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The first 6 months of 2021 - M T - 12-16-2020

In the other forum, BC expressed a wish that the NCAA would stop the FB season now and resume in the spring.  I responded that I felt the time line won't work.  This may be a good point to watch the health train wreck over the next 6 months and consider what will happen.

If you only want to hear a Pollyanna story, just quit reading now.

At this point, the US has plans for 100M courses (200M doses) of two vaccines.  The current president's Operation Warp Speed has expressed the plans to distribute those for first doses by the end of February with 2nd doses before the end of March.  (20m courses started in Dec; 30m in Jan; 50m in Feb.)   If I understand it right, the incoming president has put those 100M courses to be done in his first 100 days (early April).

After that 100M courses, the plans aren't as clear.  We need 150-200m more courses. Other vaccines may or may not be available.  If a new vaccine comes in as 70% effective, will people shun it and wait for a 90% vaccine?  Pfizer indicates they've got commitments to other countries that will keep them busy for several more months.  Our current president might have confiscated their output, but I don't think our incoming president will do that.

If Moderna is our only supplier for a while, I'd guess maybe 35M courses a month.  That's another 4 months (March - June) for first doses.  If the one-shot vaccine gets an EUA by March, maybe we can get a lot more vaccinations to finish off vaccinations by the start of June.


The FDA set the recommendation for the doses to be given to 16+ year-olds, rather than the 18+ year-olds it was tested on.  (I'm assuming that the recommendation for Moderna will be the same as for Pfizer, which isn't necessarily so.)  There are 245M 18+ year-olds, so I'll guess about 255M 16+ year-olds.   So, less than 40% of the eligible population (less than 1/3 of all the population) will have completed their vaccination by the end of March.  (I don't remember the predicted percentage for herd immunity.  I think it is around that 250M number.  But those calculations don't take into account that the remaining population congregates densely in schools.)

When it is decided that <16 year olds can get the vaccination, they will constitute an additional demand for the vaccine probably close to the number that have gotten it at that point.  Some people will be bumped even further back in the line.  Add maybe another 2 months to finish.

Someone here mentioned something that makes me fear that people are feeling "Whew, the vaccine is out.  I can relax a little.  So what if the Public Health Officer is telling me that a pick-up game of basketball is still illegal.  It is just me & my friends."

Consider whether the incoming president pushes for a different vaccine distribution plan.  To my knowledge, he has not stood up and said that this plan is fair and equitable.

There will be a lot of people mad as hell and not wanting to take being delayed any more for the vaccine and are tired of being told what they can't do.  I'm really hoping that we can get enough doses for all Americans (& the whole word) before the northern hemisphere summer (and southern hemisphere winter) comes.  Otherwise, I fear widespread civil unrest & rioting.   It is bad enough that spring fever will hit the US before the vaccines can get us to herd immunity.   Mardi Gras & spring break will see lots of spread among young adults.


I predict the current outbreak is still going strong in January, at least in terms of cases.  Deaths and ICU load should start coming down in late January.  April will again be a bad month in terms of cases.  I am seriously worried about civil unrest by June.  I feel that schools should wait to resume until at least June, but better July.  (Traditional schedules are only tradition.)

I hope I am wrong.

Edit: The US did buy a 2nd 100M doses from Moderna on Dec. 11, to be delivered by end of June. That brings committed courses to 150M people.

lex24 - lex24 - 12-16-2020

Nice, I bet your a blast at a cocktail party.

RE: lex24 - 2006alum - 12-16-2020

(12-16-2020, 08:29 PM)lex24 Wrote:  Nice, I bet your a blast at a cocktail party.

Probably as welcome as you'd feel at a grammarians' convention! 

M T, some sobering but good points. The end is not nearly in sight, and we need to stay vigilant for a while.

RE: The first 6 months of 2021 - dabigv13 - 12-16-2020

I believe we have secured another 100m doses from Moderna before the summer. I haven't seen a firm timeline on those doses though.

I'd prefer a 6 mos wait for previously positive patients. If you add up the previously infected with the 150m people we can vaccinate by late spring (?), we should have enough immune people to really dent this thing, especially if the reduced asymptomatic transmission suggested by Moderna's data holds true.

RE: The first 6 months of 2021 - Farm93 - 12-16-2020

Football is not getting delayed until the spring.  The NFL will have a draft soon, so look for almost every good junior or senior to skip out on return portion if that was the path.

This NCAAF thing is almost done now.  A lot of the bowls are getting cancelled.  They are not required anyway.   There are a couple of games that matter this weekend and 3 more games after that.   College football can get it done especially since Clemson and Alabama both have a lot of players that already had COVID in the summer.

The other sports are not as close to completion, but unless POTUS46 changes things a lot the D1 schools will be able to continue with this current approach. 

For the USA's vaccine acceptance - 

The people living in LTCFs are very well aware that the vaccines are the key to getting loved ones back in their lives.   If that group takes the vaccine the hospitals will likely enjoy an immediate improvement in capacity.   Same would apply for those with troubling comorbidities.   We may not enjoy near herd immunity with just those groups, but those groups taking the vaccine should make a big dent in the hospitalization and ICU rates.

The USA is full steam ahead on creating more TV sports content for Americans.   I do wish the NCAA would stop allowing fans in the stands as a number of the remaining sports are indoors.

RE: The first 6 months of 2021 - Goose - 12-16-2020

(12-16-2020, 08:17 PM)M T Wrote:  Pfizer indicates they've got commitments to other countries that will keep them busy for several more months.  Our current president might have confiscated their output, but I don't think our incoming president will do that.
Our current POTUS would have had a bitch of a time confiscating the Pfizer vaccine made in Belgium and Germany. I strongly suspect the EU demand can and will be satisfied from those locations. The demand from Japan and Canada may be intended for manufacture in the USA, but that isn't enough to fully meet our requirements in any case. The diplomatic effects of such a confiscation would be so terrible that I suspect even the current POTUS to back off. Both of these countries have important materials that we import from them. They can and would retaliate.

lex24 - lex24 - 12-16-2020

(12-16-2020, 08:58 PM)2006alum Wrote:  
(12-16-2020, 08:29 PM)lex24 Wrote:  Nice, I bet your a blast at a cocktail party.

Probably as welcome as you'd feel at a grammarians' convention! 

M T, some sobering but good points. The end is not nearly in sight, and we need to stay vigilant for a while.

Well, I don’t own a bow tie......And M.T, I meant no offense. It’s just an awful bleak picture.

RE: The first 6 months of 2021 - BostonCard - 12-17-2020

I am more optimistic, though as with all things COVID, "All predictions wrong, or your money back" (h/t to Gregg Easterbrook for that quote).



First off, even if we did nothing different, I would think that spring will bring a decrease in transmissions.  We don't have a ton of data on seasonality, but it looks like COVID-19 thrives most in weather that sends people indoors, the heat of the summer in the South and the cold of the fall/winter.  Spring should bring better weather, and consequently a bit of a respite from the relentlessness of infections.



Second, although we won't vaccinate enough to get herd immunity, we will be able to vaccinate the most vulnerable.  I think elderly living at most care homes (heretofore responsible for 40% of deaths) will become vaccinated, so that should drastically reduce mortality.  Then if we prioritize appropriately, we will be vaccinating those at highest risk of dying of COVID (elderly and those with risk factors), further driving down mortality, and then the essential workers at highest risk of getting (and transmitting) COVID-19.  So, even though we will only have 1/3 of people vaccinate, it will disproportionately drive down infections and, especially deaths.



Third, at this estimates are that 10 - 20% of Americans have survived COVID-19 and should have some degree of immunity.  Add that to the people who have been vaccinated and we may be approaching 50% immunity by late spring.  Again, not enough to reach herd immunity, but hopefully enough to drive down R.



I have no way of knowing for certain where we will be in six months.  I doubt the pandemic will be effectively over, or that we would even be in "great shapeæ, but we will probably be better than we are now, and hopefully we will be in good shape.  I think it might be possible to get down to 100,000 new cases a day (decline of >50%), 30,000 patients hospitalized (decline of >70%), and 300 deaths per day (decline of almost 90%).  Even if it is more like 150,000 cases, 50,000 hospitalized, and 500 deaths, it is a much better environment in which to have athletics competition than this one.



BC

RE: The first 6 months of 2021 - Goose - 12-17-2020

(12-17-2020, 05:53 PM)BostonCard Wrote:  I am more optimistic, though as with all things COVID, "All predictions wrong, or your money back" (h/t to Gregg Easterbrook for that quote).



First off, even if we did nothing different, I would think that spring will bring a decrease in transmissions.  We don't have a ton of data on seasonality, but it looks like COVID-19 thrives most in weather that sends people indoors, the heat of the summer in the South and the cold of the fall/winter.  Spring should bring better weather, and consequently a bit of a respite from the relentlessness of infections.



Second, although we won't vaccinate enough to get herd immunity, we will be able to vaccinate the most vulnerable.  I think elderly living at most care homes (heretofore responsible for 40% of deaths) will become vaccinated, so that should drastically reduce mortality.  Then if we prioritize appropriately, we will be vaccinating those at highest risk of dying of COVID (elderly and those with risk factors), further driving down mortality, and then the essential workers at highest risk of getting (and transmitting) COVID-19.  So, even though we will only have 1/3 of people vaccinate, it will disproportionately drive down infections and, especially deaths.



Third, at this estimates are that 10 - 20% of Americans have survived COVID-19 and should have some degree of immunity.  Add that to the people who have been vaccinated and we may be approaching 50% immunity by late spring.  Again, not enough to reach herd immunity, but hopefully enough to drive down R.



I have no way of knowing for certain where we will be in six months.  I doubt the pandemic will be effectively over, or that we would even be in "great shapeæ, but we will probably be better than we are now, and hopefully we will be in good shape.  I think it might be possible to get down to 100,000 new cases a day (decline of >50%), 30,000 patients hospitalized (decline of >70%), and 300 deaths per day (decline of almost 90%).  Even if it is more like 150,000 cases, 50,000 hospitalized, and 500 deaths, it is a much better environment in which to have athletics competition than this one.



BC
Sounds possible to me. We can hope we will have a better idea on what is causing the spread and how to defeat it, but failing that I think your analysis is a "median" estimate of the probable outcome. The only worry I have is there is something going on that spring weather won't fix. We will know eventually.

RE: The first 6 months of 2021 - Hurlburt88 - 12-18-2020

the one caution I keep holding up to myself regarding Spring optimism is the March/April "3rd wave" of the Spanish flu.   Was definitely a lower peak than the 2nd wave, but nonetheless was in the Spring months.   Obviously this is different and I agree that even with partial deployment the vaccine will help. Just trying to learn from history.

RE: The first 6 months of 2021 - chrisk - 12-18-2020

The crisis in LA County seems to defy the optimism about weather seasonality.

From what I have read, there is still no consensus on whether essential workers will be vaccinated before seniors and those with serious comorbidities. It may vary by state.

RE: The first 6 months of 2021 - Snorlax94 - 12-19-2020

I agree with you MT that there is a bad case scenario -- what if Moderna and Pfizer remain the only 2 approved vaccines for a while, and what if both of them hit production snafus. Already, there are reports that Confusion Arises as States Learn They're Receiving Fewer Doses of Pfizer's COVID-19 Vaccine Than Expected. (CBS  News)

But for now, I'm in the more optimistic camp, like BC, in large part, for the reasons he lists (warmer weather in the spring, first vaccines going to the most vulnerable and healthcare workers will drive down deaths and transmission, and previously-infected could add 10-20% immune to the vaccinated totals, hopefully reducing R0 along the way).

But to me, there are two big uncertainties driving how Q2-Q3 of 2021 will play out:
1) Will vaccine manufacturers be able to hit their promised numbers? 

2) And this is probably be the biggest wildcard -- will the DNA vaccines (Johnson&Johnsno & Astra Zeneca) vaccines be safe, effective and approved? I've read these vaccines are easier to manufacture, so their production can ramp up very quickly. PLus, the first trial with the J&J vaccine required only 1 shot, so 100M doses of that could protect 100M people. I read the J&J vaccine could receive an EUA in Feb/Mar.

This is why I urge my local school district to plan for 2 scenarios. In case everything goes well, we could have teachers and a large chunk of adults vaccinated in spring, and I'd want school districts in Santa Clara County to be prepared to re-start in-person instruction in the March-April timeframe, at least for elementary school students.

On the other hand, if the next 2 vaccine candidates are not approved, and if there are production snafus, yeah, this thing could take a while.

But at the least, I think places like school districts should plan for and be prepared for multiple scenarios, including, possibly, a very good case scenario.*