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Sunday, March 15, 2020

Vaccine for me (my country only, the US), not for thee: President Trump edition

Bothell High School, Washington State, digital message signboard "Wash Your Hands!!!"
Northshore School District, which includes Bothell High School north of Seattle, announced it was closing its entire district for up to two weeks.Credit...Lindsey Wasson/Reuters

At some point I'll write about the coronavirus and the implications it raises concerning universal health coverage, public health, public administration, and government competence in the face of an anti-government neoliberal philosophy.

I am flabbergasted that President Trump is trying to buy a German pharmaceutical research firm working on a coronavirus vaccine with the proviso that any vaccine produced would only be for the United States ("Germany tries to halt U.S. interest in firm working on coronavirus vaccine," Reuters; "U.S. Offered ‘Large Sum’ to German Company for Access to Coronavirus Vaccine Research, German Officials Say," New York Times).

It reminds me of the movie, "Head of State" where Chris Rock runs for president (not a great movie).  His opponent is known for the line:

God Bless America.  And no place else.



This from an administration that failed to create a working lab test ("CDC coronavirus testing failure is a national outrage," San Jose Mercury News) and has vaccine research facilities that appear unable to address the current contagion ("Federal vaccine development sites ill-suited to counter covid-19 epidemic," Washington Post).

I'm surprised that Jared Kushner ("Infighting, missteps and a son-in-law hungry for results: Inside the Trump administration’s troubled coronavirus response," Washington Post) didn't reach out to Elizabeth Holmes  ("Elizabeth Holmes' peril: Is Theranos founder facing ruin?," SJMN) for help on the testing side!

Suzanne and I are pretty different.  She has a sour  view of the community side of things, and generally doesn't believe that in bad times people will come together.  I am more optimistic, believing in the potential for community and connection even if it happens so rarely, and our elected officials aren't particularly great when it comes to vision and striving for better.

But in the vein of Suzanne, movies like "Right At Your Door" and "Contagion" challenged my thinking.  Both movies show outcomes and community and herd behavior that are pretty terrifying.

I was joking with her earlier today that the cable channels should be showing these movies on repeat.  Then again, people don't need to get ideas.

It's bad enough that supermarket shelves of toilet paper, rice and beans, and water are stripped bare.  What's wrong with tap water and do you really not have enough toilet paper stocked up otherwise?

PBS has provided open access to the American Experience episode on the "Spanish Flu" epidemic of 1918.  I guess one of the only reasons I know about it is because fiction writer John O'Hara wrote a bunch of stories about it, he being the son of a doctor active during the epidemic and a few decades ago I read a bunch of his books.

Right now, Covid19 disproportionately impacts the elderly.  What happened with "Spanish flu" is that it mutated between the first wave and the second, and became particularly virulent for young adults.

This NYT piece allows you to model various scenarios in dealing with Covid19.

-- "Opinion | How Much Worse the Coronavirus Could Get, in Charts"

Given that our health system has limited slack capacity in hospital beds generally and ICU beds specifically, a large marginal increase in demand in periods of already peak demand will swamp the system. That's what's happening in Italy ("Coronavirus: Italy records 368 new COVID-19 deaths - largest number in a day," SkyNews). To extrapolate, Italy's population is about 20% of the US.

9 comments:

  1. charlie10:26 AM

    I'm very doubtful on the German story. Yes, every county -- starting with Germany is hoarding medical supplies. Ask how many ventilators they've sent it Italy.

    But the German biotech seems more about an internal coup at the company where they got rid of their American CEO. I don't doubt they got a offer for an incentive payment for a vaccine - in fact that is what the government should be doing. Basically saying $10B for the first company to have a vaccine - but the drug is free.

    George W Bush was big in to pandemic planning -- and started four government run vaccine sites. They have done zero.


    If you want bad faith, look at the FDA trying to ban Gilead from sending experimental samples to China. Or the chinese refusing to export cured patients blood for antibody therapy -- or for that matter not shipping out virus samples. Plenty to go around.




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  2. Yes about the German thing, it's hard to say what's the truth.

    2. But about bad faith, there is a lot to go around. Authoritarianism and state control wants to push ideology first. Given the problems China has in HK, the last thing they wanted to do was show any weakness. But it blew up in their face.

    The US and "Brand America" has been diminished by Trump's international tea partyism, so of course countries are less inclined to work together.

    And the rise of supra partisanship means that ideology trumps reality and the truth is the first casualty.

    Yes, plenty of bad faith to go around.

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  3. charlie1:19 PM

    https://www.biopharmadive.com/news/coronavirus-curevac-trump-access-research-us/574181/

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  4. Thanks. Hmm. It's not like what they're working on is immediately usable. It seems to be an unproven approach, or at least, one that hasn't been approved thus far.

    (It's like reading comments on articles. I remember one saying "maybe I read too much Robin Cook, but this seems bioengineered to attack old people." If it were "that easy" to do this stuff, regular pharmaceuticals like serotonin uptake inhibitors would have more than a 30% efficacy rate.

    When I was doing the proposal on biotechnology and medical research and education for WR, that was when Inova bought the ExxonMobil site and was going all in on personalized genetic approaches to cancer, etc. They've since abandoned that approach...)

    cf. bad faith, https://foreignpolicy.com/2020/03/09/truth-coronavirus-china-trump-pence/

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  5. charlie3:38 PM

    The problem with RNA viruses is getting the dosing right. One reason why they've never been brought to market. Fauci was pushing them hard for Ebola and Zika -- the idea is you can create a vaccine in 2-3 months and manufacturing is much easier.

    moderna actually wants to do personalized cancer vaccines; again on paper brilliant but getting it to work is hard. A lot of the hype has left personalized medicine in the past year. It is great science but bad medicine.


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  6. Great line:

    It is great science but bad medicine.

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  7. charlie10:06 AM

    More on curevac:

    https://www.politico.eu/article/eu-weighs-into-german-american-spat-over-vaccine-company/

    Again I don't know what happened, but reading between the lines it seem as if the primary investor wanted the CEO out.

    Lots of score settling going on now.

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  8. charlie12:26 PM

    also this:

    https://blogs.sciencemag.org/pipeline/archives/2020/03/16/curious-case-of-curevac

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  9. thx. maybe not quite as elongated a realization curve as nuclear fusion, but not likely to be the saving grace now.

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