breaking covid rules

[Warb]

Until people start to die they will not comply.

At which point they will blame the government....

[ian]

We are now getting information that is very muddled - "we can't get the vaccine" does not necessarily mean "we can't get ANY vaccine", it might mean "we can't get Pfizer". Not the same thing, and it might be unfair to blame the government (or anyone else) for ordering a product that was the right product at the time, but has now become unpopular. As it stands, my wife will shortly be getting 300 doses of AZ delivered (the current minimum order) but has only 25 people who want it......

that might be Australia's vaccination "problem" right there.

If you are under 60, the "authorities" (the ATAGI) recommend that you get Pfizer not AstraZeneca. If vaccine wastage (for AstraZeneca) is over 90%, no wonder the Australian vaccine rollout is a "well managed" disaster. I don't know the demographic profile (age breakdown) of your regular customers, or their vaccination status, but across Australia in 2016 approximately 5 million people were aged over 60. Perhaps when discussing the number of people who can be vaccinated per shipment, I should drastically revise downwards my estimate of the number of people who are able to be vaccinated per shipment of vaccine. If vaccine wastage is over 50% -- which is still well under your reported 90% wastage -- Australia will need around 60 million doses of Pfizer to fully vaccinate everyone aged between 12 and 60. But perhaps the country will need more than 100 million doses [of Pfizer] before everyone has received two jabs.

That leads me on to the issue where I do think the government is perhaps making mistakes, in that we have millions of doses of AZ being locally manufactured, that nobody wants. And we'll still (as taxpayers) pay for them, even though we're paying a local manufacturer. Much of that production will end up being given to other countries, which is a lovely act of humanitarianism if that floats your boat, but a waste of money if it doesn't. It also creates a financial problem, because we're paying for something we don't want, whilst not getting what we do. But we've already placed the orders and seemingly (lots of "no comments" or "for commercial reasons") can't get out of them... I don't know the details of the contracts, but this does seem like a problem!

according to ABC news Australia has donated 2.5 million doses of AstraZeneca to Indonesia.




But what really gets me is the really small number of people who have so far been vaccinated in Australia.
The daughter of a really good friend is a nurse. Because she is in her late 20s she should be getting jabbed with two shots of Pfizer. But when will that be ???

[woodPixel]

Link government payments to COVID vaccination?

[Warb]

If vaccine wastage (for AstraZeneca) is over 90%, no wonder the Australian vaccine rollout is a "well managed" disaster.

The wastage is not 90%, 300 doses is just the minimum order quantity for pharmacies. Each vial contains 10 doses, and the shelf life (unopened vial) is 6 months. So the pharmacy will book 10 people (or multiples of 10) on any given day, and use a complete vial - 0% wastage. The other vials will sit on the shelf (actually in the fridge!) until they are used. I hope (!) that people will come to their senses and start getting vaccinated. If not, there are mechanisms in place to return unused medicines (well before their expiry dates) for use elsewhere.

My point was not that vaccine is being wasted, merely that it (AZ) is in fact available but people don't want it!

The Pfizer vaccine is still in short supply. Much as the Australian media likes to tout our "special relationship" with the US, and our (largely imagined) importance on the world stage, in fact we can only get what those overseas manufacturers will provide, which at this point is not very much. That will improve once their local demand decreases [I was going to say "dies down", but that sounds wrong!]. I'm not sure (even in my own area) if there's a prioritisation of Pfizer jabs for health workers, but back when I got my 1st AZ shot there was most definitely prioritisation of healthcare workers (over 50) for AZ. The early rollout in my area targeted healthcare and other associated workers, together with those with pre-existing medical issues.

It's not really relevant to this discussion, it just popped in to my head, but it's interesting to note that the medical profession makes huge numbers of recommendations. Don't smoke, don't drink too much, don't be obese, do exercise, eat healthily. It's funny how people pick and choose which "medical advice" to follow and which to ignore.

BTW, "has donated" doesn't necessarily mean they've actually been sent. Politicians are very good at making grand gestures and then taking months if not years to deliver on their promises!

[ian]

Link government payments to COVID vaccination?

Ha, Ha, Ha

At the current pace of the vaccine "roll out" it will be 2023 before there's enough vaccine doses in Australia to actually implement this idea.



Of course, the Government could implement the policy change from Monday July 19, but given that at the current rate of vaccine deliveries, it will be late 2022 before there's enough vaccine to go around. I don't think the Government really wants a rerun of the Robo Debt debacle?

[ian]

The wastage is not 90%, 300 doses is just the minimum order quantity for pharmacies. Each vial contains 10 doses, and the shelf life (unopened vial) is 6 months. So the pharmacy will book 10 people (or multiples of 10) on any given day, and use a complete vial - 0% wastage. The other vials will sit on the shelf (actually in the fridge!) until they are used. I hope (!) that people will come to their senses and start getting vaccinated. If not, there are mechanisms in place to return unused medicines (well before their expiry dates) for use elsewhere.

My point was not that vaccine is being wasted, merely that it (AZ) is in fact available but people don't want it!

Well given the extremely low number of cases in Australia. Excluding Ruby Princess, folks in aged care and those in quarantine, how many cases has there been?
less than 5,000 ? In terms of the risk of having a really bad outcome if you catch Covid vs getting blood clots from the AstraZeneca vaccine -- the relative risk of AZ looks about the same to these eyes.

And by providing Drs with an indemnity, the Commonwealth Government has just reinforced the PERCEPTION that the risk of getting jabbed with AZ is excessive.




Being trapped in a country where, between January and April, the health authorities were drawing six Pfizer doses from a five dose vial really puts the failure of Australia's vaccination effort into some sort of perspective.

[Warb]

Well given the extremely low number of cases in Australia. Excluding Ruby Princess, folks in aged care and those in quarantine, how many cases has there been?

Excluding, I have no idea. In total there have been just shy of 31,000 cases of covid, and 910 deaths. That's a 2.9% case death rate (quite poor compared to Canada and the US, both at 1.8%) . The risk of clots (TTS) with the AZ vaccine is 2.7 in 100,000 for those over 50-59, that's 0.0027%. Of those 2.7 people, the current death rate is 4% - that's 4% of the 2.7 out of every 100,000, which is about 0.1 people per 100,000 who get vaccinated, which in turn is about 0.0001%. The risk decreases with age.

So, WHEN you catch covid (let's assume that eventually if you're not vaccinated you WILL get it) you have a 2.9% chance of dying, which increases with age and underlying conditions. Alternatively you can take the massive 0.0001% chance of dying from an AZ jab.

Those are Australian figures. In the UK there have been 395 cases of blood clots (70 deaths), with around 25million first jabs (21million 2nd jabs, but I'm not sure they've ever caused an issue). So that's a 0.0003% chance of dying from the vaccine, compared with 2.6% who die from covid. Keep in mind that currently AZ is recommended for anyone over 40 in the UK, and those numbers also include the younger people who had it before the side effects were known, and before treatments for those side effects were developed - initially 25% of cases of TTS died, now, as I said, it's down to 4% because we have a better understanding of what is happening.

To put these numbers in to perspective, statistically you are more likely to get hit by lightning than die from the AZ vaccine. Taking an aspirin every day (to prevent heart disease etc.) kills 10 out of every 100,000 a year (compared to AZ at 0.1 people per 100,000). The odds of winning the smallest (AU$3million) Powerball jackpot are 1 in 76million.

Another way to look at it is that 910 people in Australia have died of covid ALREADY, even though only 31,000 have had the disease. AZ would kill (statistically) 0.1 people per 100,000, which means that if everyone over 50 got an AZ shot, and let's say that's around 7million people (just a guess), 7 would die. If (when) those 7 million get covid, 2.9% of them - that's 203,000 - will die.

Sadly many people seem to have been entirely taken in by the media's view that AZ kills everyone who even touches the bottle. Never let the truth get in the way of a good story, eh?

[ian]

Well, I never thought that Australia would become a "developing economy" when it came to approval and adoption of human vaccines. But with the AstraZeneca vs Pfizer debate, it appears to have become one.

Many years ago there was a discussion -- I think on the ABC's Science Show -- about why countries identified as "developing economies" were reluctant to endorse the use of a vaccine NOT APPROVED for use in the west (USA, Canada, Western Europe). The example country may have been India, but it's a long time ago now and I was more interested in the ethical question -- why a country should endorse a less safe vaccine when there was a "safer" vaccine alternative -- than the actual details of the particular country.

In a nut shell the discussion was -- why should a country endorse, for domestic use, a vaccine that was not approved for general use by the US CDC? The consensus response was that politically it wouldn't look good for a government to endorse a vaccine that was not approved by the CDC. A country might be able to endorse a vaccine where the side effects were in the same order of magnitude as that of an approved vaccine, but when the side effects were an order of magnitude (10x), or more, worse local endorsement wouldn't politically be feasible.

Parallels with Australia in mid-2021?

But Australia's "problem" is that almost all our eggs are currently in the AstraZeneca basket, and there is nowhere nearly enough Pfizer doses on order, let alone due in country this year, to fully immunise the entire population.
And while we are talking of Pfizer (and Moderna) mRNA vaccines, on June 23, health.com (Heart Inflammation a Rare Side Effect of mRNA COVID Vaccines in Young People | Health.com) reported that: "early data for adolescents and young adults ages 12 to 39 suggests that these problems are occurring at a rate of 12.6 per million doses" That would be 1.26 cases per 100,000. (The chart of AstraZeneca's adverse side effects -- Who can get the AstraZeneca COVID-19 vaccine in Australia and what are the risks? - ABC News -- doesn't provide data for the 12-39 cohort -- perhaps the numbers don't exist? -- but the early CDC data suggests that the mRNA vaccines are about 1/3 "safer" than AstraZeneca.



As an aside, AZ's "problems" around CDC endorsement for emergency use seem to relate to the large number of instances where only half doses were administered to volunteers during one of the trials.

[ian]

Another way to look at it is that 910 people in Australia have died of covid ALREADY, even though only 31,000 have had the disease. AZ would kill (statistically) 0.1 people per 100,000, which means that if everyone over 50 got an AZ shot, and let's say that's around 7million people (just a guess), 7 would die. If (when) those 7 million get covid, 2.9% of them - that's 203,000 - will die.

If you want to arrive at a more accurate guess than 7 million, try 3101.0 - Australian Demographic Statistics, Jun 2019 which has an age break down by sex (Male / Female) and year. For Australian's aged over 50, ABS reports an estimate of 8.51 million in a total "resident population" of 25.36 million. To which should be added about 1 to 2 million "visitors".


Having used ABS statistics in a past life, I know that you are able to obtain the detailed age and sex population break down for your part of the Central West.

Using Orange as an example:

Age cohort Orange (C)

All ages 42 451

0 - 4 3 222

5 - 9 3 085

10 - 14 2 974

15 - 19 2 618

20 - 24 2 493

25 - 29 2 896

30 - 34 3 026

35 - 39 2 784

40 - 44 2 541

45 - 49 2 637

50 - 54 2 457

55 - 59 2 414

60 - 64 2 254

65 - 69 2 083

70 - 74 1 795

75 - 79 1 240

80 -84 968

85 and over 964

so, if your part of the Central West is Orange, the population over 60 as at the end of 2019 was 10,754, or 25.3%

[Warb]

Many years ago there was a discussion -- I think on the ABC's Science Show -- about why countries identified as "developing economies" were reluctant to endorse the use of a vaccine NOT APPROVED for use in the west (USA, Canada, Western Europe).

The approval's of medications, and many other things, is largely based on international data. Very few countries have the resources or time to carry out full scale trials on every product - whether that product is a vaccine or a powerdrill. So what normally happens is that a mass of international data is presented to whatever authority is in charge, and then that authority will decide whether any local testing is required to fill in gaps in the data to satisfy any local requirements. The "international data" might be test results from a recognised lab overseas, or the results of trials in a mass of other countries. In pharma, a company will organise clinical trials in several different countries, normally those who are both initial target markets and who have more involved/fussy approvals processes. The results of those trials go back to base, the numbers are crunched by an army of SAS programmers and the results then presented to the various authorities.

The reason that developing countries prefer to use drugs approved by the major economies is actually very simple. They don't have the resources to develop and/or test drugs themselves, so piggy-backing on the work of someone else is the easiest and cheapest option. Simples.

In the case of AZ in the US, there is also a political issue. Pfizer is a US company, AstraZeneca isn't. From both political and financial viewpoint, the US would prefer to use a US made vaccine so approval of their local product is prioritised. Also remember that clinical trials are a very expensive process, and usually take years. Rushing trials through in countries where you potentially don't have a big market due to local competition (or perhaps even the ability to manufacture in sufficient quantity) is a waste of resource, especially if you have an inkling that your product might get what should I say, maybe "delayed a touch", for political reasons.

Above all this there are still three points that seem to be slipping past. Firstly, when Australia ordered the AZ vaccine, there was no reason to suspect it had any issues. Secondly, the risks are absolutely trivial - 1/3 less risk is irrelevant when the risk is so small to begin with -1/3 the risk of a side affect against 5 orders of magnitude greater risk from the disease. Lastly, the production of these vaccines is still limited, and it is difficult to change production and distribution just because some tiny little country "wants more", especially when your own government wants everything that you can produce.
It's really a pointless discussion, because the media have created an issue - presumably for politicial reasons - that has no bearing in real life. The result is that instead of having a good proportion of the population vaccinated, people are more scared of the vaccine than a disease that is 28,000 times more likely to kill them. And if/when the Sydney outbreak really takes off, tens of thousands will die as a result.

OTOH, going back to survival of the fittest, perhaps this is the new evolution? Those smart enough to get vaccinated........

[Lappa]

. The risk decreases with age.

In actual fact, it goes UP after age 70 if the information from the Australian Govt is correct.

93CF1AA8-AA9C-48FA-B4A6-C9A8E74220DA.jpg

[Beardy]

The biggest issue I see is poor communication from the government. Scomo does a poor job of controlling/ managing the media. I don’t think they necessarily do a bad job or make a lot of poor decisions but they don’t sell it or explain it well and don’t counter the dribble that the media carry on with so things get out of hand and he sits silently and lets it fester.
The fires was an embarrassment to the Libs by the way it was viewed / portrayed but I don’t think they got it that wrong as a lot the responsibility was at a state level but they copped a lot of flack because they handled the communication with the public poorly. I was embarrassed watching him visiting the communities during the fires.
Covid has been a similar thing although he started out strong as have our state leaders but he is second rate compared to the state guys when it comes to addressing the public and getting them onside with his decisions

If you cut all the crap out and look at the facts and don’t judge in hindsight they appear to have made reasonable decisions on the day with what was known at the time.
I don’t know why they don’t publicly set out the timeline and decisions that were made and explain why they were made at the time for everyone to see clearly the chain of events so we can put to bed the media circus and political point scoring that is going on and give the public some confidence that we are doing the best we can under the circumstances.

[Warb]

In actual fact, it goes UP after age 70 if the information from the Australian Govt is correct.

Well, it decrease after the age of 50-59, and then creeps back up - but still staying below the levels of the 50-59 bracket. Once again, we are comparing tiny numbers - remember that only 4% of those experiencing TTS will die, so in real terms the death rate difference between the 1.4/100,000 (60-69 year olds) and 1.9/100,000 (80+ year olds) is 0.2 people per million who get the jab. So if 5 million of each age group get vaccinated, 1 more 80+ year old will die compared to the 60-69 years old.

1 additional person over 80 out of "every" 5 million......

Compare to the death rates from covid - in Australia there have been just under 400 deaths from covid, and about 55 of them have been people under the age of 70. That means that the 2.7% case death rate from covid is almost entirely directed at the elderly. The case fatality % for the under 60's is below 0.1%. For the next three age groups it is about 1.5% (60-69yrs), 26% (80-89yrs) and 34% (90+). So 1 in four 80 year olds who get covid will die, compared to 0.76 in 1 million that will die from the vaccine.

Still the same problem, we're fixating on tiny risks whilst the whopping great big risks are bearing down on us.... 50 new cases in NSW yesterday, all but 13 have spent all or some of their infectious period wandering around the community.

[ian]

In actual fact, it goes UP after age 70 if the information from the Australian Govt is correct.

93CF1AA8-AA9C-48FA-B4A6-C9A8E74220DA.jpg

I think that Warb's point is that given the relative risk -- catching Covid and becoming so ill that you require hospitalisation vs the risk of getting a blood clot from the AstraZeneca vaccine (3.1 per 100,000 for those under 50) -- there is nothing inherently wrong with the AstraZeneca vaccine. I tend to agree with Warb, given the choice -- take the AstraZeneca jab vs get Covid badly enough to send you to hospital -- the vaccine is the better option.


However, my basic point was that the approval of a vaccine is ultimately a political decision NOT a health one. cf Australia in July 2021.
When faced with a choice between two or more nearly equal [in their efficacy] vaccines, "developing countries" tend to choose the one with the lower rate of [reported] adverse side-effects. This political decision, persists even when doing so means that because of the substantial difference in cost between the alternatives, the "developing country" can only afford to treat less than half their target population. Dredging my memory, the political decision persisted even when the disease being vaccinated against resulted in 100x the death or disability rate that the "inferior", but less expensive, vaccine would treat.
For example,
if the death rate of the disease itself is 3 in 100 (which approximates the Australian experience of the Covid death rate),
and the vaccine alternatives 'A' or 'B' will reduce that to 1 in 100,000 all might be good if the cost per treatment and adverse side-effects was the same for both vaccines.
However, if vaccine 'B' is significantly less expensive that vaccine 'A' -- in practice meaning that significantly more of the target population can be treated for the same dollar amount -- but vaccine 'B' will result in the death/disability of 3 in 100,000 (think AstraZeneca for under 60s), while vaccine 'A' will not.
The political decision will be to go with vaccine 'A', despite vaccine 'B' still producing a 1000x better result than not being vaccinated at all.



It will be interesting to see how the Australian media play out the recent news regarding heart muscle issues associated with the Pfizer and Moderna mRNA vaccines. Initial indications (reported by the US CDC) are that for those under 35, the mRNA vaccines have a similar adverse side effect risk profile as does the AstraZeneca for those over 60.
(I understand that in Australia AstraZeneca has generally NOT been available for those under 40 and the mRNA vaccines are in very short supply.)



Perhaps, in their "wisdom" Australia's pollies, led by Scotty from Marketing, will revise their vaccine recommendations to take account of the emerging health data.

[Warb]

Now we're getting closer to the real issues. Everything is a political decision, and every political decision is based on the politician's perceptions of what will get them votes. The dangers inherent in such a system are many and varied, but basically come down to the fact that no matter what you do there are people who will criticise, and if they shout loudest the politicians will start to believe that those loud voices represent the views of the majority. So for example, if you look at the SMH "live Covid blog" (shared with The Age, I believe), and read the comments, you will believe that everyone in Australia thinks "Scotty from Marketing" (or some other derogatory name) is bolloxing up everything he touches and that nobody will ever vote for him again. The reality, of course, is that the majority of those comments (which are, by the way, curated such that they are only published if they "fit" the story the paper is pushing with just enough opposing views to make it look believable-ish) come from a small number of people who would refuse to say anything nice about the government under any circumstances. If you go and look at a more right-wing paper you'll get the opposite view, but exactly the same conditions - biased reporting, curated comments, etc..

So, both politicians and the populace in general are lead around by the nose and fed the, ahem, "facts" that suit their chosen information source. In the case of the politicians, that information is "look at what these un-biased members of the public are saying, they think you're rubbish". So the politicians change their approach to try and gain support, only to find themselves labelled as "doddering" or "indecisive" or whatever. Under all circumstances, if they get it wrong - even only if judged in hindsight (e.g. the choice of AZ vaccine) - they are crucified, and if they get it right either attention is redirected to something else, or someone else (state or senate) from the "other side" tries to claim it was all down to them..... This, by the way, applies to both side of politics not just the current government(s).

Now here's the rub. If the media wanted to inform the public, rather than manipulate them, they would produce unbiased, objective reports. But that doesn't sell papers. And if politicians in office wanted to improve the country, they would do what is in the long term good of the country as a whole, even if it meant doing things that might annoy their "faithful", and not just what they think will get them votes in the short term. And if politicians in opposition wanted to improve the country, they would do what is in the long term good of the country as a whole, even if that meant sometimes agreeing with whoever is in office at that time, and even it it meant sometimes agreeing with things that might annoy their faithful, and not just what they think will get them votes in the short term. This applies to ALL politicians, it is not party specific.

But, of course, that's not the case. Both sides cherish votes above all else.

The end result is a population who by and large have no idea about the facts around ANY situation, but KNOW FOR CERTAIN that "the other side" are completely wrong in everything they say or do. They also know that Prince Harry is actually a space alien, because it said so on the cover of "No Idea" magazine. Politicians, on the other hand, quite possibly know the real facts (or have advisors who do) but are caught between doing what they know to be right (but which might get them bad press) or what they hope might engender support. Buridan's Donkey?

With the exception, of course, that opposition politicians (either side, not just at the current time) can make any statements they want because they aren't making the decisions, so there will never be any repercussions, no judgement of right or wrong, people will never suffer, no money will never be lost etc. based on what they say. When was the last time anyone demanded the resignation of an opposition politician because they said a government decision was wrong and in fact it turned out that it wasn't?

None of this is new, of course, and normally it really doesn't matter too much. Parties get voted in and out, taxes go up and down, "workers" get extra benefits, "the rich" get tax breaks on their fourth home, politicians get massive salaries and lifelong pensions, journalists get paid, newspapers get sold, etc. etc. blah blah. Been going on for years. This time, however it's different. Think for a moment what happens if covid breaks out of Sydney and as a result Australia's death toll goes from 400 to 100,000, or 200,000, or more. We could have got people vaccinated in the time we have bought ourselves, but in fact we haven't. Why? Is it because the Commonwealth Government stuffed up? Or State Governments? Are those government stuff ups the result of terror of doing anything for fear of getting it wrong? Or in-fighting between layers of government? Or mis-information from the media making people too afraid to take a vaccine that would have saved 99.9% of those lives?

It doesn't really matter, I guess, because it will have happened. And it will have happened because we've had it so easy in the recent past that we've been able to lose track of the importance of unbiased factual news reporting, or thinking outside our own little "party political" box, or supporting someone you wouldn't normally support because it's for the good of society as a whole. In the recent past we've been able to [redacted] around without any significant consequences, so that's what we've grown accustomed to doing. Perhaps we should regard the current situation as a wake-up call and start to try to improve, rather than continuing to regard it as an opportunity to score "pointless political points".

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This has been an anti-political broadcast, brought to you by Warb's "my god, they're arguing about the colour of the bullet proof vest whilst someone's shooting at them" party.

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I think I might bow out now.......