Are vaccines the light at the end of the tunnel?

[Porky55]

35 minutes ago, Crazy planning mom said:

Agree, that it’s crazy that everything is political here.  Not to sound like an old fart but I miss the old days.  

Believe me, it’s not just happening in the US, Australia has gone politically nuts too. We have a State under virtual martial law because of this pandemic. Can’t leave the house between 8pm and 5am and then only a 5km radius and IT IS being policed!!

So with you - were has all the peace, love and goodwill gone? 😳

[cangelmd]

2 hours ago, Crazy planning mom said:

So, the CDC director said it will take 6-9 months after it is approved before it can be widely available.  If they are already working on production, why does it take that long?  So, if it’s approved in November which is optimistic, it will be May at the earliest or as late as August before it’s widely available.
https://www.npr.org/sections/coronavirus-live-updates/2020/09/16/913560563/cdc-director-says-covid-vaccine-likely-wont-be-widely-available-until-next-year?utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_source=facebook.com&fbclid=IwAR0fk1PfqJRK8LFZy_JLALL3P4zu882RwcYcx5E0RDBQZV45L19mInrJQVs&fbclid=IwAR0ygkE1RT7X4RlnjvuuANKLRbF4tL_yNpLWs99AB9HvmBREmhfcjTSFrO0

It will take 2 doses most likely, so divide all numbers by 2. Also, I’m not sure after the first wave of vaccine goes out how long it will take to replace that supply.

im concerned about people in poorer countries having access to vaccine, but from what I’ve read the cutting edge vaccines have such persnickety storage requirements that will make the logistics for those difficult outside developed countries.

[Ken the cruiser]

Here's another possible twinkle of light, if approved, regarding us getting back to cruising, possibly even before COVID vaccines are available everywhere - https://cruiseradio.net/set-sail-safely-act-introduced-to-reopen-cruise-industry/

[npcl]

29 minutes ago, Ken the cruiser said:

Here's another possible twinkle of light, if approved, regarding us getting back to cruising, possibly even before COVID vaccines are available everywhere - https://cruiseradio.net/set-sail-safely-act-introduced-to-reopen-cruise-industry/

do not see it getting much support or going far in congress.

 

even if became law how long would it take to form the group and come to a conclusion. That could take years itself.

 

For it to be able to override the CDC the law would have to remove cruising from the CDC authority to enforce protections on illness entering the us. will have to see if that is in the text. otherwise it would be a bureaucratic exercise that e CDC could still override.

 

My view is it is an act by the senators to show that they are doing something, but not something that will move forward and have any impact.

Edited September 17, 2020 by npcl

[Ken the cruiser]

9 minutes ago, npcl said:

do not see it getting much support or going far in congress.

 

even if became law how long would it take to form the group and come to a conclusion. That could take years itself.

 

For it to be able to override the CDC the law would have to remove cruising from the CDC authority to enforce protections on illness entering the us. will have to see if that is in the text. otherwise it would be a bureaucratic exercise that e CDC could still override.

 

My view is it is an act by the senators to show that they are doing something, but not something that will move forward and have any impact.

So what happens if the CDC does nothing and the end of September comes and goes and the No Sail Order expires? Are the cruise lines and merchant ships free to enact their own protective procedures and start sailing to/from US ports again?

[TeeRick]

Remember there might be several vaccines approved within a few months of each other.  This should help get more people vaccinated quickly.  We keep thinking about The Vaccine but it could be several.

[grandgeezer]

1 hour ago, Ken the cruiser said:

So what happens if the CDC does nothing and the end of September comes and goes and the No Sail Order expires? Are the cruise lines and merchant ships free to enact their own protective procedures and start sailing to/from US ports again?

 

The No Sail Order was enacted by the CDC, so if things aren't in order for safe cruising, I'm sure they will extend it.

[Ken the cruiser]

The way it's looking from over here in the peanut gallery, October is going to be an interesting month. Pfizer and maybe Moderna may have vaccines ready for submission to the FDA for their respective EUAs, the CLIA and the various cruise lines are trying to come up with various plans to safely start cruising again, and the CDC has to determine whether or not to extend the No Sail Order. Should be an interesting month.

Edited September 18, 2020 by Ken the cruiser

[npcl]

1 hour ago, Ken the cruiser said:

So what happens if the CDC does nothing and the end of September comes and goes and the No Sail Order expires? Are the cruise lines and merchant ships free to enact their own protective procedures and start sailing to/from US ports again?

if CDC no sail order were to expire without restriction, then the cruise lines would be free to sail however they want, with only the same requirements as existed before covid, unless restricted by a state or local agency.

 

I doubt the CDC will just let it expire.

[K.T.B.]

This is not a political post, though some might think it is.

 

With that said, tonight on MSNBC's All In with Chris Hayes, there was a great Dr. Fauci interview.  A lot of positivity, especially for things to most likely be back to semi-normal by 3rd quarter of next year.  This is based on when he expects a vaccine to be ready.

 

I'm sure the interview will be up on MSNBC's website of Friday, though there might be some snippets on there right now.

[phoenix_dream]

23 hours ago, TeeRick said:

Remember there might be several vaccines approved within a few months of each other.  This should help get more people vaccinated quickly.  We keep thinking about The Vaccine but it could be several.

Exactly.  Also, it is very, very likely that when cruising begins it will be with a limited number of passengers.  Let's face facts - a large percentage of Celebrity's passengers are seniors.  Seniors will likely be first in line in the general population (meaning, after first responders and such).  So if the cruise lines are sailing with lessened capacity, and they require proof of vaccine prior to sailing, there may be enough people to warrant a restart earlier than people think.  This will of course (in the US ports) require the CDC to approve their procedures.  Fingers crossed.

[Ken the cruiser]

@caribill today posted the below on the following Princess thread at post #47 which I thought was worth repeating here: 

 

There was a “Future of Cruising” Zoom meeting on September 17:  The two cruise industry representatives were Ron Guiaskey of Celebrity (part of Royal Caribbean Group) and Gordon Dirker of Celestyal Cruises, a Greece based cruise company.

 

This was not a canned presentation, but after some opening statements, was a session giving responses to questions by the Zoom participants.

 

o CLIA and the CDC are working together to set up standards for resuming cruises from USA ports. Most of the affected cruise lines have already given their proposed plans to the CDC. The standards will be minimum standards.

 

o Celestyal does not expect to restart cruising until March. Ron said that he expects cruising to restart near the end of November or early December, but did not indicate which cruise line(s) he was referring to.

 

o Cruise ship cleaning on turnaround day has always been extensive, but there will be additional work done due to Covid-19. Staggered boarding times are expected to be imposed.

 

o Rapid result testing is a “game changer” allowing testing at the pier and not requiring passengers to get tested on their own several days before the cruise.  Since, at least for the USA, there is expected to be a number of people who will not get a vaccination once it is available, this on-site testing might allow the cruise lines to not require proof of vaccination in order to cruise, but it is too soon to know for sure.

 

o Royal Caribbean Group already had announced their “virtual muster” which eliminates the need to everyone to gather in crowded areas at the start of the cruise for the muster drill.

 

o Ron indicated that the first four months of cruising may see passenger loads limited to between 50% and 65% of capacity. Because Celestyal usually has a large number of solo travelers, they often sail at that lower capacity anyway.

 

o Royal Caribbean Group expects initial cruises to be for 7 or less nights. Celestyal offers 3, 4, and 7 night itineraries.

 

o Buffets will continue to exist with no reduction in offerings, but with crew doing all the serving.

 

o Many hotels on land now do not clean a room during your stay unless you request it. Cruise lines may start asking passengers in each cabin how often they want their cabins serviced.

 

o The initial reduced capacity will help with the necessary physical distancing in restaurants and at shows.

 

o Referring to the MSC experience with limiting going ashore only with ship sponsored excursions, they said they are looking at this, at least at the beginning when cruising resumes.  This protects both the passengers from being infected from local contacts as well as the local population being protected from any contagious passengers.

 

o Crew will be under the same going on shore restrictions as passengers.

 

o Although the first ships out of the USA may include private islands where the cruise line has control of the environment, that is not a Celebrity thing.

 

o Ron indicated that with the bonus FCCs given for cancelled cruises, many are booking the replacement cruises at a higher cabin category. Also indicated that with the demand being experienced so far for next year’s bookings, people should not wait for big sales that probably will not occur.

Edited September 20, 2020 by Ken the cruiser

[npcl]

7 hours ago, Ken the cruiser said:

@caribill today posted the below on the following Princess thread at post #47 which I thought was worth repeating here: 

 

There was a “Future of Cruising” Zoom meeting on September 17:  The two cruise industry representatives were Ron Guiaskey of Celebrity (part of Royal Caribbean Group) and Gordon Dirker of Celestyal Cruises, a Greece based cruise company.

 

This was not a canned presentation, but after some opening statements, was a session giving responses to questions by the Zoom participants.

 

o CLIA and the CDC are working together to set up standards for resuming cruises from USA ports. Most of the affected cruise lines have already given their proposed plans to the CDC. The standards will be minimum standards.

 

o Celestyal does not expect to restart cruising until March. Ron said that he expects cruising to restart near the end of November or early December, but did not indicate which cruise line(s) he was referring to.

 

o Cruise ship cleaning on turnaround day has always been extensive, but there will be additional work done due to Covid-19. Staggered boarding times are expected to be imposed.

 

o Rapid result testing is a “game changer” allowing testing at the pier and not requiring passengers to get tested on their own several days before the cruise.  Since, at least for the USA, there is expected to be a number of people who will not get a vaccination once it is available, this on-site testing might allow the cruise lines to not require proof of vaccination in order to cruise, but it is too soon to know for sure.

 

o Royal Caribbean Group already had announced their “virtual muster” which eliminates the need to everyone to gather in crowded areas at the start of the cruise for the muster drill.

 

o Ron indicated that the first four months of cruising may see passenger loads limited to between 50% and 65% of capacity. Because Celestyal usually has a large number of solo travelers, they often sail at that lower capacity anyway.

 

o Royal Caribbean Group expects initial cruises to be for 7 or less nights. Celestyal offers 3, 4, and 7 night itineraries.

 

o Buffets will continue to exist with no reduction in offerings, but with crew doing all the serving.

 

o Many hotels on land now do not clean a room during your stay unless you request it. Cruise lines may start asking passengers in each cabin how often they want their cabins serviced.

 

o The initial reduced capacity will help with the necessary physical distancing in restaurants and at shows.

 

o Referring to the MSC experience with limiting going ashore only with ship sponsored excursions, they said they are looking at this, at least at the beginning when cruising resumes.  This protects both the passengers from being infected from local contacts as well as the local population being protected from any contagious passengers.

 

o Crew will be under the same going on shore restrictions as passengers.

 

o Although the first ships out of the USA may include private islands where the cruise line has control of the environment, that is not a Celebrity thing.

 

o Ron indicated that with the bonus FCCs given for cancelled cruises, many are booking the replacement cruises at a higher cabin category. Also indicated that with the demand being experienced so far for next year’s bookings, people should not wait for big sales that probably will not occur.

the funny thing is that while the presentation said most cruise lines have submitted their plans to CDC the head of Princess in an interview a couple of days ago indicated that the plans will be submitted by CLIA next week. 

 

Also according to RCL the task force they set up with NCLH will not release its findings until next week.

[Ken the cruiser]

20 minutes ago, npcl said:

the funny thing is that while the presentation said most cruise lines have submitted their plans to CDC the head of Princess in an interview a couple of days ago indicated that the plans will be submitted by CLIA next week. 

 

Also according to RCL the task force they set up with NCLH will not release its findings until next week.

So does "next week" mean the one that starts tomorrow? Just checking since we've all been waiting to see what the cruise line plans are going to look like.

Edited September 20, 2020 by Ken the cruiser

[npcl]

43 minutes ago, Ken the cruiser said:

So does "next week" mean the one that starts tomorrow? Just checking since we've all been waiting to see what the cruise line plans are going to look like.

yes sometime during this week.

[Ken the cruiser]

2 minutes ago, npcl said:

yes sometime during this week.

Cool! More progress towards getting back to cruising!! Yay!!

[Arizona Wildcat]

On 9/18/2020 at 3:39 PM, phoenix_dream said:

Exactly.  Also, it is very, very likely that when cruising begins it will be with a limited number of passengers.  Let's face facts - a large percentage of Celebrity's passengers are seniors.  Seniors will likely be first in line in the general population (meaning, after first responders and such).  So if the cruise lines are sailing with lessened capacity, and they require proof of vaccine prior to sailing, there may be enough people to warrant a restart earlier than people think.  This will of course (in the US ports) require the CDC to approve their procedures.  Fingers crossed.

Am hoping you are correct.  A new issue is that it appears that people can be #1 - reinfected and #2 - antibodies only last 2-3 months.  While I do not know if this is correct - all sorts of things in the news - it brings my question:

Will antibodies from vaccination protect for a longer period of time?  If yes then we are likely to be able to be vaccinated by late spring.  If not then it will be difficult for many to return to cruising.

[K.T.B.]

9 hours ago, Ken the cruiser said:

o Rapid result testing is a “game changer” allowing testing at the pier and not requiring passengers to get tested on their own several days before the cruise.  Since, at least for the USA, there is expected to be a number of people who will not get a vaccination once it is available, this on-site testing might allow the cruise lines to not require proof of vaccination in order to cruise, but it is too soon to know for sure.

 

That bolded part really bothers me as a future cruiser.  I'd rather they require vaccinations in order for people to cruise, if only for people's saftety.

[markeb]

1 hour ago, Arizona Wildcat said:

Am hoping you are correct.  A new issue is that it appears that people can be #1 - reinfected and #2 - antibodies only last 2-3 months.  While I do not know if this is correct - all sorts of things in the news - it brings my question:

Will antibodies from vaccination protect for a longer period of time?  If yes then we are likely to be able to be vaccinated by late spring.  If not then it will be difficult for many to return to cruising.

 

#1 I'm not going to minimize the risk of reinfection, but I haven't seen anything that proves it. Early reports were of recovery of viral RNA via PCR, which is not an indication of viability. Probably need to hit the search engines again, but I've not seen anything (yet) that makes it more than an academic concern, and also not common if it does occur. That could change with more data. Certainly there was early data suggesting a lesser immune response to a less serious infection, so asymptomatic or minimally symptomatic individuals might have a lesser immune response and viral recovery from subsequent exposure might be more likely in them.

 

#2 Early reports on the vaccine candidates showed good T-Cell responses. Antibodies can decline fairly rapidly, but if there's a good population of T-Cells, you still can get a good anamnestic response from exposure, and a rapid increase in antibodies when actually needed. The various clinical trials should get a better feel for that through whatever booster studies they do. For their biological license application, the various sponsors will almost certainly report antibody titers over time, as they're easy to review. They may also have limited meaning. So I think we should all take a deep breath on antibodies. The challenge for licensure and vaccination schedules could be if there's immunity, but antibody titers prove to not be a great correlate of immunity. The natural exposure studies in Phase III should smooth out that data.

 

We're hitting that point that demonstrates why most vaccine development takes a long time and a lot of money...

[npcl]

48 minutes ago, K.T.B. said:

 

That bolded part really bothers me as a future cruiser.  I'd rather they require vaccinations in order for people to cruise, if only for people's saftety.

especially with test limitation. a faster test, will just generate its percentage of false negatives faster. if for example a cruise line detects 10 positives for a cruise. it can be pretty sure a a number of infected have gotten on board. if they detect 0 or maybe 1 or 2. the incidence in their passengers for that cruise would put the odds in there favor that no active case is on board. not 100 percent, but probably more like 80/20 in their favor.

[npcl]

22 minutes ago, markeb said:

 

#1 I'm not going to minimize the risk of reinfection, but I haven't seen anything that proves it. Early reports were of recovery of viral RNA via PCR, which is not an indication of viability. Probably need to hit the search engines again, but I've not seen anything (yet) that makes it more than an academic concern, and also not common if it does occur. That could change with more data. Certainly there was early data suggesting a lesser immune response to a less serious infection, so asymptomatic or minimally symptomatic individuals might have a lesser immune response and viral recovery from subsequent exposure might be more likely in them.

 

#2 Early reports on the vaccine candidates showed good T-Cell responses. Antibodies can decline fairly rapidly, but if there's a good population of T-Cells, you still can get a good anamnestic response from exposure, and a rapid increase in antibodies when actually needed. The various clinical trials should get a better feel for that through whatever booster studies they do. For their biological license application, the various sponsors will almost certainly report antibody titers over time, as they're easy to review. They may also have limited meaning. So I think we should all take a deep breath on antibodies. The challenge for licensure and vaccination schedules could be if there's immunity, but antibody titers prove to not be a great correlate of immunity. The natural exposure studies in Phase III should smooth out that data.

 

We're hitting that point that demonstrates why most vaccine development takes a long time and a lot of money...

the two cases I have seen have dna mapped the strains and the second infection differs from the first. in one case the second infection was asymptomatic. in the other case the second infection was worse than the first.

 

the criteria for these trials are comparisons of numbers between arms with moderate or serious symptoms. Will not count asymptomatic cases. So even if the trials show efficacy  it will not guarantee that one cannot get an asymptomatic case and spread it to others.

Edited September 21, 2020 by npcl

[Arizona Wildcat]

27 minutes ago, markeb said:

 

#1 I'm not going to minimize the risk of reinfection, but I haven't seen anything that proves it. Early reports were of recovery of viral RNA via PCR, which is not an indication of viability. Probably need to hit the search engines again, but I've not seen anything (yet) that makes it more than an academic concern, and also not common if it does occur. That could change with more data. Certainly there was early data suggesting a lesser immune response to a less serious infection, so asymptomatic or minimally symptomatic individuals might have a lesser immune response and viral recovery from subsequent exposure might be more likely in them.

 

#2 Early reports on the vaccine candidates showed good T-Cell responses. Antibodies can decline fairly rapidly, but if there's a good population of T-Cells, you still can get a good anamnestic response from exposure, and a rapid increase in antibodies when actually needed. The various clinical trials should get a better feel for that through whatever booster studies they do. For their biological license application, the various sponsors will almost certainly report antibody titers over time, as they're easy to review. They may also have limited meaning. So I think we should all take a deep breath on antibodies. The challenge for licensure and vaccination schedules could be if there's immunity, but antibody titers prove to not be a great correlate of immunity. The natural exposure studies in Phase III should smooth out that data.

 

We're hitting that point that demonstrates why most vaccine development takes a long time and a lot of money...

Agree.  Lots of anecdotal comments and crazy numbers lately.  Sure would be nice if there was some good way to sort through the chaff. Crimped, in Arizona we have only 15 counties and each compile data differently.  Last few days about 1/2 of "new" cases were from prior months.  

A question, if the standard for approval is a vaccine that is 50% effective; what does that mean?  50% effective averaged over all ages?  50% effective for how long?  Comments?

[npcl]

18 minutes ago, Arizona Wildcat said:

Agree.  Lots of anecdotal comments and crazy numbers lately.  Sure would be nice if there was some good way to sort through the chaff. Crimped, in Arizona we have only 15 counties and each compile data differently.  Last few days about 1/2 of "new" cases were from prior months.  

A question, if the standard for approval is a vaccine that is 50% effective; what does that mean?  50% effective averaged over all ages?  50% effective for how long?  Comments?

a 50% efficacy will mean that for every 2 people on the placebo arm that develop moderate or serious illness 1 develops the same in the treatment arm.

 

with that level of efficacy the fda will require 150 total moderate to serious cases out of which no more than 50 can be in the treatment arm. 

 

for the trial it is total across all demographics.

 

 

Edited September 21, 2020 by npcl

[Arizona Wildcat]

1 hour ago, npcl said:

a 50% efficacy will mean that for every 2 people on the placebo arm that develop moderate or serious illness 1 develops the same in the treatment arm.

 

with that level of efficacy the fda will require 150 total moderate to serious cases out of which no more than 50 can be in the treatment arm. 

 

for the trial it is total across all demographics.

 

 

Ok.  Understand but that does not answer my question.  Since the older you get the less effective your immunize system does that mean 80% effective at 20, 60% at 40 and progressively less for older people?

 

 

[BP99]

9 hours ago, markeb said:

 

#1 I'm not going to minimize the risk of reinfection, but I haven't seen anything that proves it. Early reports were of recovery of viral RNA via PCR, which is not an indication of viability. Probably need to hit the search engines again, but I've not seen anything (yet) that makes it more than an academic concern, and also not common if it does occur. That could change with more data. Certainly there was early data suggesting a lesser immune response to a less serious infection, so asymptomatic or minimally symptomatic individuals might have a lesser immune response and viral recovery from subsequent exposure might be more likely in them.

 

#2 Early reports on the vaccine candidates showed good T-Cell responses. Antibodies can decline fairly rapidly, but if there's a good population of T-Cells, you still can get a good anamnestic response from exposure, and a rapid increase in antibodies when actually needed. The various clinical trials should get a better feel for that through whatever booster studies they do. For their biological license application, the various sponsors will almost certainly report antibody titers over time, as they're easy to review. They may also have limited meaning. So I think we should all take a deep breath on antibodies. The challenge for licensure and vaccination schedules could be if there's immunity, but antibody titers prove to not be a great correlate of immunity. The natural exposure studies in Phase III should smooth out that data.

 

We're hitting that point that demonstrates why most vaccine development takes a long time and a lot of money...

Hi,

There was an interesting article on CNN by Dr. William Haseltine about herd

immunity and reinfection. He is an OUTSTANDING scientist! He gives

some info on another coronavirus  NL63 (HCoV-NL63) that was well

studied and is quite interesting about reinfection. I also totally agree

with your comments that immune cellular memory is important.