Corona(virus)? ITS NOT EVEN BEER DAMMIT!!!

[nicole]

Clinton wouldn't have jammed vaccines through FDA approval. I hate to say it, but on that point alone, not that there aren't hundreds more, it's a good thing she lost even though it did mean Trump won. Admittedly, that "Trump won" part is easier to say now that he's out of office and the world is still mostly intact.

Yeah. Considering I think Trump's biggest failure was not bitch-slapping the FDA, CDC, and WHO much harder, I'm not inclined to think Clinton would have been any better.

Of course, I'm also in a blue city in a blue state which had a series of absurd rules and failures and has been continually below the national average in rate of vaccination.

[nicole]

Also, we are literally laying the groundwork to just have more people living in households that aren't able to support or quarantine themselves. We're not encouraging people to be prepared, but the exact opposite. Encouraging them to live unsustainable lifestyles where they can't fulfill the basic responsibility not to endanger their neighbors if they get sick.

[Shem]

Clinton wouldn't have jammed vaccines through FDA approval.

Why not?

You think she would?

Some of the specific trappings were new, but the fight over rushing vs going slow in a pandemic was already won by "rushing" during the HIV crisis. The Covid-19 fight was led by AIDS researchers, and I have a hard time imagining they wouldn't have suggested speed (as they did now), or that any president wouldn't have agreed, if only to have someone to blame.

What makes you think she wouldn't?

[thoreau]

True, they could have made COVID-19 into Benghazi 2.0, something Hitlery deliberately bungled because she wants American Patriots to die.

But I also think there would be people refusing to stay at home if Big Government Hillary told them to.

Not as many by far, though. Look at the crazy ecosystem. Look at the hyping of non-outbreaks during the Obama presidency. The normal response is to say the government is hiding how bad things really are. They're be shit-scared, calling their homes their "bunkers", and talking about how Blue states are hiding the corpse disposal trucks from their coroners offices.

I think Trump pulled a really atypical response, a massive false negative, out of people massively biased forward false positives. That required a cult of personality that wouldn't have existed if he'd lost.

True. Bunker mentality would have mostly won out.

Clinton wouldn't have jammed vaccines through FDA approval. I hate to say it, but on that point alone, not that there aren't hundreds more, it's a good thing she lost even though it did mean Trump won. Admittedly, that "Trump won" part is easier to say now that he's out of office and the world is still mostly intact.

Yeah. Considering I think Trump's biggest failure was not bitch-slapping the FDA, CDC, and WHO much harder, I'm not inclined to think Clinton would have been any better.

She certainly wouldn't have approved them any faster. But, honesty, in terms of restoring the trust needed to get society working once people are vaccinated, I'm not sure the FDA waited too long. Yes, there's the standard libertarian argument that I should decide for myself whether to trust a vaccine, but you can't expect many people to trust it until at least the short term efficacy studies are done. Getting It all done in under a year was amazing. Without that data, you can't have enough trust to get people to take it in such numbers that the resource investments make sense.

Now, if you are willing to cross certain ethical lines, and deliberately expose volunteers to the virus after they're vaccinated, you could shave a few months off the timeline. Probably not as many as we'd like, and we'll just ignore the legal and ethical issues.

But all of these proposals to shorten even the testing that was already done come with staggering risks. If the vaccines weren't effective after the shortcuts and investments and public campaigns, we'd be in a terrible situation, even worse than COVID itself. And worse still when the next person bad virus comes along.

As it is I worry that these vaccines will turn out to have longterm side effects. Not because I think it likely, but because some of the tech is new, the testing was short, the approval process was short, and if it should turn out that they missed something the fallout will be staggering.

[lunchstealer]

Clinton wouldn't have jammed vaccines through FDA approval.

Why not?

You think she would?

Admittedly I have a pro-vaccine bias but looking like a vaccine hero is pretty much gonna be any bureaucrat's/technocrat's first instinct, and Taking This Shit Seriously would also be any technocrat's instinct, so I can't quite buy a scenario where she's all no no tick all the boxes very slowly you guys is her play. Especially not after the CDC/FDA testing debacle.

[nicole]

True, they could have made COVID-19 into Benghazi 2.0, something Hitlery deliberately bungled because she wants American Patriots to die.

But I also think there would be people refusing to stay at home if Big Government Hillary told them to.

Not as many by far, though. Look at the crazy ecosystem. Look at the hyping of non-outbreaks during the Obama presidency. The normal response is to say the government is hiding how bad things really are. They're be shit-scared, calling their homes their "bunkers", and talking about how Blue states are hiding the corpse disposal trucks from their coroners offices.

I think Trump pulled a really atypical response, a massive false negative, out of people massively biased forward false positives. That required a cult of personality that wouldn't have existed if he'd lost.

True. Bunker mentality would have mostly won out.

Clinton wouldn't have jammed vaccines through FDA approval. I hate to say it, but on that point alone, not that there aren't hundreds more, it's a good thing she lost even though it did mean Trump won. Admittedly, that "Trump won" part is easier to say now that he's out of office and the world is still mostly intact.

Yeah. Considering I think Trump's biggest failure was not bitch-slapping the FDA, CDC, and WHO much harder, I'm not inclined to think Clinton would have been any better.

She certainly wouldn't have approved them any faster. But, honesty, in terms of restoring the trust needed to get society working once people are vaccinated, I'm not sure the FDA waited too long. Yes, there's the standard libertarian argument that I should decide for myself whether to trust a vaccine, but you can't expect many people to trust it until at least the short term efficacy studies are done. Getting It all done in under a year was amazing. Without that data, you can't have enough trust to get people to take it in such numbers that the resource investments make sense.

Now, if you are willing to cross certain ethical lines, and deliberately expose volunteers to the virus after they're vaccinated, you could shave a few months off the timeline. Probably not as many as we'd like, and we'll just ignore the legal and ethical issues.

But all of these proposals to shorten even the testing that was already done come with staggering risks. If the vaccines weren't effective after the shortcuts and investments and public campaigns, we'd be in a terrible situation, even worse than COVID itself. And worse still when the next person bad virus comes along.

As it is I worry that these vaccines will turn out to have longterm side effects. Not because I think it likely, but because some of the tech is new, the testing was short, the approval process was short, and if it should turn out that they missed something the fallout will be staggering.

It’s not like it’s only about the vaccines, although I would 100% say they should have rushed faster to approve them and should have allowed challenge trials to speed the results. But there’s also other issues, like the lab tests that didn’t work last winter, the lack of approval for cheap at-home tests, the fact the FDA prohibited researchers from testing flu survey samples for covid last February, etc. I continue to primarily blame actions in January and February 2020 more than anything else.

[nicole]

Clinton wouldn't have jammed vaccines through FDA approval.

Why not?

You think she would?

Admittedly I have a pro-vaccine bias but looking like a vaccine hero is pretty much gonna be any bureaucrat's/technocrat's first instinct, and Taking This Shit Seriously would also be any technocrat's instinct, so I can't quite buy a scenario where she's all no no tick all the boxes very slowly you guys is her play. Especially not after the CDC/FDA testing debacle.

As we have seen in this thing called Real Life, every bureaucrat’s instinct has been to get vaccinated himself before almost anyone else is eligible and then not to give a fuck what happens to anyone else because it completely doesn’t matter and will have no personal consequences.

[thoreau]

I would also support challenge trials. While I think they might only buy us a few months in the more plausible scenarios, a few months would still be valuable.

But there's no way America's professional classes would allow challenge trials for anything the public would ever hear about. Too many people would get queasy, so they would only ever use them for stuff that people should get queasy about and would hence never hear about.

[D.A. Ridgely]

Clinton wouldn't have jammed vaccines through FDA approval.

Why not?

You think she would?

Some of the specific trappings were new, but the fight over rushing vs going slow in a pandemic was already won by "rushing" during the HIV crisis. The Covid-19 fight was led by AIDS researchers, and I have a hard time imagining they wouldn't have suggested speed (as they did now), or that any president wouldn't have agreed, if only to have someone to blame.

What makes you think she wouldn't?

For one thing, because she's a conventional politician and an institutionalist. For another, the risk that it might backfire on her if the vaccines proved dangerous after all, a risk Trump didn't give a rat's ass about. Finally, there isn't enough in it for her. First female president, automatic lock on history. Female president who takes a risk that goes sideways? No, not her.

But it's counterfactual, so who knows?

[Jennifer]

Here's some things Trump did which, I'm quite certain, a President Hillary would NOT have done, to make covid worse for America: confiscated PPE from well-equipped states who'd had the gall to not-vote for her; ordered whoever headed up her coronavirus task force to withhold aid from states whose voters did not pick her or whose governors deigned to criticize her; had the states compete amongst themselves for scarce PPE; told America the whole thing was a hoax invented by her political opponents to make her look bad; repeatedly encouraged her supporters to attend crowded mask-free rallies; told America that if she lost re-election, the media would cease all mention of covid by the next day.

[Eric the .5b]

And even if there had been a slightly slower vaccine rollout, if we'd just hit the grim milestone of one hundred thousand deaths instead of half a million, we'd be pretty far ahead of the real-world game.

[D.A. Ridgely]

And if wishes were horses we'd all be riding. I'm not saying Trump's push on the vaccines makes up for the rest of his botching the pandemic. I'm just saying give the devil his due on that point. And the FDA could have taken, usually does take years to approve new drugs. Would rabid Team Red members have been any more likely to quarantine or wear masks if Clinton said it was the right thing to do? I think not. As for how many people would have died if it had been on her watch, who knows?

[lunchstealer]

I would also support challenge trials. While I think they might only buy us a few months in the more plausible scenarios, a few months would still be valuable.

But there's no way America's professional classes would allow challenge trials for anything the public would ever hear about. Too many people would get queasy, so they would only ever use them for stuff that people should get queasy about and would hence never hear about.

Would challenge trials have really shaved off the necessity for Phase 1 and Phase 3 trials? The broadness and length of the Phase 3 trials was kind of necessary to determine how safe the vaccines were, in addition to how effective they were. Challenge trials might shave something off the effectiveness portion but not off the safety portion which requires a reasonably long observation of a large sample size. Seems like maybe you gain a month or two but even that doesn't seem guaranteed.

[lunchstealer]

Clinton wouldn't have jammed vaccines through FDA approval.

Why not?

You think she would?

Admittedly I have a pro-vaccine bias but looking like a vaccine hero is pretty much gonna be any bureaucrat's/technocrat's first instinct, and Taking This Shit Seriously would also be any technocrat's instinct, so I can't quite buy a scenario where she's all no no tick all the boxes very slowly you guys is her play. Especially not after the CDC/FDA testing debacle.

As we have seen in this thing called Real Life, every bureaucrat’s instinct has been to get vaccinated himself before almost anyone else is eligible and then not to give a fuck what happens to anyone else because it completely doesn’t matter and will have no personal consequences.

This isn't the DMV we're talking about. The incentives aren't there for someone to tune out before the bulk of the general populace feels safe.

[thoreau]

I would also support challenge trials. While I think they might only buy us a few months in the more plausible scenarios, a few months would still be valuable.

But there's no way America's professional classes would allow challenge trials for anything the public would ever hear about. Too many people would get queasy, so they would only ever use them for stuff that people should get queasy about and would hence never hear about.

Would challenge trials have really shaved off the necessity for Phase 1 and Phase 3 trials? The broadness and length of the Phase 3 trials was kind of necessary to determine how safe the vaccines were, in addition to how effective they were. Challenge trials might shave something off the effectiveness portion but not off the safety portion which requires a reasonably long observation of a large sample size. Seems like maybe you gain a month or two but even that doesn't seem guaranteed.

Challenge trials definitely couldn't eliminate Phase I, where you just see if the vaccine is safe to administer.

A Phase 2 challenge trial would presumably look for effectiveness in a small sample. The test of effectiveness would be shorter, because instead of following people and seeing if they come down with COVID in the course of ordinary life (and it could take a while before they've been exposed) you just expose them after the vaccine has had a few weeks to take effect. It could definitely speed that up.

What we wouldn't know after that Phase 2 challenge trial, even a large one:
1) How long does the protection last?
2) Does it protect people who aren't the more-or-less healthy sorts you could plausibly use in a challenge trial?

Even if Phase 3 were conducted as a challenge trial (which it really shouldn't be if you want to evaluate safety in a larger population that includes people who aren't terribly healthy), a phase 2 challenge trial could justify vaccinating more healthy young volunteers, especially from "essential worker" categories. That probably would have made a meaningful difference in the spread of the virus, if healthy young workers interacting with lots of other people were protected and unlikely to transmit. (Yes, I know, we don't have ironclad data on transmission yet, but humor me here. At the very least, it would cut transmission somewhat, and bring down R0.)

Meanwhile you could do a robust Phase 3 to determine whether this vaccine is worth the resources needed to get it to the general public.

Best case scenario: Phase 3 starts a couple months sooner. We get wider approval in October instead of December. A substantial fraction of essential workers have already been vaccinated when the large-scale roll-out starts, so we're another month ahead of the game. And we've reduced the number of deaths in the interim by tens of thousands, if not more.

I'd say it would be worth it, and not just in the libertarian ethical sense of "The volunteers consented."

But getting people on board with challenge trials? Yikes.

[nicole]

Clinton wouldn't have jammed vaccines through FDA approval.

Why not?

You think she would?

Admittedly I have a pro-vaccine bias but looking like a vaccine hero is pretty much gonna be any bureaucrat's/technocrat's first instinct, and Taking This Shit Seriously would also be any technocrat's instinct, so I can't quite buy a scenario where she's all no no tick all the boxes very slowly you guys is her play. Especially not after the CDC/FDA testing debacle.

As we have seen in this thing called Real Life, every bureaucrat’s instinct has been to get vaccinated himself before almost anyone else is eligible and then not to give a fuck what happens to anyone else because it completely doesn’t matter and will have no personal consequences.

This isn't the DMV we're talking about. The incentives aren't there for someone to tune out before the bulk of the general populace feels safe.

Aren’t they? Am I not paying taxes right now? Am I not in fact paying taxes for less service, ie a better deal than ever for bureaucrats?

[dbcooper]

[Mo]

Clinton wouldn't have jammed vaccines through FDA approval.

Why not?

You think she would?

There’s not a country in the world that didn’t accelerate the approvals process. The US was on the early side of approving the vaccines, but not much faster than others. Countries with policies as divergent as the UK, EU, Israel, Singapore, etc. all approved the vaccines I. The mid-Nov to mid-Dec timeframe.

[Mo]

I would also support challenge trials. While I think they might only buy us a few months in the more plausible scenarios, a few months would still be valuable.

But there's no way America's professional classes would allow challenge trials for anything the public would ever hear about. Too many people would get queasy, so they would only ever use them for stuff that people should get queasy about and would hence never hear about.

Would challenge trials have really shaved off the necessity for Phase 1 and Phase 3 trials? The broadness and length of the Phase 3 trials was kind of necessary to determine how safe the vaccines were, in addition to how effective they were. Challenge trials might shave something off the effectiveness portion but not off the safety portion which requires a reasonably long observation of a large sample size. Seems like maybe you gain a month or two but even that doesn't seem guaranteed.

Challenge trials definitely couldn't eliminate Phase I, where you just see if the vaccine is safe to administer.

A Phase 2 challenge trial would presumably look for effectiveness in a small sample. The test of effectiveness would be shorter, because instead of following people and seeing if they come down with COVID in the course of ordinary life (and it could take a while before they've been exposed) you just expose them after the vaccine has had a few weeks to take effect. It could definitely speed that up.

What we wouldn't know after that Phase 2 challenge trial, even a large one:
1) How long does the protection last?
2) Does it protect people who aren't the more-or-less healthy sorts you could plausibly use in a challenge trial?

Even if Phase 3 were conducted as a challenge trial (which it really shouldn't be if you want to evaluate safety in a larger population that includes people who aren't terribly healthy), a phase 2 challenge trial could justify vaccinating more healthy young volunteers, especially from "essential worker" categories. That probably would have made a meaningful difference in the spread of the virus, if healthy young workers interacting with lots of other people were protected and unlikely to transmit. (Yes, I know, we don't have ironclad data on transmission yet, but humor me here. At the very least, it would cut transmission somewhat, and bring down R0.)

Meanwhile you could do a robust Phase 3 to determine whether this vaccine is worth the resources needed to get it to the general public.

Best case scenario: Phase 3 starts a couple months sooner. We get wider approval in October instead of December. A substantial fraction of essential workers have already been vaccinated when the large-scale roll-out starts, so we're another month ahead of the game. And we've reduced the number of deaths in the interim by tens of thousands, if not more.

I'd say it would be worth it, and not just in the libertarian ethical sense of "The volunteers consented."

But getting people on board with challenge trials? Yikes.

Challenge trials would have, at best, shaved a month off the timeframe. The disease was so widespread in the US that life was basically a challenge trial (less true in the UK). Phase II kicked off in early May for Moderna early June for Pfizer. Throw in the 6 week timeframe from a jab to 2 weeks after the second dose and you get early Phase II data in either late June or late July. In reality, early Phase II data came in mid July/mid August. That’s a delay of a couple weeks. You end up with a similar situation for Phase III.

Challenge trials made more sense in the UK over the summer because cases were so low.

[Hugh Akston]

The early-days testing bottleneck created by the FDA was a feature in both universes.

[lunchstealer]

Jesus fucking Christ.

I was going to comment about geophysicists but that was literally the next tweet in the thread.

[nicole]

Tfw you decide to take a break from telling the press about how you knowingly lie to the American people in an effort to socially engineer their response to the pandemic

[Warren]

Tfw you decide to take a break from telling the press about how you knowingly lie to the American people in an effort to socially engineer their response to the pandemic

Ugh. My parents are on Team Fauci. Something about Trump man bad, but I don't have the patience to connect the dots in their world of delusion.
Ah well. I tell myself that they're old and will be dead soon.

[dbcooper]

[lunchstealer]

Tfw you decide to take a break from telling the press about how you knowingly lie to the American people in an effort to socially engineer their response to the pandemic

Ugh. My parents are on Team Fauci. Something about Trump man bad, but I don't have the patience to connect the dots in their world of delusion.
Ah well. I tell myself that they're old and will be dead soon.

I'm mostly on team fuck 90% of Fauci's critics. And if the social engineering bit is about the masks early on, it's way down the list for me in terms of was this straight up unethical. Dumb in that it fueled the antimaskers NBD dipshits and they should never be fueled, but if the downside requires shitty behavior on the part of shitty people for it to be a downside there's shared guilt and he at least wasn't being selfishly malicious.

And Trump etc were so incredibly dishonest and inept and belligerently incompetent that they made Fauci the near sole voice of reason when a sane/competent administration could've promoted someone more competent and actually handed him some consequences for the mask thing.