“As is now generally known, a working Covid vaccine was on the ground in late February; “

That was no working vaccine. There were preliminary mRNA designs based on the sequence of the sars-cov2 but there were alterations to the sequence for various technical reasons, and there still needed to be trials to determine the best sequence and the most effective dosage if in fact there was an effective dosage and also to determine associated adjuvants and other material to be included with the mRNA. Also the stability of vaccine for storage had to be determined.

I will concede that by August when the final production specifications were fixed assuming the stage trials were successful that risk/reward ratio favored allowing high risk groups access to the vaccine.

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Could be wrong, but I don't think used cars got expensive because of deaths. They got expensive (at least in part) because of travel restrictions. Rental cars weren't being used, so rental car companies sold their fleets. Cars weren't being produced because rental car companies weren't buying (and because there is a global microchip shortage). As things started reopening, rental car companies had to scramble to buy fleets. High demand plus low supply = higher price.

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FYI, we do already have a named Epsilon variant:


Can you concretely state why the FDA has not approved the vaccines yet? Not the blatantly hyperbolic stuff like "to cover their asses", but actually steelman their rationale? Can you then identify the costs and benefits of the FDA's current rationale? What are the long-term benefits of their current strategy? How does that compare to the long-term cost?

It's obvious that there's benefits to immediately fully approving the vaccines tomorrow, rules be damned. And it's obvious that there's benefits to dismantling the entire approval structure of the modern pharmaceutical industry and existing in a libertarian utopia. But there are costs, too!

Will your vaccine-skeptical coworker really change their tune tomorrow if the FDA announced an expedited full approval? O would they be right back to, "the vaccines weren't fully evaluated, after all they were expedited and didn't go through full review"?

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Forget about Epsilon; what are we doing to prepare for Lambda, which is sadly quite real ? I can imagine a few useful policies:

* Stockpiling masks. Real ones that protect against COVID, not Chinese knockoff ones that protect only against dust.

* Stockpiling respirators. Ditto.

* Committing to N billion dollars in new vaccine purchases, as soon as those vaccines are developed.

* Setting up mobile emergency hospitals. Some of these were used during peak COVID, but their rollout came too little, too late.

* Announcing clear and transparent lockdown targets: "your neighbourhood will be locked down if daily COVID tests reach X, un-locked down when they fall below Y".

We don't need the FDA for any of this, AFAIK, but we are doing none of it.

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To be a counter-contrarian, I'd say that focusing on the next, perhaps far worse, virus is possibly misguided, and almost certain to divert our attention and resources. It's the problem of recency bias. We just had a huge crisis with a virus. What if it happens again? And soon?

But, you know, it probably won't. It's been a hundred years since the last catastrophic pandemic. We've had scares since then, but ultimately were manageable. While we should do smart things in advance (such as really pushing research on broad scale mRNA vaccines), our efforts would better be directed elsewhere.

And by that I mean potential disasters that *haven't* happened yet, and that we so far turn a blind eye to. Catastrophic earthquakes on the West Coast. Heck, a repeat of the 8.0 New Madrid earthquake of 1811. Massive hacking of our electrical grid. An asteroid heading our way!

I'd say none of these is less a worrisome problem than Epsilon, which we tend to focus on because of how burned we feel by COVID. But they would be as bad or worse than COVID and I guarantee you, they receive an infinitesimal amount of attention and resources in comparison.

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> We should absolutely be doing more than this. We should be demanding some sort of stated plan for expediting vaccines in emergency situations, something better than “whenever we get to it - this is how it’s always been done”.

What good would that do? The UK had a plan. The mob listened to it, said fuck you, and demanded a bunch of stupid bullshit instead. What we should be demanding is that the FDA be burnt to the ground, and site of its HQ turned into a monument to covid victims. then a new institution set up with a very different mandate and a culture that starts with "Never forget that drugs save lives".

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Minor typos: In the first sentence you have "are document". In the second paragraph of the second section you have a trailing "I". Otherwise an excellent, chilling article. We must reform the FDA, allow challenge trials, speed up both emergency auth and full auth of vaccines.

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