I have read that 1.3% of NYC COVID cases have come from restaurants. Why are we shutting down indoor dining if it accounts for such a small percentage when we could go after more dangerous activities?
Well, firstly, these are the cases that we have information about; not everyone gets followup with contact tracers. Second, we have to assume that a substantial portion of people are not being honest with themselves or with contact tracers about the risks they have taken or what their potential exposure was. Based on those two things, I would anticipate that anything with a substantial signal of cases in contact tracing data is a potential issue. Being over 1% of total cases, to me, is substantial.
Lastly, I have to reject the premise that "we could go after more dangerous activities." Right now something like 74% of NYC cases are resulting from private gatherings at homes. I don't think these can be gone after. At this stage, these are almost certainly cases from Thanksgiving and other holiday gatherings. That distorts the signal but is also very difficult to police.
At this point any reduction in cases is worthwhile, to blunt the momentum of this thing. Closing indoor dining--which, in my opinion, was never appropriate to have open--is one of the few tools that are available.
What are your thoughts on the Novavax COVID19 vaccine? How does it compare with the mRNA vaccines, specifically around safety profiles. The data from the UK has been very good, no?
(Reposting because I missed your request about specific safety profile comments)
I've followed Novavax for a very long time. When I first entered the industry, I heard about them because they were working on vaccines for a number of pathogens that were of interest from a global health perspective. In the time I've followed them, they've had major failures in more vaccine areas than I can really count here. They're a small, scrappy biotech that has tilted at some major windmills, and lost every time.
Their technology in COVID-19 is a recombinant protein vaccine--something that I would have bet on over the mRNA vaccines before trial results were released, because the mRNA technology was unproven. I think the scientific argument for Novavax's design is still strong, but I think they are now playing catchup. It will be harder for them to conduct their clinical trials with other vaccines in the field, but they do have a brief period of opportunity now--while the other vaccines are still restricted in terms of the types of patients who might receive them.
The Novavax candidate is a recombinant spike protein, and that's similar to the antigens expressed in the mRNA vaccines. It may have some variations relative to those vaccines, but I can't offhand think of any reason it shouldn't work given the success of those other candidates. The big question is whether it is able to get its clinical trials completed before the wide availability of other COVID-19 vaccines makes that very difficult.
In terms of safety profile, we really do need to wait for the Phase 3 trial to be more certain about this, but so far it looks like the safety profile is nothing to be particularly worried about.
On the other hand, this kind of thing is always full of surprises. Maybe their design has some quirk that means it doesn't do the job. This is why we do trials; if we could predict what would happen, we wouldn't need to test vaccines.
Why couldn't Sanofi apply for use of their vaccine specifically for you young people (I'm 59), with the idea that giving it to 30-year-olds would leave more doses of the Moderna vaccine for people my age and older?
Well, Carl, I never would have been able to guess your age, for what it's worth.
Regardless, I think the issue is that the trial is very carefully balanced in terms of how it enrolls patients. If a substantial enough proportion of patients were inadequately vaccinated, that's going to mess up the results. I imagine that Sanofi's researchers did everything they could to try and salvage the trial before admitting defeat.
If, perhaps, they had tried to enrich their trial with younger people, maybe they would have been able to keep going. It appears that's not what happened. It's really just a shame.
I have read that 1.3% of NYC COVID cases have come from restaurants. Why are we shutting down indoor dining if it accounts for such a small percentage when we could go after more dangerous activities?
Well, firstly, these are the cases that we have information about; not everyone gets followup with contact tracers. Second, we have to assume that a substantial portion of people are not being honest with themselves or with contact tracers about the risks they have taken or what their potential exposure was. Based on those two things, I would anticipate that anything with a substantial signal of cases in contact tracing data is a potential issue. Being over 1% of total cases, to me, is substantial.
Lastly, I have to reject the premise that "we could go after more dangerous activities." Right now something like 74% of NYC cases are resulting from private gatherings at homes. I don't think these can be gone after. At this stage, these are almost certainly cases from Thanksgiving and other holiday gatherings. That distorts the signal but is also very difficult to police.
At this point any reduction in cases is worthwhile, to blunt the momentum of this thing. Closing indoor dining--which, in my opinion, was never appropriate to have open--is one of the few tools that are available.
What are your thoughts on the Novavax COVID19 vaccine? How does it compare with the mRNA vaccines, specifically around safety profiles. The data from the UK has been very good, no?
(Reposting because I missed your request about specific safety profile comments)
I've followed Novavax for a very long time. When I first entered the industry, I heard about them because they were working on vaccines for a number of pathogens that were of interest from a global health perspective. In the time I've followed them, they've had major failures in more vaccine areas than I can really count here. They're a small, scrappy biotech that has tilted at some major windmills, and lost every time.
Their technology in COVID-19 is a recombinant protein vaccine--something that I would have bet on over the mRNA vaccines before trial results were released, because the mRNA technology was unproven. I think the scientific argument for Novavax's design is still strong, but I think they are now playing catchup. It will be harder for them to conduct their clinical trials with other vaccines in the field, but they do have a brief period of opportunity now--while the other vaccines are still restricted in terms of the types of patients who might receive them.
The Novavax candidate is a recombinant spike protein, and that's similar to the antigens expressed in the mRNA vaccines. It may have some variations relative to those vaccines, but I can't offhand think of any reason it shouldn't work given the success of those other candidates. The big question is whether it is able to get its clinical trials completed before the wide availability of other COVID-19 vaccines makes that very difficult.
In terms of safety profile, we really do need to wait for the Phase 3 trial to be more certain about this, but so far it looks like the safety profile is nothing to be particularly worried about.
On the other hand, this kind of thing is always full of surprises. Maybe their design has some quirk that means it doesn't do the job. This is why we do trials; if we could predict what would happen, we wouldn't need to test vaccines.
Why couldn't Sanofi apply for use of their vaccine specifically for you young people (I'm 59), with the idea that giving it to 30-year-olds would leave more doses of the Moderna vaccine for people my age and older?
Well, Carl, I never would have been able to guess your age, for what it's worth.
Regardless, I think the issue is that the trial is very carefully balanced in terms of how it enrolls patients. If a substantial enough proportion of patients were inadequately vaccinated, that's going to mess up the results. I imagine that Sanofi's researchers did everything they could to try and salvage the trial before admitting defeat.
If, perhaps, they had tried to enrich their trial with younger people, maybe they would have been able to keep going. It appears that's not what happened. It's really just a shame.
I won't argue with the idea that it's a shame, certainly.