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The Russian Vaccine

Many will have heard Russia’s announcement that they have approved a coronavirus vaccine. I’ve already had several people ask me what I think of it, so let me be clear: I think it’s a ridiculous publicity stunt. If it’s supposed to make Russia look like some sort of biotechnology powerhouse, then as far as I’m concerned it does the opposite. It makes them look desperate, like the nation-state equivalent of a bunch of penny-stock promoters. The new airliner design prototype just got off the ground – time to sell tickets and load it full of passengers, right?

Why so negative? Look at what’s being claimed – the first coronavirus vaccine to receive regulatory approval. But “regulatory approval” is not some international gold standard, and these sorts of decisions show you why. Let’s be honest: there is no way that you can responsibly “approve” a vaccine after it’s only been into human trials for what numerous reports say is less than two months. That’s about enough time to do the first steps, a Phase I trial that gives you some idea of immune response across more than one dose. It is simply not enough time to do a reasonable efficacy workup as well, and absolutely not enough time to get any sort of reading on safety. Here’s a good article going into those timelines in more depth.

Look, we’re pushing safety and efficacy trials harder than they’ve ever been pushed already, and many people already are jumpy about the safety evaluations of the various vaccine candidates as it is. Declaring regulatory approval and taking a public victory lap in the world press before you’ve even done that safety work at all inspires pity rather than respect. The various news stories on this “approval” generally have quotes from outside experts saying that it’s important to see if Russia is following best practices and such, but that’s easy to answer. They aren’t. There are several other vaccines that could be “approved” already if we thought that this was a good idea. But it isn’t.

So what is this vaccine candidate, anyway? It’s being developed by the Gamaleya Research Institute, and it’s reported to be a mixture of two adenovirus vectors, Ad5 and Ad26. I’m still not sure what the idea behind giving both of those might be, but those two approaches are of course being used separately by other vaccine developers. The Gamaleya folks seem to like these mixed-vector vaccines – here’s a VSV/Ad5 Ebola candidate they were working on. Overall, the idea behind the vaccine doesn’t seem to be bizarre at all, though – just the development timelines.

This is just naked “vaccine nationalism”, which is really the last thing we need right now. I don’t want to see any country (including the US) beating its chest in this fashion and using the pandemic to declare the superiority of its system or its scientists. Coronavirus research needs to be as international as possible, with ideas, approaches, publications, and trials coming from around the world. This sort of stunt is taking us backwards – now people will be agitating for the “approved” Russian vaccine and wondering why the others aren’t ready yet, etc. It just creates confusion and discord – don’t we have enough of those already? Unless, of course, creating confusion and discord is the point. . .

232 comments on “The Russian Vaccine”

  1. Tony Scharf says:

    Russia creating “confusion and discord”. Sounds on-brand for them to me. This is just what they do.

    1. Pot Meet Kettle says:

      Yes, because our supposedly robust democracy was shattered by a few tens of thousands of dollars of buff Bernie ads and some leaked emails. And also, the United States would never do something like that. They prefer overt regime change, supporting Al Qaeda in Syria, Pinochet in Chile, and countless other examples.

      1. Shazbot says:

        It’s remarkable how nakedly obvious the strawmen arguments are sometimes.

        Remember, the common propaganda rules are:

        1. Deny everything.
        2. Blame the victim.
        3. Change the subject.

        1. x says:

          So, basically, everything you’re doing right now?

          No one believes Russia is a selfless friend to the US, but the specific allegations re: Russian interference in recent American elections have been debunked to death, and the only people who believe any of it are credulous suckers.

          So you’re attacking the messenger because… you’re one of the credulous suckers, or because you’re one of the propagandists who helped push those bogus allegations in the first place? Probably the former.

          “Russian interference” is the hydroxychloroquine of American politics right now – no, it’s worse than that, because it’s a known hoax, so call it the vaccine autism of American politics.

          1. Shazbot says:

            ‘The specific allegations (which, of course, are not named, and hence, aren’t specific) about Russia are without merit’ <– Deny Everything

            'If you believe them, it must be because you're a credulous moron' <– Blame the Victim

            'Hydroxychloroquine' 'Vaccine Autism' <– Change the Subject.

            It would be much easier to ask a question, such as "Why do you believe these allegations", or "What do you think actually occurred between the Trump campaign and Russia?"

            Then you get a meaningful discussion or you get to dunk on me based on what I actually think.

        2. DemocraciesWhoopieCushion says:

          The AnCap flag is also a dead giveaway this is either:

          1. an obvious troll
          2. an edgy 12 year old
          3. a total nutjob
          4. all of the above

          1. Skeptical says:

            Thanks for the AnCap reference. I’d not realized it was a big enough movement to merit a flag. It’s a pity that times are such that the knowledge is useful.

        3. chemist says:

          Hey Shazbot, briefly and in your own words describe how Russia changed the outcome of the election from a Hillary win to a Trump win. Thanks in advance, champ.

      2. Jon Strayer says:

        Troll much?

      3. Andy Stein says:

        Any thoughts on whether a combination of vectors in a vaccine could be sort of like a combination of drugs for treating HIV or cancer? Even if you don’t see synergy, maybe 2 vectors gives the immune system two chances to respond and that’s good? Even though it also gives you two chances for toxicity. I just never heard of this before, so figured I’d ask.

    2. Maria says:

      Par for the course for the mafia state.

  2. Tony Scharf says:

    Russia creating “confusion and discord”. That seems to be on-brand for them. It’s just what they do.

    1. Boniface says:

      Exactly! Putin knows it will stoke conspiracy theories, especially in the US, with people asking why it’s not being offered and Trump will no doubt comply and claim it’s being blocked by Democrats.

      1. David G Whiteis says:

        Even worse than that — Putin will claim success, offer a “deal” to make millions of doses avaialable to the U.S., and Trump will blame the Democrats (who will, rightly, be apalled at the very idea) for letting politics get in the way of saving human lives. He’ll stir up the schitt so badly that he’ll win re-election; the vaccine will be distributed here and prove to be disastrous; the resulting explosion in anti-science and anti-vax sentiment will render any legitimate vaccines or therapeutics that have been developed in the meantime entirely moot; there never will be any such thing as a “post-COVID” future. Our future will look exactly the same as it is today, only infinitely worse.

        1. confused says:

          >>Our future will look exactly the same as it is today, only infinitely worse.

          Nah. Even if vaccines fail, COVID will naturally wane from pandemic levels (because enough people will have been affected) and once it’s not “new and unknown” people will accept the risk as part of “normal life”.

          Infectious diseases deadlier than COVID (e.g. smallpox, yellow fever) used to be endemic in the US, and still are in some parts of the world (e.g. Plasmodium falciparum malaria).

          Obviously that wouldn’t be the desired outcome, but “normal life” will return one way or another. It’s just human nature.

          Also… the Russian vaccine *could* work.

          1. David G. Whiteis says:

            If you’re holding out for herd immunity, I’m afraid that’s a long way (and millions of deaths) away. Even with a vaccine, given the level of ant-vax sentiment in countries like the U.S. and Great Britain, it seems highly unlikely — and for ever notch the anti-vax sentiment is ratcheted up, that unlikeliness ratchets up, as well.

          2. confused says:

            I don’t know if herd immunity is the right term… I think that would generally imply the disease going away.

            I’m talking about the disease declining from “pandemic/epidemic” to “endemic” levels… as past flu pandemics have done, including those which happened before there was a flu vaccine (and probably the late 19th century “Russian flu”).

            And yes, there would be more deaths, which is why I said “that wouldn’t be the desired outcome”.

            But I don’t see any plausible scenario where COVID is significantly impacting human behavior in, say, 2023. People adapt. (I think in my state most people will “go back to normal” by spring 2021 no matter what.)

            And there aren’t *that* many anti-vax people in the US. Enough to allow for outbreaks of formerly but that’s because they cluster. In this case uptake rate shouldn’t need to be that high since (unfortunately) so much of the US population will already have been infected…

          3. David G Whiteis says:

            ” . . .I think in my state most people will ‘go back to normal’ by spring 2021 no matter what.”

            Maybe in your state, but in many states they won’t be allowed to. A lot of states and municipalities will probably end up closing bars or any other establishments that serve liquor without food; masking and “distancing” reuquirements in stores and other places of business will continue to be enforced; states like New York, Connecticut, and New Jersey will continue to ban travel to high-risk states, as will cities like Chicago (which has even included neighboring states like Wisconsin and Missouri on its “banned” list). And, perhaps even more to the point, many social events (gatherings, annual meetings and conventions), musical performances, athletic events, etc. will simply be cancelled.

            I see very little “normal” there, and the way things are going, I see little “normal” for most of us in the forseeable future. Unless COVID magically “goes away” as Trump seems to believe it will, we will end up enduring more, not fewer, restrictions of this nature as we move into the winter and the early part of next year.

          4. confused says:

            >>Maybe in your state, but in many states they won’t be allowed to.

            Sure… for a while. But much if not most of the US is probably on the way to enough immunity to suppress spread a lot (not that that’s a good thing), though likely not full-on herd immunity.

            After some states have gone back to normal, and it’s been 4-6 months without real trouble, it will be hard for other states to justify *not* doing the same. Long term, people and businesses would move.

            >> we will end up enduring more, not fewer, restrictions of this nature as we move into the winter and the early part of next year.

            I was talking about a bit longer term, say summer 2021 and on.

          5. David G Whiteis says:

            “. . .After some states have gone back to normal, and it’s been 4-6 months without real trouble, it will be hard for other states to justify *not* doing the same. . . .”

            With all respect, my friend, I think you’re utterly ignoring the contagiousness / virulence of COVID. We’ve already seen what happens when the numbers start going down, things start to look as if the “real trouble” is past, and states or municipalities decide that they’ve “gone back to normal” and so open things up with relatively few restrictions. That “normal” lasts for about a week. Remember — this thing spreads exponentially. Without effective testing and contact tracing (which New Zealand, for instance, has had since the beginning, and which has allowed them to do pretty much what you’re suggesting here), there’s no such thing as “ONE” case of COVID. Those “low” numbers stay “low” until they aren’t — which is usually just a few days later. (One example I’m familiar with, because I have good friends there — Jackson, TN was hovering between 0 and three or four cases a day for a while; things got a little lax, and now they’re spiking, and they have been for weeks.)

          6. confused says:

            Yeah, it can go back and forth for a bit, with restrictions being relaxed, spread increasing, then more restrictions.

            But that can’t last.

            >>Remember — this thing spreads exponentially.

            Nothing can grow exponentially forever. If you simply extrapolate exponential growth forward, soon you end up with more than 100% of the population being infected, and it’s not *that* long after that you end up with more than 100% *simultaneously* infected.

            Which is obviously impossible.

            IE – at some point it will stabilize.

          7. confused says:

            Re: 5 million cases – the real number of COVID infections so far in the US is probably 5-10 times that, depending on what you think the IFR is/how much you think it’s dropped since March/April in NYC.

            CDC claims a best-estimate IFR of 0.65%, which implies over 25 million infections from the ~165,000 deaths so far.

            When you add in that there are probably some uncounted COVID deaths, plus all the infections that haven’t yet resolved, IMO it’s hard to see the US being less than 10% infected.

          8. David G Whiteis says:

            . . . So how many people have to die, and how many others have to suffer long-lasting consequences (which are only beginning to be understood but are looking more dire every day) before this statistical miracle actually occurs?

          9. confused says:

            No one knows. Depends on what the immunity threshold actually is.

            But it’s not a “statistical miracle”. It’s just how epidemics work if something else doesn’t stop them first. (Otherwise humanity wouldn’t have survived long enough to invent vaccines!)

            I’m not saying that this would be a good thing — obviously I hope that the vaccines will work well, and soon.

            But my point is that *either way* the pandemic doesn’t drag on for five years or anything like that. It *will* end relatively soon.

          10. David G Whiteis says:

            “. . ., IMO it’s hard to see the US being less than 10% infected.”

            Great. Only 232 million to go before we reach herd immunity. There’s a comforting thought.

          11. To give some perspective to people from the US, every european country that was ‘hard-hit’ back in march-april-may have seen the number of deaths and hospitalizations decline steadily even since restrictions were lifted. They have been totally negligible since two to three months (we’re talking less than 10 deaths a day in countries of more than 50 millions inhabitants where everyone and their mother is getting tested).
            The herd immunity threshold of 65-80% is purely theoretical (hypothesis of no pre-existing immunity and homogenous population) and literally every european country’s situation is screaming that either the epidemy wanes with a much lower population percentage infected than commonly accepted, or that we vastly overstimated the IFR.
            For those who’d like to think that it’s because “european are disciplined”, a lot of people I observe (in a major european city) don’t even follow basic hygiene recommendation and social contacts are close to normal.
            The situation is heavily politicized in the US (from my perspective) which seem to prevent otherwise intelligent and rational beings to acknowledge facts; but from the evidence seen in Europe the most likely outcome is that the US will soon be reaching a plateau (they already have in some states, the recent peak is mostly sunbelt states seeing the true first-wave of the epidemic), and lifting restrictions afterwards won’t trigger a major change overall.
            By the way it’s always funny to see how many knowledgeable and smart (this is not ironic) persons on this blog were quick to criticize hydroxychloroquine treatment (rightfully so) as a case of “no clear benefits known, known risks” but didn’t reacted when we implemented an unproven strategy (with a somewhat plausible mechanistic benefit,) with major risks for almost every aspect of our lives after seeing a totalitarian dictatorship praise it.

          12. David G Whiteis says:

            Perhaps the problem, at least in the U.S., is defining “plateau.” In quite a few areas here, the numbers seemed to be leveling off; the response was to re-open rapidly and, in some places at least, minimize “distancing” requirements (e.g, in bars and public areas where large numbers of people aggregate). Unfortunately, the apparent “flattening” of the curve seems to have been illusory, thus the subsequent spikes. We’re already seeing signifant outbreaks among students who have returned to school, as well. So the question is — how do we distinguish between a temporary “flattening” and a true “plateau”? (Even New Zealand, which reported no new cases in over 100 days, has returned to a partial lockdown after only four cases showed up, all in one family. The fear of re-igniting the contagion firestorm is very real, and should probably be taken seriously.)

          13. David G Whiteis says:

            Also, and with all respect — I’m wondering where you’re getting your data from. With the arguable excption of Italy, I don’t see many European countries out of danger at all. In fact, they seem to be facing resurgances following false “plateaus” not unlike those we’re seeing in the U.S.

            https://www.usnews.com/news/world-report/articles/2020-08-10/greece-records-highest-new-daily-coronavirus-cases

            https://www.france24.com/en/20200811-french-pm-warns-covid-19-infection-rate-headed-in-wrong-direction-public-becoming-careless

            https://www.ft.com/content/d5fb0b2a-6d1d-4ccb-a349-30fccc2602d5

            https://news.yahoo.com/concerns-grow-over-rising-covid-132235459.html

          14. CommentsFromEurope says:

            You can say that you’ve hit a plateau when despite having fewer and fewer restrictions over time, the key metrics (death rates and hospitalizations) continue to decline. This is happening everywhere in Europe since two or three months. Cases have been slowly growing as testing increased (with postivity rate around 1.5%, at least in my country), but the least biased metrics (number of cases depends on testing policy, but people getting so sick that they go in the ICU is not) continue to decline and have reached an insignificant level. I think that’s it is very clear that most european countries have therefore reached a plateau, and most probably the US will as well. In places where the epidemic hasn’t really took off (such as New Zealand), of course you will get cases as you open up.

          15. WST says:

            re:
            “and literally every european country’s situation is screaming that either the epidemy wanes with a much lower population percentage infected than commonly accepted, or that we vastly overstimated the IFR.”
            We humans understand things by creating their models in our heads.
            Maybe the real issue is that we are taking a simple epidemiological SIR type model for reality, without actually checking if it is a good description? In a SIR type model, virus disappears if (1) there is a high level of immune , (2) the immune and susceptible are randomly mixed up.
            This is the only mechanism of virus elimination in the model,
            None of these conditions are met in the current Wester European countries. So, maybe the decline in recent week can be explain by something else ? The model uses also two fixed parameters, probability to meet an infected person and IFR.
            IMHO what was happening is that more testing, self-isolation and better isolation of the elderly, has decreased the probability to meet an infected person. And thus limited the spread of the infection.
            Another error in the model is that population is homogeneous, it’s not, IFR by age group spans two orders of magnitude, some should be the case of the susceptibility to get infected. It’s almost as if there was a different disease per age group, with its one parameters (supported also by serological tests that show age stratification).
            Its clearly visible in Swedish statistics of incidence per age group, in March-April, the big peak was in 80+ with associated peak in mortality, then there was a new peak of 20-40, with much lower mortality, that came down when testing was increased 50%.

            The SIR type model really does not give any useful insights other then “epidemic slows when more people get immune”. The illusory herd immunity never happened in during any epidemics and does not explain anything we see.

          16. J N says:

            In regard to David G Whiteis and his observation about how contagious COVID-19 is, look at how presumably one case has spread in New Zealand’s benign environment in just a few days. This disease naturally explodes into a population. We are used to it doubling every 2-3 weeks because even in our laggard states, there are constructive behavioral changes. Unchecked, it reproduces much faster than that.

            When you think it’s gone and go back to life a la 2019, the impact just one case can have in two weeks is stunning even without the benefit of a 1:20-100 super spreader event.

            Let’s just, hopefully, be patient and find a new, tolerable normal, and get the medicine done. I think in a few months we will get to the point where the lethality is dramatically reduced (monoclonal prophylaxis for high risk/high exposure?) and soon after that we will be in a world where one or more vaccine options are a reality.

            I’m not convinced at all that a vaccine will end COVID-19 any more than flu shots end influenza, but hopefully by 2022 COVID-19 will be a major aggravation and nothing more.

            I do hope we don’t have 25 million people with “chronic COVID” by then. Please, y’all, don’t let the fatalism drag you down into being a medical experiment.

          17. David G Whiteis says:

            Prediction: In October, a vaccine that looks promising but hasn’t been thoroughly vetted is nonetheless approved by the FDA for “emergency use” under political pressure from the White House. The international medical community reacts with alarm; in the U.S., the Democrats sue to delay release of the vaccine until further research is completed. The controversy derails the Trump campaign, and he loses; meanwhile, the vaccine remains in “limbo” as the research process continues. Sometime later, a more thoroughly tested vaccine emerges and is approved. Trump, still acting like a “shadow President’ via his Twitter account, paints this new vaccine as a nefarious Democratic plot to make the Biden/Harris administration look good; as a result, his millions of followers refuse to take it. Result: COVID never goes away; the U.S. is plunged into an economic, political, civic, and public health catastrophe that will continue to define the rest of the 21st Century.

          18. confused says:

            Nah, far too pessimistic. By October the data may very well be good enough that “the international medical community” will be on the side of approval if the vaccines work (and I think at least some will). At this pace, 2 months is a long time.

            And there’s just no way this will drag on that long (define the 21st century).

            Most likely, experiences in different countries will make it clear that the vaccines work by spring 2021; pessimistically (if they don’t work or uptake is really poor), a combination of population immunity and familiarity* will still return life to basically normal in a year or two. (I mean there will probably be more telecommuting etc., but that’s because that already made economic sense, not because fear of COVID will remain high).

            Even pessimistically, a certain death rate from COVID will just become part of the background, just as we accept several tens of thousands of flu/pneumonia deaths each flu season … yet flu vaccine uptake rates are pretty terrible. So people in practice don’t worry about it much and it doesn’t affect their behavior.

          19. Michael says:

            Good points as always, Confused.

            To your telecommuting caveat to “back to normal,” I might add strong social pressure to stay home when sick, or for symptomatic sick individuals (regardless of illness, other than allergies) to wear a mask in an indoor public place if they have to go out. And I might also add a very strong impetus to improve ventilation in offices, stores, apartment buildings, etc.

            But social contact will absolutely return. Everybody on the planet wants to socialize again. Governments and countless private industries want and need to facilitate socialization again. Every one of the many, many scientific undertakings underway (with the most funding and best tech in human history) are designed to ultimately safely restore free social contact.

            AeroNabs are just one of many promising technologies in the hopper. We will only get smarter about how to treat and prevent this.

          20. confused says:

            >> I might add strong social pressure to stay home when sick,

            It sure would be nice if going to work, church, etc. while sick with e.g. the flu started to be seen as “irresponsible” rather than “a sign of commitment”.

        2. David G Whiteis says:

          (Aagain, I hope this doesn’t end up being a multiple post) —

          With all respect, I’m wondering whether your interpretation of the data might not be too rosy. France, Germany, the Netherlands, and Greece, are all reporting new spikes after what now look increasingly like temporary faux-“plateaus,” not unlike some of those thatn have been seen in the U.S. In some cases (e.g., Germany), the rate of increase is the highest it’s been in months. Since reported death rates tend to lag behind the incidence of new cases, isn’t this cause for serious concern?

          1. ResearchTracker says:

            Europe is definitely seeing additional spikes. Right now, new cases are increasing and with time lag we will see other indicators such as increased severity, hospitalization and deaths. Look at WHO reports and numerous press reports recently. Spain recently reported 14,000 news cases in a week, France 6,325 and Germany about 4,000. Look at this FT report from July end
            https://www.ft.com/content/bcddc297-b7f2-444d-908f-54e8ce6f4f98

          2. confused says:

            This is basically why I’m actually not that bothered by the poor response in the US.

            I tend to think that it will end up endemic basically everywhere eventually (a vaccine isn’t likely to actually *eradicate* it, so even places like New Zealand most likely; they probably can’t/won’t cut themselves off from the rest of the world forever).

            So the relative harm of a poor response will be marginal (more infections earlier, before better treatments are invented) rather than dramatic.

            If you expect it to go endemic like pandemic flu viruses have post-pandemic, then there’s IMO little to no reason not to want to go back to normal life as soon as a vaccine or a really good treatment* arrives.

            So that’s where I’m coming from in this comment thread re: return to normal.

            *IE – something that can prevent progression to ICU, and probably something outpatient; not dexamethasone which really only helps in severe cases; even remdesivir is intravenous, not something you can get at a pharmacy…

          3. WST says:

            I see it differently, the infection develops in “ecosystems”. One ecosystem was closed , March-April, most sick were elderly, a new ecosystem was created. This time its around 20-40 years old, on holidays and getting together in bars, restaurants, nightclubs or private parties. The middle age of new peak is lower so is mortality.

            This will soon end and will be replaced by new ecosystems, schools-parents, workplaces, universities (like in Israel’s case).

          4. CommentsFromEurope says:

            The media coverage of the situation is extremely biased. There is a steady augmentation of cases, for sure, in a lot of different european countries. The test capacity has also dramatically increased over time – so the evolution of number of cases as a function of time is not proportional to the evolution of the virus within the population.
            Look at the official data from France (at https://www.gouvernement.fr/info-coronavirus/carte-et-donnees): cases are going up for at least two months, ICU patients (“En réanimation”) is still going down, as well as deaths.
            To the extent that the data from worldometer is reliable, we can do the same for Spain (https://www.worldometers.info/coronavirus/country/spain/): cases go up from the 10 of July (more than a month ago), yet no matching increase in deaths is seen.
            And for Sweden (https://www.worldometers.info/coronavirus/country/sweden/): cases have not stopped increasing, deaths have not stopped decreasing.
            Same for UK (https://www.worldometers.info/coronavirus/country/UK/): new cases keep being found, deaths steadily decline.
            There’s a lag between cases and deaths, yes. But a lag of approx. two weeks, not two months.
            For Germany and Greece, those countries weren’t hit by the virus as the aforementioned ones. Perhaps they will see an increase in hospitalizations and deaths as they open up, the experience from Spain/Italy/France/UK/Sweden doesn’t directly translates to them.
            My point was that all the european countries that were severely hit have since seen their deaths and hospitalizations go down even with looser restrictions, and despite the 24/7 media covering of “surges” in cases. The US seems to have been hit with the same intensity, the most probable scenario is that they will follow the same pattern, hit a plateau soon and stay there even as they reopen.
            Most european medias are not trustworthy in their coverage of the pandemic (at least from my perspective), so I would advice to look directly at the data. To give you an example, the number of ICU patients in France went from 381 on the 30/07 to 379 the 12/08 (today) (source https://www.gouvernement.fr/info-coronavirus/carte-et-donnees)
            Yet the most read newspaper in France managed to make two headlines about “ICU admissions going up” between the 30/07 and today (see https://www.lefigaro.fr/sciences/coronavirus-le-nombre-de-patients-en-reanimation-augmente-pour-la-premiere-fois-depuis-le-8-avril-20200730 and https://www.lefigaro.fr/sciences/coronavirus-plus-de-1000-nouveaux-cas-en-24h-la-remontee-des-reanimations-se-poursuit-20200804).
            So the most read newspaper of the country makes headlines about “ICU admissions keep going up” when in fact they have (albeit by an completely negligible number) decreased. What they do is that they publish those kind of articles only when the number rose from the day before. But that’s just statistical noise, not a trend. Yet most people still think that ICU admissions are going up when they are, in fact, still going down or stagnating. Point is: look at the data, don’t trust european newspaper on the covid. It’s like me giving you a headline from CNN or FoxNews about the current situation in the US and expecting it to be 100% objective and reliable.

          5. confused says:

            @WST

            So what would that mean? Schools I guess would have a very low median age, though I don’t know if it makes sense to average between the very different groups of students and teachers/parents.

            Universities… would also be really low, especially since a lot of times the TAs actually teach the classes (especially the more hands-on/closer contact things like labs) rather than the (generally older) professors.

            Not sure about workplaces, that would exclude both the youngest and oldest members of the population… Worse than bars, but maybe better than the overall population since the deaths are so predominantly among those above the usual retirement age?

            So are you expecting the third “ecosystem” to be milder (lower median age/lower infection fatality rate) or worse (higher median age/higher infection fatality rate) than the bars and such leading to the June-early July infections peak and July-current deaths peak?

          6. J N says:

            @wst: uh yeah … No. The virus is incredibly contagious. There is no scenario where we go back to a 2019 normal in the US soon and don’t see 500,000-2,500,000 deaths by mid-late 2021.

            Please note that the *IFR* in San Quentin prison is >1%.

            When the young cohort gets sick, the disease migrates to the older population. This is clearly visible in analysis of the past 6 weeks of Florida’s data. (This is hard to come by … oddly …)

            MIS-C is an OTOO 1:1000 per positive test complication of pediatric COVID. This will be in the news any old day now in South Carolina/Georgia/Florida.

            There is no going back to “living my life” because that life is just as gone as the life on September 10, 2001, and December 6, 1941.

          7. David G Whiteis says:

            “There is no going back to ‘living my life’ because that life is just as gone as the life on September 10, 2001, and December 6, 1941.”

            Perhaps, but if this is the case, be prepared for a mental/emotional health crisis that will make COVID look like child’s play. The examples you give, as traumatizing as they were, did not threaten the basic emotional and (for want of a better term) spiritual needs of human beings, AS A SPECIES.

            Human beings are social animals; it’s part of our makeup. And yes, touch and physical contact are part of that, too. We are bred for “social gathering,” not “social distancing.” Especially in times of disaster or crisis, whether “natural” or human-made, our immediate response is to gather closely together. People work side-by-side to rebuild homes, towns, and cities; people comfort one another with hugs and physical contact; people worship together (usually sitting reassuringly close to one another while doing so); when possible, people even continue to celebrate life together, often in pretty crowded settings. Strangers on the street smile at one another or otherwise show their caring and support through their facial expressions as they pass by. And, of course, working side-by-side is also the best way to solve problems. In other words, for the most part, people can maintain their mental health and emotional equilibrium through the same behaviors that will help them physically survive the crisis and rebuild afterwards.

            Now, though, that has been upended. the “solution” to the problem — [anti-]social distancing, covering our faces with masks, avoiding public gatherings — is the exact inverse of what we need most desperately: close human contact. The worse the situation gets, the more we’re compelled to do the very opposite of what’s necessary to help us survive it with our minds and souls intact. The very things that reflect the “better angel of our nature” — hugging one another, raising our voices together in praise, gathering in fellowship — have become cast as vectors of death and pestilence.

            Not all toxins are physical. Isolation and loneliness have already become a mental health crisis, and the longer this goes on, the worse it will get. People can stay “distanced” from each other, not hug or touch each other, and not be able to see each other’s faces (i.e., “emotional distancing,” just as real, and just as alienating, as “social” distancing), for just so long. This disconnect between two necessities — what it takes to stay alive, and what it takes to sustain a life worth living — is a tragic, possibly deadly, paradox for which there may be no resolution. It’s tantamount to telling a sick person: “You’ll need to take this drug to stay alive, but the side effects will be so severe that you’ll probably wish you weren’t.”

            If that’s our future, I don’t think I want to be in it.

          8. confused says:

            >> There is no scenario where we go back to a 2019 normal in the US soon and don’t see 500,000-2,500,000 deaths by mid-late 2021.

            Well, what do you mean by soon? We could have vaccines widely distributed relatively soon.

            And the upper end of that range is absolutely not happening regardless of what we do. I can see 500,000 pessimistically, if absolutely everything went wrong, though I rather doubt it. But not much higher.

            Sure IFR was a bit over 1% in some places at some points; NYC, by serology, in March-April was maybe 1.1%. But *current and going forward* US IFR is not that high. CDC says 0.65%… even that seems high for the current spike in the South/Southwest.

        3. Micha Elyi says:

          Speculative fiction isn’t science. Sell such stories in Hollywood, not here.

  3. enl says:

    Lets be honest: if it was HCN, I can guarantee essentially 100% prevention of COVID-19 with proper dosing. Of course, there may be some side effects, but we’ll work that out after approval.

  4. A Nonny Mouse says:

    How do they manage to state that it offers 2 year protection when the virus has only been general circulation for 6-7 months?

    1. Mm says:

      Obviously there is zero evidence for that claim. But it’s interesting how people don’t immediately see through this kind of bs. No wonder propaganda etc works.

      1. DrOcto says:

        Unless Russia has had copies of COVID-19 in their labs for over two years……

        1. confused says:

          Don’t genetic/phylogenetic studies of COVID-19 pretty much rule that (or any other scenario like that) out?

    2. Marko says:

      Is there a source for that 2 year protection claim ? Who is “they” ?

      I’d like to see the statement in context. This sounds like one of those rumors that take off and everyone accepts blindly , only to find out later that it was a nothingburger.

      1. Mm says:

        It doesn’t matter what source. Once again, anyone who made it through middle school will understand that there is no way to know. The interesting thing is how people don’t immediately see through it, as evidenced by a second poster apparently at least being willing to spend time looking for “sources” and finding out who “they” are. It’s fascinating but Putin’s brilliant stunt is working. Wait till Donald starts begging for a shot, maybe even on Prime TV.

        1. Marko says:

          ” It doesn’t matter what source. ”

          It matters if it’s just anti-Russia bullshit , and there is no source , and no such stated claim.

          Unlike you , I don’t just slurp up the propaganda swill. I look at evidence and sources.

      2. Me says:

        I read somewhere that the 2 year claim is class-based from experience with other vaccines in that class.

    3. daksya says:

      Likely via extrapolation of antibody kinetics, like this paper below for antibodies formed after natural infection.

      Neutralizing and binding antibody kinetics of COVID-19 patients during hospital and convalescent phases
      https://www.medrxiv.org/content/10.1101/2020.07.18.20156810v1

  5. Sebastine says:

    It’s cool

  6. Uncle Al says:

    Administer IV ascorbate as Wuhan virus treatment. We know it is safe and 100% effective for scurvy. It doesn’t cause major organ failure like remdesivir, nor it is expensive or in short supply. Even if it is inert, it is still way better than political machination dosing.

    Say it softly…”superoxide to the rescue!”

    1. SilverlakeBodhisattva says:

      It an’t “inert”,and there’s zero evidence that it would do anything. I was almost named “Linus”, after Pauling (my father was a chemist) but neither I nor my father thought the “megadose C” thing was real science, and fifty years later, it still isn’t….

      1. Uncle Al says:

        … 1) NOBODY will make a Federally-backed pile of moolah off ascorbate. No motivation.
        … 2) Wuhan virus non-silent infections favor old, infirm, multi-pathology, poor, and minority. These folks have compromised diets.
        … 3) Frenzied counters to Wuhan virus carefully ignore white blood cell response to proximate infection: burning ascorbate with oxygen to superoxide that is the actual attack.
        … 4) Soft tissue breakdown is a scurvy sign.

        Adding ascorbate to the IV drip ASAP is a low-risk inexpensive query. Oral doses are poorly absorbed. If a gram/day proves inert to early disease progression, no biggie. If it works, trivially ban it to maintain turgid hospital revenues – unknown hazards.

  7. Dmitry says:

    It’s not a mixture, there are two doses: at first they use so-called Component I, that consists 26Ad pseudo particles, and then after 3 weeks, Component II, with 5Ad. I think this approval is a shame. I can’t begin to tell you how embarrassed I was taking part in this registration process.

    1. VM says:

      Do you think they will still do proper phase 3 trials and publish the results? And should we trust what they publish? At some point, I will have to decide whether to recommend my parents take this vaccine…

  8. steve says:

    Note that Putin didn’t take it himself – he had his daughter act as guinea pig. I’ve had to deal with Russian clinical trials and approval processes. Like everything else there they are poorly run and dependent on who you know. If they’re lucky this won’t blow up in their faces with adverse effects but that will only be luck.

    1. Mm says:

      Note that we don’t actually know at all whether Putin’s daughter actually took it. The way the international press unquestioningly parrots this claim further shows how dangerous this overheated situation is. Things are simply believed, no one evaluates anything critically any more.

      1. steve says:

        The point remains that he said his daughter took it but pointedly didn’t say he took it himself. That still tells you a lot about the man.

        1. WST says:

          The rumour is that several oligarchs vaccinated themselves, knowing this state, there must a black market already, there is money to be made with a BCG vaccine…

  9. steve says:

    BTW, the double vector approach isn’t a bad one. Almost everyone has antibodies to adeno as it’s one of the major causes of “colds”. Therefore, the first injection might very well cause a spike in anti-adeno for whatever strain you use and having a booster with an unrelated strain may focus the response on the antigens you want. Russian scientists are no dummies, it’s the regulatory framework that’s not up to standards.

  10. Ken says:

    Next you’ll be saying that Russia doesn’t have working nuclear-powered cruise missiles with an unlimited range, as they announced in 2018.

    1. Bob Weiss says:

      Like the one the US was developing in the 1960s?

      https://en.wikipedia.org/wiki/Supersonic_Low_Altitude_Missile

  11. Steve Scott says:

    “Government officials have said it will be administered to medical personnel, and then to teachers, on a voluntary basis at the end of this month or in early September. Mass roll-out in Russia is expected to start in October.”

    So, they have time to get at least some results from Phase III testing before “mass roll-out” in October. In the meantime, the groups named above can take it at their own risk. And they may be just as skeptical as we are. Another consideration- how many doses are they going to be able to turn out, and how quickly?

    1. Lane Simonian says:

      Not to get too conspiratorial, but maybe Putin intends to deliver some doses to the United States before the November election. Wouldn’t that be some kind of October surprise?

        1. Marko says:

          The CNN article is spreading fake news , per the usual :

          “Russia’s coronavirus vaccine will be gradually rolled out to high-risk people before a mass vaccination of Russians begins in October.”

          This one is in Big Lie territory. Russia will do a very limited rollout in October ( similar to what may very well happen in the US under an EUA ) then the mass vaccination will begin ~Jan 1 , AFTER Phase 3 is complete.

    2. Steve Scott says:

      And here is some more: “the Russian business conglomerate Sistema has said it expects to put it into mass production by the end of the year.”
      That is what we are hearing from several of the U.S. vaccines.”Mass production in October” may be a stretch. So what is the big difference here, apart from an attempt at a shameful propaganda victory?
      Some people in Russia are being allowed to volunteer for the vaccine now. We don’t know how many. Risky? Well, what about the tens of thousands of volunteers who will be taking part in Phase III trials? Aren’t they taking a risk as well? Before Russia actually gears up for widespread distribution, preliminary phase III results could be in for their vaccine, as well as several of the U.S. sponsored vaccines.

      1. Steve Scott says:

        Update: from the Russia vaccine web site “Sputnik V” which says 2,000 people will be involved in the phase 3 trial, far less than the 30,000 you would expect. No mention of any further participants.
        That certainly reduces the level of confidence.
        ________________________________________________________________________

        “Phase 3 clinical trial involving more than 2,000 people in Russia, a number of Middle Eastern (UAE and Saudi Arabia), and Latin American countries (Brazil and Mexico) will start on August 12.

        https://sputnikvaccine.com/about-vaccine/clinical-trials/

  12. Jeffrey Imm says:

    Can Science Mag stick to “science”? As to “desperate,” with nearly 740,000 dead, the world should be “desperate.” If we are not “desperate,” we are still not taking COVID-19 seriously. The “summer respite” (with mass global deaths) is the eye of the storm and the fall and winter are around the corner.

    1. Some idiot says:

      What part of “have these vaccines been tested properly?” isn’t science?

    2. DrivingBy says:

      omg, 1 of every 10,000 people have died! And they were mostly over 70!
      Yes, it’s totally the biggest disaster ever, and if you don’t panic you’re killing Grandma.

      1. Derek Lowe says:

        And counting, my man. And counting. You might want to add in some morbidity figures as well.

      2. David G Whiteis says:

        ” . . .And they were mostly over 70!”
        Well, that makes them expendible, I guess . . .
        . . . but either way, is this still the case? If so, how long will it be? We’re seeing the incidence of new cases skewing younger and younger, and death rates in the younger agre groups are moving up, as well. We’re also learning more about the long-term effects of COVID — a young person who “recovers” today may well have some pretty serious lingering health conditions for a long time, if not for life.

        1. confused says:

          Well, the median age of COVID deaths will have to be lower in say TX or Latin America than in the Northeast or Western Europe, because the population as a whole is younger (Italy median age 45, US overall is ~38, TX is like 34 or 35, Brazil 33, Mexico 28).

          But that doesn’t mean that the relative risk by age has changed, just that there are more younger people in the populations now being hit.

          Yeah long term effects are a concern – personally they’re my primary worry. The death rates for people my age (I’m 30) aren’t really that scary.

          I don’t know why there isn’t better data on post-recovery effects. NY has hundreds of thousands of known-positive recovered people (and millions total), you’d think they could do some studies on lingering symptoms.

          Though there might be subjectivity/reporting issues. Some of the symptoms I’ve seen mentioned (headache, fatigue, etc.) have many possible causes and can even be psychosomatic. If I’d had COVID this spring and knew I had it, maybe I’d be attributing my current symptoms to that rather than to allergies.

  13. Duncan says:

    I agree with all of this, but…

    This term ‘vaccine nationalism’ seems to have entered the parlance and I don’t really think it has been talked about other than as an internet abstraction. Indeed, take this to its conclusion. The Russian vaccine comes to be regarded as a failure then that’s a failure of a national approach to vaccines. But I assume that we do not actively want failure? If it’s a success then, well what more do we want? If it’s mediocre then it’ll be replaced hopefully by a better product. In any case the Russian people can make a value judgement on their government.

    Indeed it is worth adding here that the Chinese have given military approval for a vaccine too.

    I’ve always taken the term ‘vaccine nationalism’ as indicating a wish (right in my view) that vaccines must be available globally in relatively short order to those most in need. But simply grumbling about ‘vaccine nationalism’ is not in itself a course of action. Are we saying that all vaccines should be internationalised? I don’t think anyone has said it but that’s the undertone. Indeed I am not from the US and I would find it hard to argue against the proposition that the US taxpayers that funded the OWS vaccines should have first access. That’s not vaccine nationalism, that’s vaccine development in action.

    It’s difficult. And, to be clear I hope that all taxpayer investments in vaccines for covid and other illnesses all come good and that those vaccines are widely and cheaply available around the world. But if we are going to reduce this to the internet-friendly soundbite ‘vaccine nationalism’ then I think we need a bit more of a think about the implications of what we are saying than we have had so far. I’m yet to be convinced that vaccine nationalism is necessarily A Bad Thing or that there is an inherently better alternative.

    1. Michael says:

      I agree entirely with Duncan. I have been frequently thinking along the same lines lately. I also do not live in the United States and agree that “vaccine nationalism,” as the concept has been described, is not an especially compelling reason for the US not to have first access to vaccines funded by their taxpayers.

      It would be different if there was an objective, inarguable way to arrange billions of people around the world by order of priority and supply vaccines in that order. But that’s obviously impossible. I think we have to appeal to the better angels of the nature of the wealthy countries to procure vaccines for their public first, yes, but to also contribute significantly to manufacturing and distributing vaccines for developing countries.

      I agree with Derek that the kind of “vaccine nationalism” that prompts Russia to prematurely approve a vaccine is awful. Another kind of troubling “vaccine nationalism” would be to stockpile many more doses than a country needs without re-selling or sharing the surplus, so that privileged individuals can pursue “belt and suspenders” immunity through discretionary use of multiple vaccines when the scarce doses are so urgently needed everywhere.

      But Duncan’s right. Calling basic procurement of vaccines once proven safe and effective — a fundamental duty of any national government — objectionable “vaccine nationalism” is simplistic and wrong-minded.

      1. Duncan says:

        Michael – Indeed. The stockpiling is the bit that worries me most, that is I think where the problem will flare. But for right here and right now who else is going to fund and get something like this moving? The taxpayers have a reasonable expectation of access to research. I don’t see that as some scary ‘vaccine nationalism.’ Or at the very least I don’t see anything less scary.

        It is always easy on the internet to assume the worst in people. I think that most out there are adult enough to understand that vaccines have to be global and that means rapidly sharing tech and supply. Similarly I think that most people are adult enough to understand that national regulators are going to have to make decisions based on trials in an unprecedented situation. I hope everyone makes the right call and I think most people are adult enough to understand that they are going to have to trust the system to a degree, internet bun-fights notwithstanding.

        Can I understand why it is that other national regulators are not going to follow in the Russian regulator’s footsteps on this one – absolutely. I think most people can hold more than one thought in their heads. If the Russian one proves to be a success then good luck to them, but I think I’ll be sitting this one out for now.

    2. Jeffrey Imm says:

      Duncan writes: “But I assume that we do not actively want failure?”
      And let us all reflect… THAT is the headline, yes?
      Certainly we WANT success – let’s not all forget that, in our passion on other topics.
      Let’s not deceive ourselves that the 20,000,000 documented to date with COVID-19 Coronavirus are truly the tip of the Coronavirus Pandemic iceberg.

      1. confused says:

        I am not sure what you mean about them not being the tip of the iceberg.

        Certainly 20 million *reported* cases is a severe underestimate of *total infections* worldwide.

        On the other hand, the number of undetected cases being large may not entirely be a bad thing, if it means that the IFR is lower than we think and the population of some countries is closer to herd immunity than we think.

        This depends largely on what the long-term effects are. If the long-term effects of COVID are no more than 5-10x worse than seasonal flu (as the IFR is likely in that range … or a bit higher depending on what you think the IFR for seasonal flu actually is, it’s not that well constrained) then COVID hitting natural herd immunity may not be any worse than a flu pandemic of comparable severity doing so.

        But if the long-term effects are worse, it would be more of an issue.

  14. Chris Phoenix says:

    They probably used machine learning to analyze the datasets on human safety and efficacy. It’s amazing how much time you can save that way if you just apply proper non-pharma thinking.

    /sarcasm

  15. Hmmmm says:

    Did Russia do secret challenge trials? Does anyone think they would have ethical objection?
    Maybe those data give them enough confidence to put forward the hype.

    Is there a plan in the works for Trump to parlay his love of Putin to get (or make a spectacle of trying) imported US supplies of this vaccine? Is this the Hydroxychloroquine playbook 2.0?

    Will the dirty details come out only after Trump’s wins re-election based on the “My buddy Russia saved us” or “Deep state won’t let us have Russian vaccine” gaslighting to come?

    Stay tuned.

    1. John Wayne says:

      Challenge trials do not generate safety data faster.

      1. Taylor says:

        Except Derek did say “It is simply not enough time to do a reasonable efficacy workup”…. which obviously is not true. Two months is more than enough time if you’re using challenge trials.

        Which, of course, is what everyone in the world *should* be doing. It’s some heady mix of arrogance and stupidity to claim that you couldn’t find a few hundred volunteers who understand you when you say “we think you’ll have an X% chance of dying if you agree to do this” (where X is 2x the pessimistic estimate.) You can also do stuff like test them to confirm antibody production before giving them the challenge.

        Safety data is another matter, but getting hard numbers on efficacy ASAP would be a huge win. (e.g. If it looks like one vaccine is 90% effective and another is 40%…)

    2. Russiagate=QAnon says:

      You’ve seen retraction after retraction on Russiagate stories, yet still can’t let go of the narrative. You Russiagaters are the liberal version of QAnon, except even worse since major media outlets got roped in as well, just like they did with the WMD’s in Iraq.

      1. Shazbot says:

        Here’s another example:

        1. Deny everything. “There is no Russian connection to Trump, despite him sending his lawyer to meet with multiple KGB operatives before delivering the goods to a party-only meeting of senators a couple days before they vote to block any witnesses in his impeachment trial.”

        2. Blame the victim. “It’s really just you being taken in by a narrative, instead of having events, actions, and facts to point at to defend your point of view.”

        3. Change the subject. “Iraqi WMDs! Fake News!”

      2. WST says:

        “retractions” – tell it the guys that are in prison for the Russian-gate

        Interesting that Russian trolls are present in here, what a depth of intention !

        1. Trust the FBI? says:

          No one in the Trump orbit is in jail for colluding with Russia. They were charged with “lying” to the FBI, even though none of these interrogations were recorded and you’re taking the word of the institution that spied on MLK, ruined innocent peoples lives over the Olypmic bombing and Anthrax attacks, and Bobby Mueller himself assured us that Saddam had WMD’s. And even if they in fact lied, nothing that they lied about was an illegal act.

          1. GB says:

            yeah I think if given a choice between:
            1) Random anonymous internet people who believe in Satan worshipping and child eating “deep state”
            2) Putinbots
            3) FBI
            I think I would probably trust a western world intelligence agency a bit more than the other two.

      3. GB says:

        Ummmm, one is batsh*t crazy theory, which is pretty close to “proving” that Hillary is one of the lizard people and Bill Gates is an evil mastermind hell bent on putting microchips in people… just for fun, I guess…. The other has been confirmed as legit by pretty much all Ametican intelligence agencies as well as many abroad, has resulted in multiple convictions and lots of publicly available documentation verifying it, – all that despite Trump admin fighting tooth and nail to keep it under wraps.
        Yeah, good one.

        1. Russiagate=QAnon says:

          Then only institution that looked at the DNC server itself was Crowdstrike, and they recently admitted to Congress that they had no evidence that Russia ex-filtrated a single bit of data from the DNC servers. The troll farm had memes ranging from new age BS to politics, spent a large portion of their money after the election, had the most brain dead moronic memes, and seemed to be more of a click bait farm than an elaborate intelligence operation. John Podesta fell for a phishing scam that a mediocre teenage computer nerd could have pulled off.

          In addition to this, stories about Russia hacking Vermont’s power grid, Michael Cohen traveling to Ukraine, and countless others have either been retracted or seriously amended. Rachel Maddow promised us every night that the walls were closing in on Trump, just like QAnon constantly promises that the storm is coming.

          1. GB says:

            “Then only institution that looked at the DNC server itself was Crowdstrike, and they recently admitted to Congress that they had no evidence that Russia ex-filtrated a single bit of data from the DNC servers.”
            – no, that doesnt appear to be correct (https://www.crowdstrike.com/blog/bears-midst-intrusion-democratic-national-committee/)

            “The troll farm had memes ranging from new age BS to politics, spent a large portion of their money after the election, had the most brain dead moronic memes, and seemed to be more of a click bait farm than an elaborate intelligence operation.”
            – that sort of clickbait nonsense works on some level, if it didn’t Russia’s troll farms would not spend their roubles to do it.

            “John Podesta fell for a phishing scam that a mediocre teenage computer nerd could have pulled off.”
            – Are you saying that no teenage computer nerds could be working as state sponsored hackers for Russia?

            “In addition to this, stories about Russia hacking Vermont’s power grid, Michael Cohen traveling to Ukraine, and countless others have either been retracted or seriously amended. ”
            – i wouldn’t say countless, there have been a few here and there, just like there would have been on the rightwing press. Have to say though, the ratio stories that end up checking out vs retracted definitely does not favour Trump admin.

            “Rachel Maddow promised us every night that the walls were closing in on Trump, just like QAnon constantly promises that the storm is coming.”
            – no idea who she is, for I am not an American.
            My point here is that Qannon is a made up nonsense with no base on reality, its just a bunch of conspiracy nuts searching for connections and hidden meanings in all sorts of random events.
            Russiagate on the other hand is a pretty well proven thing to have happened, with over a 100 plus known contacts between Russian and Trump people, only thing that there was not sufficient evidence for was that there was an illegal conspiracy, which you can appreciate is hard to prove when you install an very Trump protective AG overseeing the DOJ.
            …so thereforce Russiagate ≠ Qanon.
            Having said all that, from where I am looking I think the writing is on the wall, sooner or later Trump’s protection will fail, his financial records will leak and then the real fun will begin.

  16. Just another chemist says:

    It’s a risk reward proposition. They are betting on this being an acceptable vaccine before doing full trials. It might be a reasonable vaccine that offers some protection and enough safety. Or they could be giving a dangerous vaccine with little to know protection.

    If it works out for them imagine the hero’s treatment that Putin will get. If not he has enough power to evade criticism anyway.

    We are doing at risk production in the US. It’s just we are only risking money and time.

  17. Blaine White, M.D. says:

    Derek,
    Do we know what the Russian vaccine targets? Is it the S or N proteins? Do we know if it produces a robust T-cell response? Do we know if they have post-vaccine challenge data on primates? These aren’t rhetorical questions. What if anything do we know about this vaccine?

  18. Peter Kenny says:

    Beware of Russians bearing electrophiles?

  19. Geoff PR says:

    “The new airliner design prototype just got off the ground – time to sell tickets and load it full of passengers, right?”

    Believe it or not, Russia did pretty much that in 2012 with their new Sukhoi ‘Superjet’ airliner. Loaded it up with prospective customers for a demonstration flight and promptly flew it into the side of a mountain, killing everyone :

    https://en.wikipedia.org/wiki/2012_Mount_Salak_Sukhoi_Superjet_crash

    I suppose not too surprising, seeming how a few years later their space program took a few serious hits doing fully-avoidable ‘accidents’ like drilling holes in the Soyuz pressure hull and (my personal favorite) installing the attitude angular velocity sensors backwards. The sensors could only be installed one way. So the ‘technician’ used a hammer to pound it in place upside down. The rocket tried it’s very best to go where it was programmed to go, the center of the earth. Oops. :

    https://www.youtube.com/watch?v=vqW0LEcTAYg

    A Russian vaccine? What could possibly go wrong?

    1. Jörn Nettingsmeier says:

      The wikipedia link you posted is very clear that the reason for the aircraft accident was pilot error, nothing at all to do with the engineering abilities of the manufacturer.
      Please do not contribute more confusion and do your research properly, particularly if it only involves reading a single source to catch a major reasoning error.
      As for the rocket failure, yes, that does look hilariously funny indeed, but remind me which eastern bloc country lost a satellite because someone mistook metric for imperial units?
      I’m all for taking a critical view on this vaccine stunt, but not by ridiculing the originating country with half-truths and schadenfreude.

      1. eyesoars says:

        The fact that it may have been pilot error doesn’t make the problem any better. Apparently they didn’t spend enough time with the aircraft to train its pilots fully.
        Here we have a more-or-less unknown quantity, of something with a great deal of potential — both good and bad. E.g., one of the early polio vaccines went seriously sideways, and there is a lot of potential for vaccines to have long-term bad effects, either through contamination, error, or mischance. Many others have had issues in phase III or phase IV trials, and been withdrawn.
        If this plague had Ebola-like mortality rates, it might be worth that risk. It might be worth that now — but I don’t know anyone who can make that call.
        But as Derek points out, anyone seeing these claims should know what they mean, and the point is, 95% of those that hear them won’t, and can’t. Russia has certainly had its own public health challenges since 1990, and I won’t gainsay their public health people to say they’re wrong. But taking this announcement for what it is is a very different thing from taking it for what it will be taken to mean by most people.

        1. sgcox says:

          “Apparently they didn’t spend enough time with the aircraft to train its pilots fully.”
          You are talking about Boeing 737 Max, right ?

      1. Marko says:

        If that was being done in Russia or China , I would say that it must be very , very bad.

        Since it’s being done in the US , however , I’d say it demonstrates our unique , innovative spirit , and will breathlessly await its certain stunningly successful outcome.

      2. Mammalian scale-up person says:

        What the F…?!?

        No, this is a terrible idea. For oh, so many reasons, many of which have been discussed here extensively. Starting with ADE and ending somewhere around “just add zinc!”

        I’m the first person to say George is a great molecular biologist, but he is not an immunologist and he doesn’t know crap about public health. I would not want to Sasha Shulgin a vaccine. I understand the argument that people put god only knows what into their bodies for pure recreation, but when it affects other people (by thinking you’re immune when you’re not at all immune, by becoming an asymptomatic carrier as opposed to actually immune, by giving yourself some nasty sequelae, etc) it stops being your personal choice to mess up your body/life and starts being a social problem. That’s the whole point of why public health protections have to be mandated with legal teeth (fines, forced quarantine), because too many people are idiots. We’ve done this experiment back in the late 1800s – early 1900s, and it turns out people are dimwits who will happily poison themselves, other random people, and their families if they’re allowed to use homebrewed drugs.

        And that’s where you get into REALLY sticky territory: if someone wants to give themselves a vaccine they cooked in their kitchen, well, they are apparently consenting adults, and we can think of all the consenting adults who end up as emergency room jokes for having intimate relations with inanimate objects and conclude that humans are a foolish species. What happens when they give their homebrew to their children? To their elderly mother with dementia who lives with them? To people who cannot consent? Already we have parents of autistic children forcing their kids to drink bleach – do you think they won’t give their kids this stuff too? Should children and people unable to consent have to suffer because their guardians couldn’t think their way out of a wet paper bag?

        1. David G Whiteis says:

          . . . and again, just as people have suggested could happen with “Sputnik V,” a failure (or a catastrophe) would further erode public confidence in a vaccine. That, in fact, could be the most serious and long-lasting “negative outcome” of something like this.

          1. Mammalian scale-up person says:

            People will sell it on NextDoor, Facebook or craigslist. I would bet good money that someone would even put together an official-looking Certificate Of Vaccination and tell folks they can show it to anyone who questions their travel, lack of mask, etc. There is no shortage of underground markets for drugs that people very much want, regardless of the long term harm and side effects associated with those drugs. That’s how you end up with clusters of people dying or permanently disabled because they got injected with god-knows-what from the pre-med student down the road who was just trying to make some tuition money. I mean, holy moly, look at all the actual trained physicians injecting “stem cells” into people’s spines and other assorted bullcrap! Don’t we have enough quackery killing people in the world?

            I’m an actual real life biologics process development engineer, and *I* wouldn’t try to make this in my kitchen and inject it, and I even know what I’m doing and have access to a large supply of water for injection! I’d love to go back to the gym and Friday night happy hour, but not so much I’d take something that hasn’t been through at least Phase 2. There are plenty of drugs I could, hypothetically, homebrew, and some I might even be willing to self-administer in the direst of straits (if, say, my other option is definitely dying or suffering excruciating pain), but vaccines aren’t one of them.

            Furthermore, it is 100% intellectually lazy to assert, as the authors have, “hey, there’s biological variability and risk in everything, so *shrug* just wing it!” We know how to characterize that variability and risk. We have known for decades. All biomedical risk is NOT equivalent and we have also known that a looooooong time, and this should be embarrassingly obvious especially in the case of COVID. If they don’t know how to design a series of experiments to characterize the biological variability among humans and how to define and mitigate that risk, they can go back to school and learn how to do it – Harvard certainly teaches clinical trial design strategy courses. But you don’t get to assert that because a subject is difficult to study, therefore it is not worth the effort.

  20. MTK says:

    This is bad.

    As much as everyone would like to get a vaccine as soon as possible, any type of failure due to cutting corners will result in complete erosion of public trust in any future vaccine no matter how safe or effective those future vaccines may be. We’re already probably going to have problems convincing a large portion of the population to get vaccinated. A failure here and that issue is going to be even more difficult.

    1. Michael says:

      Well, we can look at the glass half full here. It should be possible to effectively communicate to the public that unlike the Russian approach, Vaccine X had a rigorous Phase III trial involving tens of thousands of subjects and was proven to be more safe and/or more effective than an untested vaccine that failed.

      A failure from an objectively less rigorous approach shouldn’t necessarily undermine public trust in a more rigorous approach with plenty of published data.

      1. Mm says:

        You have a lot of optimism regarding the public’s ability to differentiate. Also, you have a very generous view of the rigor of western covid vaccine trials. The fact is, everyone’s cutting corners, however in a game of chicken where the one with the highest risk appetite wins, the Russians are unbeatable.

        Another problem here is that the public pressure for a “quick win” vaccine increases in the short term (especially considering the US elections), however the risks are slightly more long term. So the west will be pushed to accept an even less rigorously tested vaccine, with an even higher chance of disastrous side effects (which typically emerge after a couple of months at least, more than the minimal time frame that it looks like a “western” vaccine will be tested for).

        1. confused says:

          >>You have a lot of optimism regarding the public’s ability to differentiate.

          In general, I would agree that the public wouldn’t be good at drawing the distinction.

          However, the fact that this is from Russia (a nation which is widely distrusted in the US) I think will greatly limit the impact of any failures on acceptance of US vaccine programs.

    2. David G Whiteis says:

      Yes, I agree entirely — as we in the U.S. are trying desperately to find ways to convince upwards of 30% of our population that vaccines are good and essential to our survival, we’re now faced with the possibiity that the Russian vaccine could prove disastrous, thus inflaming the anti-vax passions here (and elsewhere) to previously unimagined levels. This Russian caper could doom any legitimate scientific/medical effort to contain COVID-19 for the forseeable future.

      1. confused says:

        Nah, there’s enough distrust of Russia in the US that a failure there won’t mean much to anyone who wasn’t *already* leaning in that direction.

  21. Cindy Cristancho says:

    I’ve been waiting for your opinion since the rumors began in the press about the Russian vaccine. I share your opinion that the results have been obtained in a hasty manner, putting safety at risk. Everything seems more like a political campaign than a scientific effort with ethics and prudence. I am a chemist graduated from Russia and I understand the pressure that the government can exert on the scientific community

  22. Rahul Malhotra says:

    The Russian vaccine will not be distributed to the general public until 1st January 2021, by which time the phase 3 results should be available. The distribution this year is only going to be to high risk occupations like medical workers. Its hard to see what the issue is with that sort of limited distribution. Experimental vaccines have often been given to health care workers in the past before all the data is in.

    1. Russiagate=QAnon says:

      Why are you bringing context into this? Haven’t you learned over the past 3+ years that Russia is evil, so any standards of truth and due diligence when criticizing them are no longer necessary.

  23. Aleksei Besogonov says:

    The vaccine vectors seem to have been tested before, so safety is likely to be OK.

    And if you’re ruthless enough, efficacy testing via provocation might have been performed on “volunteers”.

  24. mallam says:

    This sounds like another Russian ploy toward forcing Trump to force FDA to act early in declaring success for US vaccine(s). Competition that will embarrass Trump, particularly he knows nothing about the actual normal process and won’t listen to our experts. Early vaccine declared successful, just like Bush II on the aircraft carrier.

    1. confused says:

      Russia has COVID problems of their own (over 15,000 deaths). So I doubt foreign policy/impact on US politics is the first thing they are thinking of with regards to COVID vaccines.

      IMO Occam’s razor is that the Russian government just has a higher tolerance of risk than Western ones, so they are willing to approve stuff faster. They are probably much less vulnerable to public backlash if it goes wrong, so if they think it is likely to work…

      Not everything is about the US.

      1. Some idiot says:

        I tend to agree with confused… They have the problem, they have the scientific resources, and they are probably less concerned with the ethical dilemmas. A pragmatic decision from their part, I would guess.

        This is not an argument supporting their decision, but just a rationalisation.

  25. SteveM says:

    Trump Hate => Russia Hate => Beat Down Russian Vaccine Efforts. For those who are interested, here is the web page for Sputnik 5: sputnikvaccine dot com/

    It explains their approach and also lists 2 open study trials at clinicaltrials dot gov. The developers plan to initiate Phase 3 trials on August 12. They hope to have the product available for release January 1, 2021. The product will be manufactured in Russia for Russian citizens and probably out-licensed to other countries. Gamaleya has indicated it will provide reducing pricing for disadvantaged countries.

    The Russians declared “success” based on the limited but positive Phase 2 outcomes. I.e., antibody production and minimal adverse effects. Nobody in Russia claims that the Phase 3 trial is not necessary. If the Phase 3 trial fails before Jan 1, Gamaleya will eat the loss for the cost of parallel production.

    So that’s it. I suggest we see how the science plays out and keep the politics out of it.

    P.S. I really don’t get the TDS driven Russia Hate.

    1. Derek Lowe says:

      You are not describing Phase 2 outcomes, but Phase 1. I have seen no data on the efficacy of this vaccine in protecting people against coronavirus infections, which is what one actually measures in Phase 2 and 3, among other things, and that (coupled with the limited safety data) makes this “approval” something of a joke. The trials at Clinicaltrials.gov show 38 participants each, and neither of them have reached their estimated study completion date. No data on the vaccine’s effects in anyone, to the best of my knowledge, have even been made public so far.

      Makes you wonder why Moderna, Pfizer, Novavax et al. didn’t just declare “success” at the same endpoints. Right?

      1. SteveM says:

        I made my observation based on this from the Sputnik 5 site:

        “Phase 1 and 2 clinical trials of the vaccine have been completed on August 1, 2020. All the volunteers are feeling well, no unforeseen or unwanted side effects were observed. The vaccine induced strong antibody and cellular immune response. Not a single participant of the current clinical trials got infected with COVID-19 after being administered with the vaccine. The high efficacy of the vaccine was confirmed by high precision tests for antibodies in the blood serum of volunteers (including an analysis for antibodies that neutralize the coronavirus), as well as the ability of the immune cells of the volunteers to activate in response to the spike S protein of the coronavirus, which indicates the formation of both antibody and cellular immune vaccine response.”

        They are not declaring absolute “success” but success based on completed testing with the acknowledgement that more work must be done to get the vaccine registered globally. There is absolutely no evidence that the Russian development team is unethical.

        My take on the “success” proclamation is their professional pride in the work that they have done to date. The splenetic Trump Haters => Russia Haters won’t even grant them that. I myself will grant them that and dispassionately wait for further data and results to either confirm or discount the value of their vaccine.

        1. Derek Lowe says:

          The idea behind their vaccine is as sound as any other – it could well work. And what they’re saying could be said, just as truthfully, about Moderna’s vaccine, and the Pfizer/BioNTech vaccine, and the Novavax vaccine, et al. Only in those cases we have actual data to look at, rather than general statements, and (most importantly) none of these has been declared “approved” with great blasts of trumpets. Why do that?

          1. debinski says:

            We actually have no data to look at for the Pfizer vaccine that’s in Phase 3 (bnt162b2). They had a press release a couple weeks ago claiming to have animal and phase 1/2 data that showed it to be more effective and safe than the b1 vaccine but there is no real data that is public. They said it would be out “soon”. I’m hoping something comes out before I receive the first injection in their phase 3 trial next week. If I don’t lose my nerve by then.

            By the way, the bnt162b1 data was published in Nature today: https://www.nature.com/articles/s41586-020-2639-4

    2. Marko says:

      “P.S. I really don’t get the TDS driven Russia Hate”

      I “get” it , but it’s not TDS-driven. This is bipartisan fear-mongering , and we’d be seeing the exact same thing if HRC was POTUS right now , only the Repubs would be somewhat more vocal about it rather than the Dems.

      You can’t read a COVID-19 twitter list without being bombarded with US regime-change and Russia/China-bashing propaganda by the likes of James Palmer and others. Big Pharma propaganda is , of course , another hazard we must constantly deal with. Every field of interest has been corrupted in this way. If you’re just interested in “science” , you won’t find it on this page or anywhere else. You have to accept your daily dose of narrative control and manufactured consent. You have no choice. You either drink it in and obey or you must tune out altogether.

      I find little remarkable about the Russia timeline. The US timeline has been shortened as well. The Russians happen to be using a platform ( adenovirus-based ) that has proven safety based on previous studies ( Ebola , etc. ) , not to mention the decades of experience we all have with circulating common cold adenoviruses. What the Russians are doing is little different than what we do with the annual flu vaccine – plop some new antigens onto an old platform and declare it safe and effectve. Voila !

      1. kismet says:

        Small difference being that Russia bashing is almost completely justified: horrible COVID track record, horrible human rights record, horrible economy. In contrast China has a spectacular economic and COVID track record, while also being horrible re. respecting human rights. If you want to see a silver lining, you can with China, but it is harder with Russia.

        None of this should detract from justified criticism, though.

    3. confused says:

      Hostility to Russia has at least a 70-year history in the US, despite cooperation on things like the ISS. It’s not really about Trump (if anything, it’s a bit less overt on the Republican side now).

      I don’t like it much, but it’s true.

      1. steve says:

        Never understood the TDS nomenclature. Yes, Trump IS deranged but it’s not a syndrome, it’s his own unique pathology.

    4. GB says:

      Ahem, TDS is a lazy ad-hominem is a made up thing by people who view everything through the lens of Trump (i.e. his fans), so they assume that everyone else must do as well.

  26. VM says:

    On July 23, a Russian electronic resource Meduza published an interview with the chief scientist behind this Gamaleya Institute vaccine, Denis Logunov. A link should be in my handle. Here are a few points from there:
    – They have a vector-based Ebola vaccine registered. Worked for 3 years on a MERS vaccine. It got to phase II trials. Covid19 vaccine is based on this MERS work.
    – He emphasized that T-cell immunity is important. He says, they did experiments with different vaccine platforms, and vector-based vaccines performed much better, in particular with regard to CTLs.
    – Why use two different vectors. Their vaccine is intended to be administered in two shots. They observed that this is necessary in their Ebola and MERS work. Second shot with the same vector as in the first doesn’t work due to immunity to the vector. They use two different vectors for the two shots.
    – Tested for safety in mice, rats, hamsters, rabbits, primates. Did challenge trials in hamsters and macaques and observed that animals are protected. Not yet published but they plan to publish in international journals.
    – Did human trial on 38+38 people. Planned readouts on 42 days, 3 months, 6 months after vaccination. The interview was on day 28. Plan to test for antibodies, CD4, CD8 cells. All will be published in international journals.
    – After this human trial, they expect “limited approval”. If the results don’t replicate in a larger study, the approval will be rescinded. He says, this limited approval should allow use in “risk groups” (e.g. healthcare workers, I imagine). No vaccinations for kids or elderly. Will run phase III trial on 2000 people in parallel. Expect to start in August.
    – When asked about personal opinion, he says, he believes animals were protected and there is no reason to believe the vaccine won’t work. His personal worry is about how long the immunity will last and what an infection will look like after it wanes.
    – He expects mass production to start by the end of the year. His institute will be making 3-5 million doses/year by then. Several more companies (he named three) are also planning to produce this vaccine.

    1. DZed says:

      Doesn’t this sound like a phase III trial by a different name?

      1. Marko says:

        No , it sounds like a Phase III trial named as such.

      2. VM says:

        Not quite. Presumably, they will also immunize “high-risk groups”, whatever that means. Also, if they issued this “limited approval” with no properly published data and no clear procedure, one may start having doubts about the quality of that phase 3 trial

  27. D says:

    If there is herd immunity for this virus, then the Russian vaccine roll out may coincide with it naturally petering out anyway. In this scenario, Putin could claim victory regardless of whether or not the vaccine is a placebo and people in the west will never trust a scientist again.

    I know there is skepticism about herd immunity in this case, but I don’t recall any deadly flu strains sticking around for any longer than a couple of winters. Sweden is also seeing deaths naturally reduce to zero without implementing lock down measures. Their death rates, while high, have also been far far far below the initial estimates that sparked a global shut down that has very likely opened the gates for the other horseman to ride in on.

    1. David G. Whiteis says:

      Problem is, COVID is NOT a “flu strain.” I don’t think we can expect the same timelines as we’ve seen in earlier influenza epidemics.

      1. confused says:

        Sure, it’s not an influenza virus, but the mechanism of spread is similar.

        The timelines will be different because there’s been much more mitigation action than in flu pandemics. On the other hand it got to almost every part of the world really fast before travel shutdowns. So it might balance out.

    2. confused says:

      >>If there is herd immunity for this virus, then the Russian vaccine roll out may coincide with it naturally petering out anyway.

      Not in Russia. Russia is at 15k deaths out of 145M population, just a bit over 1 in 10,000. Some countries are at 6 to 8 in 10,000… and if you adjust for under-reporting/excess deaths not listed as COVID some parts of Latin America may have hit or passed 1 in 1,000 (10 in 10,000).

      Their medical system isn’t *that* much better and their population isn’t *that* much healthier. Russia’s median age is near 40, higher than the US, much less Latin American nations.

      1. D says:

        That’s if you trust Russian statistics. But even if COVID runs it’s it full course, the deaths will probably by minor compared to those brought on by political instability. At least by Russian standards.

      2. confused says:

        (note: technically, according to the JHU tracker, the highest nation in terms of COVID death rate per population is San Marino, which is already over 1.2 per thousand (12 per 10,000). I wasn’t counting that since its *total* population is under 40,000 people, so isn’t really comparable to other nations.)

    1. confused says:

      Even if their plan was a bad idea, I think the Swedish experience is still evidence that COVID won’t continue to kill at high rates for years on end even without shut-down orders.

      IE – we will return to normal life with or without a vaccine.

      Now Sweden has done social distancing measures, and they might see a modest second spike when those are relaxed. But I think the really high death predictions are out the window at this point, at least for Sweden.

      1. Marko says:

        Not likely.

        The multiple examples we have of high attack rates in populations where mitigation has been absent or impossible to implement prove that this virus doesn’t run out of gas at some low threshold of immunity or death rate. 57% attack rates in Bergamo and the slums of Mumbai. 70-80% in prisons and detention camps. 71% by seroprevalence in Iquitos , Peru. And the eamaples just keep piling up. You can’t simply ignore all of them. If there is some fraction of the population that has pre-existing sterilizing immunity , it’s small , and will have minimal effect on the HIT.

        1. Rob says:

          The picture is still murky, but it looks like there may be some pre-existing immunity from things like the BCG vaccine and other coronaviruses. Likely to be substantial geographic variation. I wish we knew more.

          Tangentially, could the high false positive rate of antibody tests be related to cross-reactivity to other coronavirus antibodies? Or are the tests more specific than that, or the immunity thought to be only T-cell mediated.

          1. David G Whiteis says:

            Acutally, I’ve been wondering something else (and someone here, please correct me if I’m utterly wrong about this) — We know that a lot of asymptomatic carriers aren’t being counted, simply because in most caes they dont feel the urgency to be tested. Assuming that recovering from COVID ensures at least a degree of immunity for a while (as far as I know, we don’t have any fully documented cases of reinfection, although there’s still a lot of gray in this area), don’t these undetected cases end up giving us a larger numerator when we’re trying to figure out immunity rates? In other words, if we’re missing ten or fifteen percent of our COVID cases because they’re asymptomatic, and if these people recover and acquire at least some immunity, coudn’t this (perversely/paradoxically) actually be considered “good news” when we’re trying to figure out how many folks will need to get vaxx’d in order to move us closer to widespread immunity? Or am I mssing something here?

        2. confused says:

          I didn’t make any claims about pre-existing immunity. I think pre-existing *sterilizing* immunity is probably pretty unlikely.

          >> 57% attack rates in Bergamo and the slums of Mumbai. 70-80% in prisons and detention camps. 71% by seroprevalence in Iquitos , Peru. And the eamaples just keep piling up. You can’t simply ignore all of them.

          I’m not ignoring anything. But those places all have *enormously* higher population density and very different pre-social-distancing contact patterns than Sweden.

          If the herd immunity threshold is 70% in Iquitos (and infections *can* go past the herd immunity threshold) it will not also be 70% in Sweden… and probably not close.

          My comment about the second spike was that if Sweden went totally back to normal the current level of immunity wouldn’t be enough. But I don’t think it would go anywhere near 70% since Sweden is nothing like Iquitos or the slums of Mumbai.

          …That’s why I ended my comment “at least for Sweden”.

          (Although, I was talking about *death* rates being lower than predicted, not just infection rates. And I think there’s a pretty strong correlation between Iquitos/Mumbai-like cities and low median age.)

          1. Marko says:

            I think this chart does a good job of illustrating where various regions , including Sweden , are likely to be right now regarding social distancing and the potential for further relaxing. Bergamo is probably out of the woods for all intents and purposes. NYC and Sweden have a ways to go. Swedens current mitigation efforts are more similar than different from other countries in their impact on viral spread :

            https://twitter.com/zorinaq/status/1292910759114989569

          2. confused says:

            Uh… to me that chart shows NYC *is* on the “shrinking outbreak” side of the line, not still having a ways to go.

            And Sweden’s outbreak IS shrinking. Have social patterns changed there since April or May? If not, why isn’t the Occam’s razor assumption that either “social connectivity” is overestimated or “percent infected” is underestimated?

          3. Marko says:

            “Uh… to me that chart shows NYC *is* on the “shrinking outbreak” side of the line, not still having a ways to go.”

            No , look again. Compare Bergamo to Sweden. If Bergamo lifts the brake entirely – returning to 100% ( i.e. pre–pandemic ) social connectivity , they’d still be at a low Rt , with minimal spread. If Sweden ( or NYC ) did the same , they’d be at a high Rt , with rapid spread.

            Sweden has been successful BECAUSE they’ve maintained most of the mitigation efforts adopted earlier. Their relative failure in the beginning , compared to their neighbors , could simply be a matter of a couple weeks difference in how their populations reacted to the news of the pandemic. In Sweden ( as in the UK ) , thought leaders were all about “herd immunity” in the early days. This probably caused a delay in behavioral response by Swedes ( and Brits ) relative to , say , Norway and Finland.

          4. confused says:

            But surely “normal” contact patterns – let’s say, the state of things a year ago, when COVID didn’t exist – is not at all the same in Bergamo, NYC, and Sweden! (% of multigenerational households, population density, etc. etc.)

            If that chart is saying 100% means “normal” for everywhere… that’s very weird.

          5. confused says:

            Hmm… ok today I think I see what you mean. I was reading the “social” % as a measure of the social connectivity of the area in the first place, not as a measure of distancing/response to COVID.

            Hmmm…

            So OK the chart does say what you originally said. Oops, sorry.

            I’m still not sure I agree, as Sweden is going to have started out very “social distanced” relative to NYC or Italy, and other places are more so than Sweden.

            (And the chart shows Sweden on the “growing” side when its outbreak has shrunk dramatically* so it does seem to err on the pessimistic side.)

            *generally 1 or 2, maybe 3, COVID deaths per day now; Sweden hasn’t seen double-digit COVID deaths in over 3 weeks.

  28. Barry Bunin says:

    Although a PR Stunt…if it works, it works. The positive side is that we will get more data (hopefully)

  29. Chris hawkins says:

    While there is a bunch wrong with the Russian approach here, we would be well served by allowing more people to voluntarily take potential COVID vaccines that are roughly in phase III trials.

    1) It allows more data to be collected, benefiting society as a whole
    2) the “net risk” of vaccine candidates may genuinely lower than the risk of COVID for some populations. The standard for voluntary usage should be risk versus the alternative, not risk versus a gold standard.
    3) there is little downside to society as a whole, so we should generally support people’s right to take something so long as they are reasonably informed.

    Paternalistic attitudes by governments and the medical community are frustrating and I wish they would stick to ensuring the data and statistical upsides/downsides are clearly presented instead of just saying a binary “this prevents COVID” or not.

    1. David G. Whiteis says:

      But if they don’t work, or have disastrous side effects, won’t that discourage people even more from getting vaccinated at all? We could end up with resurgences of measles, pertussis, and Lord-knows-what-all as a result.

      1. confused says:

        I doubt it. COVID is a pretty unusual situation, not sure how much it will impact public perception of “regular” vaccines.

        And I think anti-vaccination sentiment is not terribly strongly linked to any actual evidence anyway. A COVID vaccine failure might *confirm* the beliefs of those already leaning in that direction, but I don’t think it would *convert* people who currently accept vaccines.

  30. Lysenko says:

    Soviet science has a history or great rigor!

    1. Lysenko says:

      “of” great rigor. Sorry.

      1. Doug says:

        In Soviet Russia, comment apologizes to YOU!

  31. dearieme says:

    Proposition: Putin fears being overthrown and so is taking a desperate gamble.

    Test of proposition: the CIA hasn’t said it so it might be right.

  32. Fonli says:

    Quick correction, it is not a mixed vaccine. You get the Ad26 vector load first, then 3 weeks later Ad5. I suppose they want to circumvent the acquired immunity to Ad26 in the booster shot.

  33. luysii says:

    Back to the glory days when the Russians claimed to have invented baseball

  34. David G Whiteis says:

    “. . ., IMO it’s hard to see the US being less than 10% infected.”

    Great. Only 232 million to go before we reach herd immunity. There’s a comforting thought.

    1. confused says:

      What do you think the herd immunity threshold is for the US?

      I doubt it’s anything like that high. 232 million + 33 million (10%) = 266 million or 80% of 330 million.

      I don’t see any way for it to be anywhere near 80%.

      Sure *some* places have hit ~60%-70% infection. But those are very different in terms of contact patterns from pretty much anywhere in the US.

      Even US big cities shouldn’t be 60-70%, and the US as a whole should be significantly less than just the big cities.

  35. David G Whiteis says:

    Yesm it’s true that we’ve seen a lot of estimates — I’ve seen as low as 40%, as high as > 80%. Most, though, fall somewhere beween 65-70%, I think. I went “high-end” on my estimation to avoid any kind of un-called-for optimism. If we go “low-end,” that still leaves us with 177 million. In all honesty, that COULD take upwards of five years, with a lot of hellish minutes, hours, days, weeks, and months between now and then.

    1. confused says:

      Some papers (at least preprints) have said that heterogeneity in contact networks could put it below 20%.

      And you might not have to achieve actual herd immunity for the virus to drop to “endemic” rather than “pandemic” levels.

      And there will not be *one* herd immunity threshold for the virus, just as there is not *one* R0 and IFR. It will depend on contact patterns, which are radically different across the world.

      So if the threshold is (say) 70% in Iquitos, Peru, it pretty much can’t also be 70% in the US.

      (Actually, “the US” is not meaningfully *one* population. It won’t be the same in South Dakota as in Houston, and won’t be the same in Houston as in NYC.)

  36. David G Whiteis says:

    . . . and I meant “Yes,” not “Yesm.” I was not making a sexist slur!!!!

  37. David G. Whiteis says:

    Will an “endemic” level be sufficient to allow the kind of return to “normal” life we’ve been alluding to? Dr. Allison Arwady, the director of Chicago’s Department of Health, has pretty much dictated that until a vaccine proves “100% effective,” we’ll still have masking and “distancing” requirements, as well as bans on most social gatherings and public events. realistically speaking, that means things are going to stay like this, pretty much forever. And I think most public health officials would probably see things in a similar light. Anthony Fauci is somewhat harder to read on this score, but his recent comments about how “public health” measures will continue to be essential indefinitely even if a vaccine is upwards of 75% effective would indicate that he’s on board, too.

    1. confused says:

      >>Dr. Allison Arwady, the director of Chicago’s Department of Health, has pretty much dictated

      What people say now about a potential future may have little resemblance to what they will actually do when that future comes about.

      Places like Texas are not going to do that. And at some point, other states/cities will have to follow suit or see all their businesses go to “open” states.

      Maintaining these measures indefinitely is just not practicable, nor will people follow them once the fear of COVID recedes (which I give a year, max). And cities and states will be forced to deal with this reality, whatever they say now.

      People will stop being especially afraid soon, because it won’t be “new and unknown” soon and the actual risk is probably not *that* high to the majority of the population*.

      *IE, losing weight/eating healthy/exercise probably impacts your life expectancy more than catching vs. not catching COVID, unless you are very old. So if people don’t bother to do that, as obesity statistics suggest….

  38. David G Whiteis says:

    ” . . .losing weight/eating healthy/exercise probably impacts your life expectancy more than catching vs. not catching COVID, unless you are very old. So if people don’t bother to do that, as obesity statistics suggest. . .”

    “. . . the vaccine might not do very much for them, anyway. Don’t get me wrong — I hope this does NOT prove to be the case (I loathe even the implication of fat-shaming), but if it does, it just points to one more reason why Americans are proving to be so vulnerable. We have a lot more co-morbidities — diabetes, cardiovascular disease, hypertension, poor nutrition — than most other “developed” countries. We also have a much greater income gap between the wealthy and the very poor, and of course our health care and public health “systems” are a [sick] joke.

    A lot of us (me included) tend to focus on the appalling behavior of the Orange Demon in Washington as the catalyst for our COVID miseries, but the cold, hard fact is that there are many, many reasons we’re in such bad shape, and not all of them can be laid directly on him.

    1. confused says:

      Well, regular vaccines work just fine in the US population despite all that, so I don’t see why a COVID vaccine that works in general shouldn’t

      I am not sure how much the problems with US health systems have actually hurt us in this specific situation. US has e.g. very high ICU capacity per-capita compared to most Western European countries, from what I’ve seen. The usual advantages of other systems don’t necessarily help as much in this situation. (I mean, is the IFR of COVID in the US higher than most places? I don’t think so.)

      My point was more that people will accept large risks when they become seen as part of the normal background of life, and COVID will eventually be in this category even if vaccines aren’t terribly effective.

  39. Christophe L Verlinde says:

    Derek, what is your objection against the argument by the Russians that their vaccine technology with the 2 human adenovirus (5 and 26) vectors has been used in tens of thousands in the last 6 year to vaccinate against MERS and SARS with a very good safety record, and that the only difference is that now the cargo comes from the SARS-CoV2 virus. They state that the Oxford vaccine is actually more a step in the dark because it uses a monkey adenovirus instead of a human virus.

    1. Ilya says:

      As far as I know, there were no publications on those previous efforts in peer-reviewed high rank English journals. Therefore, we only can rely on their words.

      In contrast to EMA and FDA, Russian Ministry of Health doesn’t publish the expert reports upon the approval of drugs (thus violating the Federal Law, but who cares).

      The level of biomedical experiments is very low in Russia, so is the understanding of ethical principles behind the clinical trials conduct. We recently analyzed publications on clinical trials in Russian journals and found many cases of misconduct, conflict of interest and legal violations. We wrote a paper on that but it just got rejected by the BMJ. Any suggestions where to apply with it?

  40. exGlaxoid says:

    If 40% of the US already has some immunity, thus they either don;t catch it or just become asymtomatic carriers (https://www.seattletimes.com/nation-world/40-of-people-with-coronavirus-have-no-symptoms-might-they-be-the-key-to-ending-the-pandemic/) then it should only take about somewhere between 10 and 30% of the remaining people to acquire immunity via an infection to create a much lower rate of infection.

    Based on data from Wake Forest Univ. and NY data, several areas are in that range, most likely. That may be why we are seeing rates fall in places like NYC and Sweden, which is clearly showing new case rates and deaths (https://www.worldometers.info%2Fcoronavirus%2Fcountry%2Fsweden).

    Even more likely is that 10-30% of the population (mostly older or sicker people, many are in assisted living type facilities, but more are just staying home) is keeping home for the most part, thus that that part of the population is not adding to the new cases much. So if half of the people without some immunity (~60%) that are getting out and about get the virus, then that should slow the spread amongst them, which may help protect the remaining people. The problem is that the people who are staying home will eventually want to get out, and without a vaccine, they will be the most at risk. If we get MABs approved, that may help those people, until we get a vaccine.

    1. David G Whiteis says:

      If I understand you correctly, this also means that the estimates we’ve seen about how many people would have to be vaccinated for true immunity to develop have also been vastly overstated. If roughly 65% (a little under 2/3) of Americans agreed to be jabbed with a vaccine that was somewhere between 50 – 70% effective, according to yuor data that should be sufficient. Am I reading you correctly? If so, why haven’t any of the “official” estimates (includidng Dr. Fauci’s) considered this possibility?

      1. confused says:

        The models that show herd immunity happening well below the “classic” values* say that that happens because the population isn’t homogenous — people who have more social contacts are more likely to catch COVID and also more likely to infect a lot of people once they have COVID. So the people who are most likely to be superspreaders are removed from the “susceptible pool” earlier.

        People with the most social contacts aren’t necessarily more likely to get vaccinated first, though, so this may not happen with vaccine-acquired immunity.

        I don’t have the expertise to say how solid these models are/how likely it is they are correct. But that is the hypothesis.

        It at least seems prima facie plausible – I’m an introvert and highly value personal space, so it seems right that I’d be much less likely to get COVID and also much less likely to spread it if I did than someone who is always yelling in crowded bars and slapping people on the shoulder, etc.

        *1-(1/R0), e.g. 50% for R0=2 (1 – 1/2), 67% for R0=3 (1 – 1/3)

        This is why I was very skeptical of the 80% you were suggesting in an earlier comment. That would require both no improvement from networks /and/ a very high-end R0.

        1. David G Whiteis says:

          I’m desperately trying to find a cause for optimism in these projections, but given what’s going on in Europe, India, South America, and most of the U.S., I can’t do it. The numbers on the ground continue to show a virtually intractable situation constantly on the verge of (re-)exploding out of control. And I’m sorry, but I can’t take solace in the “endemic” suggestion — this wouldn’t be like the flu or the common cold at all; it’d be more like annual or semiannual outbreaks of smallpox or yellow fever. We’d be living in constant fear of the next one, dutifully masking and “distancing” ourselves all the while. (I guess our sports stadiums, theaters, auditoriums, and concert halls can be repurposed to provide housing for the millions of laid-off workers who’ll never find another job in the “new normal” economy.”) Even with a vaccine, predctions are that COVID won’t ever “go away” — at best, it can be “managed.” Which, in reality, means pretty much what I just said.

          I do sincerely apologize if this is one of those “hot-air . . . low quality posts” that folks are upset about. I’m not trying to be a troll or a flamer. It’s just that things look really bleak and hopeless right now — like the song says, “I’ve seen the future, baby — it is murder.”

          1. confused says:

            >>I’m desperately trying to find a cause for optimism in these projections, but given what’s going on in Europe, India, South America, and most of the U.S., I can’t do it.

            Well, pretty limited point in arguing about the future (we’ll know in a year, probably sooner), but I’ll at least say why I think it will be far better than that.

            >>And I’m sorry, but I can’t take solace in the “endemic” suggestion — this wouldn’t be like the flu or the common cold at all; it’d be more like annual or semiannual outbreaks of smallpox or yellow fever.

            Oh, not even close, those had vastly higher fatality rates. Smallpox (variola major) was like 30% fatal!

            Current COVID IFR in the US is probably well below 1% (CDC estimate is 0.65%… which might still be too high for infections happening *now*, not including the higher IFR in March/April).

            So, even with a fairly conservative rate, smallpox was *50 times worse*.

            And we still don’t know that much about treating it. Next year we’ll do better (likely have monoclonal antibodies by then). And we’ll probably have an at least partially effective vaccine. And a lot higher degree of population immunity…

            These will have a multiplicative effect… fewer cases because of vaccine and “natural” immunity x lower IFR because of better treatment. COVID deaths will drop through the floor.

            In a couple of years there will probably be more flu deaths than COVID deaths (because so many people just don’t bother to get the flu shot).

            >>We’d be living in constant fear of the next one, dutifully masking and “distancing” ourselves all the while.

            No way. Human beings just don’t work that way. People will just stop being more afraid of it than of other possible causes of death. “Familiarity breeds contempt”.

            IMO, this would be true even if we stabilized at (say) 100,000 COVID deaths/year, several hundred per day, for the US. But it will be far, far lower soon.

            Remember we’ve only known about COVID for less than 9 months, and it’s really been in the public eye in the US for only 6 months.

            It’s still new and unknown. That won’t be true long.

            >>Even with a vaccine, predctions are that COVID won’t ever “go away” — at best, it can be “managed.” Which, in reality, means pretty much what I just said.

            Nah. It will still exist, but it won’t be scary enough to warrant taking special measures to avoid.

          2. David G. Whiteis says:

            Unfortunately, New Zealand right now — apparently teeter-tottering between returns to “normal” and frantic episodes of panicked retrenchment into lockdown in the face of sudden new cases threatening to spread out of control — is living precisely the “endemic” nightmare/future I envision.

            All of us, constantly looking over our shoulder for the dreaded but inevitable “next time,” never a moment of peace, never a moment of confidence or relaxation, never an encounter with a fellow human being that’s not permeated by dread (“COVID paranoia” — the new “urban paranoia,” only more widespread and relentless) — it makes the 1950s/early ’60s “duck and cover” era look like an Edenic time of sanctuary and solace by comparison.

          3. confused says:

            New Zealand has had very little COVID infection. You can’t compare that to a situation where 25% of people have already had COVID (much less one where the majority of people have had it, which has already happened in some places.)

          4. confused says:

            I mean, COVID is *not* endemic in NZ, so how can it be a model for a potential future where COVID is endemic?

            Do you really expect a population where most people have been vaccinated for COVID, and everybody knows someone who’s had COVID, the vast majority of which were very mild cases (which wouldn’t require a greater-than-flu-vaccine level of effectiveness… most COVID cases are mild *now*), to have a high level of fear of COVID?

            In New Zealand (and to a lesser degree in the rest of the world, this early) COVID is unfamiliar. Human beings just do *not* evaluate familiar risks like they do unfamiliar ones. This is irrational, but clearly true about human nature (consider coal vs. nuclear power plants, or fear of airplanes vs. cars).

        2. David G. Whiteis says:

          “. . .People will just stop being more afraid of it than of other possible causes of death. ‘Familiarity breeds contempt”. . . IMO, this would be true even if we stabilized at (say) 100,000 COVID deaths/year, several hundred per day for the US.”

          . . . Once again with all due respect, my friend, it’s obscene to suggest that we can, should, or ever will shrug off 100,000 deaths per year and/or several hundred per day as acceptable. Good gracious, I want to return to a “normal” life as desperately as anyone possibly could (every time I even see a picture or read an account of people gathering together the way humans have done for millennia — close together, face-to-face, without fear or trepidation — my heart breaks and a piece of me dies inside), but not at that kind of a price.

          1. confused says:

            >>. . Once again with all due respect, my friend, it’s obscene to suggest that we can, should, or ever will shrug off 100,000 deaths per year and/or several hundred per day as acceptable.

            Oh, I don’t really believe endemic COVID will be anywhere near that deadly.

            But people *would* accept that, whatever you and I think now.

            Infectious disease in general used to be far deadlier in the US and people weren’t constantly wearing masks in the 19th and early 20th century.

            And anyway… it’s quality of life vs quantity of life. Why would people accept a huge hit to quality of life, for many years, to avoid a very small chance of death? Losing 50% of your quality of life for your whole remaining life to avoid even the *current* risk of COVID (maybe 0.65% IFR times whatever your chance of catching it is), much less a much smaller future risk, just isn’t a smart bet.

            I won’t. Once I get a vaccine, even if it’s flu-vaccine level effectiveness, I’m going to stop living my life based on COVID. And I think the majority of people will do the same.

            Taking measures makes sense *now* because we expect a vaccine & better treatments in the near future, so the risk will be reduced significantly. IE -being exposed now is probably significantly worse than in March of next year.

            Once there’s a vaccine and treatments are well understood, there’s little to no benefit in taking further measures.

        3. David G Whiteis says:

          RE: Herd immunity — Maybe there is, in fact, evidence that some areas of the U.S. are approaching it. Not a panacea, of course, but potential good news in terms of the potential effectiveness of a vaccine once it gets introduced. Of course, this would apply only in areas like NYC which were extremely hard-hit at the beginning. There’s certainly no evidence of anything like this going on in Florida, Mississippi, Tennessee, or Georgia.

          https://www.news-medical.net/news/20200731/Research-suggests-New-York-City-may-have-reached-coronavirus-herd-immunity-threshold.aspx

          1. confused says:

            Eh, I dunno that places like Florida actually have a much smaller % infected than New York.

            Sure, per-capita deaths so far are a lot lower, but we’d actually expect that.

            IFR is going to be a lot lower, both because treatments have improved (better understanding of how to use ventilators & proning patients, dexamethasone, maybe remdesivir and convalescent plasma) and because the population infected is probably significantly younger due to behavioral changes (even though the median age of Florida as a whole is higher).

            Also, New York is basically done reporting COVID deaths from its spike, Florida isn’t. There is probably a lot of lag in death reporting.

            But even individual states are going to NOT be homogenous populations. There’s no way every town in Florida or upstate New York has a high enough % infected to dramatically reduce spread*.

            But if the “hub” cities are, it might be almost comparable in practice.

            *still not sure what we’re talking about is really full-on “herd immunity”.

          2. WST says:

            re: NYC & herd immunity article
            I’m very sceptical about this and similar attempts to add more heterogeneity to the base SIR epidemiological model. It’s like adding more circles to Ptolemy geocentric model, makes it more precise and matches the reality better for each addition, but perpetuates false simplified reality artefacts.

            “how epidemics die out as herd immunity is attained.” is the key phrase but.. this was not observed with free running smallpox, polio etc. Did not happen in real world. Adding more time variable heterogeneity may help modelling (a posteriori) a second wave.

            NY & NJ show the “long tail”, as many European countries did, the virus is circulating, acquired immunity is still low, so second wave can break out if a new ecosystem appears. This could be return to work or school, university, or cold weather forcing people to socialise indoors, whatever, some unexpected gatherings with little protection. My crystal ball is bit muddy and paranoia failing….-)

            In Sweden and France, the recent uptrend is driven by 20-59, return to work. Schools start in one-two weeks time and lets see what happens within next few weeks…

      2. David G. Whiteis says:

        “, , ,Losing 50% of your quality of life for your whole remaining life to avoid even the *current* risk of COVID (maybe 0.65% IFR times whatever your chance of catching it is), much less a much smaller future risk, just isn’t a smart bet.”

        I don’t want to pursue this forever, but remember — it’s not just about “ME” losing 50% of “MY” quality of life; it’s about risking OTHER PEOPLE’S lives.

        Yeah, I’ll take the risk — maybe I’d also take the risk of lung cancer and smoke cigarettes, maybe I’d also take the risk of having an accident and drive drunk, too — but those other folks don’t deserve to be put at risk just for the sake of my Evel Knievel fantasies.

        1. confused says:

          >>I don’t want to pursue this forever,

          Yeah, perhaps we should stop and see what actually happens, not just argue about the future…

          >> but remember — it’s not just about “ME” losing 50% of “MY” quality of life; it’s about risking OTHER PEOPLE’S lives.

          Sure – but the same calculation applies to all those other people too!

          If I’m OK with the residual risk post-vaccine, then I’m not expecting anyone else to take measures to protect me (that’s what it means to say I’m OK with the residual risk).

          The situation is essentially symmetrical you vs. anyone else… at least unless you are a low-risk person who has tons of contact with high-risk people (such as a young nursing home staff member). Which is a tiny, tiny subset of the population.

          If the total expected loss of (quantity x quality of life), across all of society, from maintaining measures post-vaccine or treatment is greater than the total expected loss of (quantity x quality of life) from avoided COVID infections… then *you’re not making things better overall*.

        2. J N says:

          David G Whiteis: The 2019 normal is gone. A new 2021 normal working with the reality of COVID of necessity will come into existence.

          I just don’t it to be the one where everybody got the zombie plague.

          As for humans being social creatures, sure we are. I think the new normal is going to be plenty social, but (maybe much) more tribal and cliquish.

          1. David G Whiteis says:

            I see your point — but when it comes to gathering together, being close to one another without fearing one another, and communicating via face-to-face contact, that’s not a “2019 normal” — that’s millennia of “normal” bred into us as human beings. As for being “tribal and cliquish,” I think we were already pretty much that way. I know that in my case, the “social gatherings” I miss most are among dear friends with whom I share common interests. Also, “public rituals” like festivals and other arts perrformances — again, a facet of the human expierience and the human spirit ever since humans have been here. It’s things like these that I fear having to be without for an extended length of time. I’m not a big church-goer, but certainly those who cherish gathering togther in houses of worship will echo mhy sentiments, as well. The human spirit, not just the human body, needs to be nurtured and preserved.

  41. Guppy says:

    @Derek Lowe We need some moderation in here. The comments — usually filled with thoughtful posts and experienced sci/med folks — have increasingly been filled with hot-air political opinions and low-quality posts. Something needs to be done before things are over-run.

    1. Tom says:

      @Guppy – My thoughts exactly.

      Only caveat, is that some level of discussion should exist for better or worse… though as I agreed with you, the level of that discussion has certainly waned recently.

    2. Derek Lowe says:

      There are indeed waves of that stuff in particular posts, but then they move on. I worry that I’ll be putting myself in the position of Grand Inquisitor if I try to draw the line, though, which will give some of these folks even more ammunition when they complain that the Powers That Be are trying to silence them. So I let them yell and carry on, mostly into the void, for all the good it does them. This will pass!

      1. Phil says:

        Grand Inquisitor from Karamzov? – I would say you’re pretty much the opposite: long may you post.

  42. Thomas Hoeg-Jensen says:

    Why is it that vaccines can be taken thru clinical trails in about 1 year (in best case), whereas “normal” drugs take years longer? I suppose it helps that formats can be quite similar amongst various vaccines types, but that goes for some types of drugs too, several types of insulins, antibodies, SGLT2i’s etc , but they still need full clinical program. It seems like approval for vaccines fall closer to “biosimilar” pathway than “new drug”, even though vaccines are often entirely new molecules/entities.
    BTW, what’s the US/EU record shortest time from first-human-dose to market approval for vaccines and for “normal” drugs?

    1. Ken says:

      Some possible reasons:

      Vaccine trials are looking for an antibody or T-cell response, and these can be detected within a few weeks. Other drugs may require weeks of dosing before any response is even expected.

      Nearly anyone can be a subject in a vaccine trial. Other drug trials have to locate people with the condition that is to be treated.

      1. Metaphysician says:

        There is also the fact that vaccine endpoints are fairly swift and unambiguous, compared to most other modern experimental drugs. You aren’t trying to treat a slow acting, poorly understood chronic disease, but an infection. Either the patient catches it, or not. Or the patient dies of it, or not. Straightforward to measure, and on a short time course. Plus, with vaccines, nobody cares about just-this-side-of-significant outcomes differences. Either the effect size is unambiguous, or nobody is going to use it. A vaccine that reduces infection rates by 5% is worthless.

    2. MrRogers says:

      The length of a trial is heavily dependent on the timeline of the targeted outcome. If you’re trying to see if someone is protected from a high-prevalence virus, that will take less time than if you’re trying to see if survival is improved in a cancer that often takes 3-4 years to kill someone.

    3. sort_of_knowledgeable says:

      In addition to the other comments, this vaccine is a special case, because money is being traded for speed. Normally the phase two study is planned after the phase one results are in so that money isn’t wasn’t if the phase one study has unexpected results. But in this case recruiting volunteers and other preparations are being made for the follow up study before the results of the previous study are complete.

  43. David G Whiteis says:

    Dare I suggest that Joe Biden’s choice of Kamala Harris as his running mate could be good news in terms of addressing the (justifiable) vaccine distrust in the African-American community? Granted, there is still sigificant doubt about Harris in the Black community stemming from some of her actions as Attorney General in California; nonetheless, given the tenor of this campaign, I’m guessing she’ll garner overwhelming Black support. If she launches an agressive “pro-vax” csmpaign when/if a vaccine is finally approved, do folks think that this might make a significant difference?

  44. Ol' Bone Spurs says:

    Vlad is truly a master of discord and western trolling, not to mention pilfering the Russian public – the Donald must be envious. Surely the vaccine and novichok manufacturing facilities will be segregated.

    1. SteveM says:

      Re: “Vlad is truly a master of discord and western trolling, not to mention pilfering the Russian public – the Donald must be envious. Surely the vaccine and novichok manufacturing facilities will be segregated.”

      Suggest you retreat back to your preferred non-scientific ideological ghetto to mutually reinforce your politics with your pals.

      1. Ol' Bone Spurs says:

        It’s called the White House.

  45. debinski says:

    Repeating myself here but I’ve not seen anyone comment on this. The Pfizer bnt162b2 vaccine, similar to the Russian vaccine, has no data (animal or human) publically available. They said it was effective in a press release (and better tolerability than the bnt162b1 vaccine) but no numbers out there, not even a preprint. I find this bothersome since the phase 3 trial has already started. Then on top of that, they started another phase 3 trial a few days ago with the bnt162b1 vaccine in China. Why not stick with the b2 if it has a better profile? Also, the phase 1/2 trial on the bnt162b1 data was published today in Nature but the pdf won’t download for me. Wondering if anyone else can get it to download? https://www.nature.com/articles/s41586-020-2639-4

    1. Marko says:

      Downloads OK for me.

    2. Derek Lowe says:

      I commented on the preprint version of that Pfizer paper here: https://blogs.sciencemag.org/pipeline/archives/2020/07/01/pfizer-and-biontechs-first-vaccine-candidate

      And I would definitely like to see the paper on bnt162b2 – but I’m willing to bet that it gets published before we see any such material from the Russian effort.

      1. debinski says:

        Thanks, yes I saw the comments on the preprint. I would love to read the Nature article from today to see if they included any of the endpoints they left out of the preprint (ie, Day 35 neutralizing antibody titer) but only the first page downloads.

  46. Rudolf says:

    They are taking a flyer. Most would consider what they are doing as unacceptably irresponsible. And I would agree.
    However they have convinced themselves based on a limited number of short term trials the vaccine will not cause general adverse side effects…and they hope nothing rare, but know its a risk.
    Similarly they have seen indications of antibodies. They don’t know for how long or whether they will confer immunity….. but they think there is a fair chance.
    So they will take a flyer. Monitor those treated and hope for the best.
    And no one can yet say they will be proved wrong.
    Thousands are dying every day worldwide. Whenever we treat first with whatever, there will be a….hopefully very small..element of risk.

    Maybe we have to think more carefully where to draw the correct balance

  47. David says:

    A reminder about the quality of clinical trial data from Russia. The TOPCAT trial studied spironolactone for heart failure. 30% of active-treated subjects at Russian sites had no detectable drug metabolite measures, compared to 3% elsewhere, suggesting very poor compliance. N Engl J Med 2017; 376:1690-1692. Dimebon was approved in Russia to treat Alzheimer’s disease, based on Russian phase II clinical trial data. It has since failed to show any hint of efficacy in 2 large US/Western European studies.

    Even if Putin were waiving clinical study reports from 2 phase III trials, if they were done in Russia, I would not trust them.

  48. Marko says:

    Looks like Trump’s October Surprise is being packaged for delivery :

    ” Was just on a very large webinar with CDC re: COVID vaccine. Dr. Messonnier, Director NCIRD stated a COVID vaccine COULD be ready for limited populations as soon as October 1, 2020.
    Buckle up.”

    https://twitter.com/jtenenbaum/status/1293639751921172482

    And Russia is the one that’s forging ahead irresponsibly ?

    1. confused says:

      Eh, it seems like the really irresponsible thing is the PR statement that the vaccine is “approved” without qualifications. It doesn’t sound like Russia is already vaccinating the general population.

      China has (according to Reuters at least) already started vaccinating businesspeople who travel outside China.

      Depending on what they mean by “limited populations”, this might be totally reasonable. And October 1 is quite a while away on this timescale.

      As for the October thing… the thing is, if Phase 3 trials started in late July in areas with high infection rates, mightn’t data start coming in around then? How soon would results be expected?

      If so, a “warp speed” approval might legitimately be in October… which is unfortunate timing, since it would *look* election-influenced (and thus might mean lower uptake rates) even if it actually was just “approval as soon as we see data”.

      1. David G Whiteis says:

        **SERIOUSLY** lower uptake rates, esp. among people of color, many immigrants, and others who’ve come to see Trump as virtually an existential enemy. For that matter, it will almost be a political necessity for Biden and Harrris to express extreme doubts about it (even if, as you suggest, it could well be legit), meaning that going into next year, regardless of who won the election, we could have a vaccine on line with well over half the U.S. population refusing to take it. And the negativity and doubt would spill over onto subsequent vaccines, as well. We could end up living in a COVID-19 defined world for years to come.

        1. confused says:

          Apparently, I’ve become the resident optimist, which is odd as I’m not generally that way…

          >> For that matter, it will almost be a political necessity for Biden and Harrris to express extreme doubts about it

          Nah, this I really doubt. This will not be a typical campaign season (it already isn’t, we’re *less than 3 months from Election Day* and not that much actual ‘campaigning’ has happened).

          And I really can’t see Biden doing that, given that he’s likely to win and will have to deal with the consequences once he does. If he was in the weaker position, maybe, but he’s not.

          >>years to come

          It’s just not going to last that long. Any election-related issues with COVID vaccine acceptance probably won’t last until Inauguration Day, much less next spring. (The rest of the world’s developed nations will be vaccinating by then, and I really don’t expect major problems).

          And the uptake rate just doesn’t have to be that high, given we’ll probably be 20%+ infected soon anyway.

          If by the time the vaccine is available to the *general public* 25% of the US has had COVID, and only 50% of the remaining 75% get vaccinated, that’s 62.5% – plenty, if the R0 is say 2.5.

          1. David G. Whiteis says:

            “Any election-related issues with COVID vaccine acceptance probably won’t last until Inauguration Day, much less next spring. . . ”

            Sure about that?

            https://www.nbcnews.com/politics/congress/house-democrats-begin-probe-trump-s-warp-speed-vaccine-initiative-n1236638

          2. confused says:

            Nothing is sure about either the future or politics, much less both! Basically everyone expected Hillary Clinton to be President.

            But Biden appears currently favored to win the election, and there is a *big* difference between criticizing how the other party is handling a problem, vs. being responsible for handling it yourself!

            Now, the current administration’s response deserves a LOT of criticism!

            But that also shouldn’t, IMO, blind us to pre-existing structural/bureaucracy issues with e.g. the CDC and FDA response… Just changing the President won’t necessarily fix the problems.

  49. DTX says:

    Vaccine trials are often quicker than drug trials because the vaccines are often targeted towards acute disease, i.e., infection. In contrast, drugs often target subchronic or chronic illness, so it takes longer to determine outcomes.

    There are exceptions to this: I don’t know the #s, but the Gardasil vaccine likely took many years because it was for cancer prevention.

  50. Wasd says:

    Russian intelligence groups have a long history of successfully hacking networks much more secure than the average pharmaceutical lab. They were in the pentagon, white house, energy grids, state department.. ironically basically everything except Hillary Clintons own e-mail server. DHS and the NSA have become much more cautious about naming Russia in their public warnings these days but for this last campaign they did a new thing where they signed on to the British NCSC-UK warning. This suggests the NSA knows something about targets in the US. If you read the technical details in this British public warning you can clearly see this wasn’t a small hacking campaign. It is plausible that at least with some of the vaccine projects they managed to get in.

    From the “sputnik vaccine” website we can see it uses a version of the gene for the spike protein. From their clinicaltrials.gov entry we know they put that in an ad26 vector for the first shot and an ad5 vector for the second. While this may be an approach many would take I can’t help but wonder if the people that designed Johnson and Johnsons ad26 vaccine and CanSino Bio’s ad5 vaccine aren’t getting very curious about what exactly is in this Russian vaccine. A genetic sequence might easily be stolen digitally and then reproduced anywhere.

    Using both ad26 and ad5 could be about hedging their bet on at least one of these being effective. Since both this “sputnik” and the CanSino bio vaccine have already been approved for the military and since any military would be very eager to have a vaccine for such a major threat to military readiness I wouldn’t be surprised if there had been some human challenge testing already.

    On safety if they are in the networks of others developing vaccines they could be slurping up early phase-III data as it comes in and use that to help make the final decisions on large scale use.

  51. anon says:

    AeroNabs! This technology is so powerful that viral illness might have been conquered. It might even be so powerful that the anti-vaxers will need to find a new cause. If we had had AeroNab technology one year ago perhaps the entire COVID pandemic could largely have been avoided.

  52. Carl says:

    As far as I can tell Russia is simply relabeling a Phase III trial for dramatic effect.

    Are you planning to write anything on AeroNabs because I’m curious how you assess their promise at this point?

    1. Derek Lowe says:

      Posted just as you were writing that comment!

      1. Carl says:

        Fast as a Russian vaccine trial!

    2. confused says:

      >>As far as I can tell Russia is simply relabeling a Phase III trial for dramatic effect.

      It might be a bit more than that re: giving it to high risk groups, but then China’s apparently vaccinating their military & certain traveling businesspersons already.

      I think the primary irresponsibility here is the PR re “approval”, not what is actually being done with the vaccinations themselves!

  53. An Old Chemist says:

    Russia offers to help US with Covid-19 vaccine; US says no

    https://www.cnn.com/2020/08/13/europe/russia-us-coronavirus-vaccine/index.html

  54. István Ujváry says:

    I was confused by the term ‘approved’ so reading the brief article on what it is meant clarified things:
    “The [registration] certificate allows the vaccine, developed by the Gamaleya Research Institute of Epidemiology and Microbiology in Moscow, to be given to “a small number of citizens from vulnerable groups,” including medical staff and the elderly, a Ministry of Health spokesperson tells ScienceInsider. But the certificate stipulates that the vaccine cannot be used widely until 1 January 2021, presumably after larger clinical trials have been completed.”
    https://www.sciencemag.org/news/2020/08/russia-s-approval-covid-19-vaccine-less-meets-press-release

  55. SALEH says:

    Derek Lowe says:
    “There are indeed waves of that stuff in particular posts, but then they move on. I worry that I’ll be putting myself in the position of Grand Inquisitor”
    The only way to avoid “off topic” icluding ethical or political comments is creating a thread treating exclusively of these needed aspects”
    This pandemic is such a global issue that it can’t only be squeezed to its technical dimension. There is a need to have a broader vision.
    Concerning Herd imunity , it is hard to be affirmative about the “real” level since so many persons have adapted their behaviour to the risk (masks , distancing) explaining maybe the lethality shrink in europe.
    The evolutive pattern is still not very clear
    Its as if the observed reduction in mortality is an addition of two things : 1-Behavioural changes + 2-Some level of Herd imunity = ( though most new cases in Europe are the result of much younger persons). Its artificial to separate these two dimensions.
    What I beleive is that we might be better prepared in some parts of the world to face the next phase if it ever . this is maybe wishfull thinking but who knows!!!

  56. An Old Chemist says:

    New RDIF Website Details Russia’s COVID-19 Vaccine as Global Phase III Trials Begin

    https://www.biospace.com/article/new-rdif-website-details-russia-s-covid-19-vaccine-as-global-phase-iii-trials-begin/

  57. David G Whiteis says:

    Not sure whether this is the appropriate thread — but it would appear as if our Fearless Leader is going to play dirty to ensure that a vaccine gets approved while it can still benefit him politically. If you thought there was a lot of scary vax-resistance going on before, just wait ’til THIS hits the fan . . .

    https://www.nasdaq.com/articles/moderna-and-other-coronavirus-vaccine-makers-to-take-reduced-payments-if-approval

  58. SteveM says:

    Russia’s COVID-19 Vaccine is Work of Several Decades, Gamaleya Deputy Research Director Reveals

    https://sputniknews.com/interviews/202008171080192137-russias-covid-19-vaccine-is-work-of-several-decades-gamaleya-deputy-research-director-reveals/

    Development pathway and clinical testing protocol described the Gamaleya Deputy Research Director. You guys in the business can assess his credibility and logic.

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