COVID-19 medical discussion

[wild_turkey 3187]

I thought it would be helpful to have a thread specifically for medical discussion and developments - vaccines, treatments, clinical trials, personal medical questions for surly docs, etc.

I'll start with a topic that's been of interest to me. My only medical condition is an autoimmune disease that is treated with hydroxychloroquine with excellent control. I've considered the potential impact of the condition itself vs. the treatment with regards to my immune system. Fortunately for me, there has been some literature published about chloroquine and hydroxychloroquine as potential treatments for COVID.

In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).

https://www.ncbi.nlm.nih.gov/pubmed/32150618

Abstract
BACKGROUND:
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) first broke out in Wuhan (China) and subsequently spread worldwide. Chloroquine has been sporadically used in treating SARS-CoV-2 infection. Hydroxychloroquine shares the same mechanism of action as chloroquine, but its more tolerable safety profile makes it the preferred drug to treat malaria and autoimmune conditions. We propose that the immunomodulatory effect of hydroxychloroquine also may be useful in controlling the cytokine storm that occurs late-phase in critically ill SARS-CoV-2 infected patients. Currently, there is no evidence to support the use of hydroxychloroquine in SARS-CoV-2 infection.

METHODS:
The pharmacological activity of chloroquine and hydroxychloroquine was tested using SARS-CoV-2 infected Vero cells. Physiologically-based pharmacokinetic models (PBPK) were implemented for both drugs separately by integrating their in vitro data. Using the PBPK models, hydroxychloroquine concentrations in lung fluid were simulated under 5 different dosing regimens to explore the most effective regimen whilst considering the drug's safety profile.

RESULTS:
Hydroxychloroquine (EC50=0.72 μM) was found to be more potent than chloroquine (EC50=5.47 μM) in vitro. Based on PBPK models results, a loading dose of 400 mg twice daily of hydroxychloroquine sulfate given orally, followed by a maintenance dose of 200 mg given twice daily for 4 days is recommended for SARS-CoV-2 infection, as it reached three times the potency of chloroquine phosphate when given 500 mg twice daily 5 days in advance.

CONCLUSIONS:
Hydroxychloroquine was found to be more potent than chloroquine to inhibit SARS-CoV-2 in vitro.

Edited March 14, 2020 by wild_turkey

[wild_turkey 3187]

My 2 separate quotes were getting combined for some reason. Here's the second one I wanted to list:

Quote

Chloroquine and hydroxychloroquine as available weapons to fight COVID-19.

https://www.sciencedirect.com/science/article/pii/S0924857920300820?via%3Dihub

Regarding viruses, for reasons probably partly identical involving alkalinisation by chloroquine of the phagolysosome, several studies have shown the effectiveness of this molecule, including against coronaviruses among which is the severe acute respiratory syndrome (SARS)-associated coronavirus [1,12,13] (Table 1). We previously emphasised interest in chloroquine for the treatment of viral infections in this journal [1], predicting its use in viral infections lacking drugs. Following the discovery in China of the in vitro activity of chloroquine against SARS-CoV-2, discovered during culture tests on Vero E6 cells with 50% and 90% effective concentrations (EC50 and EC90 values) of 1.13 μM and 6.90 μM, respectively (antiviral activity being observed when addition of this drug was carried out before or after viral infection of the cells) [3], we awaited with great interest the clinical data [14]. The subsequent in vivo data were communicated following the first results of clinical trials by Chinese teams [4] and also aroused great enthusiasm among us. They showed that chloroquine could reduce the length of hospital stay and improve the evolution of COVID-19 pneumonia [4,6], leading to recommend the administration of 500 mg of chloroquine twice a day in patients with mild, moderate and severe forms of COVID-19 pneumonia. At such a dosage, a therapeutic concentration of chloroquine might be reached. With our experience on 2000 dosages of hydroxychloroquine during the past 5 years in patients with long-term treatment (>1 year), we know that with a dosage of 600 mg/day we reach a concentration of 1 μg/mL [15]. The optimal dosage for SARS-CoV-2 is an issue that will need to be assessed in the coming days. For us, the activity of hydroxychloroquine on viruses is probably the same as that of chloroquine since the mechanism of action of these two molecules is identical, and we are used to prescribe for long periods hydroxychloroquine, which would be therefore our first choice in the treatment of SARS-CoV-2. For optimal treatment, it may be necessary to administer a loading dose followed by a maintenance dose.

Edited March 14, 2020 by wild_turkey

[Parliament 14352]

My wife's sister sells essential oils on Facebook, and she says they help. I'll get he your contact info.

[Digdogger 1344]

Just now, Parliament said:

My wife's sister sells essential oils on Facebook, and she says they help. I'll get he your contact info.

Send pics too.  For medical purposes

[Newdoc 3455]

I have been looking at the Plaquenil/Zinc data on the original SARS virus and then also recovered Covid patient antibodies from their serum.  If I get really sick for some reason then I'm begging for these two treatments.

 

[EuroHorn 3272]

26 minutes ago, Parliament said:

My wife's sister sells essential oils on Facebook, and she says they help. I'll get he your contact info.

Scentscy?

[BrickHorn 18292]

38 minutes ago, Parliament said:

My wife's sister sells essential oils on Facebook, and she says they help. I'll get he your contact info.

I’ve been huffing one of those Gwyneth Paltrow poon candles for the last week and, as far as I can tell, I haven’t died of coronavirusitis yet.  

[Fuck Tim Beck 3834]

This is starting to mimic the movie Idiocracy. I expect Dr. Chad Briscoe to show up any minute.

[Dnaguy 12128]

16 minutes ago, Fuck Tim Beck said:

This is starting to mimic the movie Idiocracy. I expect Dr. Chad Briscoe to show up any minute.

I think more like this:

 

 

[GRHorn 105]

Everyone should take zinc supplements while this is going on. Little downside. Has demonstrated anti-viral activity. 

Edited March 14, 2020 by GRHorn

[Poe It Up 126]

So I take a daily vitamin that has zinc in it, wouldn’t that sufficient? I remember talking to a doctor a few years back and he made a remark that Americans have the most vitamin rich piss in the world due to lack of absorption. 

[triplehorn 2664]

There were several different news outlets based in the Philippines that reported yesterday on a medication that allegedly is showing promise in helping to overcome severe Sars-Cov-2 infection.  CNNPhilippines article here.

The drug is called Cycloferon.  Abstract from a 2015 Russian article on it:

Abstract

Results of the use of cycloferon, a low molecular weight inducer of interferon production, for the treatment and prevention of influenza and acute respiratory viral infections (ARVI) in adults and children are presented It was shown to reduce symptoms of these diseases and their duration, correct disbalanced activity of the immune system, prevent complications, decrease the frequency of influenza and ARVI. The effectiveness of cycloferon did not depend on etiology of the disease.

 

---> "disbalanced activity of the immune system" sounds like "cytokine storm" we've been hearing about in the severe Covid cases.  We know about 80% of cases of this are mild and then there's a minority, albeit very significant in numbers, that have a very complicated course that can be fatal, or if not fatal result in scarring of the lungs (fibrosis) which is a bodily response.  If Cycloferon targets neutralizing those cases that would otherwise run amok, that would make sense as an intervention.

If there's some validity to this, any validity at all, it would certainly be welcome news.

Edited March 14, 2020 by triplehorn

[GRHorn 105]

More chloroquine discussion 

https://docs.google.com/document/d/e/2PACX-1vTi-g18ftNZUMRAj2SwRPodtscFio7bJ7GdNgbJAGbdfF67WuRJB3ZsidgpidB2eocFHAVjIL-7deJ7/pub

 

[triplehorn 2664]

on it.  I'm taking it daily though for presumptive active sars-cov-2 infection.

 

[Js1 85634]

1 hour ago, Dnaguy said:

I think more like this:

 

 

One of the more horrific yet hilarious things on tv in the past week. Excluding our game against Ok State

[GRHorn 105]

Interesting podcast here with Italian Er doc interview. Fascinating how they’ve had to change their processes, but in the end, they’re getting it done. 

 

[aggie08 21561]

My wife is in biotech, and basically says we're fucked.

In my best dumbass, Neanderthal attempt at translation: it's a complex test with a lot of moving parts, delicate collection, and strict temperature requirements that requires a high level of technical proficiency. The small labs are inadequate to keep up with the demand. Currently there are 78 labs only processing 1000 tests a day. Even then, they need enough positive and negative tests to create a solid "baseline" to verify positive tests. Larger labs are working to create that validation to share, but it may take 6-12 weeks. Many labs are saying "F it" and developing their own tests.

[crimsonlonghorn 2310]

Question about tests for you medical guys.

Is this test similar to others where they test for the presence of antibodies?

Specifically, if that is the case, if someone is “asymptotic”, how do we know that they are actually currently “infected” or is all we really know Is that they were exposed to the virus previously and now they are immune for lack of a better term?
 

In other words, what is the difference between being asymptomatic and being immune?

 

[LTtxfan 49378]

Thx for finding this @DalTxHornFan 

 

[TwiceHorn 31619]

Testing thread here. 

Answers some of these questions.

 

[triplehorn 2664]

1 hour ago, crimsonlonghorn said:

Question about tests for you medical guys.

Is this test similar to others where they test for the presence of antibodies?

Specifically, if that is the case, if someone is “asymptotic”, how do we know that they are actually currently “infected” or is all we really know Is that they were exposed to the virus previously and now they are immune for lack of a better term?
 

In other words, what is the difference between being asymptomatic and being immune?

 

Symptoms are created by the body as a product of response to an infection.  Different people's bodies can produce different symptoms to the same bug, which can be pretty specific or range greatly in some cases like we're seeing with Covid, and can include minimal or no perceivable symptoms of infection.  However an actual test can prove the bug is present using a microscope, or in the case of Covid, spotting its genetic material with a test from a swab of your nose, throat, sputum, or as it turns out stool.

Being immune is when the infection is over, symptoms are gone, and the immune system retains a lasting memory of that initial infection.  You won't visibly find the bug or readily find its genetic material in a sample.  

You can test blood at any time and look for the presence or absence of immune memory in the form of antibodies which can indicate if you have been exposed to a bug or not, even if you have no recollection of ever having had symptoms.  

 

[triplehorn 2664]

Another write-up: Of chloroquine and COVID-19

Basically it says we need to see the Chinese data to substantiate their reports.  It should be noted however that SoKo and Italy both have also employed chloroquine in their management, so the power of clinical observation is motivating their treatment right now.

Two days ago I started taking a prescription of chloroquine for off-label use of a presumed active Covid infection from an understanding physician.  I don't have signs of progression to pneumonia so far - the biggest fear - and I feel better today than I did the last 3 days when it was mildly harder to breathe.  The risks of lung involvement seem a lot worse than any side effects of of chloroquine.  No idea if its related to any changes in how I feel but grateful its not worse right now

 

[triplehorn 2664]

I post this relating to the tinyurl links in the middle.  Good quick reads in each one.  The larger thread that Sinclair made is also interesting.  Sinclair is probably best known for his work on the molecular biology of aging.

From that 'therapies' one: 

"Drugs are possibly effective for 2019-nCoV include: remdesivir, lopinavir / ritonavir, lopinavir / ritonavir combined with interferon-β, convalescent plasma, and monoclonal antibodies. "

 

Edited March 15, 2020 by triplehorn

[wild_turkey 3187]

15 hours ago, triplehorn said:

Two days ago I started taking a prescription of chloroquine for off-label use of a presumed active Covid infection from an understanding physician.  I don't have signs of progression to pneumonia so far - the biggest fear - and I feel better today than I did the last 3 days when it was mildly harder to breathe.  The risks of lung involvement seem a lot worse than any side effects of of chloroquine.  No idea if its related to any changes in how I feel but grateful its not worse right now

Obviously you are doing this under the direction of a physician, but I want to point out for everyone else that chloroquine does have side effects of cardiomyopathy and retinal toxicity. It probably goes without saying, but no one should attempt to obtain these medicines or any other potential COVID-19 treatments except through their physician. The benefit here is still unclear with limited published data and a lot left to learn.

[GRHorn 105]

It will be very interesting to see in a year or so how many people actually have +IgG for Covid-19. I guess that is when we’ll have the true denominator here. 

[triplehorn 2664]

56 minutes ago, wild_turkey said:

Obviously you are doing this under the direction of a physician, but I want to point out for everyone else that chloroquine does have side effects of cardiomyopathy and retinal toxicity. It probably goes without saying, but no one should attempt to obtain these medicines or any other potential COVID-19 treatments except through their physician. The benefit here is still unclear with limited published data and a lot left to learn.

Correct.  It's a potential risk vs potential benefit decision.  Since the chloroquine exposure should be brief  (5-10 days tops), that should help reduce the risk of side effects vs longer term use.  Chloroquine has been around a long time and from I gather has been taken by tens of millions of people.  If the incidence of dangerous side effects were particularly substantial, healthy people wouldn't be taking it for prophylaxis against parasites all these years.  There's obvious contraindications related to cardiac condition and combining with other meds that could disrupt your heart rhythm.  Getting the sign-off by your physician first is important.  I presented mine with emerging medical publications, albeit absent controlled studies, and they understood and supported having a small amount on hand, with a hope to be able to discard it later without use.  I just planned on holding it in the event I contracted coronavirus.  We're neighbors with WA and Portland metro was one of the top 3-5 hot spots in the US even two weeks ago.  67% of the state's cases are within a 15-20 min drive of me in three directions.  Felt like invasion of the body snatchers the last two weeks because I understood what was already present.  My breathing symptoms are in a holding pattern and been obvious for 4 days now.  It feels like it could get worse but it hasn't yet.  I do think I'm going to be ok from whatever this is (not able to get tested for confirmation).  fwiw Ive never had pneumonia, dont smoke and can't remember the last time I had anything resembling chest involvement with any bug.  Chloroquine with zinc may not be doing anything, just don't know.  I'd start taking some zinc alone in advance regardless.

[Walden Ponderer 12639]

More cytokine storm discussion. Sounds like we should still home treat, but maybe see the Dr. sooner than previously thought: get the immune system stuff under control at the first hint of pneumonia:

Quote

https://m.facebook.com/story.php?story_fbid=10100158460994977&id=28600081 

 

[triplehorn 2664]

19 minutes ago, Walden Ponderer said:

More cytokine storm discussion. Sounds like we should still home treat, but maybe see the Dr. sooner than previously thought: get the immune system stuff under control at the first hint of pneumonia:

 

^^^^ hugely important.  This is how we keep people from getting on vents, dying, or even surviving but with lasting lung damage during this pandemic.

[pacman 7375]

On 3/14/2020 at 4:17 PM, GRHorn said:

Everyone should take zinc supplements while this is going on. Little downside. Has demonstrated anti-viral activity. 

Well, specific to covid-19, zinc has no mechanism to penetrate the cell without chloroquine to essentially escort it into the cell. Correct?

Further, US doesn't regulate supplements much so hard to say what is included in your zinc supplement and if it has any capability to be successful.

Edited March 15, 2020 by pacman

[triplehorn 2664]

9 minutes ago, pacman said:

Well, specific to covid-19, zinc has no mechanism to penetrate the cell without chloroquine to essentially escort it into the cell. Correct?

Further, US doesn't regulate supplements much so hard to say what is included in your zinc supplement and if it has any capability to be successful.

Boosting your zinc will have an effect of increasing intracellular zinc, just not 1:1 equillibrium.  Chloroquine in one study I saw referenced carries zinc across cell membrane to increase it about x10.  It sounds like if a person takes chloroquine alone, the extracellular zinc that is already normally present without supplement might be enough to boost intracellular levels for a clinical benefit, but I don't know.

also, the devastating immune response setting in 5-6 days after fever breaks is scary as hell.  I'm day1-2 since last chills/sweats.  Got my pcp on speed dial for that -umab if I go down.

[TwiceHorn 31619]

Good luck finding any zinc.  That's one semi-intelligent thing the rubes have bought out.

[Walden Ponderer 12639]

I haven't checked lately, but LifeExtension.com sells zinc. I get multivitamins and Omega-3 from them, but I occasionally refill on other miscellaneous OTC pills.

Their follow up mailings and marketing materials are irritating, but paper can be recycled.

[Anastasis 23473]

I only have 50 rapid dissolve zinc tablets for a family of 5. 

[triplehorn 2664]

We're going to be hearing contradictory information and assertions that ultimately will be found to not be valid.  So don't take anything to the bank.

The comments to this contain some compelling thoughts:

 

 

Sinclair again with more on Chloroquine and Covid-19 (mixed/contradictory).  Also interesting info in the comments:

The comment about Cloroquine being most effective in the early initial stages of Covid-19 infection caught my attention.  It intuitively makes sense.  If you can slow or disrupt the early viral replication, you give your own defenses a chance to really hobble it at the inception.  Once complications form later, or the size of the infection becomes too large, chloroquine may not hurt and might still offer some help, but simply not be able to tip the scales nearly as much.  Again still some clinical advocates speaking up.  Also a French Chloroquine trial underway per comments.

 

Edited March 16, 2020 by triplehorn

[Hmmm 155]

steroids as a "definite no" seems like an absolute statement.  i think the first 11 cases in IL were all women, though I could be absolutely wrong.  i'm simply throwing shit at a wall to see if it sticks, and also, would like some DHT.  also, DHT is the best form of medicine (this is probably the most inaccurate term) to prevent aging.  if anyone has samples and is looking for a willing participant, PM ME.

another also, it is my understanding that DHT can only be obtained be dead people.  and their sperm that still resides.  so, the cycle of life can be put to use here?

Edited March 16, 2020 by Hmmm

[triplehorn 2664]

I think they mean immunosuppressive steroids.

[triplehorn 2664]

Related to the tweet just above about a possible association between NSAIDS and young patients w Covid-19 who need ICU level of care, I wonder how much that affects older patients who seem so vulnerable?  I’d think on average more older folks would be taking aspirin, ibuprofen, naproxen etc. for general aches and pains from aging joints, not to mention aspirin for vascular protective purposes.   
 

NSAIDS May cause upregulation of ACE2 cell surface receptors ?  That’s like making a can’t miss rapid hit target for a virus, and lots of targets for lots of viruses all at once - potentially a dangerous accelerant for the infection from the start.

i have an allergy to NSAIDS, so maybe it cuts both ways for once.

 

Edited March 16, 2020 by triplehorn

[Newdoc 3455]

6 hours ago, triplehorn said:

It intuitively makes sense.  If you can slow or disrupt the early viral replication,

This does make sense. Maybe in the same way a neuraminidase inhibitor works on influenza to halt replication or nucleoside analogs to halt herpes replication.  If you have significant replication already then the zinc/hydroxychloroquine may not be beneficial. I have also read about corticosteroids not being effective. 

[triplehorn 2664]

This appears on PubMed re Chloroquine for Covid-19

Quote

Zhonghua Jie He He Hu Xi Za Zhi. 2020 Mar 12;43(3):185-188. doi: 10.3760/cma.j.issn.1001-0939.2020.03.009.
[Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia].


[Article in Chinese; Abstract available in Chinese from the publisher]

multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia.

Abstract

in English, Chinese
At the end of December 2019, a novel coronavirus (COVID-19) caused an outbreak in Wuhan, and has quickly spread to all provinces in China and 26 other countries around the world, leading to a serious situation for epidemic prevention. So far, there is still no specific medicine. Previous studies have shown that chloroquine phosphate (chloroquine) had a wide range of antiviral effects, including anti-coronavirus. Here we found that treating the patients diagnosed as novel coronavirus pneumonia with chloroquine might improve the success rate of treatment, shorten hospital stay and improve patient outcome. In order to guide and regulate the use of chloroquine in patients with novel coronavirus pneumonia, the multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia developed this expert consensus after extensive discussion. It recommended chloroquine phosphate tablet, 500mg twice per day for 10 days for patients diagnosed as mild, moderate and severe cases of novel coronavirus pneumonia and without contraindications to chloroquine.



KEYWORDS:

Chloroquine; Novel coronavirus pneumonia


PMID:32164085DOI:10.3760/cma.j.issn.1001-0939.2020.03.009
 

 

[triplehorn 2664]

I don't like posting unofficial medical related stuff, but the NSAIDS/Covid-19 worsened course to complications association seems to be getting some traction.  If you don't need to take them and are facing exposure (basically all of us) seems reasonable to consider avoiding them right now:

 

 

Edited March 16, 2020 by triplehorn

[wild_turkey 3187]

49 minutes ago, triplehorn said:

I don't like posting unofficial medical related stuff, but the NSAIDS/Covid-19 worsened course to complications association seems to be getting some traction.  If you don't need to take them and are facing exposure (basically all of us) seems reasonable to consider avoiding them right now:

Thanks for posting all the info on NSAIDs today. I unfortunately took 2 ibuprofen this morning but from this point forward I'm gonna tolerate a little muscle soreness and avoid NSAIDs, at least until we know more.

[Dutch 4488]

15 hours ago, Anastasis said:

I only have 50 rapid dissolve zinc tablets for a family of 5. 

Try GNC; as of today, they're still selling Zinc (a "100-day supply" bottle of 30mg/serving) online as of this morning.

Edited March 16, 2020 by Dutch

[The Dog 44171]

Just a total wild assed guess but it could be that NSAIDs lower fever and you want to run a fever to kill off the virus (as long as it's not super high like 103+). Right? 

I'm no doctor though. 

[triplehorn 2664]

16 minutes ago, The Dog said:

Just a total wild assed guess but it could be that NSAIDs lower fever and you want to run a fever to kill off the virus (as long as it's not super high like 103+). Right? 

I'm no doctor though. 

Yeah, it's only an initially observed association without any established cause and effect.  But the world is adjusting on the fly right now.  These kinds of timely initial observations can later prove to be extremely important.  With cases over 65y/o, there are probably multiple contributing risk factors for bad complications/outcomes.  Since risk factors are comparatively limited for young people, for this NSAID association to jump out in young people, it might be sharply narrowing the focus.  It very well could be that not taking NSAIDS has a similar risk reducing effect for 65+ y/o though other risk factors may not be so easily overcome.  For the immediate short term, I'd pass it along to avoid all NSAIDS unless a prescribing physician tells you the risks of not taking them outweigh the unknowns.

 

Edited March 16, 2020 by triplehorn

[Walden Ponderer 12639]

Well, fucking hell. For years and years, aspirin has been my preferred OTC of choice because it just plain works better for aches, pains, fevers, etc. for me. Tylenol doesn't do diddly squat unless I take more than I should, which I instinctively know not to do.

I've got a feeling if I get the snaky-sneezies, any fever reduction I'm going to be doing is going to take the form of ice-baths, because a fever over 103°F ain't gonna be kicked by Tylenol. My body just doesn't respond to the stuff for whatever reason.

[triplehorn 2664]

this would we most welcome if true:

 

 

[wild_turkey 3187]

For anyone who missed it, the first vaccine injections took place yesterday. Vaccine is produced by Moderna and will be a trial of 45 young healthy patients with the goal of determining safety. There are 3 different doses of the vaccine that will be given to 15 patients each.

https://www.nytimes.com/2020/03/16/health/coronavirus-vaccine.html

The first testing in humans of an experimental vaccine for the new coronavirus began on Monday, the National Institute of Allergy and Infectious Diseases announced.

The main goal of this first set of tests is to find out if the  vaccine is safe. If it is, later studies will determine how well it works.

The trial was “launched in record speed,” Dr. Anthony Fauci, the institute’s director, said in a statement.

Such rapid development of a potential vaccine is unprecedented, and it was possible because researchers were able to use what they already knew about related coronaviruses that had caused other diseases outbreaks, SARS and MERS.

Despite the rapid progress, even if the vaccine is proved safe and effective against the virus, it will not be available for at least a year.

The tests, which are being conducted at Kaiser Permanente Washington Health Research Institute in Seattle, use a vaccine made by Moderna Inc.

Seattle was chosen as a test site before the United States had any known coronavirus cases, not because of the outbreak that erupted there. Washington State has been hard hit by the virus, with more than 670 cases to date.

Moderna uses genetic material — messenger RNA — to make vaccines, and the company has nine others in various stages of development, including several for viruses that cause respiratory illnesses. But no vaccine made with this technology has yet reached the market.

The infectious disease institute has been working with Moderna because the RNA approach can produce vaccine very quickly, said Dr. Barney Graham, the deputy director of the institute’s Vaccine Research Center.

He said the researchers at the vaccine center were focused on pandemic preparedness.

“The goal here is to be ready for all the virus families that can infect humans,” he said.

As bad as this epidemic is, Dr. Graham said, in one way it is lucky that a coronavirus caused it, because the researchers were at least partly ready for it. If another type of virus had caused the outbreak, it could have taken months longer to create a potential vaccine.

Other companies, using different approaches, are also trying to manufacture coronavirus vaccines. Moderna is the first to reach a clinical trial.

The trial will enroll 45 healthy adults ages 18 to 55. Each will receive two shots, 28 days apart. Moderna calls the vaccine mRNA-1273.

Three different doses will be tested — each in 15 people — and the participants will be studied to determine whether the vaccine is safe and whether it stimulates the immune system to make antibodies that can stop the virus from replicating and prevent the illness it causes.

Four participants were vaccinated on Monday, and four more are to get shots on Tuesday. Then there will be a pause to monitor them, before more participants receive injections, Dr. Graham said.

The participants will be followed for a year, but Stéphane Bancel, the chief executive of Moderna, said in an interview that safety data would be available a few weeks after the injections were given. If the vaccine then appears safe, he said, Moderna will ask the Food and Drug Administration for permission to move ahead to the next phase of testing even before the first stage is finished.

The second round of testing, to measure efficacy as well as to verify safety, will include many more participants.

Moderna, with headquarters in Cambridge, Mass., and a manufacturing plant in nearby Norwood, is already buying new equipment so that it will able to produce millions of doses. Mr. Bancel acknowledged that the company was taking a risk, because neither safety nor efficacy has been proved yet.

“Humans are suffering and time is of the essence,” he said. “Every day matters. We have taken these decisions to take the risk, because we believe it is the right thing to do.”

The company’s stock price jumped in February in response to news reports about the vaccine. And on Monday, Moderna’s stock rose more than 24 percent, rising $5.19 to close at $26.49.

Work on the vaccine started in January, as soon as Chinese scientists posted the genetic sequence of the new coronavirus on the internet. Researchers at Moderna and the National Institute of Allergy and Infectious Diseases identified part of the sequence that codes for a spike-like protein on the surface of the virus that attaches to human cells, helping the virus to invade them.

A nonprofit group, the Coalition for Epidemic Preparedness Innovations, helped pay to manufacture the vaccine for the trial.

That spike sequence is the basis for the vaccine. Moderna does not need the virus itself to produce its vaccine: The company synthesizes the stretch of RNA required for the vaccine and embeds it in a lipid nanoparticle.

By Feb. 24, Moderna had a batch of vaccine ready to ship to the infectious diseases institute, for use in the trial. On March 4, the Food and Drug Administration gave permission for the trial to begin.

[Bruno Sardine 147]

22 hours ago, Dutch said:

Try GNC; as of today, they're still selling Zinc (a "100-day supply" bottle of 30mg/serving) online as of this morning.

At some point when people were discussing this previously, the claim was made that zinc is only beneficial in lozenge form – that its palliative properties derive from the interaction between the zinc and the lining of the throat. In other words, zinc in pill form is ineffective against viruses. 

Would anyone in the know have an opinion? 

[SydneyCarton 48222]

22 hours ago, The Dog said:

Just a total wild assed guess but it could be that NSAIDs lower fever and you want to run a fever to kill off the virus (as long as it's not super high like 103+). Right? 

I'm no doctor though. 

Well, neither is Triplehorn, so I'm not sure I'd take his advice seriously either.

[GRHorn 105]

On 3/15/2020 at 4:57 PM, triplehorn said:

^^^^ hugely important.  This is how we keep people from getting on vents, dying, or even surviving but with lasting lung damage during this pandemic.

The link is gone but I’m curious how they think “cytokine storm” can be modulated in the case of this virus. It’s just another name or iteration of SIRS. People’s immune systems react differently to infections. We don’t exactly know why some people get just sick, and some people go into shock and multi organ failure. This virus is rough because you can’t treat the underlying infection like you can a bacterial infection to get out of the woods.