COVID-19 - Facts and Information Only Topic

[BillsFan4]

 

 

[BillsFan4]

https://www.backtoworksafely.org

 

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This site features expert, industry-specific guidance for both businesses and consumers to safely re-open and re-engage as they emerge from the COVID-19 quarantines.

 

Sponsored by AIHA (American Industrial Hygiene Association)

 

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The links below offer specific, easy-to-follow, science-based recommendations for limiting the transmission of the coronavirus while operating a wide variety of businesses, including restaurants, retail outlets, and hair and nail salons.

 

These guidelines were developed for those smaller business that don't have readily available occupational health and safety resources. We encourage employers, employees, and customers to carefully read and implement as many of the recommendations contained in the guidance document provided for your industry as possible.

 

All guidance plans are 100% free to download, if you wanted to print+distribute any of them.

 

These recommendations would be in addition to all federal, state and local guidelines (that must be followed). 

[Hapless Bills Fan]

Really good data source on testing shared in discussion thread by @bdutton (thank you!):

 

https://ourworldindata.org/coronavirus-testing#

 

What I like is that it's all open source, the data set can be downloaded, and many of the graphs are user-customizable right on the site, and they express many things in a "per capita" basis" - it's a legit beef that some have made that it paints a misleading picture to just look at totals, as a big population is bound to have (for example) more

 

 

I like this graph, which looks at how many tests are performed to find 1 covid case.  The number needs to be large to be reasonably sure one is finding all the cases.  US is not large enough.

[Hapless Bills Fan]

Mask-querade!

 

This is my compilation of information on masks, especially cloth masks, and their use to prevent the spread of covid-19.

First thing is to remember masks reduce infection in two ways: inward-facing, and outward-facing.  

 

Medical professionals and first responders who are necessarily exposed to infected people badly need inward-facing protection.

 

Disrupting infection chains only requires outward-facing protection - IF everyone, or almost everyone, needs to take part.  The preponderance of evidence suggests widespread mask use, even of relatively ineffective cloth masks, is an important infection control strategy IN ADDITION to other measures such as maintaining distance and careful hand hygiene. 

 

The key is to think of your mask as protecting others; their masks protect you.  It's not about whether you're afraid of getting sick yourself; it's about protecting the Grandy Gert of the person next to you and their Immunocompromised Aunt Irene.  And in my world, Macho Studly Dudes care about other people because well, if you're truly Macho and Studly, you just can.

 

Evidence review:
https://www.preprints.org/manuscript/202004.0203/v1
Royal Society (UK) summary:

https://rs-delve.github.io/reports/2020/05/04/face-masks-for-the-general-public.html
Key points

1. Asymptomatic (including presymptomatic) infected individuals are infectious. Without mitigation, the current estimate is that 40%-80% of infections occur from individuals without symptoms¹²³⁴. Universal screening of asymptomatic SARS-COV2 in women admitted for delivery in New York City shows that 13.7% were infected, and that asymptomatic women accounted for 88% of infected individuals in the study⁵. Of individuals who do become symptomatic, viral loads are the highest in the presymptomatic and early symptomatic phase, decreasing thereafter^6789101112.

2. Respiratory droplets from infected individuals are a major mode of transmission¹³. This understanding is the basis of the recommendations for physical distancing, and of the PPE guidance for healthcare workers¹⁴. Droplets do not only come from coughing or sneezing: in a-/pre-symptomatic individuals, droplets are generated via talking and breathing¹⁵.

3. Face masks reduce droplet dispersal. Cloth-based face masks reduce emission of particles by variable amounts, for example Anfinrud et al¹⁵ showed that they are almost completely eliminated. Davies et al¹⁶ showed that cloth masks filtered viral particles during coughing at about 50 to 100% of the filtration efficiency of surgical masks, depending on fabric, with absolute filtration efficiencies of 50-70%, and about 70-80% for oral bacteria. van der Sande et al¹⁷ showed 50% filtering efficiency for airborne particles.

Site promoting face mask use and their reference list:

https://masks4all.co/

https://docs.google.com/document/d/1HLrm0pqBN_5bdyysOeoOBX4pt4oFDBhsC_jpblXpNtQ/edit#heading=h.1ap92mreh872

 

Evaluation of material to make face masks: 2 layers of cotton fabric good, but mixed-fiber fabrics may be better

https://pubs.acs.org/doi/abs/10.1021/acsnano.0c03252#

https://pubs.acs.org/doi/suppl/10.1021/acsnano.0c03252/suppl_file/nn0c03252_si_001.pdf

 

LMK if you find anything else and I'll add

Edit: Vanity Fair article describing the motivation and work of some modelers

https://www.vanityfair.com/news/2020/05/masks-covid-19-infections-would-plummet-new-study-says?fbclid=IwAR00y92qBckdGfLOYbJ2a3LC_8P_PMuAieYf1M96xVFnjH391K79dzy56LQ
 

Study discussed in the article:

https://arxiv.org/pdf/2004.13553.pdf

 

They have a simulator to play around with the effect of wearing masks

https://www1.icsi.berkeley.edu/~dekai/mirror/masksim/

 

[OldTimeAFLGuy]

....Hap, is this "breakthrough" company something to be optimistic about?..................

 

California biopharmaceutical company claims coronavirus antibody breakthrough

By Perry Chiaramonte | Fox News

 

EXCLUSIVE — A California-based biopharmaceutical company claims to have discovered an antibody that could shield the human body from the coronavirus and flush it out of a person’s system within four days, Fox News has exclusively learned.

Later Friday, Sorrento Therapeutics will announce their discovery of the STI-1499 antibody, which the San Diego company said can provide "100% inhibition" of COVID-19, adding that a treatment could be available months before a vaccine hits the market.

 

"We want to emphasize there is a cure. There is a solution that works 100 percent," Dr. Henry Ji, founder and CEO of Sorrento Therapeutics, told Fox News. "If we have the neutralizing antibody in your body, you don't need the social distancing. You can open up a society without fear."

 

https://www.foxnews.com/science/covid-cure-california-biopharmaceutical-coronavirus-antibody-breakthrough

 

[Hapless Bills Fan]

 

On 5/16/2020 at 5:43 AM, OldTimeAFLGuy said:

....Hap, is this "breakthrough" company something to be optimistic about?..................

 

California biopharmaceutical company claims coronavirus antibody breakthrough

By Perry Chiaramonte | Fox News

 

EXCLUSIVE — A California-based biopharmaceutical company claims to have discovered an antibody that could shield the human body from the coronavirus and flush it out of a person’s system within four days, Fox News has exclusively learned.

Later Friday, Sorrento Therapeutics will announce their discovery of the STI-1499 antibody, which the San Diego company said can provide "100% inhibition" of COVID-19, adding that a treatment could be available months before a vaccine hits the market.

 

"We want to emphasize there is a cure. There is a solution that works 100 percent," Dr. Henry Ji, founder and CEO of Sorrento Therapeutics, told Fox News. "If we have the neutralizing antibody in your body, you don't need the social distancing. You can open up a society without fear."

 

https://www.foxnews.com/science/covid-cure-california-biopharmaceutical-coronavirus-antibody-breakthrough

 

 

A number of pharma companies are very likely working on blocking antibodies.  A big pharma like the one I used to work for has it all down to a cookbook - the techniques they would use to screen for effect, then something like 6 months to FIP (first in patient).   Several companies are likely to beat that because SARS and Covid-19 target the same receptor, and a number of companies had antibodies in the freezer that they’d designed for SARS.  So they’re able to skip about 2 months.  It’s telling that to my knowledge said big pharma I used to work for is only pursuing small molecule therapeutics and vaccines for Covid-19, even though we can be Monoclonal Central.  (Or so a little bird might have told me).

 

Good news/bad news here:

1) Human antibodies (assuming they were properly designed and don’t have wierd modifications) are a relatively slam-dunk pharma technology.  We know how to purify them and most places have a template manufacturing process and relatively standard set of release assays.  We know where they’ll go in the body (pharmacodynamics) We know how long they’ll last in the body (pharmacokinetics, metabolism).

2) The chances that they’ll translate from test tube to the body are relatively high, because of the well-understood properties.  No worries about will it get properly absorbed, will it get delivered to the right tissues, will it break down too fast, will it have toxicities.  These are actual bioengineered human antibodies, so we know all that.

 

So that’s the good news, it’s relatively likely to translate to in Vivo and to work.

 

Bad news:

1) Monoclonal antibody therapeutics are expensive as all get-out and hard to scale up.  These are the drugs for rheumatoid arthritis etc which cost like $18,000/treatment.  Of course a bunch of that is profit, but a lot of it is the fact that they are grown in mammalian cells that divide slowly and require expensive growth media, the standard purification process requires expensive equipment and reagents, they require expensive frozen storage, and they’re administered by expensive IV infusion.  This ain’t gonna be a pill.  The supply will be limited, and it will cost $$$$.   It’s still a big benefit if it can keep vulnerable people off ventilators and get them out of hospitals more quickly.

2) They’re monoclonal, mono = one.  They bind to one target on the virus.  That particular target mutates BOOM no more effective drug.  I could be missing something, but I believe we have no monoclonal therapeutics for influenza for just that reason - virus mutates too durn fast.  SARS-Cov2 seems to mutate more slowly, but still, in a few months, there are several mutations in the spike region identified.

 

I think upthread there are links to several other companies with monoclonal antibody therapies they’re trialing or getting ready to trial for Covid-19.  I’ll look later and link this in.  Edit: here it is:

Article on the earlier report of antibody

https://www.10tv.com/article/pandemic-scientist-says-his-team-has-discovered-potential-cure-covid-19-2020-mar

 

I would score this as promising - we really need effective treatments to stop people from becoming so desperately ill and to cure them when we do.  So even something expensive and with a limited time window would be a great boon.
 

On 5/16/2020 at 8:54 AM, Limeaid said:

Good (?) news is there are cases of virus being transmitted to animals so they might be able to do animal testing although I'd rather use protesters without masks but that is just my personal preference.

 

The problem with studying human monoclonal antibodies in animals is that the animals' bodies object to having a human antibody infused into them - the very drug that's being tested is Bad News to a Bear (or a mouse, or a rat).  Sometimes non-human primates can work :(. 

In a longer time frame, to study a therapeutic effect, researchers construct a mouse or rat antibody with the desired binding properties, study the effect in a mouse or rat animal model of the disease,  then translate the learnings to primates/humans and create a human antibody

 

PS I will say that any time anyone says "100% cure" my "Skeptical!" flag pops up.  Salesmen and grifters like attention grabbing numbers like 100%.  Scientists who work with real-life conditions and patients will always hedge even if we're super-positive, which makes us boring.

 

 

[The Dean]

Hap, here's something sent to me from a graduate of this university. It looks interesting, but I'm sure it is nowhere near fully tested. But I found it an interesting approach for some applications:

 

https://news.uoguelph.ca/2020/05/u-of-g-research-behind-surface-coating-that-kills-covid-19/

 

Any input on this?

 

14 hours ago, Hapless Bills Fan said:

Outside my lane, but sounds intriguing.  If it's a coating one sprays on, might be more cost effective than copper-cladding everything

I

 

[meazza]

@Hapless Bills Fan I just listened to a joe Rogan podcast where he had dr Rhonda Patrick on.  She went on for a bit about how a lot of the victims in the Philippines and other areas were vitamin d deficient. She’s a bit proponent  of vitamin d.

 

Curious your thoughts
 

14 hours ago, Hapless Bills Fan said:

I can't really comment on what Dr Rhonda Patrick said on Joe Rogan's podcast because didn't listen.  If you care to summarize, I might have more to say.  General vit D thoughts:

I bought a bottle of vit D3 last week and we're taking it.  Because why not?  It's inexpensive and in moderate quantities, won't hurt.

 

Vitamin D deficiency is a funny thing (not funny ha ha, interesting story funny).  Vitamin D deficiency is linked to all kind of diseases - cancer, diabetes, obesity, osteoporosis, heart attack, stroke, depression, cognitive impairment, autoimmune conditions. 

 

But, paradoxically, studies of vitamin D supplementation have quite consistently failed to find an effect at reducing or preventing these diseases:

https://www.nejm.org/doi/full/10.1056/NEJMoa1809944

 

For balance, here is a recent article reviewing the evidence around the effects of vit D deficiency and how it may contribute to ARDS and potentially covid-19.  Vitamin D has known effects on nerve transmission and on immune response; it falls in the category of "can't hurt, might help" to suggest supplementation (though I dunno about the 10,000 IU these authors recommend). 

 

As for the paradox of why vit D supplementation doesn't actually affect some of the diseases that vit D deficiency is linked to:  "correlation may not be causation".  Maybe low vit D levels are actually a marker for low sun exposure, and that sun exposure is needed for other things that impact health such as nitric oxide (synthesis of nitric oxide is also increased by sun exposure).  Sunlight also influences production of all sorts of other compounds, seratonin and endorphins.

 

Even so, nitric oxide has a known effect on lowering blood pressure by relaxing blood vessel walls.  Hypertension is clearly linked as a risk factor to morbidity and mortality from covid-19.   And nitric oxide synthesis is increased by a number of things - including sun exposure, exercise (increases blood flow), AND vit D and calcium

 

My thoughts are "it's complicated".  I don't think vit D supplementation can hurt.  It might help. I don't think we can ignore the fact that when studies have tried to look at effect of vit D supplements on various diseases that correlate with vit D deficiency, they fail to show an effect - so it may be a correlation.

 

I think sunlight and exercise are very important, too. 

 

That said, it's time to go take my D3 supplement

[Hapless Bills Fan]

VACCINE UPDATE!  This is big news, and good news

 

Moderna, the first company to start clinical trials in US, just released results from their Phase I trials.

There has been different coverage of this so let me try to boil it down for you

-45 patients - typical Phase I "safety" size except for vaccines, you can see if they developed antibodies (potential immunity)

-RNA vaccine, meaning RNA that will synthesize and present a viral epitope is injected into people. 

-3 dose levels 25, 100, 250 mcg

-All participants developed overall antibodies "comparable" to the levels of infected/recovered patients , the 25 mcg dose after 2 injections
-So far only 8 "neutralizing" antibody response measured (antibodies shown to bind to the virus and block its ability to infect cells). 

-Three of the 15 participants dosed at 250 mcg developed "severe adverse events", described as "fever and flu-like symptoms"

-One of the participants dosed at the 100 mcg level developed a "severe injection site reaction" which is a raised red patch >10 cm in diameter
 

What this trial does NOT show and thus remains unknown:

-Whether antibodies provide protection from re-infection

-For how long the protection will last, if so
-Whether neutralizing antibodies were the only immune response seen, or whether a T-cell response was successfully induced

 

The number of severe adverse events in a limited number of trial participants is concerning.  One wants a vaccine to which the immune system takes notice, but not too much or too aggressive notice.  That's 6.6% AE rate.  "those symptoms could be cause for concern. The injection site redness was classified as severe, or grade 3. That’s a red spot 10 centimeters in diameter, says Mark Slifka, a viral immunologist at Oregon Health & Science University in Portland. The next step is death of the tissue. Milder side effects are typically common with vaccines, “but if there are a consistent number of grade 3s, that’s a concern for a vaccine you want to use broadly.”

 

The company has already gotten permission from the U.S. Food and Drug Administration to go ahead with the second phase of human safety tests. The company will eliminate the 250-microgram-dose arm and add a 50-microgram group. Lower doses may offer equal protection against the virus and stretch limited supplies of the vaccine, Zaks said.

The initial tests were in people 18 to 55 years old. The next phase of testing will also include people 56 to 70 years old, and an over-70 group.

 

Here's another summary of the data from Moderna's candidate.

 

RNA vaccines are the hot new kid on the block in the field of vaccine development, because of how fast they are to develop and how straightforward and fast they are to modify and manufacture.  They have this property because they essentially make the vaccinated person do all the work of synthesizing and presenting the viral antigen, we just send in the template and tell the immune system "get to work!"
BUT to date, there is only one licensed RNA vaccine that I know of, and that's in horses, not in people.

 

“These data are extremely promising, but they are in eight people,” says Brianne Barker, an immunologist at Drew University in Madison, N.J. “I agree with Moderna and NIAID that they should keep going” with the vaccine, she says. “But I don’t know that we fully know yet that this is going to be a home run.”

Other vaccine candidates are proceeding in trials

Leading candidates include Oxford's vaccine, which is actually being trialed to see if it will produce a protective effect against covid-19 infection in >1000 patient study:

https://www.sciencefocus.com/news/oxford-coronavirus-trials-heres-what-we-know-so-far-about-the-covid-19-vaccine/

Half the patients get the covid-19 vaccine, half get a licensed meningitis vaccine, and the infection rates with covid-19 will be compared in the two groups

The Oxford vaccine is a modified Adenovirus that produces the SARS-Cov2 spike protein.  It has been shown to protect rhesus monkeys against contracting covid-19, although that study has been criticized.  The Moderna vaccine did not perform a preclinical trial in monkeys.

Here's a reasonable summary of various candidates by cnbc:

https://www.cnbc.com/2020/05/13/coronavirus-scientists-race-to-find-a-cure-or-vaccine-here-are-the-top-drugs-in-development.html
In addition to the Oxford and Moderna vaccines, Innovio and Pfizer have vaccine candidates in clinical trials, Innovio started  on April 6 with readout expected by late summer, Pfizer started in Germany in late April and in US in early May.  Not clear when readout is expected.  Other companies are a bit further back. 

 

For those who don't like cnbc and who do want more depth, here's vaccine dev commentary by my boi pharma blogger Derek Lowe:
What the picture looked like in April: https://blogs.sciencemag.org/pipeline/archives/2020/04/15/coronavirus-vaccine-prospects

Deeper dive: https://blogs.sciencemag.org/pipeline/archives/2020/04/23/a-close-look-at-the-frontrunning-coronavirus-vaccines-as-of-april-23

[he includes the Chinese development work, which is helpful]

And just now, another update: https://blogs.sciencemag.org/pipeline/archives/2020/05/18/another-set-of-coronavirus-vaccine-candidates

 

I suppose I should add that Derek is essentially a discovery guy, while my background is in development - meaning I have a way different viewpoint on the desirability of purifying large quantities of vaccine candidates from tobacco leaves and insect cells than he does, for good reason - but it's still worth looking at the Big Picture.

 

Cheers!

[Edit: this is a pretty good article that describes the immune system and what scientists hope to achieve with vaccines

https://www.wired.com/story/moderna-covid-19-vaccine-trials/ LOL at the "Screaming Baby Rambo" innate immunity analogy]

[Gugny]

I'm not sure if this is the right place for this, so if it's not, please delete.  I think it's relevant because it shows how much misinformation is out there and we all know how dangerous that can be.  I hesitated posting this because it has the potential to go to the dark side.  I'm hoping that doesn't happen.

 

Researchers: Nearly Half Of Accounts Tweeting About Coronavirus Are Likely Bots

https://www.npr.org/sections/coronavirus-live-updates/2020/05/20/859814085/researchers-nearly-half-of-accounts-tweeting-about-coronavirus-are-likely-bots

 

Researchers culled through more than 200 million tweets discussing the virus since January and found that about 45% were sent by accounts that behave more like computerized robots than humans.

It is too early to say conclusively which individuals or groups are behind the bot accounts, but researchers said the tweets appeared aimed at sowing division in America.

 

"We do know that it looks like it's a propaganda machine, and it definitely matches the Russian and Chinese playbooks, but it would take a tremendous amount of resources to substantiate that," said Kathleen Carley, a professor of computer science at Carnegie Mellon University who is conducting a study into bot-generated coronavirus activity on Twitter that has yet to be published.

 

Researchers identified more than 100 false narratives about COVID-19 that are proliferating on Twitter by accounts controlled by bots.

 

Among the misinformation disseminated by bot accounts: tweeted conspiracy theories about hospitals being filled with mannequins or tweets that connected the spread of the coronavirus to 5G wireless towers, a notion that is patently untrue.

 

[whatdrought]

https://www.foxnews.com/health/cdc-now-says-coronavirus-does-not-spread-easily-via-contaminated-surfaces

 

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For those of you still wiping down groceries and other packages amid the ongoing coronavirus pandemic, breathe a sigh of relief: The Centers for Disease Control and Prevention (CDC) now says the novel virus “does not spread easily” from "touching surfaces or objects" — but experts warn that doesn’t mean it’s no longer necessary to take "practical and realistic" precautions in stopping the spread of COVID-19.

 

 

https://www.usatoday.com/story/news/health/2020/05/20/coronavirus-does-not-spread-easily-surfaces-objects-cdc/5232748002/

 

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The Centers for Disease Control and Prevention has always warned that "it may be possible" to become infected with coronavirus by touching contaminated surfaces or objects.

It just "does not spread easily" in that manner, the agency says, nor by animal-to-human contact or vice versa.

"COVID-19 is a new disease and we are still learning about how it spreads," the CDC's recently updated guidelines say. "It may be possible for COVID-19 to spread in other ways, but these are not thought to be the main ways the virus spreads."

 

The problem with a Novel Virus, everything is new. People overreact to so many little things they're told only to have them walked back or completely changed a month or so later. 

[Hap sez: very good points both, and thanks for sharing.  For me, the issue is the large number of cases where the source of transmission are not known. There are still the data that it can live on hard surfaces such as metal and glass for a couple of days.  It's probably correct that the focus should be on person-to-person, airborne transmission, but I'm not sure that rules surface transmission out.  There are a couple contact-tracing case studies where the only discernable contact was sitting in the same seat at a church service that someone with covid-19 had occupied earlier or similar, so it can happen.  Let's just say if you're scrubbing your gallon of milk then huddling up shoulder-to-shoulder at a bus stop unmasked, that's probably misplaced concern]

[Gray Beard]

https://www.nejm.org/doi/full/10.1056/NEJMoa2007764?query=featured_home
 

https://www.wktv.com/content/news/570720892.html
 

Researchers have finally published the data that led the federal government to recommend the use of the antiviral drug remdesivir in very ill coronavirus patients, and they say the drug alone will not be enough to help patients.

The data, published in the New England Journal of Medicine, show the drug shortened the course of illness from an average of 15 days to about 11 days.

"Preliminary results of this trial suggest that a 10-day course of remdesivir was superior to placebo in the treatment of hospitalized patients with Covid-19," the researchers wrote. But it was not a cure and it did not act quickly.

"These preliminary findings support the use of remdesivir for patients who are hospitalized with Covid-19 and require supplemental oxygen therapy," the researchers, led by a team at the National Institute of Allergy and Infectious Diseases, wrote.

"However, given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient," they added. "Future strategies should evaluate antiviral agents in combination with other therapeutic approaches or combinations of antiviral agents to continue to improve patient outcomes in Covid-19."

Other teams are already combining antiviral drugs, including remdesivir, with immune modulating drugs in coronavirus patients. The NIAID says it has started a trial that compares remdesivir alone to remdesivir combined with the anti-inflammatory drug baricitinib, used to treat rheumatoid arthritis.

The study also showed that it's important to start treatment early.

"Our findings highlight the need to identify Covid-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation," NIAID'S clinical research leaders Dr. John Beigel, Dr. Clifford Lane and their team wrote.

Late last month, the federal government announced that the drug was helping and the US Food and Drug Administration gave remdesivir an emergency use authorization to treat Covid-19.

 

The study's findings were considered significant because it was the first double-blind, placebo-controlled trial to test the drug in patients. That means some patients got no drug, and neither patient nor doctors knew who was getting the real treatment.

But some critics complained that the data were not published and worried the federal government was rushing the results.

The team tested 1,063 patients. They found those who got the infused drug recovered after an average of 11 days. Those who got placebo treatment took 15 days on average to recover. As previously reported, 7% of patients who got remdesivir died, compare to 11.9% given placebo infusions. But those results were not statistically significant.

Patients who needed oxygen appeared to benefit the most from the drug, the researchers reported.

"These findings support the use of remdesivir in this population, with the largest benefit observed among individuals who required oxygen supplementation but were not mechanically ventilated," Gilead Sciences, which makes the drug, said in a statement.

"We anticipate that results from our Phase 3 SIMPLE-Severe study, which is evaluating remdesivir in a similar population of COVID-19 patients requiring oxygen but not on mechanical ventilation, will be published in the near future. These data from the SIMPLE-Severe study support treatment of some patients for 5 days rather than 10 days, depending on clinical status."

 

Remdesivir did not cause an excess of side-effects and appeared safer than placebo, they added.

 

[Johnny Hammersticks]

Coronavirus fact?  We’re ***** blowing it with how people are handling the lessening of restrictions.  Highest # of daily infections and hospitalizations in NC since pandemic began.  Arkansas seeing a second spike, and running out of ICU beds in some cities.  Several other states including Virginia, Illinois, Florida and DC seeing spikes in numbers.

 

 

 

https://www.google.com/amp/s/fox2now.com/news/coronavirus/st-louis-county-issues-travel-advisory-after-lake-of-the-ozark-videos-go-viral/amp/

 

https://www.npr.org/sections/coronavirus-live-updates/2020/05/18/857943858/coronavirus-cases-surge-in-texas-panhandle-as-state-continues-to-reopen

 

https://www.businessinsider.com/dire-coronavirus-alabama-icu-no-beds-2020-5

 

https://www.google.com/amp/s/thehill.com/homenews/state-watch/499322-nc-sees-coronavirus-cases-surge-in-highest-single-day-total%3famp

Edited May 27, 2020 by Hapless Bills Fan
Just the facts

[PromoTheRobot]

Research reveals gene role in both dementia and severe Covid-19

https://www.theguardian.com/world/2020/may/26/research-reveals-gene-role-in-both-dementia-and-severe-covid-19?

[PastaJoe]

2 hours ago, Joe in Winslow said:

So, after three months have we flattened the curve yet?

Certainly in NYS we are past the flattening and are on the lower portion of the curve. Regions continue to open in Phase 1 with Long Island the latest to open. NYS Covid deaths dropped to the lowest since the start of tracking in March. But we have to remain cautious and not make the mistakes of other states that are having a rise in cases because people there are disregarding CDC guidelines.

Edited May 29, 2020 by PastaJoe

[thebandit27]

Not sure if already posted:

 

Looks like the WHO recommends mask use only when you have symptoms or are in the presence of someone with symptoms:

 

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

 

Obviously this is different from CDC recommendations. 
 

@Hapless Bills Fan, any advice on this?

[Hapless Bills Fan]

On 5/29/2020 at 7:35 AM, thebandit27 said:

Not sure if already posted:

 

Looks like the WHO recommends mask use only when you have symptoms or are in the presence of someone with symptoms:

 

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

 

Obviously this is different from CDC recommendations. 
 

@Hapless Bills Fan, any advice on this?

 

This is diverging from “Facts Only” since it’s my opinion based on my survey of the published evidence.

 

I’ve said it before and I’ll say it again:  I don’t think it’s coincidence that the places that have had the Best Luck reining this thing in are the places with a high incidence of public mask wearing.

 

Initially, public health folks figured this Covid-19 thing transmitted like flu, where droplet transmission (doesn’t spread that far) and surface transmission are a thing.  Now I think there’s a good bit of evidence that aerosol transmission is a thing.

 

There is also IMO a good bit of evidence that people may be most contagious for 1-2 days BEFORE they develop symptoms.  There are several very clear reports transmission where someone who was asymptomatic at the time spread the disease through aerosol transmission.

 

Then there are the ijits like the Springfield, MO Great Clips hairdresser who worked for 8 days while symptomatic  exposing something like 91 people (and visited Walmart, CVS, Dairy Queen, and a health club to boot) [update: and now a second hairdresser at the same location has tested positive and apparently worked while symptomatic, exposing another cluster of people.....]

 

Given these things, the advice to wear a mask “only when you have symptoms” or “are in the presence of someone with symptoms” seems....Ineffectual....to me.  First off, how will you know if you’re in the presence of someone with symptoms?  And if you are, are they gonna do the right thing, or are they gonna boogie about snorting on you?

[oldmanfan]

On 5/29/2020 at 8:35 AM, thebandit27 said:

Not sure if already posted:

 

Looks like the WHO recommends mask use only when you have symptoms or are in the presence of someone with symptoms:

 

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

 

Obviously this is different from CDC recommendations. 
 

@Hapless Bills Fan, any advice on this?

That is dated information from March, I believe.  The CDC has more recent recommendations indicating mask usage and I believe that WHO is currently examining whether to change their recommendation status.

[thebandit27]

WHO seems to be downplaying the impact of asymptomatic and pre-symptomatic spread:

 

https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html?fbclid=IwAR1OxLbBPaZSLJeDaL3DnDCdbwsA87QQs1Xi4HRyxYDeMik-OPkQ-WUdCOo

[BillsFan4]

https://www.axios.com/who-asymptomatic-coronavirus-69c56ce3-41e0-4ea7-ab2a-de866713b4cf.html

 

Quote

The World Health Organization clarified comments an official made on Monday that called asymptomatic transmission of the coronavirus "very rare," saying in a press conference that these carriers do take part in spreading the virus but that more information is needed to know by how much.

 

What they're saying: WHO official Marisa Van Kerkhove clarified Tuesday that patients sometimes confuse not having any symptoms with only exhibiting mild symptoms. In addition, some patients transmit the virus before developing symptoms. Contact tracers classify this group as "presymptomatic," rather than asymptomatic.

 

• Van Kerkhov said the WHO estimates 16% of people are asymptomatic and can transmit the virus. Some models suggest up to 40% of coronavirus transmission might be due to asymptomatic spread, she added, but much more information is needed.
• Van Kerkhove stressed that her comments on Monday were specific to particular studies and did not represent a new policy or direction. The WHO said it regrets saying that asymptomatic spread is "very rare."

 

[Edit: I would still like to know what "particular studies" she refers to in her clarification.  If they're there, give us a list!  What's so hard here?]

[Hapless Bills Fan]

2 hours ago, BillsFan4 said:

https://www.axios.com/who-asymptomatic-coronavirus-69c56ce3-41e0-4ea7-ab2a-de866713b4cf.html

 

So to the point, if presymptomatic people can infect other people, then asymptomatic infection is by definition, something that can be defined only in hindsight.

Thus saying "don't worry about asymptomatic people" is rather useless from a public health standpoint; you can only determine if someone if someone is a- or pre-symptomatic in hindsight.  Let's just call them "people without symptoms at the time" which is lengthy but unambiguous

 

I spent a bunch of time looking for the evidence supporting what Marisa Van Kerkhove said.  I could not find it.

I say modestly, that even bereft of the tools I used to have, I am pretty good at this.  I looked for stuff from this country, from Singapore, from S. Korea, and from China.

 

Here is the best source material I could find:

Summary: https://wwwnc.cdc.gov/eid/article/26/7/20-1595_article

Article summarizes epidemiological evidence, virological evidence, and modeling. 

Key points:

-There are a number of case studies which strongly imply that virus transmission from people without symptoms at the time is occurring.

-Titer measurements of people without symptoms at the time overlap titer measurements of people with symptoms (if you have as high viral titer in your upper respiratory system as someone with symptoms, what magic would render you unable to spread virus?)
-Modeling (which of course depends upon assumptions) of different situations: "Although models are highly dependent on the assumptions built into them, these models suggest that the speed and extent of SARS-CoV-2 transmission cannot be accounted for solely by transmission from symptomatic persons"

Conclusion:

"Each of the epidemiologic, virologic, and modeling studies described has limitations. However, in the aggregate, these diverse studies suggest that SARS-CoV-2 can be transmitted by persons with presymptomatic or asymptomatic infection, which may meaningfully contribute to the propagation of the COVID-19 pandemic."

 

 

[Hapless Bills Fan]

Vaccine update.  Long overdue.  This is a punt (or shall I call it a delegation?) to long-time Pharma blogger Derek Lowe.

He put out a very good summary of the "State of the Dev" on 26 May.

https://blogs.sciencemag.org/pipeline/archives/2020/05/26/coronavirus-vaccine-update-may-26

Really good blog by a pharma Discovery guy who knows his stuff.

 

TL;DR - CanSino’s Ad5-nCoV candidate published detailed phase I results that include T-cell response and neutralizing antibodies (the gold standard) for all. 

Publication in Lancet, a reputable peer-reviewed journal.  Bad news: the Achilles Heel of an adenovirus vector is that a lot of adults have anti-adenovirus antibodies which will damp the immune response to the vector.  Here's the Lancet article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31208-3/fulltext

 

Lay article in Forbes on Pfizer's vaccine development effort

https://www.forbes.com/sites/nathanvardi/2020/05/20/the-man-betting-1-billion-that-pfizer-can-deliver-a-vaccine-by-this-fall/#1772a718382e

I never worked under this guy, but he sounds like a breath of fresh air.

[Hapless Bills Fan]

Hydroxychloroquine for prevention of Covid-19 disease: Gold standard, double-blind study for prevention of covid-19 in exposed HCW halted for futility

https://www.nejm.org/doi/pdf/10.1056/NEJMoa2016638?articleTools=true

 

HCW were 66.4% of the study, 76.7% exposed at work

Household exposure 29.8% of the study

 

Sidebar thing that interests me: 13% of the study participants developed new covid-19 infections with no statistical difference between each group.  87.6% of them reported high-risk exposures (without eyeshield, surgical mask, or respirator).  There isn't breakdown I could find of how the exposure risks correlated to those who developed infections, but it's an obvious point of interest. 

Commentary by Derek Lowe:

https://blogs.sciencemag.org/pipeline/archives/2020/06/04/hydroxychloroquine-for-avoiding-infection

He states that a smaller group of the study participants were taking zinc (both arms), and had no difference in outcomes (for the zinc-treatment fans among us).  But, I can't find that info in a quick read through of the paper.  If anyone else can, obliged.

[BillsFan4]

3 hours ago, Hapless Bills Fan said:

Hydroxychloroquine for prevention of Covid-19 disease: Gold standard, double-blind study for prevention of covid-19 in exposed HCW halted for futility

https://www.nejm.org/doi/pdf/10.1056/NEJMoa2016638?articleTools=true

 

HCW were 66.4% of the study, 76.7% exposed at work

Household exposure 29.8% of the study

 

Sidebar thing that interests me: 13% of the study participants developed new covid-19 infections with no statistical difference between each group.  87.6% of them reported high-risk exposures (without eyeshield, surgical mask, or respirator).  There isn't breakdown I could find of how the exposure risks correlated to those who developed infections, but it's an obvious point of interest. 

Commentary by Derek Lowe:

https://blogs.sciencemag.org/pipeline/archives/2020/06/04/hydroxychloroquine-for-avoiding-infection

He states that a smaller group of the study participants were taking zinc (both arms), and had no difference in outcomes (for the zinc-treatment fans among us).  But, I can't find that info in a quick read through of the paper.  If anyone else can, obliged.

Here:

The relative risk with zinc use was 1.23 (95%CI, 0.82 to 1.83)
The relative risk with vitamin C use was 1.60 (95%CI, 1.12 to 2.28).

This observational comparisons may suffer from confounding by indication, in that those who deemed themselves at highest risk of developing infection may have been more likely to additionally take either zinc or vitamin C. Regardless, there was no suggestion that zinc added to hydroxychloroquine had additional benefit. Among those randomized to hydroxychloroquine, those taking zinc had a 15.0% incidence of new Covid-19 versus 10.8% incidence of new Covid-19 without self-reported zinc use.
Zinc has received a great deal of attention as a potential adjunctive therapy to be used with hydroxychloroquine. A 2014 in vitro study by Xue et al. used human ovarian carcinoma cell culture to examine the interaction of chloroquine and ionic zinc.4 Xue found that chloroquine acts as a zinc ionophore, increasing cellular uptake of zinc in culture media and increasing the cytotoxic effect of chloroquine to cause the death of cancer cells at levels 30-fold higher than what would be achieved in plasma with our trial’s dosing.4,5 Importantly, this lab experiment was not designed to emulate zinc levels in the average human body, but in a cell culture media which started with minimal zinc. North Americans have a very low prevalence of inadequate dietary zinc intake (<15% prevalence).6 Based on this sub-group analysis, we found no evidence of supplementary zinc intake had any effect on incidence of new Covid-19 compatible illness after high-risk exposure. The exact details of zinc formulation, dose, and duration were not queried, so this is not conclusive information.

 

It is on page 14 here:

 

https://www.nejm.org/doi/suppl/10.1056/NEJMoa2016638/suppl_file/nejmoa2016638_appendix.pdf

Edited June 9, 2020 by BillsFan4

[Hapless Bills Fan]

Unintentional case study on the use of masks wraps up in Springfield MO.

 

Mask use by both client and stylist

>15 minutes of close contact with a known symptomatic infected person

42 tested people: 0 positives (Everyone was offered testing, many declined - unfortunate)

Everyone (146 people 140 clients 6 stylists): > 2 weeks quarantine with 2x/day health checks by DPH - 0 symptoms

 

No one wanted it to happen, and it wouldn't have been ethical to set up a study like this, but the results are very encouraging. 

 

https://www.springfieldmo.gov/CivicAlerts.aspx?AID=6941

The health department is currently gathering further information about the type of masks worn, how they were used, etc

 

 

[BillsFan4]

https://www.medrxiv.org/content/10.1101/2020.04.02.20051417v2.full.pdf

From Hapless’s boy, Trevor Bedford (and many other authors). This paper is from a while back.

 

Cryptic transmission of SARS-CoV-2 in Washington State

Quote

Genome sequencing of SARS-CoV-2 strains allows for the reconstruction of transmission history connecting these infections. Here, we analyze 346 SARS-CoV-2 genomes from samples collected between 20 February and 15 March 2020 from infected patients in Washington State, USA. We found that the large majority of SARS-CoV-2 infections sampled during this time frame appeared to have derived from a single introduction event into the state in late January or early February 2020 and subsequent local spread, indicating cryptic spread of COVID-19 before active community surveillance was implemented. We estimate a common ancestor of this outbreak clade as occurring between 18 January and 9 February 2020. From genomic data, we estimate an exponential doubling between 2.4 and 5.1 days. These results highlight the need for large-scale community surveillance for SARS-CoV-2 and the power of pathogen genomics to inform epidemiological understanding.

 

Quote

Here we report on the putative history of community transmission in Washington State as revealed by genomic epidemiology. We conclude that SARS-CoV-2 was circulating cryptically, ie undetected by the surveillance apparatus, in Washington State since January 2020...

 

Quote

We analyzed the sequences of 346 SARS-CoV-2 viruses from the Washington State outbreak collected between 20 February and 15 March 2020. The large majority (293, 85%) of these viruses fall into a closely related clade, and all share the mutations possessed by WA1 and the additional mutations C17747T and A17858G.

 

 

 

 

Quote

We sought to test these two hypotheses: (a) SARS-CoV-2 was introduced into Washington State on 15 January 2020 with the arrival of WA1; subsequent cryptic transmission led to a community outbreak first detected on 28 February 2020 and (b) SARS-CoV-2 was imported on 15 January 2020 but this infection did not transmit onwards; a second, initially undetected importation event of a genetically identical or highly similar virus occurred, followed by cryptic transmission that led to a community outbreak.

 

 

Quote

In addition to the 293 viruses sampled from Washington State falling into the WA1 outbreak clade, we observe that seven viruses sampled from the Grand Princess cruise ship in late February and early Mar 2020 all group into the same outbreak clade (Fig. 1A). The genetic relationship among these viruses is consistent with a single introduction onto the Grand Princess cruise ship of the basal outbreak variant, possessing C17747T and A17858G, and subsequent transmission and evolution on the ship.

 

 

 

 

Quote

In January and February, 2020, screening for SARS-CoV-2 in the United States was directed at travelers with fever, cough and shortness of breath, with the geographic areas increasing as new outbreaks were identified, but also specifying travel to China up until 24 February 2020 (18, 19) . Our analysis suggests that a single clade of SARS-CoV-2 had likely been circulating in the Seattle area for 4–6 weeks by the time the virus was first detected in a non-traveler on 28 Feb 2020. By then, variants within this clade constituted the majority of confirmed infections in the region (293 of 346;85%). 

 

Quote

Several factors could have contributed to the delayed detection of presumptive community spread, including limited testing among non-travelers or the presence of asymptomatic or mild illnesses. Genetic evidence suggests that this cluster may descend from an initial introduction in mid-January with the WA1 travel case, but other origin scenarios are also possible.

 

Quote

Our results highlight the critical need for widespread surveillance for community transmission of SARS-CoV-2 throughout the United States and the rest of the world even after the current pandemic is brought under control. The broad spectrum of disease severity (20) makes surveillance challenging (21). The combination of traditional public health surveillance and genomic epidemiology can provide actionable insights....

....We see the combination of community surveillance, genomic analysis and public real-time sharing of results as empowering new systems for infectious disease surveillance.

 

 

[\GoBillsInDallas/]

https://www.mlive.com/public-interest/2020/06/from-hair-salons-to-gyms-experts-rank-36-activities-by-coronavirus-risk-level.html

 

[Hapless Bills Fan]

FDA revokes EUA for hydroxychloroquine to treat covid-19 disease

 

Text:

https://www.fda.gov/media/138945/download

 

 

 

[Hapless Bills Fan]

This seems to  be a very very useful site.  Oxford post-doctoral and PhD candidates reviewing and summarizing immunology-focused covid-19 literature.

 

https://www.immunology.ox.ac.uk/covid-19/covid-19-immunology-literature-reviews/search?category=immunology-immunity

 

Can select "all categories" or focus in.

[shoshin]

 

 

One of the first things I've seen with promise for late-stage Covid patients. Pretty good-sized study here too, and a widely available drug (at least it was before this study!).

 

My medical friends who treat this, as well as the stuff I've read, have termed the ventilator as the Hail Mary moment for Covid. Not many good outcomes if you have to go on one. 

 

 

On 6/16/2020 at 9:43 AM, Buddo said:

 

It's also saying that it reduced death in instances where people needed oxygen only, i.e. 'unventilated' by a fifth. It appears it doen't make any difference to people who don't need any oxygen treatment of any sort.

 

If it had been used from the start of the pandemic in the UK, it's estimated that 5,000 lives might have been saved. No idea what that might have meant for other countries, but at least it holds out some more hope for people affected in the future, throughout the world.

[Hapless Bills Fan]

12 hours ago, Nelius said:

This thread is crazy. It's a "novel" coronavirus for a reason, as you can tell by the breadth of responses here. There's still a tremendous amount of questions which is why there will be no normal any time soon. At best I'm hoping for some kind of truncated season in a bubble, and I'm convinced that there's no way any of us will be attending a major sporting event live for at least the rest of 2020.

 

 

Genuinely curious if there's any truth to the immunity part? I've heard otherwise but have been taking a bit of a media break lately so may have missed an update. Awesome if true, but if not, then this is exactly the kind of serious confusion that I'm talking about.

 

This was asked in TSW by @Nelius, and because I am trying to keep a bunch of threads from becoming "covid-19 discussion threads", I'll answer here.  It would be nice if a true immunologist would "out" themselves and step up.  I'm not an immunologist, I've just worked on vaccines and gone to the project meetings.

 

Briefly put, when people are infected their early immune response is non-specific.  It includes various white blood cells and soluble factors (cytokines and complement factors).  After 1-3 weeks, they develop adaptive immunity, which ideally confers long term immunity.  Adaptive immunity includes B-cells, T-cells, and antibodies (first IgM, then IgGs).

Wiki about it

 

What we know about people who have recovered from covid-19: those who have been tested (serology or blood testing) [Edit: at least 3 weeks post symptoms] have antibodies against the virus.  Most antibody tests are just +/-. The testing that has measured the quantity of antibodies in people who have been infected, indicate that the level of antibodies people have vary widely.  That's not uncommon.  The quantity of antibodies a person has in their blood after they recover from a disease doesn't really indicate how effective their immunity is; what's more relevant is how rapidly the person's immune system can "dial it up" in response to a new challenge with that organism (not ethical to assess in humans) and whether a long-term B cell and T cell response has been induced (see below).

 

What we don't know about people who have recovered from covid-19 and have antibodies: 1) whether they all have neutralizing antibodies (antibodies that can prevent the virus from entering and infecting cells) 2) whether they have a T cell and B cell response (important to efficient lasting immunity).  The reason we don't know this is testing for T cells and for neutralizing antibodies, antibodies able to keep the virus from infecting cells) is more complicated and needs to be performed with live virus in a high-level biocontainment facility, so it's not widely done.  3) how long their immune response will persist and be effective.    Adaptive immunity to some diseases is lifelong - measles is an example.  What was found with SARS and MERS is that the antibodies persisted 6 months - 2 years.  That's the current guess with covid-19: that people previously infected will be immune, but that the immunity will only ~2 years.  In part this is because of....

 

....viral mutation rate.  The "money" part of measles virus, the part the virus needs to infect cells, effectively doesn't mutate.  A vaccine developed decades ago is still good. Influenza virus, on the other hand, has the ability to infect with dozens of strains that look "different enough" to the immune system that every few years our immune system is effectively a "blank slate".  Virologists are studying the mutation rate of covid-19 intensely and so far it looks to mutate way more than measles, but for the "money" part, the part needed to infect cells, more slowly than influenza.

 

What we can do is infect or vaccinate non-human primates, like rhesus monkeys, then expose them again and see if they get sick.  The studies that have been done so far say they are protected and don't get sick.  Because the virus hasn't been around that long, we can't say yet how long the protection will last.

 

So, bottom line: we think having anti-covid-19 antibodies means you're immune to covid-19, but we don't KNOW that for a fact, nor do we know how long it will last.

 

A note about vaccines: vaccines never "essentially give someone the virus".  There's a hundred-year-old process that did that for smallpox, called "variolation".  The first vaccines, for smallpox, used a related virus and gave people the related virus, cowpox.  We don't do that any more.    What modern vaccines do is:

1) inject a different, related virus that will produce an immune response to the target disease.  Smallpox vaccine was an example - it used cowpox.  BCG for tuberculosis is another example.

2) Use an inactivated virus combined with chemicals (adjuvants) that arouse a better immune response.  The virus is dead, it can not make you sick.  This has probably been the most common strategy, and once proper manufacturing controls and release tests were instituted to ensure that the virus is really, truly dead, it's safe.

3) Inject a live, but attenuated virus that is selected, treated, or mutated to make it too wimpy to cause the disease.  Oral polio vaccine is an example.  It's an effective vaccine but it can (very rarely) back mutate in the intestinal tract and cause polio in a non-immune person.  It's no longer given in the US for that reason.

4) Conjugate vaccines - we take part of the viral coat protein and combine it with a carrier protein that arouses the immune system, manufacture and purify it, then combine it with adjuvants.  Pneumoccal pneumonia,  meningitis, and modern whooping cough vaccines are examples of this.  These are very safe vaccines, but don't necessarily produce as lasting an immune response.

5) Viral coat protein without the viral genetic material.  HPV vaccine is an example of this.  Because the virus genetic material isn't there, it can not replicate and make you sick.  (This works best for viruses with a self-assembling protein shell rather than a bunch of proteins embedded in lipid.)

6) DNA and RNA vaccines - we combine genetic material that our bodies can translate to make part of the viral coat protein.  It will either be packaged inside the coat protein of another virus (adenovirus is common) or with some other carrier material.  It's an exciting approach because it can be fast - all you need is the genetic sequence of the virus coat protein to throw it into your platform system and start manufacture.  But experience is limited.  So far only one vaccine has been approved using this approach (equine encephalitis).

 

Approaches being attempted for covid-19 include 4 and 6; someone may be trying for 3).  Most of the focus is on 6 - the Moderna, Can-sino and Pfizer vaccines for example, are all variations of this using different carriers and perhaps different pieces of the spike protein.

 

Hope this helps.

[Hapless Bills Fan]

Are we past the peak?

 

This is a set of tools from JHU web site showing  a 3 day average of new confirmed cases

https://coronavirus.jhu.edu/data/new-cases-50-states

Pick your state

 

My interpretation is that except in a few states, we are not "past peak". 

NYC had so many cases that it dominated the data for the country as a whole for a long time, but if we compare the NYS graph to the US graph here on the same site:

https://coronavirus.jhu.edu/data/new-cases

That's no longer true.

 

Note that these are total daily cases, not per capita daily cases.  Would love a source for the latter

Another source, again total daily cases per state.  I can't find an explanation for how they color-code, but this site allows one to access county by county data

https://www.endcoronavirus.org/states?fbclid=IwAR04j_L3gO5IZcm2Ev35j02QKBOKrJZNUG6hv-h_GZ3YaEfRsUSM9RPV4Xw

 

 

[muppy]

so much for antibodies presenting a second infection of covis-19....I dont know how,  if this is widespread or just an anomaly but the implications are  Resurgence is a possibility months later even with antibodies. Just a part of the article quoted.

https://www.msn.com/en-us/health/hea...enf?li=BBnb7Kz
 

Quote

 

Dallas Woman Tests Positive for Coronavirus Again After 4 Months: 'I Was Floored'

 

 

Dallas Woman Tests Positive for Coronavirus Again After 4 Months: 'I Was Floored'

 

A woman in Dallas is fighting her second battle against Covid-19.  Doctors are unsure why the virus sometimes reappears — or if it is contagious the second time aroundMeredith McKee first tested positive for the potentially deadly virus in February, diagnosed after feeling "clear and obvious" symptoms, she told NBC 5.

"I had a dry cough like you would not believe. It would not stop,” McKee recalled, explaining that she managed to fight off the first bout of the virus from home.
She even donated some of her plasma after testing positive for antibodies.
"I felt great finally [doing] something good coming out of the hell that I’ve been through because I'm going to help up to eight people with this plasma,” she said.
However, last week, McKee shared a tearful photo of herself from a hospital bed at Texas Health Presbyterian in Dallas. After admitting herself with high blood pressure and a headache on Friday, she found out she was one again positive for COVID-19 four months after her initial diagnosis.
"I was floored when it was positive," McKee said.

 

 

 

Some other cases:

https://www.newsweek.com/italian-woman-tests-positive-covid-19-after-60-days-quarantine-swabbing-1500202

https://www.washingtonpost.com/health/2020/06/11/coronavirus-chronic/?arc404=true

 

Just now, Hapless Bills Fan said:

 

So the big unanswered question here is: are these people being reinfected?

Or is the virus simply persisting in a reservoir somewhere in their body and resurging in response to something? (known to happen with other viruses)

 

Or, has their immune system been thrown out of whack, and now they're dealing with the aftereffects of an over-reactive immune system?

 

We don't have answers at this point.

 

It's a valid point that these folks have antibodies and the antibodies clearly aren't kicking virus butt.  The immune response is more than just antibodies, obviously (see post above) so another question is, is there a problem with their T cell or B cell or innate immune response?

 

It's clear this is something real that is affecting some people.  So far it seems a relatively small number.

 

It may fall into the category of "when you have somewhere between 8 million and 160 million people worldwide infected with a novel virus, you're gonna see some weird ***** go down" (to use a technical term)

[Hapless Bills Fan]

PSA:  Help!  My mask is making my glasses fog up!

 

#1 solution: mask with a flexible wire along the top that will allow it to be fit against your nose/cheeks.  Can add a pipe cleaner, coffee bag wire, or pipe cleaner - stitch at each end and in middle on outside of mask  (or hot glue - won't hold as well).

#2 solution: double-sided Fashion tape.  Designed to hold against sweat and body oils

#3 solution: treat glasses with baby shampoo or soap solution and allow to dry

 

https://www.nytimes.com/article/glasses-fog-wearing-mask-coronavirus.html

[Hapless Bills Fan]

Is it more testing?  Probably not.

Covid-19 in US vs EU, 7 day rolling average of new cases March-June

 

The population of the EU is estimated at 445 million people as of Feb 2020

The member EU states have performed approximately 53,000 covid-19 tests per 1M population (obtained by summing individual EU member data on Worldometer)

 

The population of the USA is estimated at 330 million people as of Dec 2019

The US has performed approximately 83,000 covid-19 tests per 1M population

 

However, testing differences are probably not the explanation here.  The US has a positive test rate of ~8.4% (~7,000 cases/1M population, ~83,000 tests/1M population).  The EU has an estimated positive test rate of ~5% (again, summing individual EU member data (2,770 cases/1M population, 53,000 tests/1M population).  Both regions preferentially tested sick people during the height of the initial epidemic and are now testing more broadly.

 

For a graphical representation, in case the math behind that seems obscure let's look at 6 individual EU countries - the most populous and 2 with the highest rates of per capita testing.  Says to me their cases are declining (including in 4 countries with similar or higher per capita testing than USA)

 

4 most populous countries in EU:

Germany 60,000 tests/1M

France 21,000 tests/1M

Italy 81,700 tests/1M

Spain 103,000 tests/ 1M

 

two bonus countries with high test rates

Belgium 94,800 cases/1M

 

Portugal 102,700 cases/1M

 

My conclusion: EU (which is also re-opening) has done a far better job of kicking covid-19 butt than US, which appears stuck on "covid plateau" and may be increasing.

 

[HappyDays]

Troubling news:

 

 

 

It seems that much of the country has just decided to reopen itself and we're starting to see the consequences.

[ndirish1978]

Hi @Hapless Bills Fan. I have a question if that's ok. Has there been a lower rate of cases vs deaths? I feel like I keep reading that test cases coming in positive recently have had a large percentage of asymptomatic subjects. Thanks!

 

EDIT: Great question, ndirish1978 and I'm not sure of the answer.  

In the US and globally, we're running about 5.1% CFR (case fatality rate), with of course a bunch of patients still hospitalized and outcomes uncertain.

At one point I think we were running 8% CFR in the US, which was 10-13% in NYC and 3% everywhere else.

https://coronavirus.jhu.edu/map.html

 

It really can't be otherwise - early in the epidemic, you had to have flown back from Wuhan where you swore you licked a pneumonia patient to get a test.  In NYC people who had clearly covid-19 relevant symptoms but weren't critically ill were given a sheet of instructions, no test, and sent home.  Only very sick people got admitted to hospital and only hospital admits got tests.

We have more hospital capacity now, so we can start hospitalizing and treating people before they're desperately ill, and we have more testing capacity so we can test people who have just been exposed.

 

I don't think that's all of it though  - I think we have better treatment protocols, and a better handle on which existing medications are truly helpful, so people who are seriously ill have better outcomes as long as we maintain hospital capacity

Opinion: I think the infected, asymptomatic younger people were always there, we just didn't have the testing capacity to know they were there before.

 

[plenzmd1]

First time I have seen Covid and the protest linked. Very surprising to see it reported in the LA Times

 

https://www.latimes.com/california/story/2020-06-22/for-third-day-in-a-week-l-a-county-reports-more-than-2-000-new-coronavirus-cases

[GottaRun]

Taken from the dataisbeautiful sub on reddit.I believe it shows 2 regions decreasing in cases and 2 regions increasing (using key on the left).  Accurate as of June 22nd.  Reading graphs isn't a strong point of mine.

 

[Edit: read it perfectly as far as I can tell.  Point is showing that the overall US cases shape can obscure the actual pattern in different regions of the country, some falling, some rising - quickly.  -Hap]

[Nervous Guy]

On 6/23/2020 at 4:17 PM, The Dean said:

 

 

Why? The LA Times is a respectable newspaper that follows the basic tenants of journalism. You will note, unlike purposefully biased news outlets, they report events irrespective of the political implications, as does the NY Times and the Washington Post. All of these papers have reported (and even broken) stories damaging to both liberal/Democrat and conservative/Republican politicians. Look to see if your "alternative to mainstream" news sources have that same integrity. If they are committed to reporting only stories that support their bias, then you know you have a source that isn't to be trusted.

They may report them equally but the bias is still there...here is an interesting site that reveals political leaning of news sources, it also has a link to Allsides which rates the bias of about 600 media outlets. 

https://guides.lib.umich.edu/c.php?g=637508&p=4462444

Edit: leaving this here because of very useful link to media bias ratings from NG, but in general, if we want to discuss media bias, elsewhere please.

I started this thread upon request of several folks to have a covid-19 thread that was just links and info.  Discussion -> discussion thread please!]

 

And also links from The Dean:

On 6/24/2020 at 10:39 AM, The Dean said:

In general the straight forward bias rating sites have the major networks, NY Times, Wash Post as "slightly left". Those that also rank reliability place them in the "high reliability" sector as well. Some outlets like Brietbart (for example) are found to lean heavily to one side and have low reliability. In general, the further to the left or right one outlet strays, the less reliable they are.

 

Here's a site that ranks both bias and reliability

https://www.adfontesmedia.com/interactive-media-bias-chart/

 

Of course, the devil is in the details (methodology, bias of the data interpreters, etc). The good thing is, for the most part these relatively unbiased rankings are in general agreement on the lean of the bias. Shooting for sources with high reliability and a minimum of bias is probably your best bet if you are looking to be well informed.

 

Now I don't want to get too technical here, but the study of news bias was my main concentration of study for my Masters degree and all my PhD work. That was years ago, of course, and some things have changed. But I'm pretty sure the major bias in most new gathering/reporting organizations that still cling to traditional journalistic values, is that of getting the work done quickly, while still getting the story accurate.