COVID-19: Vaccine and testing procedures Megathread Part 2 [Mod Warning - Post #1]

lucernarian

Sky King wrote: »

You're right. When vaccinating people in the same category they should make them play rock paper scissors to decide. FFS .

Pretty unnecessary reply, I offered an extra category that has a major factor in who should be prioritised - staff who are highly vulnerable themselves.

astrofool

lucernarian wrote: »

Alphabetical order, Jesus wept. I hope and frankly pray there's a reason they're not using +60 years old as a separate criteria.

Probably because it's the fastest to organise vs. getting people to line up by age, unless you want a slower rollout?

lucernarian

astrofool wrote: »

Probably because it's the fastest to organise vs. getting people to line up by age, unless you want a slower rollout?

Organising by clinical necessity for staff is more complicated than the existing priorities for clinical necessity that's being done for the population at large? Organising consent *per patient* and scheduling individuals for appointments seem like much more onerous requirements by themselves.

funnydoggy

Staying off this thread until Monday. Not much happens on weekends really does it, news wise!

CrabRevolution

lucernarian wrote: »

Pretty unnecessary reply, I offered an extra category that has a major factor in who should be prioritised - staff who are highly vulnerable themselves.

You seem to want a level of granularity that just can't be achieved when time is so scarce.They can't just roll it out by age with no regard for logistics.

If they did the 60-70 year olds in every facility, then started on the 50-60 year olds in every facility when the 60-70s were done, then moved on to the 40-50 year olds etc. it would be enormously time consuming and wasteful. They'd have to visit the same facility numerous times, only covering a small proportion each time.

It makes far more sense to just catch every eligible worker regardless of age in a facility in one go, then move to the next facility and the next. Obviously not every facility can be done simultaneously so yes, a 60 year old in hospital A might get the jab later than a 30 year old in hospital B but in the bigger picture it's far more effective this way.

lucernarian

CrabRevolution wrote: »

You seem to want a level of granularity that just can't be achieved when time is so scarce.They can't just roll it out by age with no regard for logistics.

If they did the 60-70 year olds in every facility, then started on the 50-60 year olds in every facility when the 60-70s were done, then moved on to the 40-50 year olds etc. it would be enormously time consuming and wasteful. They'd have to visit the same facility numerous times, only covering a small proportion each time.

It makes far more sense to just catch every eligible worker regardless of age in a facility in one go, then move to the next facility and the next. Obviously not every facility can be done simultaneously so yes, a 60 year old in hospital A might get the jab later than a 30 year old in hospital B but it's far more effective this was.

That is an exaggerated level of granularity. Something like a split between 60+/vulnerable and below 60/non-vulnerable would take care of most outliers like that. And I raised already how nursing home residents and staff were supposed to be the number 1 priority in the cabinet approved plan. NIAS have decided differently on both counts, with no explanation except from a couple of Boards posters on this thread.

lbj666

lucernarian wrote: »

That is an exaggerated level of granularity. Something like a split between 60+/vulnerable and below 60/non-vulnerable would take care of most outliers like that. And I raised already how nursing home residents and staff were supposed to be the number 1 priority in the cabinet approved plan. NIAS have decided differently on both counts, with no explanation except from a couple of Boards posters on this thread.

By that premise hospitals should only have started this week to keep behind nursing homes and stick to document, how stupid does that look?

Melanchthon

lucernarian wrote: »

Organising by clinical necessity for staff is more complicated than the existing priorities for clinical necessity that's being done for the population at large? Organising consent *per patient* and scheduling individuals for appointments seem like much more onerous requirements by themselves.

Don't be annoyed about it there is a cohort of posters here who are very defensive about criticism even if it's legitimate.

private non health care companies have done these type of assesments of staff e.g about return to office etc but expecting a hospital that's staffed by health experts and spends it's entire time handling complex scheduling to do similar, Your a naysayer and you can't expect them to do that.

On a similar note is there any good articles or documents about why vulnerable younger people seem to be rather far down the list, this is a genuine question as it would seem that it goes against what I understand of quality-adjusted life years and health economic theory? Genuine question.

lucernarian

lbj666 wrote: »

By that premise hospitals should only have started this week to keep behind nursing homes and stick to document, how stupid does that look?

So you're saying that we shouldn't have assigned priorities in the vaccination plan and acted on those? If throughput is what you're pursuing, you'd look to have an appointment system for all healthcare providers and hospital employees to go to designated facilities rather than have staff await the arrival of a team from a hub.

polesheep

lucernarian wrote: »

What an incredible comment.

"Scientists have expressed concern that vaccines being rolled out may not be able to protect against the new variants, particularly the one that emerged in South Africa.

Simon Clarke, an associate professor in cellular microbiology at the University of Reading, said this week that while both variants had some new features in common, the one found in South Africa “has a number additional mutations” that included more extensive alterations to the spike protein."

But there is no evidence to say that it will not be covered by the vaccines, therefore the question doesn't arise.

lucernarian

Melanchthon wrote: »

Don't be annoyed about it there is a cohort of posters here who are very defensive about criticism even if it's legitimate.

private non health care companies have done these type of assesments of staff e.g about return to office etc but expecting a hospital that's staffed by health experts and spends it's entire time handling complex scheduling to do similar, Your a naysayer and you can't expect them to do that.

On a similar note is there any good articles or documents about why vulnerable younger people seem to be rather far down the list, this is a genuine question as it would seem that it goes against what I understand of quality-adjusted life years and health economic theory? Genuine question.

I've wondered the same, the NHS have used a more granular 3-tier system to identify vulnerable people since the early days of the pandemic, e.g. the highest tier were told to shield, similar to our cocoon, but the NHS had two other levels while the HSE just had very vulnerable people/70+ and then "the rest". There's some fairly defensive characters here but as I've a personal stake in it, I'm probably defensive minded myself

lucernarian

polesheep wrote: »

But there is no evidence to say that it will not be covered by the vaccines, therefore the question doesn't arise.

You can't have evidence right now for or against what is currently an untested hypothetis, that is a non-sequitur.

The question arises because the protein motif is different in the other variants, and this is a genuine question that would arise with respect to antibody recognition. This is one of the fundamentals of immunology even.

polesheep

lucernarian wrote: »

I'd say the 66 year old cleaners, fitters, electricians and kitchen staff in a nursing home 5 days a week should equally all have been vaccinated by now too

It's not just about protecting staff, it's also about stopping the spread of infection. There are a lot more people coming and going in a hospital than in a nursing home.

My son isn't medical staff but he does have to access the lab in the hospital and therefore HAD to get the vaccine. It's about keeping a very big and busy hospital safe for patients.

lbj666

lucernarian wrote: »

So you're saying that we shouldn't have assigned priorities in the vaccination plan and acted on those? If throughput is what you're pursuing, you'd look to have an appointment system for all healthcare providers and hospital employees to go to designated facilities rather than have staff await the arrival of a team from a hub.

No what I am saying is just because one stream of the rollout is higher priority but complex and done at a steady pace, is not a reason for next priority down and a totally separate workstream to not tear through theirs and look for more means of efficiency.

As for priorities within that stream, fine, sort the list by oldest first, some didn't. I am not interested in putting the microscope on things to that level to be honest.

polesheep

lucernarian wrote: »

You can't have evidence right now for or against what is currently an untested hypothetis, that is a non-sequitur.

The question arises because the protein motif is different in the other variants, and this is a genuine question that would arise with respect to antibody recognition. This is one of the fundamentals of immunology even.

The scientists will be examining the SA strain and that's great. But why assume that it will be an issue? The vaccine is a reason to be cheerful, I don't understand why some people are so keen to poke holes in it.

odyssey06

polesheep wrote: »

It's not just about protecting staff, it's also about stopping the spread of infection. There are a lot more people coming and going in a hospital than in a nursing home.
My son isn't medical staff but he does have to access the lab in the hospital and therefore HAD to get the vaccine. It's about keeping a very big and busy hospital safe for patients.

Except we dont know for sure how far the vaccine prevents spread.

polesheep

odyssey06 wrote: »

Except we dont know for sure how far the vaccine prevents spread.

That doesn't mean that you can't act on the basis that it will, even if it's to a lesser degree. Do you simply say "We don't know if it will stop spread, so we won't bother using it for that purpose"?

lucernarian

polesheep wrote: »

The scientists will be examining the SA strain and that's great. But why assume that it will be an issue? The vaccine is a reason to be cheerful, I don't understand why some people are so keen to poke holes in it.

It sounds more like you're saying that there's no question as to its efficacy against the increasingly prevalent SA-origin strain.

How is asking questions about this an assumption? If anything it's the exact opposite. I'm still moderately confident but variable levels of immunity worldwide as the vaccine proceeds will inevitably introduce heavy pressure on the viral genome and any potential antibody escape mechanisms (which for SARS-COV-2 I've not seen much literature on).

lucernarian

lbj666 wrote: »

No what I am saying is just because one stream of the rollout is higher priority but complex and done at a steady pace, is not a reason for next priority down and a totally separate workstream to not tear through theirs and look for more means of efficiency.

As for priorities within that stream, fine, sort the list by oldest first, some didn't. I am not interested in putting the microscope on things to that level to be honest.

The two streams needn't be distinct from each other for vulnerable staff who can travel to hubs to have the vaccine along with on-site hospital staff. Describing the issue like it's splitting hairs sounds more like an excuse and a way to dodge any scrutiny over the rollout.

polesheep

lucernarian wrote: »

It sounds more like you're saying that there's no question as to its efficacy against the increasingly prevalent SA-origin strain.

How is asking questions about this an assumption? If anything it's the exact opposite. I'm still moderately confident but variable levels of immunity worldwide as the vaccine proceeds will inevitably introduce heavy pressure on the viral genome and any potential antibody escape mechanisms (which for SARS-COV-2 I've not seen much literature on).

So a change in the virus might one day render the vaccines impotent. We might as well pop those cyanide pills right now.

I'm following funnydoggy and getting off this site for the weekend to escape the negativity.

odyssey06

polesheep wrote: »

That doesn't mean that you can't act on the basis that it will, even if it's to a lesser degree. Do you simply say "We don't know if it will stop spread, so we won't bother using it for that purpose"?

Focus on direct protection of the vulnerable first - for which we know the vaccine is effective.

Micky 32

polesheep wrote: »

So a change in the virus might one day render the vaccines impotent. We might as well pop those cyanide pills right now.

I'm following funnydoggy and getting off this site for the weekend to escape the negativity.

I don’t blame you. The first part of your post is correct BUT like the flu vaccine it will tweaked accordingly as time goes on.

Happydays2020

funnydoggy wrote: »

Staying off this thread until Monday. Not much happens on weekends really does it, news wise!

One can imagine the conversation in the Department of Health on a Friday - ‘it’s the weekends lads, go out and frighten the bejaysus out of them’.

And they need to stop language that the virus is out of control. They did not even do that back in March.

niallo27

This should help, if anyone getting infected now has immunity until the end of year or further. It will mean a few less 100 thousand that need to get vaccinated. Remember the days with all the panic over a few people getting reinfected.


https://science.sciencemag.org/content/early/2021/01/06/science.abf4063

is_that_so

Cork2021 wrote: »

Just heard on news talk there De gascun saying the vaccines won’t be as affective with the SA variant.
Highly irresponsible from him in my opinion. Especially when Pfizer and moderna are extremely confident it’ll pose no problems!

He's quoted on RTE as saying they need more data to see.

lucernarian

niallo27 wrote: »

This should help, if anyone getting infected now has immunity until the end of year or further. It will mean a few less 100 thousand that need to get vaccinated. Remember the days with all the panic over a few people getting reinfected.


https://science.sciencemag.org/content/early/2021/01/06/science.abf4063

This is fantastic, if the HSE use this to their advantage.

Miike

Cork2021 wrote: »

Just heard on news talk there De gascun saying the vaccines won’t be as affective with the SA variant.
Highly irresponsible from him in my opinion. Especially when Pfizer and moderna are extremely confident it’ll pose no problems!

Everywhere I've seen this quoted has stated he said there is a theoretical risk this strain will impact how vaccines work, which is a far cry from what you've posted. I'm not saying you made it up by the way, perhaps that is word for word what he said in the radio interview but elsewhere seems to have a different spin. There is a major hunt going on to figure out if the vaccine is effective against this new strain and as things currently stand today there is no sufficient or definitive data to say it does or doesn't.

astrofool

lucernarian wrote: »

Organising by clinical necessity for staff is more complicated than the existing priorities for clinical necessity that's being done for the population at large? Organising consent *per patient* and scheduling individuals for appointments seem like much more onerous requirements by themselves.

The goal is to vaccinate all staff at the hospital as quickly as possible, the goal is not to vaccinate all staff at the hospital by order of age, to do the second, you compromise the first, with the first, the vaccine immunity of everyone who works in the hospital kicks in as soon as possible, you want to slow that down for some reason. I would also doubt they'll be sticking strictly to alphabetical order (oh you're here Walter, but Ben hasn't arrived yet, lets get you done while I'm waiting for Ben).

But look, in to be fair, please outline the order we should be vaccinating in, and include all the subgroups within those groups (immuno-compromised, age(including how many separate groupings of age), been infected previously, estimated exposure to others) and create your own list, and do some logistics on getting those groups in at the correct time and vaccinated before moving onto the next group (sorry, you're 59, and we have an outstanding 61 year old to vaccinate first). Come up with a comprehensive plan for that, and we can then debate your comprehensive plan, rather than hand wringing.

CrabRevolution

astrofool wrote: »

The goal is to vaccinate all staff at the hospital as quickly as possible, the goal is not to vaccinate all staff at the hospital by order of age, to do the second, you compromise the first, with the first, the vaccine immunity of everyone who works in the hospital kicks in as soon as possible, you want to slow that down for some reason. I would also doubt they'll be sticking strictly to alphabetical order (oh you're here Walter, but Ben hasn't arrived yet, lets get you done while I'm waiting for Ben).

But look, in to be fair, please outline the order we should be vaccinating in, and include all the subgroups within those groups (immuno-compromised, age(including how many separate groupings of age), been infected previously, estimated exposure to others) and create your own list, and do some logistics on getting those groups in at the correct time and vaccinated before moving onto the next group (sorry, you're 59, and we have an outstanding 61 year old to vaccinate first). Come up with a comprehensive plan for that, and we can then debate your comprehensive plan, rather than hand wringing.

The demand for logistics and speed to be disregarded in order to ensure priority is maintained has me picturing a nursing home that has a few people across 5 priority categories and they've to run 10 separate vaccination clinics over the course of several months because the HSE have decided to slow down the vaccination process to a crawl in order to stick religiously to the priority list.

Gael23

Will
This quicker speed benefit the rest of us getting it sooner?