triplehorn

It depends on how you define won. He’s been wildly successful to date. If we’re talking about restoring our damaged western alliances, tackling the financial/banking system to curtail their mass flow of international illicit cash, and addressing the usurpation of news information platforms/socmed to dump endless divisive/harmful propaganda on us, we’re looking at 5 years from now at least. Let’s make what he and his mob have done to date absolutely not worth it. Long game.

watch your cornhole, vlad

Yale is crushing it.

Here's a presentation by Prof. Iwasaki on the multidisciplinary collaboration at Yale med on their work studying Covid pathogenesis. I had to watch this a couple times even though she does a pretty remarkable job of making it understandable. The first part discusses their use of mice transduced to express the human ACE2 receptor. That allowed them to selectively observe what kinds of effects the virus has on human cell signaling as a function of immune response. The second part discusses their work studying human Covid patients and observed differences related to disease outcomes. Additional work they did observing gender differences is notable. People who fare better have a robust initial immune response with corresponding viral load reduction . Those who fare worse have a delayed response in some respects with an apparent inability to lower and clear viral load. The persistence in viral load, or inability to reduce it in some people, drives the continued inflammatory response with irregular features. She points out that their study doesn't look at what is happening right at inception (when people are infected but not yet identified as sick for study) to understand differences. But a lot sure seems to point to in T cell numbers and function for bringing the infection to heel, or not.

Useful perspective about the actual meaning of T cell memory, cross reactivity, and the risk of misconstruing it as it relates to achieving herd immunity thread:

Yep. After thinking more about it, I re-read it and realized it was incomplete. was too late to edit.

I tend to agree with @utee94 's take above. However, here's the NYT op-ed penned by Prof. Akiko Iwasaki (the same Yale immunobiologist whose thread I posted in the last page or so on identifying disease trajectory clusters and early immune signatures predictive of bad outcomes, the role of inflammasomes with special attention to IL-1B and IL-18) on the likelihood of a covid vaccination. Read it carefully though and take note of the emphasis on T cell immune function: Scared That Covid-19 Immunity Won’t Last? Don’t Be : Dropping antibody counts aren’t a sign that our immune system is failing against the coronavirus, nor an omen that we can’t develop a viable vaccine. For comparison, look at this from the CDC today: CDC gives three-month window of immunity after COVID-19 infection I'm not even sure what stock to put into anything coming out of the "CDC" today. It's been perversely undermined, obstructed, and manipulated since January. (I had a recent talk with a med student with friends employed at CDC who describe jaw dropping fuckery going on from the beginning inhibiting their standard responses and function during a pandemic). To me, "3 month window" translates as a message that "errbody gets a $$$hot no matter if you've already had it or not!" Contrast that with what Iwasaki wrote in the NYT above. The more pressing question emerging today is 'do we even need a vaccine for Covid'.

What shocks me is how easily Mitch and Senate R’s avoid daily public scrutiny and accountability for enabling the unfolding destruction.

Got this from Oregon Health Authority today: "PORTLAND, Ore. — As of mid-June, 1% of Oregonians without COVID-19 had evidence of past infection of the virus in their blood, which is 10 times higher than the reported rate of infections obtained through conventional testing, according to a new study. Oregon Health Authority epidemiologists who authored the study, which appears today in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report (MMWR), found that nine of 897 blood specimens collected from 19 health care facilities around Oregon between May 11 and June 15, 2020, contained antibodies against the virus that causes COVID-19. The study also suggested that rates of infection increased with age, with no antibodies detected in the blood of pediatric patients 17 and younger. The rate was 0.4-0.5% in those ages 18-64; and 1.6-2.1% in those 65 and older. The results indicate a “substantial” proportion of Oregon residents have undiagnosed and unreported infection from COVID-19. [...]" ---> If our rate of infection is appx 10 times higher than conventional testing suggests, and considering we haven't been hit hard yet, that could have substantial implications on the timeline to reach herd immunity in other states that are being/have been walloped. Graphs are hinting that that is what appears to be coming into focus right now on a US regional (and select international) basis. ----> "no antibodies detected in the blood of pediatric patients 17 and younger." hmmmm.

Regarding the path to herd immunity, restrictive measures alter the shapes of the curves, but the the area under the curves are the same unless definitive interventions like vaccines are available before herd immunity occurs. Other available meds like HCQ and Ivermectin could conceivably help approach the end game of herd immunity more safely and with a lot less mortality. Regarding HCQ as an early intervention to reduce need for hospitalization and death take note of this: Over 3 Cr N95 masks, 1.28 Cr PPEs, 10 Cr HCQ tablets given to states, UTs by Centre for free That is 108 Million doses of HCQ that have been distributed to India's population so far, provided by the Indian govt for free. With 2.5M Covid cases, India ranks 3rd in the world behind the US and Brazil. India's CFR is at about 1.9 to 2 while the US is at about 3 to 3.1. If you apply and extrapolate India's CFR to US cases, we would have about 70K fewer deaths today. Is that all due to dispensing 100M HCQ doses to the population for free? No, that's oversimplifying. But you can sure as shit say that it's not making things worse.

Herd immunity debate is now in full swing: Herd Immunity May Be Slowing Spread in U.S., As Study Finds 40 Percent Community Infection Provides Protection

Oh surprise. Ivermectin is now being targeted with the same playbook as hcq was: What is ivermectin, and should we be using it to treat Covid-19? Scaremongering about safety with a safe drug. Daktari images of injecting pig medicine. Imprecise language followed by mixed associations that distort perception and meaning. Pitching the exclusivity of needing large randomized controlled trials to ever "know." This article features a greatest hits of big pharma media tropes targeting a fearful public. There are several others I could highlight. It should all start to sound familiar by now. There's a usurpation, a theft, of the doctor-patient relationship underway that I've never witnessed. I understand the need for heightened precaution and vigilance for a new and lethal pathogen. But we're past that now as it relates to basic safety with concurrent use during coronavirus infection, and with early treatment in particular where the initial disease course is no different than a common cold. Not only have they been proven safe since January, a large preponderance of evidence shows they can help - a lot - when applied optimally. Research is only as useful as the questions being being asked. There's a naked pattern of asking the wrong questions, narrowly and exclusively pointing to those subsequent negative answers, and speaking with imprecise umbrella generalities that ignore vital distinctions. It's all about control and profit. The business and marketing front of big pharma is due some serious comeuppance after this.

Out here in OR, given relative size of state population, infections suggest we're still over-performing on shutdowns, masks, and distancing. If we open up too fast, we're taking a ride on the Kingda Ka. My question is, for how much longer do we have to smolder to reach herd immunity than those states that spiked hard? If it results in delayed major openings past December for Oregon, letting the heat turn up on local spread might not be the worst thing. The folks OR is working with for modeling (the WA folks I believe) are calculating this to inform the risk/benefit of timed phased openings. Could be getting ahead of eventual reality, but today I'm still leaning towards the worst being behind us and relative normality returning by mid-Oct into Nov in the US without a bumper Spanish Flu fall/winter reprise. The US missed the window to nip this one at inception, and I expect we'll do better next time around.

The variables are undoubtedly multifactorial and manifest as a mosaic across the world population. Some variables are larger contributors and some are small. T cell cross reactivity would appear to be a substantial one, given the eye opening data around the prevalence of T cell immune cross-reactivity to a supposed 'novel' pathogen. A smaller variable might be something like people who may share a genetic mutation that prevents Covid from infecting their cells - as is the case for HIV. In HIV, the CCR5 receptor mutation confers this advantage and is thought to have appeared and propagated in the human population a couple thousand years ago. An estimated 10% of people carry this innate genetic resistance to being infected with HIV. But that 10% affects the math and helps lower the threshold for herd immunity. Shutting down along with distancing and masks affects the curves - the rate to burnout - but not the percent infected needed for actual herd immunity. With deadly outbreaks, the goal should still be for eradication without enduring the carnage before bottoming out at herd immunity. In the end, you just look at the curves. The second waves appear to have occurred in various cities and regions when opening up happened prematurely with a relatively small percentage of infected population. If a default to herd immunity ends up being around 20% of population exposed, we should feel very, very fortunate compared to early worst case predictions.

To clarify, evidence of herd immunity being attained in certain major cities, and certain regions and nations is one thing, why it is happening apparently without 60-70% of the respective populations being infected is another. Just looking at the graphs of those places it looks likely that herd immunity is emerging. "Likely" is not making a "hard conclusion." Looking at the graphs, "likely" reaching herd immunity is not wild-assed conjecture. Is is certain? No, of course not. But it's not a blip. These sustained trends have been emerging for a few weeks now. What could explain herd immunity being achieved around 20% instead of 60-70% for a "novel" pathogen? T cell immunity is the best explanation I've seen. Moreover, it's why I posted the well thought out twit thread last page for everyone to digest. It contains math, and numbers and science stuff. To get from theorized 60%+ required population exposure for herd immunity to a "novel" pathogen down to 20%+ for HI, you have to account for about an additional 40% of the population being neutral to spreading infection. Look at the math and science stuff above re T cell immunity and non-antibody mediated cross-reactivity. It computes. But no, the knee-jerk is to respond with a ginned-up caricature of some reich wing friendly clown-doctor spreading the vile unholy word that Plaquenil could be even remotely safe, you know, for actual human ingestion. *gasp* If HI is emerging in various areas, the outstanding question is "does it change management"? My initial thought is no. You don't stop distancing, hand washing, and mask wearing. All of those things help accelerate R0 being less than 1 and the viral run stalling out. But it also means that places where only 5% of the population has been exposed due to effective curve flattening from distancing, masking up, and hand hygiene still stand to have new cases persist at higher levels than places like NY, MA, CT, NJ etc where they got burned hot and fast but where hell has passed. While that sounds like a mixed-news scenario, the 5% places that have coordinated state govt and a willing population is where you can eliminate it through continued mitigation behaviors, contact tracing, and EARLY targeted use with cheap generic repurposed drugs like Ivermectin and the Quinine derivatives to safely help EARLY to limit hospitalizations, illness severity, and risk of death. food for thought: if a pandemic is a war, big pharma is the military industrial complex. chew on that for a sec.

well, well, well. Dr. Fauci picks up on T cell immunity being a thing. Why does COVID-19 strike some and not others? Fauci sees an answer in new study There's some content that think is backwards however: ^^^ Or, understanding T cell immunity in resolution of this pandemic increases the likelihood there will be no need for $10B in vaccines for this virus. Arguably, it's the T cells that are the first line of defense. Natural killer T cells that recognize and eliminate cells that have been compromised by pathogens without antibody type specificity. Young, healthy, well nourished people with robust T cell immune function in many cases likely wipeout Covid well before antibodies ever appear. But additionally, for many pathogens, our immune system harbors long term memory via T cells even after antibody titers are essentially undetectable. We're seeing that now with T cell cross-reactivity in many of us who have previously been exposed to common coronaviruses and other RNA viruses. What it means is that we likely are already seeing evidence of herd immunity taking hold in select regions of the US and in other countries.

We're seeing this in NY, London, France, Egypt, Pakistan, and others. Cities that peaked at about 20% infected are not having second waves. Here's NY now:

Established scientific understanding of T cell immunity and emerging serologic evidence is being presented, not his original thoughts. Show me a "non-clown" MD who is incorporating understanding of essential T cell immunity into the unfolding dynamics of this pandemic that differs from what is presented above. The newfound confusion people have around established science and medicine is shocking and tragic. The entirely manufactured and false scaremongering around the safety of quinine derivatives, like the everyday use of Plaquenil, is the prime example in this context. The fear and demonization is not supported by decades of well understood safe medical practice. It was triggered by an outright fraudulent study. The tough pill to swallow is how many Americans died as a result of this fuel of mass confusion. The hysteria over Plaquenil is exactly that, unsubstantiated imprecise hysteria. The docs who are (bravely) putting themselves in the political crosshairs are doing so to counter rampant misinformation in an effort to save lives and inform understanding about best policy moving forward. They have no choice but to appeal to those who are in a position of power to actually do something, ie the current administration.

I know who he is. He’s as much a conservative hack as I am. Care to take a stab at T cell immune function wrt attaining herd immunity? It’s dumb and lazy to attack the messenger then put the blinders on.

There are increasing signs the raging spread of this bug is going to fade out more quickly than expected. The reason appears to be linked to T cell immune function. Good T cell primer thread on this 'novel' coronavirus wrt epidemiology: The last 8 thread tweets (not copied above) swerve into opinion about the profit incentive for vaccines and the role of lockdowns and masks which diverge from the useful science of understanding the role of T cell immune function, and assessing how much sooner than expected herd immunity may arrive compared to prevailing thought just a few months ago. Obviously it would be great news if this is true. It appears to now be happening in multiple countries already, including several states in the US.

Biden campaign announces some VP staff ahead of the VP. Karine Jean-Pierre will be the chief of staff for Biden's running mate. I’m guessing the VP has known for long enough to get some things rolling.

Would love to see that, even more so if they could immediately become available to hit the tv interview circuit targeting their respective Trump admin counterparts. Have each individual speak to the position they would lead highlighting the current danger, corruption, and incompetence of the current occupants. It makes it harder to focus attacks on Biden. Being publicly surrounded this early by competent people all speaking the same team goals language would have a powerful neutralizing and normalizing effect to counter the onslaught of whacked russian-fed propaganda.

Good question, I don't know. Regarding cytokines, it looks like Remicaid specifically targets TNF and has an effect of lowering IL-1. It also looks like Remicaid affects helper T cell function which for autoimmune conditions like AS helps further reduce immune attack on one's own tissues. Two major functions we want to fight Covid is a robust T cell immunity to attack novel pathogens right away before we have an adaptive antibody response, and a normally regulated immune response that doesn't lead to end-stage cytokine storm. Inhibiting TNF and IL-1, IL-1 in particular, could possibly reduce the risk of dying from Covid (death is from consequences of haywire immune inflammatory response, not virus proper). I'm looking at IL-1b and IL-18 as major upstream culprits here related to inflammasome activation run amok. Alternatively, you don't want to globally knock out all T cell function used to fight a novel pathogen. Remicaid appears to focus its influence on "helper" T cells and not directly at NK "killer" T cells used to go after virus infected cells. So I'd generally side with your rheumatologist's thinking here.

[...] The congressional probe into the National Rifle Association’s relationship with Russia shows a U.S. tax-exempt organization working as a conduit to provide Russian officials access to Republicans with the quid pro quo of “lucrative personal business opportunities. [...]” oh. and just a friendly reminder that Barr-as-fixer can't fire or quash the NYAG in this matter.

NYAG highlights the self-dealing, but wait until the forensic money trail gets laid out. Where did all the money flowing into the NRA come from and where else did it go? This has been cooking for a good while (from Sept. 2019): NPR: NRA Was 'Foreign Asset' To Russia Ahead of 2016, New Senate Report Reveals "Attorneys general in the state of New York and the District of Columbia are conducting separate probes into alleged wrongdoing at the gun rights organization. These probes have a broader scope than the Senate report, which focuses on Russia."