the US is administering ~250k covid vaccine doses per day. we prob need to get ~100-150M ppl vaccinated = 200-300M doses = 800-1200 days at current rate. last mile clearly a problem as many doses sitting with states, who have discretion over admin process.
states + hospitals don’t know what to do. this likely becoming key issue in coming days. lots of finger pointing. problem may be paperwork burden, process and procedural overhead. or just complete lack of uniform planning. distribute and hope clearly not a great strategy
math for alternative central planning: 10k care providers give 1 dose every 3 minutes for 8 hours/day = 1.6M/day = 4 months to achieve goal...
there are 3.8M nurses in US. fed govt could hire 10k nurses at $1k/day, assign them pop-weighted to congressional districts, track patients with SSNs, administer at federal sites (post offices), don’t charge. $1.2B total delivery cost.
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BTC has likely created more millionaires (10,000+?) and deca millionaires (1,000+?) than any company or startup in history. these are individual “retail” investors realizing these returns, not institutions, which may drive the Rise of Retail...
1) retail interest in speculative (high-risk/high-reward) investments will continue to sky rocket. BTC’s meteoric USD-denominated value climb sets a new benchmark. everyone is already chasing the next dragon.
2) more speculative public equity is being purchased by retail investors who are increasingly becoming key driver of public offering events (through SPACs, direct listings, and IPOs syndicated to retail investors. instead of a handful of “strong” institutional investors).
amazing paper. 40-60% of population that have NOT had SARS-CoV-2 already have activated T Cells to the virus! likely due to cross-reactivity w/ other "common cold coronaviruses". may explain large % having easy time clearing virus and/or mild/no symptoms. cell.com/action/showPdf…
"... CD4+ T cell responses were detected in 40-60% of unexposed individuals. This may be reflective of some degree of crossreactive, preexisting immunity to SARSCoV-2 in some, but not all, individuals..."
"Whether this immunity is relevant in influencing clinical
outcomes is unknown—and cannot be known without T cell measurements before and after SARSCoV-2 infection of individuals—..."
"re-opening" is not a binary thing. People, Places, and Processes (PPP) define our current and future state. which people can go out, where they can go, what processes are in place when they do go out.
we aren't in a binary lockdown today. in sf, for example, anyone can go to the grocery store or "exercise outside". there are some processes in place (i.e. must wear masks to enter the grocery store; but not req'd to do temp checking on entry). our "lockdown" is already nuanced.
thus, it's not ideal to talk abt binary states. and it's non-sensical to believe we can "crush" the virus. even if # infected ppl in US fell to 50 we'd be where we were early March & infected would expand as before w/o a change in PPP. you can't just "return to normal"
here are my tl;dw notes if you don't have the time to watch:
epidemiology:
- asian response to pandemic was informed by their experience with SARS. already common practice to wear masks in public, knew how to rapidly test & trace, isolation protocol planned & ready; thus, better curve flattening over US
- outbreak now much worse in Europe and US than it ever was in China
- key metric to watch is daily new cases per 1M pop
- china peaked at 10, spain steady over past week at 173, italy steady over past week at 100, US now at 90 rising every day (these are my calcs)
antibody testing update:
- now seeing some asymptomatic infections in general pop
- don't have enough high quality day to conclude anything
- <60% of tests distributed are reporting
- there is clear bias in the data
- there are sensitivity issues with test kits
(details follow)
data:
- 437 reported results
- 11 positive, 401 neg, 24 inconclusive (user error)
- of positive:
-- 4 out of state (ppl shipped test to sick friends)
-- 3 known cases (broke protocol)
-- 2/392 in SF, 2/40 on peninsula
-- 100% of positives reported SOME symptoms vs 71% of negs
we traced positives we report here to verify. i think tests underrepresent true positives based on performance w c19 PCR+ patient sera. however 0.5% of SF population (our limited data shows) is 10x reported rate. but i dont have faith in our data given bias, cleanliness, & scale.
how do we test everyone? we need to test active infection (RNA) AND past infection (antibodies) cheap/quick to really trace/track. antibody tests now getting approved & coming to market (yay!).. these are cheap (<$10) easy-to-use (finger prick at-home) & fast (10mins)...
best solution to test for active infection may NOT be PCR. PCR is best CURRENT solution - costs $6, but requires central lab, 6 step procedure, 45 minutes, and requires people, swabs, and reagents. can we get cheap/fast at-home active infection test? yes, we should, soon...
there is a new technology based on CRISPR that is actively being developed.. a CRISPR molecule with a "guide RNA" matches up to specific SARS-CoV-2 RNA & changes color if match is found. this can be "printed" on strip of paper and turned into an at-home/doc office test..