Gmoney

Gmoney

Audioholic Samurai
Quick update from my corner of the world...

It's been a pretty good week. The cough still comes and goes, but not severely. Still have almost no smell. Every so often I can catch a whiff of something, but then it's gone in an instant.

My coworker is recovering much slower than I did. After 3 weeks she still doesn't feel well enough to come back to work. But they only pay for the first 2 weeks... She's probably going to go on short-term disability until she recovers. :confused:

My stepdaughter had a successful and uneventful delivery Saturday 8/1 early AM. They tested the baby and his results were negative. They all came home Monday afternoon...

Just in time for Isaias to pass through Tuesday morning... knocking out their power for almost 2 days. Fortunately our House 2.0 didn't lose power so they had a place to spend a night with air conditioning and some creature comforts.

Welcome to 2020, Nathan. Sorry you picked the shittiest year in modern history to be born, but you won't remember any of this nonsense.

Now flex them pythons! Nate strong! Nate smash!
View attachment 38698
What a beautiful child you have my friend!
Many blessings my he have in life! That's what life Is All About!
 
TLS Guy

TLS Guy

Audioholic Slumlord
I suspect there is a fatal flaw to my logic, but if you were a nurse or doctor who has had Covid-19 and recovered ...
1) Wouldn't it make sense to deliberately maintain exposure so you don't lose your antibodies (or whatever allowed you to beat the virus)?
2) If you were maintaining such a state of immunity, would you be a risk of exposure to others (aside from contact transmission)? Right or wrong, I am thinking that the virus needs to gain a solid presence in your body before using you to replicate itself.

I'm sure I am missing something because I have not heard of anyone doing this, so where is the fault?
Thanks!
That is a reasonable hypothesis, but there is no data. I'm not aware of any institution advising removal of PPE for medical staff who have recovered from Covid-19.
 
Trell

Trell

Audioholic General
I suspect there is a fatal [my bold] flaw to my logic, but if you were a nurse or doctor who has had Covid-19 and recovered ...
1) Wouldn't it make sense to deliberately maintain exposure so you don't lose your antibodies (or whatever allowed you to beat the virus)?
2) If you were maintaining such a state of immunity, would you be a risk of exposure to others (aside from contact transmission)? Right or wrong, I am thinking that the virus needs to gain a solid presence in your body before using you to replicate itself.

I'm sure I am missing something because I have not heard of anyone doing this, so where is the fault?
Thanks!
The word "fatal" is possibly not a word I would use in this context o_O, but I'm also interested if this is a good approach that you rise.

Edit: @TLS Guy gave an answer while I took my own sweet time to compose my post.
 
TLS Guy

TLS Guy

Audioholic Slumlord
There is more bad news about this virus. The big issue with this virus is that it is an infectious vasculitis. This makes in unique among infectious diseases. That is a big reason there has been so much trouble getting a handle on it. What that means is that the virus infects and injures blood vessels. Everything else seems secondary to that primary disease process.

So there has been a lot of puzzlement as to why brain injury has been so particularly prevalent. The cause may be related to air bubbles getting into the blood stream from the lungs. The lung is packed with small blood vessels which flow around the alveolar airs sacks. Oxygen if transferred to the blood and CO2 to the airways. Well it seems that this infection damages those blood vessel to the extent that macro air bubbles can transfer to the blood stream.

These then travel to the left side of the heart and out to the aorta. Since we are upright mammals, these bubbles go to the brain preferentially and cut off the micro circulation to parts of the brain, causing patchy hypoxic brain injury.

This may well explain these most unusual "scatter shot" brain injuries seen on CT and MRI. Of course we also know that a lot of these neurological injuries are due to actual blood clots. However stroke in the presence of vigorous anti coagulation are well described.

As I have been saying for a while that this infection is very likely to leave a grim long term legacy.

I think this news is highly disturbing. It leaves me to believe that all school and university education needs to be remote until this is over. The last thing we want to do is expose our youngest individuals to this sort of risk.

This really is a very nasty infection.
 
Swerd

Swerd

Audioholic Spartan
I suspect there is a fatal flaw to my logic, but if you were a nurse or doctor who has had Covid-19 and recovered ...
1) Wouldn't it make sense to deliberately maintain exposure so you don't lose your antibodies (or whatever allowed you to beat the virus)?
2) If you were maintaining such a state of immunity, would you be a risk of exposure to others (aside from contact transmission)? Right or wrong, I am thinking that the virus needs to gain a solid presence in your body before using you to replicate itself.

I'm sure I am missing something because I have not heard of anyone doing this, so where is the fault?
Thanks!
I don't think you understand how the immune system works – and you wouldn't be the only one. That includes just about every news reporter who ever wrote something about SARS-CoV-2.
When I first learned about it, as a grad student, there was a lot that defied common sense, and still does.

Here goes Immunology 101, with lots of broad generalizations and over-simplifications.

An immune response to an infectious disease (virus, bacteria, or other pathogenic single-cell organism like tuberculosis or malaria) doesn't happen overnight. It can take anywhere from about 2 weeks to as long as 6 weeks. It ends up becoming a race between the virus and the immune system.

The first response usually has low specificity to the foreign pathogen (lets say virus), but it happens quickly. It may be enough to blunt the disease, but not eliminate it. The second wave of immune response takes at least 2 weeks or longer, but it is highly specific to the virus, and can eliminate it both with antibodies that mop up any virus particles circulating in the blood, and with Killer T-cells that directly kill the host cells that are already infected with the virus. Key to the second wave are the so-called Helper T-cells that signal Killer T-cells and antibody producing B-cells to get busy. These Helper T-cells, highly specific to the foreign invader, are what takes at least 2 weeks to develop.

Once you recover from a viral disease, the second wave is shut down, but your immune system isn't done yet. It develops what is called 'memory cells'. They sit around quietly, responding only if you get re-exposed to the same virus at a later time. Those memory cells quickly respond, bypassing the first response that I described above, and immediately going into the second wave.

1) Wouldn't it make sense to deliberately maintain exposure so you don't lose your antibodies (or whatever allowed you to beat the virus)?
No, because the presence of circulating antibodies doesn't matter if you have the memory cells standing by as a ready reserve. These memory cells respond to the presence of a new viral infection by dividing and rapidly stimulating the production of new Killer T-cells and antibody producing B-cells with the same high specificity as in the second wave immune response. (These memory cells are the goal of any good vaccine, and are the reason why many vaccines require a booster shot. The first shot stimulates the primary immune response, and the booster stimulates the secondary response, as well as the memory cell response.)​

2) If you were maintaining such a state of immunity, would you be a risk of exposure to others (aside from contact transmission)? Right or wrong, I am thinking that the virus needs to gain a solid presence in your body before using you to replicate itself.
No, most virus infections usually go immediately into rapid replication mode*. Without that, they would fail at their primary function, to reproduce. It's up to the immune system to respond as fast as it can. As I said above, it's a race. Once you develop a specific state of immunity, that viral infection is a goner. You may still have plenty of damage left behind, making for a slow, or even failed, recovery (See TLS Guy's post #3024 above), but you shouldn't be infectious to others.​

That's about as short as I can make my answer. I hope some of it makes sense.

* As usual, there are exceptions to the rule. They would be the so-called retroviruses, such as HIV (Human Immunodeficiency Virus), HTLV (Human T-cell Lymphotropic Virus), or other leukemia viruses. These viruses can go into an active infection similar to other viruses, or they can go dormant where they do not replicate directly as a virus. Instead, they incorporate their viral DNA into the DNA of the host cell they've infected. They quietly remain disguised in the host cells' DNA, replicating only when the cells divide. At some later time, these dormant viruses can be stimulated into an active infection. They can be particularly insidious. Some of these retroviruses can cause leukemia or lymphoma while they are dormant, as they cause the host cell to become transformed into a cancerous state. HIV is particularly bad, as it infects only Helper T-cells (mentioned above) that are key to fighting all infections. HIV leads to the AIDS syndrome where no functional immune system remains.
 
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Kvn_Walker

Kvn_Walker

Audioholic Chief
There is more bad news about this virus. The big issue with this virus is that it is an infectious vasculitis. This makes in unique among infectious diseases. That is a big reason there has been so much trouble getting a handle on it. What that means is that the virus infects and injures blood vessels. Everything else seems secondary to that primary disease process.

So there has been a lot of puzzlement as to why brain injury has been so particularly prevalent. The cause may be related to air bubbles getting into the blood stream from the lungs. The lung is packed with small blood vessels which flow around the alveolar airs sacks. Oxygen if transferred to the blood and CO2 to the airways. Well it seems that this infection damages those blood vessel to the extent that macro air bubbles can transfer to the blood stream.

These then travel to the left side of the heart and out to the aorta. Since we are upright mammals, these bubbles go to the brain preferentially and cut off the micro circulation to parts of the brain, causing patchy hypoxic brain injury.

This may well explain these most unusual "scatter shot" brain injuries seen on CT and MRI. Of course we also know that a lot of these neurological injuries are due to actual blood clots. However stroke in the presence of vigorous anti coagulation are well described.

As I have been saying for a while that this infection is very likely to leave a grim long term legacy.

I think this news is highly disturbing. It leaves me to believe that all school and university education needs to be remote until this is over. The last thing we want to do is expose our youngest individuals to this sort of risk.

This really is a very nasty infection.
That's my #2 worry (#1 being catching this sh1t again down the road). I might feel better now, but how many years has it taken off my life? When I hear the words "brain" and "blood vessels" in the same sentence, my stroke flags all start waving.
 
Trell

Trell

Audioholic General
I don't think you understand how the immune system works – and you wouldn't be the only one. That includes just about every news reporter who ever wrote something about SARS-CoV-2.
When I first learned about it, as a grad student, there was a lot that defied common sense, and still does.
...
You can include me as well :)

Thanks for your informative post.
 
Swerd

Swerd

Audioholic Spartan
That's my #2 worry (#1 being catching this sh1t again down the road). I might feel better now, but how many years has it taken off my life? When I hear the words "brain" and "blood vessels" in the same sentence, my stroke flags all start waving.
That's why it's very important that you do not get sick again in the next year, especially with respiratory viruses. Give yourself time to recover.

In my area, the local drug stores and pharmacies already have this years flu vaccine. I'm going to get mine soon. Even if you've never received a flu vaccine before, now is the time for you and your wife to get it.
 
M

Mr._Clark

Full Audioholic
That's why it's very important that you do not get sick again in the next year, especially with respiratory viruses. Give yourself time to recover.

In my area, the local drug stores and pharmacies already have this years flu vaccine. I'm going to get mine soon. Even if you've never received a flu vaccine before, now is the time for you and your wife to get it.
Swerd, thanks for the informative posts.

What are your thoughts on the various flu vaccines this year? Is one likely to be more effective than the others? For example, it seems as if a 4 component vaccine would be more effective against more strains than a 3 component vaccine. The CDC lists several vaccines that are "recommended" but I'm not sure if any given drug store or pharmacy will actually have one on the list.

(https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm)

Also, I've read a few news reports to the effect that vaccines with an adjuvant might help against COVID-19, even if the vaccine is designed to protect against a different virus:

>>>Casper says the vaccine community has underestimated the importance of adjuvants. He even has data suggesting that adjuvants alone might be capable of preventing infectious disease. That has enormous implications.

"Every time a new infection pops up, there's a race to develop a new vaccine for it," Casper says. "But what if you could give the adjuvant alone and you didn't have to develop a vaccine? That adjuvant could be stockpiled, it could be made at millions of doses, placed on the shelf, sitting there waiting for the next pandemic."<<<

(https://www.npr.org/sections/health-shots/2020/08/06/899813217/the-special-sauce-that-makes-some-vaccines-work)

Here's an article entitled "The possible beneficial adjuvant effect of influenza vaccine to minimize the severity of COVID-19"



I'm not 65, but I'm wondering if a flu vaccine with an adjuvant might help a little against the coronavirus? It seems like there's probably little downside risk in getting a flu vaccine with an adjuvant?
 
Swerd

Swerd

Audioholic Spartan
What are your thoughts on the various flu vaccines this year? Is one likely to be more effective than the others? For example, it seems as if a 4 component vaccine would be more effective against more strains than a 3 component vaccine. The CDC lists several vaccines that are "recommended" but I'm not sure if any given drug store or pharmacy will actually have one on the list.

(https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm)
Each year the annual flu vaccine is always a mix of vaccines against 3 or 4 influenza strains. It's always a crap shoot as to which strain or strains will be making the rounds in the US.

My guess is any flu vaccine is better than none. I'm sorry I can't give a better answer.
 
Swerd

Swerd

Audioholic Spartan
Also, I've read a few news reports to the effect that vaccines with an adjuvant might help against COVID-19, even if the vaccine is designed to protect against a different virus:

>>>Casper says the vaccine community has underestimated the importance of adjuvants. He even has data suggesting that adjuvants alone might be capable of preventing infectious disease. That has enormous implications.

"Every time a new infection pops up, there's a race to develop a new vaccine for it," Casper says. "But what if you could give the adjuvant alone and you didn't have to develop a vaccine? That adjuvant could be stockpiled, it could be made at millions of doses, placed on the shelf, sitting there waiting for the next pandemic."<<<

(https://www.npr.org/sections/health-shots/2020/08/06/899813217/the-special-sauce-that-makes-some-vaccines-work)

Here's an article entitled "The possible beneficial adjuvant effect of influenza vaccine to minimize the severity of COVID-19"


I'm not 65, but I'm wondering if a flu vaccine with an adjuvant might help a little against the coronavirus? It seems like there's probably little downside risk in getting a flu vaccine with an adjuvant?
I saw that NPR story on adjuvants the other day. It's basically correct, but the whole subject of adjuvants is tough to explain to the general public.

Adjuvants in vaccines have been in the past, a subject of mystery and trade secrets. I guess it still is now. There are many different adjuvants and additives in vaccines that make them of greater interest to antigen presenting cells (APC), especially the dendritic cells. These cells are the scouts of the immune system. How they react to potential foreign invaders is not well understood.

Essentially, small foreign molecules as vaccines attract little or no attention from the APCs. Larger globules or particles, at least as big as virus particles, get more active attention. Adjuvants can also contain oil-like and/or solid components that can bind the vaccine material. They keep the vaccine in the form of an aggregated semi-solid suspension, kind of like salad oil mixed with water.

Adjuvants can also contain lipid components from bacteria membranes, known as endotoxin or lipopolysaccharide (LPS). LPS alone can stir up immune cells, activating them, even producing a fever. But it can help a vaccine become more immunogenic. With a little LPS or LPS-like derivatives mixed into a vaccine containing an adjuvant, you will get flu-like symptoms of fever, aches, pain at the injection site, general malaise, as if you're getting sick. It usually lasts 1-3 days. It's what makes people believe the falsehood that vaccination makes them get sick.

I doubt if adjuvant alone, without any vaccine antigen, is worth injecting in people. It can do harm, but cannot provide any long-lasting immunity. But adjuvant of the right type, mixed with the vaccine antigen, can produce a more potent vaccination.

Vaccine manufacturers carefully guard their adjuvants' composition, treating it as proprietary.

There is lots about the immune system that still is not understood. This is especially true for the early steps in immunization with the APCs. As a result, when the public hears dumbed down 'explanations' of how vaccines work, it can seem like a lot of voodoo. If I understood it better, I could give a simpler, shorter, and more informative explanation.

Here's my usual reading assignment from Wikipedia:
 
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Gmoney

Gmoney

Audioholic Samurai
Now the FDA is part of the deep state. The man gives new meaning to the term "a loose cannon":

Ivr, Trump just Approved Plasma therapy to be used on the, China virus. Major breakthrough!
 
Irvrobinson

Irvrobinson

Audioholic Spartan
Irv, Trump just Approved Plasma therapy to be used on the, China virus. Major breakthrough!
Trump didn't do anything, the FDA did. He's just taking credit when he thinks he can benefit. Otherwise, they're part of the deep state. Here's the official announcement:

 
Gmoney

Gmoney

Audioholic Samurai
Irv, read that, there isn't any hard Evidence that it really works. He sure is working hard on his Image though. Like Nancy Pelosi said don't believe Trump. Coming from a drunk no less.
 
Swerd

Swerd

Audioholic Spartan
Trump didn't do anything, the FDA did. He's just taking credit when he thinks he can benefit. Otherwise, they're part of the deep state. Here's the official announcement:

Last week, and again on Saturday, Trump accused the FDA as being part of the 'deep state' because it refused to approve authorization for political reasons. Trump, through his minions, may have applied pressure on Steven Hahn, the FDA Commissioner. The timing, days before the republican National Convention, is enough to raise suspicions.

NIH people, including Faucci, pointed out that the results from a Mayo Clinic study on convalescent plasma was not strong enough to warrant Emergency Use Authorization. Steven Hahn replied that no one at the NIH had the authority to approve or disapprove medical treatments. Hahn should know better. He also does not have that authority. The FDA can act to approve a drug only after an independent review board recommends that, after reviewing all the trial results.

It looks like Steven Hahn has Trump tire marks up and down his back. And we know they couldn't be Goodyear tires.
 
TLS Guy

TLS Guy

Audioholic Slumlord
Last week, and again on Saturday, Trump accused the FDA as being part of the 'deep state' because it refused to approve authorization for political reasons. Trump, through his minions, may have applied pressure on Steven Hahn, the FDA Commissioner. The timing, days before the republican National Convention, is enough to raise suspicions.

NIH people, including Faucci, pointed out that the results from a Mayo Clinic study on convalescent plasma was not strong enough to warrant Emergency Use Authorization. Steven Hahn replied that no one at the NIH had the authority to approve or disapprove medical treatments. Hahn should know better. He also does not have that authority. The FDA can act to approve a drug only after an independent review board recommends that, after reviewing all the trial results.

It looks like Steven Hahn has Trump tire marks up and down his back. And we know they couldn't be Goodyear tires.
I agree I think there has been manipulation. However in fairness to Steven Hahn, this probably was not the hill to die on. The fact is plasma is produced in many hospitals via plasmaphoresis. Many hospitals have there own blood banks. I know for a fact that many hospitals have used, and are using, convalescent plasma off label. My former hospital I know is, and has been doing so early in the game. So my view is that this will have little effect other than to legitimize what I suspect has been current practice for some time. This seems to be widely known in communities. I have been told that patients and relatives are reluctant to enter trials, and do not want placebo. They demand convalescent plasma. So this horse has been out of the barn for some time.

The bigger issue is what to do about vaccines. There is huge concern that phase III trials are taking too long. Professor Whitty the UK's chief medical officer stated yesterday, that the way things are currently going it will be sometime 2022 before a vaccine is available. This is causing outrage and increasing public demand for challenge studies. This pressure will increase. In the UK and most of the developed world the R factor is too low to make double blind trials practical. Doing them in the third world is not the answer as too many subjects are lost to follow up.

Meanwhile Germany is releasing restrictions in some areas, even though they are showing a smart uptick in cases. Austria has even opened its opera houses and showing uptick in cases. Many suspect this may be a deliberate attempt to increase the R value so that phase III double blind trials can be carried out.

This is all complicated by the fact that Oxford are confident their vaccine is safe and effective. India for one is poised to produce it in large quantities. You know they will roll it out, like Russia has their vaccine. So this will inevitably lead to a criminal black market in vaccines from places like India. Worse recipients under such schemes will have no guarantee the vaccine is genuine or fake, given illicit distribution will be via the criminal element.

I think for all of these reasons this issue has to be decided promptly. Many including myself think that the most ethical way of handling this is a well done non blinded large challenge study. I am now firmly of the opinion that traditional means of trialing are no longer tenable in this instance. If we persist we will have chaos. Whatever it takes, we need to be vaccinating people on mass before year's end and certainly not 2022. That is just not going to fly, when there are good reputable scientists , with nothing to gain financially, that believe they do have to key to ending this nightmare. Even if there is risk, which I think there will be, the lives saved with this approach is likely to be vast compared to traditional procedure.
 
Swerd

Swerd

Audioholic Spartan
The bigger issue is what to do about vaccines. There is huge concern that phase III trials are taking too long. Professor Whitty the UK's chief medical officer stated yesterday, that the way things are currently going it will be sometime 2022 before a vaccine is available. This is causing outrage and increasing public demand for challenge studies. This pressure will increase. In the UK and most of the developed world the R factor is too low to make double blind trials practical. Doing them in the third world is not the answer as too many subjects are lost to follow up.
As you already know, I oppose this idea. My reason, however, is not because of any personal adherence to medical ethics – I'm not a physician – and I never took the Hippocratic Oath.

It would be wrong to abandon the high standards of clinical trial-based evidence that the US FDA requires. If we do it now because of the SARS-CoV-2 pandemic emergency, we will regret it in the future. These high standards have been the result of hard lessons learned in the past when those standards were lower, or did not yet exist. I can think of two examples: Thalidomide and the Polio Vaccine.

Thalidomide led to a major change in law in both the USA and the UK.
https://en.wikipedia.org/wiki/Thalidomide_scandal#Change_in_drug_regulations

Fortunately, the Polio Vaccine story seems to have ended well. Although the SV40 tumor virus contamination created a real scare, enough time has passed to realize it was probably harmless. In fact, few people outside of biomedical science even know about it.

Both episodes resulted in a genuine tightening of laws and regulations for testing drugs. They led to a carefully worked out and more rigorous system of testing for safety and efficacy for new drugs that remain as the gold standard.

In more recent times, I can remember when Interferon was said to be a magic bullet against cancer. It was the first gene product to be manufactured by recombinant DNA methods and was revolutionary for the drug industry in the 1990s. It was widely tested against a number of cancer types, and was reported to have significant positive effects against colon cancer. I recall at least six clinical trials reporting that. Unfortunately, these trials were the small Phase 2 trials. There were not enough patients to allow genuinely significant results, and many of them did not include a control arm where similar colon cancer patients were tested with standard therapy only.

Years later, three very large Phase 3 trials were completed, in North America (USA plus Canada), Asia, and Europe (all the EU plus the UK). All of them produced negative results – Interferon was not effective against colon cancer, and it was significantly toxic when given at the high doses used in the trials. Before those results were available, many oncologist were clamoring for early approval of Interferon. After it was found to be ineffective, the overwhelming opinion among oncologists was that they were glad Interferon was not given an early approval. In fact, the whole Interferon episode was said to be a good example why we must do those large and time consuming Phase 3 clinical trials.
https://en.wikipedia.org/wiki/Interferon#Interferon_therapy

The bottom line – wait for the results of properly designed large Phase 3 clinical trials. Don't allow panic to bust the drug testing & approval system. We worked very hard in the past to get it as good as it is now.
 
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M

Mr._Clark

Full Audioholic
The NYT is reporting the first documented case of a person being reinfected. The fact that it was only 4.5 months after the first infection is not exactly comforting. On the other hand, he had no symptoms the second time so that may be some good news.

I realize one case doesn't say much about how common it may be, but it does show it's possible.

>>>“An apparently young and healthy patient had a second case of Covid-19 infection which was diagnosed 4.5 months after the first episode,” University of Hong Kong researchers said Monday in a statement. . . . The 33-year-old man had only mild symptoms the first time, and no symptoms this time around. . . . Doctors have reported several cases of presumed reinfection in the United States and elsewhere, but none of those cases have been confirmed with rigorous testing. Recovered people are known to shed viral fragments for weeks, which can cause tests to show a positive result in the absence of live virus.

But the Hong Kong researchers sequenced the virus from both rounds of infection and found significant differences in the two sets of virus, suggesting that the patient was infected a second time.<<<

 

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