this is the case, I am saying perhaps we shouldn't be so quick to judge.

No, Adam Skelly (owner) is a bit of a character. He's a true redneck as are most of his patrons: uninformed and hateful. He's a well known individual in the Toronto restaurant industry. He isn't suffering financially one bit. Earlier in the year, he had a massive meltdown on social media about the first lockdown, throwing around all sorts of profanities towards people with learning difficulties and certain people of colour. https://www.reddit.com/r/toronto/comment...d/fou5hi7/

If his business WAS failing, that sucks, but that doesn't mean he gets to freely break the law and potentially risk killing others so a few people can have a hoedown to "own the libs". My life is worth more than some shitty barbecue place and its racist owner, so I don't think he should be allowed to break the law because he wants to make money regardless if he was suffering financially or not. Actions like this only worsen things, from convincing the public that the rules don't matter if you choose they don't, to causing even more virus spread throughout the world and elongating this pandemic.

[danbrotherston]

Data error means Ontario reports just 1,009 new COVID-19 cases, almost half in Toronto: https://www.msn.com/en-ca/news/canada/da...r-BB1bjNy8

Meanwhile in Toronto, rednecks defy indoor dining ban in order to cram themselves into a BBQ joint run by a conspiracy theorist to super spread the virus and listen to country music: https://twitter.com/jpags/status/1331256737442242562

I am not sure what you mean by "Rednecks".... and you make it sound like it is wrong  to listen to country music?  You choose to use your unconscious bias to see it one way.  What about this view point.  A desperate business owner watching his livelihood disappear in front of him with no ability to pay back his debt without claiming bankruptcy. Perhaps he has a family at home to feed and is scared he doesn't know how he will do it now...  I don't know this is the case, I am saying perhaps we shouldn't be so quick to judge.

Maybe read a bit, he is none of those things, he is angry about the "freedom" not about his livelihood.

Not ticketing him is sickening in the face of the protestors arrested in Ottawa, and worse, the threat of legal action against the carpenter making housing for the homeless.

Honestly, the police are really aiming to maximize their bad optics here...

But police bad actors aside, I'm done treating assholes with kid gloves. It's time to treat them the way we've treated marginalized people for centuries.  The way we pretend we treat all bad people.

By far the most disappointing thing to learn as an adult is that it matters less what you do, and more who you are and who you know, when it comes to what consequences you face to committing crimes. And if you think that is an unkind thing to say, you're right, it is, lets make it untrue rather than shooting the messenger.

[Rainrider22]

I am not sure what you mean by "Rednecks".... and you make it sound like it is wrong  to listen to country music?  You choose to use your unconscious bias to see it one way.  What about this view point.  A desperate business owner watching his livelihood disappear in front of him with no ability to pay back his debt without claiming bankruptcy. Perhaps he has a family at home to feed and is scared he doesn't know how he will do it now...  I don't know this is the case, I am saying perhaps we shouldn't be so quick to judge.

Maybe read a bit, he is none of those things, he is angry about the "freedom" not about his livelihood.

Not ticketing him is sickening in the face of the protestors arrested in Ottawa, and worse, the threat of legal action against the carpenter making housing for the homeless.

Honestly, the police are really aiming to maximize their bad optics here...

But police bad actors aside, I'm done treating assholes with kid gloves. It's time to treat them the way we've treated marginalized people for centuries.  The way we pretend we treat all bad people.

By far the most disappointing thing to learn as an adult is that it matters less what you do, and more who you are and who you know, when it comes to what consequences you face to committing crimes. And if you think that is an unkind thing to say, you're right, it is, lets make it untrue rather than shooting the messenger.

Dan, please don't try and tell me what to do with your condescending comments please...