Coronavirus

[Irvrobinson]

I want to immolate every single administrator who thought it was a good idea to open schools up in the midst of such an infectious disease.

Perhaps enrolling them in human challenge testing for one of the vaccines would be a bit more just than immolation? (Sort of kidding...)

 

[Verdinut]

Mind if I ask what state your niece's school is in?

My son is doing everything on-line, but many of the local school districts have in-person classes. I'm concerned that it will spread through the school to my coworkers, and I'm not sure what would happen then.

It annoys me how many people are anxious to avoid all precautions except those mandated by the government (apparently on the theory that COVID-19 is basically just the flu and all restrictions are therefore ridiculous). I suspect that those who are most opposed to restrictions will prove that restrictions are necessary.

IMO, restrictions are of the most importance. Here in our Quebec province, many children have returned to school. There has been an increase of new outbreaks, but there is no actual confirmation to date that the schools have been nests of Covid-19 propagation. Most outbursts were related to gatherings, weddings, family reunions and in one instance, a karaoke bar where the microphone might have helped in the transmission.

For instance, in Montreal where we had the highest numbers of infected people and deaths since the beginning of the pandemic, we have not experienced any important increase in cases lately whereas new outbreaks were reported in other regions even one nearby.

 

[GO-NAD!]

Within one week of school re-opening, my niece got a fever and then tested positive for COVID-19. That was Friday. Now my brother and sister-in-law are exhibiting symptoms of having caught it too. It was clear that it came from my niece's school. Just a horrific failure on all levels of government, especially since this was all so predictable. I want to immolate every single administrator who thought it was a good idea to open schools up in the midst of such an infectious disease.

I'm so glad my daughter is starting university from her bedroom, even if she doesn't like it.

 

[GO-NAD!]

Hey, @TLS Guy what do you make of this?

https://www.cbc.ca/news/world/coronavirus-covid19-world-sept-9-1.5716866

 

[Swerd]

Hey, @TLS Guy what do you make of this?

https://www.cbc.ca/news/world/coronavirus-covid19-world-sept-9-1.5716866

In the UK, one person on the trial came down with a serious reaction to the vaccine, or a serious illness. We don't know details of the reaction or illness, nor do we know if that person received the corona virus vaccine or the placebo vaccine. The Clinical Trial's Safety & Data Review Board will examine the case, and decide whether to proceed with the trial, or not. This is standard with all clinical trials. It should not be reason for concern. I'd expect at least several cases of severe reaction when some 30,000 people are being immunized.

 

[TLS Guy]

Hey, @TLS Guy what do you make of this?

https://www.cbc.ca/news/world/coronavirus-covid19-world-sept-9-1.5716866

I think it is to be expected. We do not know the details, so can't really judge it until we have details of the case report.

 

[TLS Guy]

The woman's illness in the UK causing a pause in the trial of the Oxford vaccine, is Transverse myelitis. This is an inflammation of a section of the spinal cord. The cause is suspected to be an immune reaction. This is a rare reaction to a number of virus infections including influenza.. It seems to be a particular problem associated with Covid-19 infection. So it would not be surprising if vaccinating against Covid-19 caused it. So I suspect this incident is vaccine related.

The other neurological problem related to viral infection and immunization is Guillain-Barre syndrome, this is particularly associated with influenza and influenza immunization. I treated a number of these cases over the years. This syndrome has been reported quite often in Covid-19 infection. I know this has been seen in Covid patients both in Fargo and Bismark ND. This problem was a significant issue with H1N1 immunization.

So I am not surprised that this has turned up as a vaccine related complication. It is likely going to be seen rarely with all the vaccines. The reason is that if in some individuals the infection will trigger this abnormal immune response, then immunization against the infection is likely to do the same.

This should not be a barrier to immunization against Covid-19. If the incidence of these two diseases is not significantly higher in those receiving vaccination compared to natural infection, then this would not prevent the introduction of vaccines.

In fact I would be of the opinion that unless it was a lot higher, it should not be a barrier, as Covid-19 does a lot more nasty things than these two syndromes.

In the UK today, the government has increased restrictions due to a sharp rise in cases in the last few days. It looks as if a sharp second wave is taking off there.

 

[Swerd]

After a week on Clinical Hold, the large UK trial of the Oxford SARS-CoV-2 vaccine has resumed.

Coronavirus: Oxford University to resume vaccine trial after pause

The late-stage trials were paused due to a reported side effect in a patient in the UK.

www.bbc.com

No further comments were available about any relationship between the case of transverse myelitis and the vaccine. I don't know details of how serious adverse events are handled in the UK, but in the US, this would require a formal assessment on a 5-point scale:

1. Definitely Related
2. Probably Related
3. Possibly Related, possibly unrelated, but unable to rule out
4. Probably Unrelated
5. Definitely Unrelated

It's my guess that this case might be assessed as a 3 Possibly Related. Apparently, transverse myelitis is rare, often has an unknown cause, and is usually treatable (with cortico-steroids?). It's easy to guess that this case involved a person who received the experimental vaccine, and not the placebo vaccine.

If it happens enough times on the experimental arm of this trial, it might be given a higher assessment of 2 Probably Related. If it happens quite a few times, that might be cause to stop the trial, but it would have to be quite bad to justify ending the trial early, as we now have no vaccine. I hope this doesn't happen.

In the meantime, all the other SARS-CoV-2 vaccines are now alerted to look for transverse myelitis on their clinical trials. It could be a false alarm, but no one can afford to ignore it.

 

[TLS Guy]

After a week on Clinical Hold, the large UK trial of the Oxford SARS-CoV-2 vaccine has resumed.

Coronavirus: Oxford University to resume vaccine trial after pause

The late-stage trials were paused due to a reported side effect in a patient in the UK.

www.bbc.com

No further comments were available about any relationship between the case of transverse myelitis and the vaccine. I don't know details of how serious adverse events are handled in the UK, but in the US, this would require a formal assessment on a 5-point scale:

1. Definitely Related
2. Probably Related
3. Possibly Related, possibly unrelated, but unable to rule out
4. Probably Unrelated
5. Definitely Unrelated

It's my guess that this case might be assessed as a 3 Possibly Related. Apparently, transverse myelitis is rare, often has an unknown cause, and is usually treatable (with cortico-steroids?). It's easy to guess that this case involved a person who received the experimental vaccine, and not the placebo vaccine.

If it happens again on the experimental arm of this trial, it could be given a higher assessment of 2 Probably Related. If so, that might be cause to stop the trial. I hope not. We'll see.

In the meantime, all the other SARS-CoV-2 vaccines are now alerted to look for transverse myelitis on their clinical trials. It could be a false alarm, but no one can afford to ignore it.

Swerd, I would not be surprised to see a few more cases and I fully expect to see cases of Guillain-Barre syndrome. Both of these and especially the latter, are associated with viral infections, especially influenza. Influenza vaccines have always been associated with cases of Guillain-Barre syndrome. I have personally treated cases of Guillain-Barre related to influenza vaccination. Fortunately the treatment has improved greatly with the use of IVIg (intravenous immune globulin) or plasma exchange (PE). IVIg is safer then PE.

So we recommend influenza immunization despite vaccine related GB. So since Covid-19 causes both these syndromes, and especially GB, it would not be prudent to stop trials or in time the administration of vaccines, unless the incidence of these syndromes is much higher than the natural disease.

Cases in France and Spain are rising fast. Some French ICUs are nearing capacity. In the UK the incidence is rising close to a vertical line this last week.

We are coming up on flu season, a recent paper from China in JAMA showed that coincident infection last winter season was not uncommon, and raised the mortality almost 20%. We now have good figures on on hospital mortality on Covid-19. It is 2.7%. That is very high considering the large number of cases. What is the most concerning to me is the long term damage, especially the neurological damage. A good study showed a permanent CNS damage in hospitalized patients to be in the 65 to 79% range depending on series. This should not surprise given that it is now known the virus can infect CNS neurons and glial cells. Better news on the lung damage. Patients with very serious lung injury post discharge, seem to be showing a very slow but continuing recovery.

Children are now known to be definite spreaders. Personal contacts of mine are telling me they are seeing increased cases of symptomatic children, especially teenagers.

We now know why individuals of different ethnicities vary in susceptibility to Covid-19 infection. It is because of Racial/Ethnic Variation in Nasal Gene Expression of Transmembrane Serine Protease 2 (TMPRSS2) . African Americans have three times the mortality rate of Caucasians. This is a terrible burden for this community.

Another recent paper in JAMA showed that between March and May this year we under counted Covid-19 deaths by 28%. I would bet we still are. The reason I suspect is sudden cardiac deaths, which increase significantly in Covid-19 hot spots.

That is most of the news, I have now. Information and data is coming in at faster and faster rates, as it becomes better, but still imperfectly understood.

I really do think we are in for rough ride this fall and winter. This administration has squandered the time where we would have had a chance to go into this difficult season from a lower base line. The US is about to pay a terrible price for this prolific liar of a President.

 

[Swerd]

On second thought, my comments about another case of transverse myelitis are too stringent. I'll edit it.

Your point about Guillain-Barre syndrome and other such infectious disease vaccine effects are good. They aren't so rare as to be unexpected.

My wife & I got our annual flu vaccine shots the other day. No time better than right now.

Australia just ended it's flu season. It had noticeably fewer cases this year than normal. Their efforts to prevent the spread of Covid-19 may have also limited spreading of the flu. We should be so lucky in the US!

 

[shadyJ]

A good read on the president's failure to contain the spread of COVID-19

 

[Ponzio]

 

[Irvrobinson]

Australia just ended it's flu season. It had noticeably fewer cases this year than normal. Their efforts to prevent the spread of Covid-19 may have also limited spreading of the flu. We should be so lucky in the US!

I have suspected that all of the hygiene strategies to avoid COVID-19 would significantly reduce the number of flu cases this winter. I'd be surprised if cases aren't down by at least 50% in the US, since the flu has a much lower R0 than COVID-19 and there are flu vaccines.

 

[Ponzio]

I have suspected that all of the hygiene strategies to avoid COVID-19 would significantly reduce the number of flu cases this winter. I'd be surprised if cases aren't down by at least 50% in the US, since the flu has a much lower R0 than COVID-19 and there are flu vaccines.

From your mouth to [insert your god here].

 

[shadyJ]

I am not sure what to make of this: In ‘Power Grab,’ Health Secretary Asserts Authority Over FDA. Nothing that the Trump administration does is good so I can only assume that it will result in calamity. Here is an analysis of the policy. It looks to me like the Trump administration is setting it up so that a vaccine will be announced before election day to bolster his support, even if the science behind it is very weak. Who wants to place bets on the final US death toll will be by the end of this thing? 400,00? 500,000?

In other news, by eliminating COVID-19, New Zealand also avoided influenza. The same New Zealand that Trump mocked for their handling of this pandemic.

 

[KEW]

Who wants to place bets on the final US death toll will be by the end of this thing? 400,00? 500,000?

Obviously, it depends on whether major changes in attitude occur, but as far as traditional flu season living with Covid 19, we are less than halfway through.
Biden's election would result in more public confidence and clarity as the public received straightforward direction from experts without a presidential manipulation, however, I think Trump's base is so vested in Trump as great that they may have a mindset of science = deep state! So I expect there will still be belligerence toward public safety measures.
I'll go with 350,000 if Biden wins and 500,000 if Trump wins election.
I think we'll be around 235,000 dead by election.
Another wild card is whether any extreme craziness happens during lame duck period should Trump lose (he doesn't think much of losers)!

 

[highfigh]

That's the main issue with him. One day he sounds like a loony tune and the next he seems to get the message. Then he goes back again.

He sadly has no thoughts of his own. He only repeats things he's heard. Too many people are like that now. Just parroting things without thinking about whether or not they're true, or demanding sources.

I found that to be a pretty effective way of getting people to stop their BS. I just ask what they're source is. I never get one, but they at least shut up.

I never thought he took advice from anyone and I have said (since before he was elected) that he needs handlers and a muzzle.

Social media is a dumpster fire of misinformation.

Offer a source to some people and they immediately yell "False equivalency!" and "Straw Man!" just because it's not the source they prefer or use. It gets old.

 

[TLS Guy]

Here is a damning editorial from this weekend's JAMA about Trump's handling of the crisis.

I'm very worried about the next few months. The Virus is getting out of control in most of Europe now. I fear far more serious trouble than we have had so far in the coming months.

 

[GO-NAD!]

In other news, by eliminating COVID-19, New Zealand also avoided influenza. The same New Zealand that Trump mocked for their handling of this pandemic.

I don't know how we managed it, but our 4-province "Atlantic Bubble" (combined population - 2 million) has done even better than New Zealand. As we approach the completion of the second week of the school year, everyone is holding their breath, wondering if we'll have an outbreak.

Nova Scotia, with a population of 1 million, has ten universities. Some, but not all, are holding in-person classes. Most of them have a high proportion of foreign/out-of-province students who were all required to self-isolate for two weeks before classes commenced. Students who violate the protocols are being heavily fined. One was expelled and punted from the province for a repeat offence.

There have been calls for the Atlantic Provinces to open up to the rest of Canada (meaning, no need for a "valid" reason to enter - such as an essential worker - and no requirement to self-isolate for two weeks upon arrival). While cases have been spiking in the rest of Canada - 800 to 1000 cases per day over the last week, people here are not very amenable to that idea.

 

[highfigh]

Did she go into that store without a mask? Maybe she parked right outside and no one around to need a mask?
This is inside the store getting hair washed and dried.
And, buy the way, why was the hair salon open in the first place? Owner broke the law and apparently more than once.
Did the owner or hair dresser have a mask on?
In reality the store should have been closed, period. And, of course the video had to be handed over to Carl Tucker.

Hair dressers can be open, if they require masks. Don't know about the owner, but Pelosi should have worn one- if she wants to call others out for not wearing a mask, she really needs to do it, too.

It's not a law, it's a recommendation.