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The market for vaccines is not like the stock market

(Part 2: The ‘every state and city for itself’ model of vaccination)

This is disappointing but not surprising: “Mumbai: No bidders yet for BMC vaccine tender“.

However, on the same day: “PCMC to float global tender to procure 15 lakh vaccine doses

One of the reasons the COVAX multi-national vaccine initiative exists is because small, low-to-medium income countries lack the negotiating strength to compete individually against the developed world, especially when most vaccine developers and manufacturers are from those developed countries. It’s unrealistic to have not just states but individual bodies compete for supplies.

Another equally important aspect of this is that there is no global market for vaccines. Unlike a stock market, there is no counter-party holding on to vaccines waiting to sell them to the highest bidder.

As the two economists in the interview that we linked to in earlier post said,

The other [plan] was that we should go and bid in the global marketplace for vaccines. If that was the case, some rich trader at Goldman Sachs would have said, I’ll buy up the whole vaccine supply of the world, and you come and trade with me every day. I would have created a market for vaccines. That can’t be the case because there is no marketplace. Otherwise, some dark pool would exist for vaccines right?

The few companies with vaccine know-how plan their manufacturing based on the orders that they get from countries/groups of countries:

It is highly unlikely that in the face of an EU order for a billion plus vaccines, that Pfizer will entertain a 0.4 million order from Navi Mumbai, or a 1.5 million order from Pimpri-Chinchwad.

Ditto with Moderna, whose commitments until the end of the year “include delivering 300 million doses to the US, 150 million doses to the EU by the end of this year, 50 million doses to Japan, and roughly 50 million doses to Canada and South Korea”

Novavax, who has contracted the Serum Institute of India to manufacture its vaccine, is limited by the US’ reluctance to export enough raw materials to get production lines rolling:

Still other vaccine makers like AstraZeneca are hamstrung by capacity constraints and export bans in India. In any case, the national government has ruled it’ll purchase, at a pre-determined fixed price, half of any doses manufactured in India. That leaves less for states and municipal corporations.

Full circle – it should be no surprise that Mumbai’s municipal corporation has received no bids: vaccine supplies are not listed on a globally liquid supply-and-demand marketplace; on the contrary manufacturing itself is planned based on pre-paid advance orders; other vaccine manufacturers are facing constraints on raw materials and production. I hope states’ global tenders receive responses, but I am skeptical.


(Featured Image Photo Credit: Spencer Davis/Unsplash)

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The unintended consequences of abuse control tools for new social networks

How blocking works on the voice-only group chat app Clubhouse:

When you block someone on Clubhouse, it doesn’t just affect communications between the two of you, as it would on Facebook or Twitter. Rather, it limits the way that person can communicate with others too. Once blocked, they can’t join or even see any room that you create, or in which you are speaking—which effectively blocks them for everyone else in that room. If you’re brought “onstage” from the audience to speak, anyone else in the audience whom you have blocked will be kept off the stage for as long as you’re up there. And if you’re a moderator of a room, you can block a speaker and boot them from the conversation in real time—even if they’re mid-sentence.

Imagine a live panel discussion in which each member of the panel has the power to cut the mic of any other member, at any moment and for any reason, and also the power to have that person dragged from the lecture hall by security. That’s roughly how blocking works on Clubhouse. This is not just a personal decision, but a social act, with implications for who can speak at what times and in what settings.

There’s even a visible emblem of this regime. When a user you don’t follow has been blocked by some unspecified number of people whom you do, that user’s profile will appear on your app with an ominous icon: a black shield with a white exclamation point. Clubhouse calls this feature a “shared block list.” Some users call the badge the “black check mark”

Today’s techniques to control our own social media experience have been designed for algorithmic feeds. Here, each person has their own list of who they follow. Tools like block, mute account, mute keywords apply to one’s own experience.

A Clubhouse room is by its design a continuously shared experience. Giving one particiapnt the ability to control their experience affects others. This is not to judge Clubhouse’s tools – I have not thought about them well enough – but it is clear that different social experiences are emerging, Clubhouse-like rooms perhaps being the most promiment among them [1], and designers will need to create different tools for each of them.

[1] Venmo, the person-to-person payment app, also shares your payments on a public and semi-public feed, creating a different social experience. While you have some control over privacy, as the USA president Biden learnt, it’s not always enough.

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The ‘every state and city for itself’ model of vaccination

(Part 1: whether IP waivers or manufacturing constraints are the gating factor in mass vaccination in India)

This is the best estimate I could find of states and city municipal corporations ‘floating’ global tenders for vaccine acquisition.

Navi Mumbai’s tender for four lakh is unfortunately laughably low.

The known numbers in the table total 191 million doses, which would vaccinate less than 100 million people.

It’s baffling, to me, to state governments, to commentators published in the media, that the national government refuses to import vaccines. After all, even the 27-member European Union, not even a single nation-state, has negotiated vaccine purchases as a bloc – securing a total of 1.5 billion shots from just Pfizer-Biontech for its population of 450 million people, to be delivered through 2023. That includes booster shots. One would think that this is one occasion when the country’d use its large population to its advantage. To use this analogy from an interview with two economists on the vaccination rollout:

 Think about how McDonald’s does procurement. If you have 1000 McDonald’s stores across the length of the country, McDonald’s doesn’t say each of these 1000 independent franchisees should go and procure the potatoes and the oil themselves from the local daily market. The reason you have centralised procurement is precisely because it’s the most efficient way to do it.

The only possible reason I could think of the national government’s refusal is that importing vaccines would be a reversal of its messaging of being the ‘pharmacy of the world’, a claim made publicly as recently as mid-March 2021. I hope there is another reason to have states compete against one another.

Then there’s the claim made by a member of the national Covid task force that over two billion doses would be available between now and December 2021.

If those doses actually materialise, they would be enough to vaccinate the entire adult population and more.

Here are the manufacturers’ supposed estimates:

This Economic Times article has more details on the delivery schedule. I couldn’t find a definitive answer to whether the national government has committed to paying for these doses in advance, or according to a schedule – something that every major country worldwide has done.

As the graphic above states, these numbers don’t include imported vaccines. That is, the very doses that states and municipal corporations are ‘floating tenders’ for. So the country may well end up with more vaccine doses than it needs. State governments looking at this estimate have also probably wondered whether their procurement, costing a significant percentage of their state budgets, is redundant – once again, puzzling.

The well-known heart surgeon and hospital founder Devi Shetty also called for national vaccine procurement – and urgently:

… whatever has happened has happened; now for the vaccination the country has to buy together. So the bulk order will give you huge leverage in terms of negotiating for the best price. And unless these companies get money in advance, they won’t commit. We need at least five different vaccine manufacturers to come forward and say, okay, you give me the money, I will deliver you on this time.

We should just open our door for any country’s vaccine company to come here, set up the shop, and sell it to us. But they have to give it to us within the next three months. After that, it may not make that kind of a difference.

Q: Multiple states have floated global tenders, corporates have asked the government to liberalise vaccine import…
A: All of them should come together as one vaccine procuring agency.

– Interview | We should be mentally prepared for COVID-19 pandemic to last until mid-2022: Devi Shetty

To me the most convincing case is economic. Devi Shetty in the same interview:

So one day of lockdown, how much it is going to cost us; the vaccine is the cheapest solution we have today against COVID and we have to use it…

According to an April 2021 Barclays estimate, the economic cost of ‘sporadic lockdowns’ is USD 12.5 billion per week. Those are numbers, of course; this feature has a clearer picture of what that loss looks like for people.

(Part 3: The market for vaccines is not like the stock market)

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App Store as Zeitgeist

From the excellent Morning Brew newsletter:

One way to find out where people’s heads are at is by looking at the top of the App Store rankings. Last year it was Zoom, in February it was Robinhood, and yesterday, with the Colonial pipeline shutdown causing all kinds of havoc, GasBuddy topped the list for the first time ever.

I looked at the Play Store India rankings. I’d have expected the Aarogya Setu and CoWin apps to be higher on that list, although entertainment apps domainating is a good sign.

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Discovery and Curation

A cultural beige

From Edward Bernays’ 1923 book Crystallizing Public Opinion:

While the ‘moral and spiritual’ writing to inculcate a ‘public conscience’ that Bernays describes exists on the Internet today, it is very hard to find.

There are relatively few destinations to discover newness on the Internet today, and they are all heavily optimized to capture and retain attention, not necessarily promote variety and depth. Publishing on the Internet has, in response, optimised these algorithms, which have in turn learnt.

The Internet, as viewed through the lens of its gatekeepers, is a cultural beige.

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Discovery and Curation Life Design The Dark Forest of the Internet The Next Computer Wellness when Always-On

Life pre-internet

This question on Reddit had a bunch of answers that I think are worth reflecting on.

”People old enough to remember life pre-Internet, what are some less obvious things you miss about that time?”


Work-life balance

“Leaving home and just being gone for the day. No cell phones.”

Mind-wandering

“I miss spacing out. Like, you could legit just sit on a bench or ride a bus and space out completely, letting your mind wander into those creative zones. Now phones/tech makes it much harder to get there.”

“Having an idea, finding a new hobby or skillset or project to work on, going to the library or bookstore to educate yourself about it, start learning and growing and excited about a new passion. Now… you look it up online, realize there’s a bunch of people who are wayyy better at it than you will ever be, and so you immediately give up out of discouragement. :\”

Presence

“If there were cameras, it was really different. You used them to take pictures of things or had people take pictures of you. But there was no social media to preoccupy your mind. It was just doing something. And whoever you were with, was who you were with.“

“My former housemate – who is twenty years younger than me – and I both left our phones at home by accident one day. So we kept on keeping on doing the days activities. Some errands and some wandering around. At one point, she turned to me and said “So this is what the 80s were like?”

“We weren’t getting texts all the time. No constant robocalls and spam e-mails. No expectation of instant reply 24/7. No constant stress or pressure. We were just there enjoying the moment and the simple stuff.”

The news cycle

“News only being on at 6pm. That was it. Now we have 6 hours of local news and 24 hours of cable news. Not being bombarded all day with “news.” And when you saw “Breaking News” on the screen you knew some serious shit went down.”

A curious one for me was one about identity:

“The ability to start over. I moved a lot, every move I could reinvent myself, bookworm, punk, preppie, I got to try out lots of aspects of my personality and my past wasn’t a factor.”

and its reply “I think especially when young it’s genuinely damaging to be locked into an identity by the stuff you have said / done years ago. How are we supposed to grow? Also being judged by the norms of a previous era which are not cool now.”

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Decentralisation and Neutrality Discovery and Curation Wellness when Always-On

“The News consumes us”

Quick quote from a short blog post I read last week:

The News is like alcohol. Both are drugs that give you a quick buzz but both are depressants. Both are habit forming. Some people can do moderation but many struggle with that.

2020 showed us that if you lock people in their homes for months on end, deprive them of the people they love, their basic freedoms and hook them up to The News and Social Media 24 hours a day, they go completely mental.

it has felt like The Public Square is broken. Online discussion is a poor substitute for face to face discussion. It’s only when discussing things face to face that you get the full range of vocal cues, body language and tonal emphasis. 

To me, the most important bit in the post was this:

We can choose to reduce and control our intake. We can get more of our information from primary sources. 

The most reliable information in the right context is from primary sources. It’s suprising how many news articles, tweets and blog posts all eventually quote the same source. And how different interpretations (not always malign) can change the original meaning.

But locating that source takes time. And it follows that because you can only read so many news sources, that you pick them carefully.


Related:

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Covid 19 vaccination – patent waivers vs capacity constraints

Because there were a lot of Covid-19 vaccine names mentioned in the Indian and other press, I put together a list of vaccines that appear to be in the market or in Phase 3 trials as of 10 May 2021.

The WHO has a basic primer on the different types of Covid vaccines.

I recently read a detailed two-part article exploring the constraints holding back vaccine manufacturing and distribution. Written by a professor of Law at Yale. Part One, Part Two.

The material focuses on patent law, and is probably the writer’s expertise.

But I am also interested in understanding manufacturing constraints: how long it takes for existing manufacturers to ramp up vaccine facilities, build new ones and repurpose other vaccine/drug facilities for a Covid vaccine. From a Financial Times article:

While some EU leaders do not want to appear intransigent on the IP waiver issue, they mostly agree that it is a distraction from the more pressing issue of expanding near-term production capacity through licensing deals and sharing technology… But that puts the onus on the EU to come up with industrial solutions for increasing production and for sharing its own supplies, due to expand vastly in the second half of the year, with developing countries.

– EU is the vaccine good guy that manages to look like the villain

After all, India’s SII already has a license and has transferred tech for the AstraZeneca vaccine. Another company, along with a couple of government agencies, has developed an effective indigenous vaccine branded Covaxin. A third pharmaceutical firm has licensed the Russian-origin vaccine, Sputnik V, but even after having been cleared for administration in India on 13 April, as of 13 May, a fresh round of ‘local testing’ means there is no clarity on when distribution will begin, despite 150,000 doses having arrived from overseas on 1 May.

So. Licensing has not alleviated the vaccination crisis in India.

While there are legitimate and necessary debates about granting other vaccine makers the rights to the locally-created vaccine, the high lead time to expand production capacity means a terrible slowdown in India’s vaccination rollout:

From the Indian government’s ‘cowin’ dashboard. Vaccination has declined for five straight weeks. The slower the vaccination rollout, the slower the current ‘wave’ will recede; the longer the patchwork of lockdowns will last.

and has meant that despite being home to the world’s largest manufacturer, despite having a vaccine not limited by global IP rules, despite having a decentralised distribution mechanism, despite having no anti-vaxx movement, vaccination coverage in India is dismal.

(Part 2: pitting the centre, states and cities against each other)

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Life Design Wellness when Always-On

“Feel awesome in the morning”

A question asked on Twitter about what one could to do “to feel awesome in the morning” had interesting and commonsense replies. Here are some of both:

https://twitter.com/edwardsorado/status/1391512730654314496?s=21
In my experience, waking up in the middle of a sleep cycle ruins a whole day. A major downside of alarms, and why apps like Sleep Cycle are helpful.
Yep. A good eye mask and ear plugs are among the most valuable cheap things I have bought.
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Letters as literary extravagance

In the introduction to his book Glimpses of Bengal (1885-1895), Rabindranath Tagore writes about letters:

He felt “the writing of letters… to be a delightful necessity” which he considered as “a form of literary extravagance only possible when a surplus of thought and emotion accumulates”.

– Rabindranath and Bangladesh: The umbilical cord

(Featured image: outside the Victoria Memorial, Calcutta, 2013)