This thread discusses “vaccine shortage”. Data from news reports over last 6 months.

Tl;dr: Situation is not shortage as such. India has stockpile of ~140m doses end March. However there’s a tricky situation with supply vs consumption over short term.

1/

Situation: SII and BB accumulated significant stockpiles much before earliest approvals.
SII 40m by mid Nov: https://t.co/esy5oYoN1z
SII 270m doses produced end-March: https://t.co/peKENQvrxW
Covaxin 20m stockpile March: https://t.co/s4mZ7bSHZU

2/
Vaccine exports total 64.9 million : https://t.co/pLKalzySrL but dropped to almost 0 in April.

Total consumption is 173.1 million up to April 12: 108.2 m local vaccinations plus 64.9m exports .

3/
However, due to SII and BB both producing ahead of time, India accumulated a stockpile much before first vaccinations and exports began 3rd week of Jan.

Currently this stockpile is estimated at over 140m doses start of April .

4/
At the ongoing 3.6 million doses / day we consume 108m doses a month. Even though monthly production is 65m doses, the stockpile enables current vaccination rate to continue.

5/
SII is due to expand to 100m/month in May. BB to 12m doses in June. Lets extrapolate forward, assuming 4m vaccinations/day through July. Will we run out ? Extrapolating:

6/
So… it’s tricky but can be done without shortages. It depends on things continuing to work on schedule - SII / BB keep executing , and additional capacity comes on stream as expected.

I do not count Sputnik, Zydus/Cadila and other vaccines. That would be a bonus here.

7/
The govt is threading a fine needle between extremely high vaccination rate, utilizing stockpile, deferring export and hoping to meet the expanded supply in time. But there’s no “shortage” - otherwise they could not ramp up as they did.

8/
So far we have been fortunate. EU bought half of Pfizer production only to be massively delayed: https://t.co/DTAAiVx320 . Pfizer decides where vaccines go: https://t.co/ZZxYmEgKT0

9/
There have been arguments for ‘let people buy Pfizer/Moderna/JJ in open market’.

There is NO open market. Any order made now won’t be fulfilled until months from now, late summer or in autumn. This is not something you order on Amazon or Tomato.

10/
Think SII is doing badly ? Compared to their 270m production by end March, Pfizer, Moderna, JJ committed to a combined 240m by end March, and failed: https://t.co/lbaojo9tnl
https://t.co/8VcHPxxVJp

11/
Vaccine production at this scale so far is not easy. J&J discarded 25m and are evaluating another 62m for contamination: https://t.co/comCMiq1b8

12/
We have been fortunate so far. SII and BB gambled their futures by producing significant volumes before approval, got approval, so far have delivered with fewer than the problems seen elsewhere. These efforts need support!

13/
While other countries beg for and fight over vaccines, we have been able to be masters of our own destiny, outproducing combined US production upto March just from SII .

This is no time to undermine these efforts.

14/
It is important to clearly understand the nature of the situation - not a shortage right now, but a demand/supply imbalance that may hurt in 2-3 months if things do not happen to plan.

15/
I hope @MoHFW_INDIA @PMOIndia help SII and BB get funding immediately for expansion. Current vaccine trials must be expedited. Pay for production before approval so there’s ready supply on approval.

16/
This situation while tricky, can be managed. Compared to original plan for 250m vaccinations by July, govt will do more than 2x that as estimated. This is driven by the urgency of the 2nd wave.

Due to stockpile, we can manage it.

17/
5m/day is unlikely to be possible now unless supplies can reliably support 150m doses consumption per month. SII also has COVAX commitments it has deferred and must meet soon.

This is the situation today.

18/18

You May Also Like

@EricTopol @NBA @StephenKissler @yhgrad B.1.1.7 reveals clearly that SARS-CoV-2 is reverting to its original pre-outbreak condition, i.e. adapted to transgenic hACE2 mice (either Baric's BALB/c ones or others used at WIV labs during chimeric bat coronavirus experiments aimed at developing a pan betacoronavirus vaccine)

@NBA @StephenKissler @yhgrad 1. From Day 1, SARS-COV-2 was very well adapted to humans .....and transgenic hACE2 Mice


@NBA @StephenKissler @yhgrad 2. High Probability of serial passaging in Transgenic Mice expressing hACE2 in genesis of SARS-COV-2


@NBA @StephenKissler @yhgrad B.1.1.7 has an unusually large number of genetic changes, ... found to date in mouse-adapted SARS-CoV2 and is also seen in ferret infections.
https://t.co/9Z4oJmkcKj


@NBA @StephenKissler @yhgrad We adapted a clinical isolate of SARS-CoV-2 by serial passaging in the ... Thus, this mouse-adapted strain and associated challenge model should be ... (B) SARS-CoV-2 genomic RNA loads in mouse lung homogenates at P0 to P6.
https://t.co/I90OOCJg7o
A brief analysis and comparison of the CSS for Twitter's PWA vs Twitter's legacy desktop website. The difference is dramatic and I'll touch on some reasons why.

Legacy site *downloads* ~630 KB CSS per theme and writing direction.

6,769 rules
9,252 selectors
16.7k declarations
3,370 unique declarations
44 media queries
36 unique colors
50 unique background colors
46 unique font sizes
39 unique z-indices

https://t.co/qyl4Bt1i5x


PWA *incrementally generates* ~30 KB CSS that handles all themes and writing directions.

735 rules
740 selectors
757 declarations
730 unique declarations
0 media queries
11 unique colors
32 unique background colors
15 unique font sizes
7 unique z-indices

https://t.co/w7oNG5KUkJ


The legacy site's CSS is what happens when hundreds of people directly write CSS over many years. Specificity wars, redundancy, a house of cards that can't be fixed. The result is extremely inefficient and error-prone styling that punishes users and developers.

The PWA's CSS is generated on-demand by a JS framework that manages styles and outputs "atomic CSS". The framework can enforce strict constraints and perform optimisations, which is why the CSS is so much smaller and safer. Style conflicts and unbounded CSS growth are avoided.
Still wondering about this 🤔


save as q