Coronavirus/COVID-19 (No Politics)

[Mikado463]

I as well don't have 'the' answer but from what I understand three things come to mind........

. flattening the curve and show sustained signs of reversal

. need for much improved testing not only in #'s but reliability and timeline for results

. higher ratio of working treatment procedures for those infected


I hope these measures can work and allow 'start' of the return to working America in the next 3-5 weeks

 

[Mr._Clark]

So to avoid this predictable debate, I'm asking to explore the question now.

Please explore this question on the other coronavirus thread.

 

[herbu]

Please explore this question on the other coronavirus thread.

This is not a political question. It is a Corona question intended to circumvent politics. Knowing what we know now, and learning what we expect to learn tomorrow, what should be our criteria for turning the country back on?

I don't know what metrics should be used, but I agree with Mikado. The turn-on should be implemented differently in different areas, depending on the local exposures and risks. I'd like to see us define a set of metrics that allows reasonable comparison between Covid-19 and the flu, aids, and whatever other communicable diseases we think are appropriate. Once those comparisons are established, comparisons of risks and effects should be considered. If the overall risks of Covid are less than the comparable risks of other diseases, it might be time to turn back on.

 

[highfigh]

I agree that's what should be done. However, that means the answer(s) will be based on some judgement. I'm not sure Covid-19, and all its offspring, will ever be totally eradicated. And that means some people will still die AFTER the country begins turning back on. And that means no matter who makes the decision, half the country will say it was too soon.

So to avoid this predictable debate, I'm asking to explore the question now. Who is willing to say NOW what conditions/numbers YOU would require before starting to turn the country back on? Rather than criticism after the fact, let's try suggestions before the fact. Doc did that early on, and it turns out he was right. Frankly, I don't have a clue. I suppose somehow we should come up with metrics to compare the effects of Corona to other existing diseases, making allowances for elements like R0, mortality, etc. There are lots of diseases and other conditions for which we don't shut down the country. At what point does Covid-19 become one of them? And how do we decide, rather than just waiting for it and then complaining?

Once a vaccine is developed, this is likely to effectively go away, although that assumes anti-vaccine idiots will go away/stfu and non-developed countries will get it easily enough to administer it to anyone who wants to live and those who don't want to infect others. Polio is almost totally gone, Smallpox was gone for years, but it occasionally shows up. We have Flu vaccines they, as do others, have side-effects.

The problem with this crap is it's so infectious, it takes more time for symptoms to show, it's apparently mutating and people are too arrogant/stupid to avoid contact with others. Wisconsin's state parks have been closed, supposedly because of vandalism, littering and people who weren't keeping their distance. Not maintaining distance in a park???????? That's almost like going into an empty theater that's showing something nobody else wants to see, finding a great seat and then, some pinhead sits in one of the seats to the right, left, front or back.

 

[herbu]

The problem with this crap is it's so infectious, it takes more time for symptoms to show, it's apparently mutating

Can a vaccine still be effective on a virus that is mutating?
How far out is availability of a likely vaccine?
Is that what we wait for to turn back on?

 

[panteragstk]

Can a vaccine still be effective on a virus that is mutating?
How far out is availability of a likely vaccine?
Is that what we wait for to turn back on?

This is what we have to consider for the flue. So many strains are floating around that a vaccine works, but not all that well for some.

 

[NINaudio]

This is what we have to consider for the flue. So many strains are floating around that a vaccine works, but not all that well for some.

Well, every year is a guess at which flu strains will be most prevalent and those are the ones that go in the vaccine as there is approximately a 6 month lead time from production to availability. Get that wrong and the vaccine isn't very effective that year, so yes, it's possible to make a vaccine for different strains. I'd say that at this point a vaccine for Covid-19 is at least a year out.

 

[highfigh]

Can a vaccine still be effective on a virus that is mutating?
How far out is availability of a likely vaccine?
Is that what we wait for to turn back on?

Not that I know much about mutations, but I think some of this is due to people reinfecting themselves in the same way it happens with a cold- they continue using the same toothbrush and other items that can hold germs or active viruses, for whatever length of time needed. I saw that COVID only lives for hours on Copper, but for several days on many plastics. Copper is used for preventing algae and barnacles sticking to the bottom of boats.

We have never seen anything like this in our lifetime and it's so much easier to travel great distances now, COVID vectoring can't be compared to the Bubonic plagues because those infected locally at first and then, people and rodents may carry the disease and fleas to nearby towns. Bubonic plague hasn't been eradicated, but it's much more rare because we have better sanitation. In places where sanitation is bad or populations are low, it still shows up- the desert SW of the US still has cases almost every year.

 

[3db]

Doctors here in Canada are looking at the effects of using ventilators now based upon what the world has learned so far about the virus. Its intersting to note that there are some people who should show symptoms of oxygen starvation but are completely lucid despite having dangerously low oxygen levels. Im wondering if these people actually have low oxygen levels or if the virus is masking the ability to measure oxygen levels correctly? Im just throwing that question out there.

'Different than anything we've seen': ICU doctors question use of ventilators on some COVID-19 patients

coronavirus, COVID-19, ventilators

nationalpost.com

 

[herbu]

Well, every year is a guess at which flu strains will be most prevalent and those are the ones that go in the vaccine as there is approximately a 6 month lead time from production to availability. Get that wrong and the vaccine isn't very effective that year, so yes, it's possible to make a vaccine for different strains. I'd say that at this point a vaccine for Covid-19 is at least a year out.

I'm hearing that, like the flu, a vaccine would likely be only partially effective and could be a year away.

So do we maintain current disipline until a vaccine is available? Or do we look for another criteria?

 

[highfigh]

Doctors here in Canada are looking at the effects of using ventilators now based upon what the world has learned so far about the virus. Its intersting to note that there are some people who should show symptoms of oxygen starvation but are completely lucid despite having dangerously low oxygen levels. Im wondering if these people actually have low oxygen levels or if the virus is masking the ability to measure oxygen levels correctly? Im just throwing that question out there.

'Different than anything we've seen': ICU doctors question use of ventilators on some COVID-19 patients

coronavirus, COVID-19, ventilators

nationalpost.com

How lucid were they before the virus struck them?

I went home from work yesterday because the water pill I'm taking can cause orthostatic hypotension and that's what I was experiencing. I told my boss that I was feeling light-headed and when he didn't respond to that, I stared at him. He asked why I was staring and I told him I was surprised he didn't ask "How can you tell?".

 

[mtrycrafts]

If you pinch your nose closed and eat or drink something- sense of taste is almost gone.

I just tried that with some coffee. A choking experience besides my hand being in the way of drinking. But still had that milk taste. I guess I need to clip it and experiment.

 

[Mikado463]

I just tried that with some coffee. A choking experience besides my hand being in the way of drinking. But still had that milk taste. I guess I need to clip it and experiment.

LOL, my coffee tastes like coffee not milk !

 

[mtrycrafts]

LOL, my coffee tastes like coffee not milk !

Yes, I don't drink it straight.

 

[3db]

How lucid were they before the virus struck them?

How would I know? The point is, nurses are able to tell the difference and theses people werent exhibiting symptoms of low oxygen levels. Please dont be so dismissive.

 

[Swerd]

I'm hearing that, like the flu, a vaccine would likely be only partially effective and could be a year away.

Influenza viruses are significantly different from most other viruses, especially in the ways that it can easily vary its outer envelope proteins (those H and N proteins) from one season to the next. Unlike other viruses, Influenza viruses have 8 small RNA segments that make up its genome. You can think of them as similar to separate chromosomes. During influenza virus replication, if an individual is infected by more than one sub-type of Influenza A (it's known to happen both in the lab and in nature), it's possible to mix & match those different fragments. As long as the resulting viral progeny have one each of those 8 different fragments, they're viable. I'm oversimplifying, read more about it here.

Every year this RNA segment exchanging results is new Influenza strains that are not recognizable in people vaccinated with the previous year's vaccine. This happens so often that deciding on what newly emerged Influenza strains should be in next year's vaccine is always a gamble. To hedge their bets, these vaccines are usually a mix of 3 or 4 different strains that are deemed likely. The result is variably effective vaccines from one year to the next. 50% effective is actually a good result.

Unlike Influenza A, most other viruses, including Coronavirus, have one single nucleic acid strand as it's genome. They can't play that mix & match game. So it's wrong to assume a Coronavirus vaccine would be only partially effective, like the yearly crop of Influenza vaccines.

It's also wrong to knock a vaccine as only partially effective. 1) Nearly all vaccines, including the very good ones against measles or polio are partially effective. In nature, there is no such thing as 100%. 2) A partially effective vaccine is better than no vaccine at all.

So do we maintain current disipline until a vaccine is available? Or do we look for another criteria?

Looking for economic performance criteria in the absence of a vaccine would be a dangerous mistake.

 

[Mr._Clark]

I've been seeing articles about oral vaccines. I will concede I do not fully understand how these (supposedly) work.

Stabilitech says: "A viral vectored oral vaccine will infect the epithelial cells in the GI tract and thus should be able to generate both a mucosal and systemic immune response. . .
OraPro uses a non-replicating viral vector to deliver the COVID-19 DNA to cells in the GI tract. This ensures that no anti-vector immune response is generated. A strong anti-vector response would inhibit the re-use of the same vector for second doses (if required) and therefore limit other new vaccine candidates. This lack of anti-vector immune response unlocks a plug-and-play aspect for OraPro, where only the infectious disease antigen is changed between developments, enabling a large amount of manufacturing, regulatory and safety continuity. . .
OraPro utilises adenovirus type 5, a non-integrating virus and one of the most well characterised viral vectors. Additional gene deletions are performed to ensure the recombinant adenovirus vector (rAd) is non-replicating to further enhance safety aspects."

I guess it's easy peasy?

Israeli scientists: 'In a few weeks, we will have coronavirus vaccine'

Once the vaccine is developed, it will take at least 90 days to complete the regulatory process and potentially more to enter the marketplace.

www.jpost.com

OraPro-COVID-19 | Home

www.stabilitech.com

 

[Swerd]

I've been seeing articles about oral vaccines. I will concede I do not fully understand how these (supposedly) work.

Which part don't you understand, the oral vaccine part, or the non-replicating viral vector part? Both can be long answers. It can be tough trying to 'splain every thing when only a part is needed.

 

[Mr._Clark]

The New England Journal of Medicine just posted an article about remdesivir administered on a compassionate-use basis.

My initial impression is that the results are encouraging (18% mortality of patients on vents compared to 80% mortality for patients on vents in NYC). I realize there's no way to know for sure what other factors may have contributed to the better outcomes in these cases.

>>>Results
Of the 61 patients who received at least one dose of remdesivir, data from 8 could not be analyzed (including 7 patients with no post-treatment data and 1 with a dosing error). Of the 53 patients whose data were analyzed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated. A total of 25 patients (47%) were discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive ventilation.

Conclusions
In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomized, placebo-controlled trials of remdesivir therapy. (Funded by Gilead Sciences.)<<<

https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

 

[Mr._Clark]

Which part don't you understand, the oral vaccine part, or the non-replicating viral vector part? Both can be long answers. It can be tough trying to 'splain every thing when only a part is needed.

Thanks Swerd, I realize it's chore explaining this to those of us without the requisite education. I'll try to get myself up to speed.