hi everyone live from warm sunny colorado uh today's video is a special video as many of you know i've been following the vaccines for a while as they've been going through clinical trials and there are many many different kinds of vaccines that are hitting the market uh so the first to hit market were the rna vaccines made by pfizer and moderna and then the next they hit market was the astrazeneca vaccine which is an adenovirus so basically they take a genetically engineered virus usually from an animal close to us but uh sufficiently far that it's not endemic in humans and then they put viral dna in it and they use that to make something from the virus to trigger immune response and then finally a protein subunit where they take an insect cell that's been genetically modified and then what they do with the insect cell is they have it produce these viral proteins and then they connect them to a nanoparticle that makes it look a lot like a coronavirus and then it can trigger an immune response so this week there were two press releases one from johnson johnson and the other one from novavax and the johnson johnson press release i have it right here it says that the candidate is 72 percent effective in the u.s trial and 66 effective overall uh at preventing moderate to severe covet and 85 effective for severe disease and hospitalization and the other one the novovax trial uh the uk trial just came to an end and they've unblinded some of the data it's 89.3 percent effective that's the top line and there's some evidence that the south africa strain has there's been some escape from that and so anyway this is incredibly good news for two reasons one is that the johnson johnson vaccine is a single shot platform which means that you just inject and you're done and what we've noticed with all the vaccines that have hit market which have all been two shots is that there's a significantly higher degree of reactogenicity with the second shot what that means is when you get the second shot the second shot tends to trigger a very aggressive response and so people have reported arms being sore for days or weeks fever chills uh and it's pretty universal that that that's a very strong reaction the fact that you have a single shot platform there's no having to go back and do another thing which always causes problems and second the shots were very well received by the general public now the novovax is a two-shot platform and there was not much said the press release about uh the symptoms and side effect profiles and these types of things other than it was well received so what happens is that when these companies get to this stage they apply for something called emergency use authorization so what they'll do is they'll go to the food and drug administration they'll say hey we think that this is necessary for a big lost internet there for a second okay get this into market so we can start getting this to uh to people uh and so to do that they have to take all the data and put it to a big filing and then it's done in a very open transparent way it's given to not only the fda but it's also publicly available and then a committee will come together make a recommendation then the internal people at the fda will decide whether to approve or reject the eua now uh the committee meeting is also open and transparent and we've gone through this uh just uh last month in december with both pfizer and moderna and those filings they tend to be quite large and a huge amount of data that needs to be parsed the odds are that johnson johnson will apply for eua sometime in mid-february in that data package that they produced that the all the the run-up of what happened during the clinical trial will also become uh known now one thing i'm very interested to see is that there is evidence of transverse myelitis with and we're not sure if it was either in the placebo group or in the vaccine group but it was apparently just there and that was one of the reasons why the johnson johnson trial was a little late there was some delays as a consequence of that so that's going to be inside the eua package of what happened there and there's probably a few other things that were discovered that happened there uh so it's going to be interesting thing to look at uh novofax it's unknown whether the fda will allow them to apply for an eua with uk data there is also a clinical around the united states for the astrozenica vaccine the phase three clinical trial will probably conclude in april to may and it's unclear whether astrazeneca can also apply for emergency use authorization uh in february off of the uk data set it makes frankly no sense why not because they've already distributed that vaccine to millions of people in the uk and india and safety data looks reasonable although there are some efficacy questions above those over the age of 65. and there's some debates about that both germany and france so why is this important well it's important for two reasons one johnson johnson has gargantuan manufacturing capacity they're one of the largest pharmaceutical companies in the world and this particular platform is very easy to mass manufacture and it's stored at refrigeration temperature and it's also a single shop platform so what that means is that we can expect hundreds of millions of doses in circulation as we exit the spring spring and enter the summer time and those doses are going to be very easy to distribute throughout the world in fact this year alone we expect one to two billion doses produced so having a gargantuan uh manufacturer be successful releasing a vaccine is great and it's one of the reasons why i was very sad when sanofi and gfk gsk's trial uh turned out to be a failure uh because they had equivalent manufacturing capacity and yeah them being set behind by nine months was a very problematic novovex the protein subunit manufacturing process they have they seem to be very confident they can scale that to about 1.6 billion doses by the end of 2021. now they're saying that they're going to start making 150 million doses a month is what their estimate is going to be as they scale up so the sooner that that can come to market uh the better now here's the reality variants included including the south africa variant which seems to lower the efficacy of the novovax vaccine the phase 2b trial to under 50 percent uh if one is vaccinated there would be no pandemic at least a traditional sense this virus would be endemic around the world and people would be getting it but honestly had just the johnson johnson vaccine been well distributed people had taken it we had naturally that level of immunity there'd be no social distancing there'd be no mass there would be no lockdowns because politically it'd be impossible to even have that conversation because the death rate would actually be lower than influenza if you do the math and you take a look at these things the level of production that's being claimed so what's going to happen in the next six months now that we have likely five vaccine platforms which are safe and effective before the end of june is that we're going to see a bottoming of lethality we've already seen this in israel over over half of the israeli population vaccinated and there's a incredibly positive data that's starting to flow out of this process where there's a latency with cases so they still are seeing a high case load and high mortality rate uh relative populations but within the next three to four months we're going to start seeing those curves move permanently in a very favorable direction and so by the end of the first half of this year if these vaccines can get into circulation especially johnson johnson and novavax uh then there's a very good possibility that we could see up to a 90 to 95 percent reduction in death that's optimistic but it's definitely doable and possible because the majority of the people who will likely die from this will have been vaccinated and all of these vaccine programs are showing platforms are showing a massive reduction in lethality so that is the first major stage in breaking the back of the pandemic is creating a degree of natural resistance and resilience in the community in the population for the disease as a whole and now there's the question of variance so the best adaptive platforms for variants uh of the virus like the south africa variant or the uk variant and so forth uh is the the mrna platforms the ceo pfizer and the ceo of monera have both stated that they feel optimistic that they could have a booster shot available uh within a hundred days that is custom tailored against the uk and south africa variants that are discovered so to stay ahead of this there's two things that need to happen one genomic surveillance has to be done so basically in all developed countries as cases are being detected some subset of them are being analyzed and we say hey we go beyond just testing for covet we actually sequence it to see if it's the same type of code we expect to see or a variant of it and there are all kinds of scientists and techniques and epidemiological stuff that people do um to know how to do that well unfortunately united states is number 43 in genomic sequ surveillance we need to be better at that so that gives you a sense of what you need to vaccinate against and the mrna platforms are extremely robust in being able to keep up with the mutations of the virus and it's a very important understanding that even as the virus mutates it's rare for it to completely escape the vaccine efficacy so what will happen is that if you contract the virus instead of it being a serious case if it was going to be a serious case it would still likely be a moderate to mild case and in many cases the the frustration with the variants are the lack of sterilizing immunity so normally you'd have it meaning that you don't spread it to people but you lose that because of the variant but you still have enough cushing in the in the immune response that it's not going to be a major problem so this pandemic is is going to be broken and i think in the next six months massive inroads and strategies are going to be made the world is going to get consensus on genomic sequencing and uh their surveillance and they're going to get to a point where we have the ability to modify the vaccines to keep up kick keep up with the mutations now modifications do not require new regulatory approvals such that you have to go back through a stage three clinical trial they don't for influenza there's no reason for them here so what's likely going to happen is that these vaccines towards the end of the year will be updated and rolled into likely the influential influenza platforms in fact this has already been suggested by the ceo of novovax saying they have an influenza platform called nanoflu and what they want to do is blend it with the novovax vaccine so the first step is get as many people vaccinated as possible ideally 70 to 75 percent uh that would break the back of the lethality of the disease and massively slow the spread slower spread less mutation less mutation less variance that can escape or develop some degree of resilience against the vaccination platform then genomic surveillance they basically get a good idea of the different strains floating around or variants floating around and then you can modify the vaccines within three months to target these new strains or variants and then give people boosters towards the in the ear there's still the doughnut hole of the developing world there's simply not enough vaccines to go around there so that is a problem because the virus will continue to mutate so it's very possible that coronavirus will be with us for decades if not forever if we do not find a way to vaccinate people in the developing world so the good news is that when we say with us forever the cold the common cold and influenza has been with us forever it's not really a huge problem for most of us so as strains common variants come the odds are will because it's no longer novel and the community has a high degree of resistance uh that it's not going to have the same impact that it had before so in other words i think by the end of the year the world is coming back to normal and the world's back to normal in 2022 but coronavirus is going to be part of our vocabulary forever and we're going to see a source code v3 and 4 and 5 that continues to flare up because of a lack of a global vaccination campaign that said there's probably going to be a blending as i mentioned with the influenza vaccine and the vulnerable will get vaccinated and then there's no political appetite for lockdowns or mass or social distancing when your disease is a hundred times less lethal than it was when it first came out so this is a huge huge step forward for the pandemic the fact that these two vaccine platforms appear to be both safe and effective and that they belong to manufacturing capacities in the billions many many more will come online in the second half of 2021 and we're going to get much better at mass manufacturing mrna in fact the vaccines in fact pfizer is already examining how to convert their vaccine to a freeze-dried vaccine so it can get rid of the deep cold requirements that they have and these platforms potentially could be placed into local manufacturing facilities like what kirvak is doing which is a german company that does mrna now why do i care so much about this i care so much about this because i want the world get back to normal and i want people to be able to travel again and i want businesses to reopen and restaurants to reopen and uh you know sending politics of the matter aside and the the insanity of these government responses uh the only way politically the world is going to come together and agree to reopen is when vaccinations or herd immunity has reached the level where and death rate has plummeted enough that it's politically palatable to do so so in essence vaccines are a mcguffin that politicians can latch on to and a target that politicians can latch on to and say okay we've reached the magic number we feel okay everything is back to normal now that's rosy colored glasses because there's a lot more to do and even after things are reopened the reality is the economic damage of this is tremendous in every respect and there are tens of millions of people suffering from long covet neurological conditions destroyed lungs permanent damage to their heart and other organs and what's going to end up happening is a whole subfield of medicine is going to form specifically the tree long coping government investigations class action lawsuits scandals corruption investigations you are all going to see this next five years to uh 10 years to basically clean through it you can't have an event of this scale and not have massive amounts of opinions on the matter the good news is that this has pushed medicine as a field the science of medicine ahead by decades especially the science of mrna vaccines in the science of technology in general so the whole point of making vaccines and deploying vaccines there's going to be a wave of innovation in that field that is unbelievable it's a golden age for it why should we care because i think within my lifetime there's a very good chance that we'll see dozens of cancer vaccines as a result for this that are custom made specifically for you the individual if you contract cancer i think within my lifetime we will also see an hiv vaccine as a direct result of this the field of virology will also gain tens of thousands of new researchers because of people inspired by this and the knowledge of virology will become far more global and so much more research will be done there's also been a great acceleration because of the wave of preprints in medicine of analyzing medical research faster also there's going to be a deeper discussion about emergency youth authorization and a deeper discussion about approving medicines faster for people and including fast review of old medicines when pandemics occur so all things considered there's some light at the end of the tunnel for everything that's bad you get something good you know and this is no different and we can always choose to look at a glass half full instead of a glass half empty but i am optimistic that the trends will continue my own country the vaccination rates 1.3 million doses per day likely within three months that will be two to three million doses per day and general public availability should probably happen somewhere between april to june at this trend if pfizer excuse me if novavax and johnson johnson and astrazeneca are approved because we'll simply have more doses than people there's no reason to ration at that point and anybody who wants one can go and get one i think what will occur is we'll get to 50 to 60 vaccination rates pretty quickly and then there will be a long tail because of vaccine hesitancy which tends to erode over time because what happens is more people know people in their social circles who have been vaccinated and had no issues with it and they say okay i guess i'm going to do that the other side is that many vocations will require you to get vaccinated such as being a teacher or a doctor or other things uh if not in the united states and abroad so it's going to be endemic we're probably going to live with it forever but the world came together and we made a few great strides that allowed us for the first time in human history to manage a pandemic without natural herd immunity normally how this goes down is that we quarantine people as best we can it's ineffective and tens of millions of people die and then eventually humans develop built-in resiliency to the disease and it goes away sometimes takes years in cases of small pox never quite and when they did flare up it was decades the roman empire for example during the reign of marcus aurelius suffered from this and this was one of the contributing causes to the destruction of rome it forever diminished the power of the empire and set them on a long path to decay plagues tend to break empires and they tend to shatter great nations and there's no exceptions in human history to this and the very fact that a year into this one i gave us a different way of doing things now as i mentioned prior video my ama i cautioned everybody i said it is really really really a wake-up call this is the least lethal of the pandemics we're going to get in the 21st century the reality is that in an age of crispr there is an asymmetry to the spreading of disease whether this came from a lab in wuhan or came from a bat or a pangolin it doesn't matter it started small there was a small group of people who were infected and then it grew exponentially and now it's a pandemic imagine if this was engineered in a way that had a very long incubation time that was asymptomatic with a highly lethal tail like 30 percent 40 percent as we see was conditions like ebola or andes virus uh which is american hantavirus or things like that if that's the case we could be looking at a pandemic that kills over a billion people so it's extremely important that we take a moment to realize that because of globalization and genetic engineering and because of terrorism and asymmetrical warfare that the chance of another pandemic within all of our lifetimes is much greater than 50 percent and the chance of that pandemic being an engineered virus that was built from the ground up to maximize contagiousness and lethality is extremely high as well so the incredibly important that everybody realized that this is the last opportunity we have as a global society all countries to come together and come up with unified responses when pandemics occur now the good news is that because of what we've learned from the vaccines because what we learned from rapid drug manufacturing i'm very confident we probably could develop effective therapeutics and vaccinations pretty quickly in fact if we pre-build them for most of the pandemic causing viruses within four months we can bring a vaccine to market there's a recent paper out of cell that describes how to do that now the bad news is we failed with contact tracing we failed with ppe we failed with initiating lockdowns properly closing borders properly and no cases in the world except for a few countries like vietnam new zealand taiwan and so forth was this done properly so i am not at all optimistic of confidence that we've gotten out of that and i really hope that as we close this out the investigations begin and the lawsuits begin and the finger pointing these other things happen at least some wisdom prevails in on a global level that things look better and that we get our way out of it so anyway that's all i have to say about this topic it's uh today it's extremely good news and it makes me really really happy i know some people personally who have been devastated by contracting coronavirus i i was knew that was going to happen the minute that it became a pandemic and the data came out about how bad it is i have friends who have lost family members and i have lost friends over this i and i know some people who after nine months after contracting it are still going through long coven and they're having headaches and fatigue and respiratory problems and they have not been able to return to work so it's just been devastating on the other side of it i also know a lot of people who have been devastated by the economic consequences of bad government policy the lockdowns shutting things down and they've lost restaurants over it they've lost livelihood over it huge amount of reduced business i have a lot of friends in the entertainment industry in the music business and the superstars they have cash cushions the people who make the magic happen behind the scenes they usually don't and they're usually underpaid because they like working for rock stars and unfortunately because they can't have concerts because an entertainment venues aren't working properly most of them got laid off and most of them are living paycheck to paycheck with odd jobs sometimes they're sometimes not this has been catastrophic for the bottom 25 percent in wages in the united states and abroad uh and that's not going to get any better for some time that said the vaccines are the path out of this because it's the political mcguffin that the politicians have chosen it's either natural hurt immunity and willing to accept the criticism and the deaths or its vaccination immunity those are the two options you have sweden tried the natural immunity they got so brutally criticized that the government had to buckle and back off and now everybody's pushing towards vaccination and that's fine as long as there's a plan and a supply to get it done and people know how to handle the variance in a way that's responsible the good news is it seems somehow someway there's enough of a plan and enough momentum that it looks like by the end of the year uh we'll be mostly out of it and we can all get back to work and get on to the post coveted phase of cleaning things up and hopefully better leaders will come and prevent the next one from happening the other thing is that there needs to be a great quantification in my view of all the civil liberties that we've lost and all the things the government did that was both unnecessary and harmful to our rights as a society all those accountable must be punished at the ballot box and many cases perhaps with civil lawsuits and with criminal charges especially in cases of corruption and my hope is that in the coming years that deep investigations and electoral changes will be able to flesh all of that out and there should be a removal of any statutes of limitation over corruption related to covet at least in the united states so i really really hope that that is the outcome and you know what i'm getting richer and more political these days i will definitely donate money and definitely participate towards causes that ensure that in postcovid this never happens again we didn't have to shut the world down we all could have been smarter and our politicians didn't have to lie to us we could have worked with them instead of against them or be crushed by them for us to get through a very bad situation instead we were treated like children there was an enormous amount of corruption and dishonesty and even today we are not getting real information it's available but it's buried under narratives that are counterproductive and constantly either diminishing what is really a bad situation or overreacting to a situation treating it as if it's bubonic plague or ebola it's neither the truth is somewhere in between and we're all tired we're all fatigued myself included and it's caused all of us in our own ways a lot of harm and damage but you know the shining beacon is that there are good people and those good people went to work every day 24 hours a day seven days a week to try to do their best to manage and in the case of these therapeutics and vaccinations actually produce hope to get us out of this so that's a good thing thanks you all for listening i hope this is a bit helpful as soon as the euas are applied for we'll actually have the uh the inserts and of course i'll post them in one of my amas or something like that and i'll tweet the links to them like i did modern on pfizer as these are open documents you can read yourself and the kimonos open they have to in an eoa report everything regardless if it's convenient or not and we'll find out more cheers everyone
