COVID-19 medical discussion

[triplehorn 2,664]

On 8/4/2020 at 8:21 AM, GRHorn said:

So the big question that is unanswered is how much this kind of memory T cell immunity (amongst other factors) could lower the threshold for herd immunity? 

 

This along with other factors would contribute to lowering the threshold for herd immunity.  I'm not convinced it's happening everywhere the curves hint at it (other nations in particular), but there is some reason to believe this bug could drop off faster than expected if multiple lines of heterogeneity in our population have an effect, which it certainly should.

[triplehorn 2,664]

FranceSoir interviews the lead investigator of the new large Italian retrospective study (n=3,451) that shows a 30% mortality reduction in hospitalized patients treated with Plaquenil.  

google translation of interview with study leader, Licia Iacoviello , Director of the Center for Epidemiology and Preventive Medicine at the University of Insubrie, Varese, and Director of the Department of Epidemiology and Prevention at IRCCS Neuromed.

Quote

An Italian study carried out on a group of more than 3,000 patients, hospitalized for Covid-19, concluded that "the use of hydroxycholoroquine is associated with a 30% reduction in mortality".

The research mobilized the main Italian hospitals, from north to south, including the " Agostino Gemelli " university polyclinic , where Roberto Cauda is the Director of the Department of Infectious Diseases, " our structure provided data for this retrospective multicenter study, he must be said that the clinical results on the reduction of mortality are consistent and in line with the other hospitals involved, there is a significant difference with the group treated with hydroxychloroquine - and concludes - but it is necessary that by fall a serious meta-analysis on all published studies on hydroxychloroquine be performedCurrently, treatment is still blocked by European health regulatory agencies. To better understand how the research was carried out, we interviewed the study leader, Licia Iacoviello , Director of the Center for Epidemiology and Preventive Medicine at the University of Insubrie, Varese, and Director of the Department of Epidemiology and Prevention at IRCCS Neuromed.

FS: How many patients are affected by your study?

LI: Our study (COVID-19 RISK and CORIST Collaboration Treatments) was carried out on a cohort of 3451 patients admitted to 33 clinical centers across Italy. This is a retrospective observational study.

 

FS: What structures are involved in collecting clinical data on patients?

LI: The study focused on 33 structures, among the most recognized and important in Italy: Gemelli, Humanitas, San Matteo di Pavia, San Donato, San Gerardo di Monza, Spallanzani, Cotugno di Napoli, Miulli di Acquaviva delle Fonti, Monzino . University of Napoli Federico II, Catania, Palermo, Cagliari, Chieti.

FS: It's a study involving Italian hospital structures, from North to South. What conclusions did you reach?

LI: We have seen a 30% decrease in the risk of death in patients receiving hydroxychloroquine. The inverse association of hydroxychloroquine with in-hospital mortality was particularly evident in patients with elevated C-reactive protein upon entry.

 

FS: What do you mean by “they had a high level of C-reactive protein on entry”?

LI: C-reactive protein is a marker of inflammation. Having a high level of C-reactive protein when entering the hospital means that the Sars-Covid II infection has caused a significant inflammatory response. We believe that HCQ acts on this very component of the disease rather than inhibiting viral replication.

FS: What were the mortality rates in the hydroxychloroquine and control groups?

LI: The mortality rate of patients receiving hydroxychloroquine was 8.9 / 1000 patients / day, the mortality rate of those not receiving hydroxychloroquine was 15.7 / 1000 patients / day. Treatment was started on the first day of admission in most clinical centers, at a dose of 400 mg once a day, for an average duration of 10 days. 76% of patients were on HCQ treatment .

FS: Did the drug have statistically significant side effects?

LI: Our study did not collect information on adverse effects. However, the studies already published by the different centers participating in our study did not show significant cardiovascular clinical events, although there was an increase in the ECG QT. (sources: https://linkinghub.elsevier.com/retrieve/pii/S0167527320322233 and https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.048476 )

 

FS: Is the prolongation of the heart rate (QT) seen on the electrocardiogram a serious adverse event or can it vary in magnitude?

LI: Exposure to a drug capable of inducing QT prolongation does not always lead to delayed ventricular repolarization and the development of serious complications in patients with long acquired QT interval appears be a rare occurrence.

FS: Are there some common medications that we use every day that can prolong the QT interval?

LI: Other commonly used drugs can prolong the QT interval, among the most well-known antipsychotics: like haloperidol, macrolide antibiotics like erythromycin and clarithromycin or quinolones like moxifloxacin.

 

FS: Could hydroxychloroquine have a significant impact on the treatment of Covid19?

LI: Our study is currently being reviewed in the European Journal of Internal Medicine. Its results can make an important contribution to the debate on the use of HCQ in COVID-19.

[In an emergency situation such as a pandemic, the “gold standard” of intervention studies cannot be used and even randomized clinical trials (RCTs) cannot be performed under the best conditions.]

Therefore, all data from both retrospective and RCTs should be considered, provided they are conducted appropriately. We believe that HCQ given early after the diagnosis of Covid-19 at low doses of 400 mg per day can be an effective and safe drug, inexpensive and easy to use, and not just in Italy.

FS: The main European medical agencies have blocked the use of hydroxychloroquine. There are currently many publications that support the efficacy and safety of hydroxychloroquine. What are the prospects for the fall?

LI: Other European studies already published have shown the effectiveness of treatment with HCQ in reducing the risk of mortality. In particular, a study carried out in France on more than 3,100 patients with COVID-19 showed that treatment with HCQ reduced the risk of hospitalization and death. A study conducted in Portugal suggests that the HCQ treatment protects against infection with SarCOV2.

[Today's debate is hampered by the difficulty that positive studies face in getting published.]

In the fall, when these studies are available, we will have a clearer and more balanced picture of the effectiveness of HCQ, which could lead to the reopening of the prescription of the drug in low doses and in special situations.

 

 

Of note: 

FS: What do you mean by “they had a high level of C-reactive protein on entry”?

LI: C-reactive protein is a marker of inflammation. Having a high level of C-reactive protein when entering the hospital means that the Sars-Covid II infection has caused a significant inflammatory response. We believe that HCQ acts on this very component of the disease rather than inhibiting viral replication.

--> After the Yale Med revelations on early immune signatures associated with complicated illness trajectory, last week I suggested it's the anti-inflammatory mechanism of Plaquenil that is most likely reducing mortality and morbidity in Covid, with suspicion that the target is the upstream reduction of inflammasome activation/pyroptosis and associated increased IL-1b and IL-18 secretion which then cascades to late stage complicated immune dysregulation and elevated C-reactive protein among other signs.  Same anti-inflammatory effect that is capitalized by rheumatologists to treat Lupus and RA every day.  It stands to reason it's why treating as early as possible appears to nip it.  Anti-viral replication effects are likely still the same, but would only have a meaningful effect when pre-medicated prophylactically.

[MNLonghornFUKM 8,916]

This along with other factors would contribute to lowering the threshold for herd immunity.  I'm not convinced it's happening everywhere the curves hint at it (other nations in particular), but there is some reason to believe this bug could drop off faster than expected if multiple lines of heterogeneity in our population have an effect, which it certainly should.

So dumb it down for me because I’ve tried to understand the whole tcell thing. a common cold can produce tcells that fight covid? How the hell can so many people be sick from covid all while having to contract the common cold at some point throughout their life?

[Surly Bevo 25,501]

Not all common colds are caused by coronaviruses for starters

[kevwun 15,943]

Many different viruses cause the common cold.  The theory is that some of them can help fight off covid19, but since there are so many, not everyone has had one of those that can help.

Edited August 6, 2020 by kevwun

[Sbbruin 21,912]

6 hours ago, triplehorn said:

FranceSoir interviews the lead investigator of the new large Italian retrospective study (n=3,451) that shows a 30% mortality reduction in hospitalized patients treated with Plaquenil.  

google translation of interview with study leader, Licia Iacoviello , Director of the Center for Epidemiology and Preventive Medicine at the University of Insubrie, Varese, and Director of the Department of Epidemiology and Prevention at IRCCS Neuromed.

 

Of note: 

FS: What do you mean by “they had a high level of C-reactive protein on entry”?

LI: C-reactive protein is a marker of inflammation. Having a high level of C-reactive protein when entering the hospital means that the Sars-Covid II infection has caused a significant inflammatory response. We believe that HCQ acts on this very component of the disease rather than inhibiting viral replication.

--> After the Yale Med revelations on early immune signatures associated with complicated illness trajectory, last week I suggested it's the anti-inflammatory mechanism of Plaquenil that is most likely reducing mortality and morbidity in Covid, with suspicion that the target is the upstream reduction of inflammasome activation/pyroptosis and associated increased IL-1b and IL-18 secretion which then cascades to late stage complicated immune dysregulation and elevated C-reactive protein among other signs.  Same anti-inflammatory effect that is capitalized by rheumatologists to treat Lupus and RA every day.  It stands to reason it's why treating as early as possible appears to nip it.  Anti-viral replication effects are likely still the same, but would only have a meaningful effect when pre-medicated prophylactically.

Interesting.  I am on Remicade for an rheumatological condition called ankylosing spondylitis.  Initially the assumed that the immunosuppressive effects of remicade would put me at high risk.  Now they think, while having a suppressed immune system may create some increased risk, the expectation now is that it would like inhibit the cytokine storms from occurring which tend to take people out.  Still unknown, but that's the thinking according to my rheumatologist. 

[Bevo 13,633]

On 8/4/2020 at 10:36 AM, Bevo said:

I know someone who took care of her niece this past weekend. The niece's mom tested positive on Monday. The woman who I know is getting tested tomorrow at 1:00. She tells me that she will have the results in one day. Considering a PCR test takes almost a day to run, I suspect that she is getting an Ab test. If she tests positive, I assume she will have to quarantine for 14 days after results. If she tests negative, what is the protocol for going back to work?

I found the answer to my questions. According to the CDC, PCR is no longer the standard for deciding when healthcare workers can return to work. This is because there is viral shedding long after the infected person stops being contagious. So the new standard is to wait 10 days after symptoms start before returning to work: Personally, I thought this would be too short and would prefer 10 days after the person recovers, but that isn't what the CDC says.

 

Recommendations

1. Duration of isolation and precautions
   • For most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10 days after symptom onset¹ and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms.
     • A limited number of persons with severe illness may produce replication-competent virus beyond 10 days that may warrant extending duration of isolation and precautions for up to 20 days after symptom onset; consider consultation with infection control experts.
   • For persons who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive RT-PCR test for SARS-CoV-2 RNA.
2. Role of PCR testing² to discontinue isolation or precautions
   • For persons who are severely immunocompromised, a test-based strategy could be considered in consultation with infectious diseases experts.
   • For all others, a test-based strategy is no longer recommended except to discontinue isolation or precautions earlier than would occur under the strategy outlined in Part 1, above.
3. Role of PCR testing² after discontinuation of isolation or precautions
   • For persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery, retesting is not recommended within 3 months after the date of symptom onset for the initial COVID-19 infection.
   • For persons who develop new symptoms consistent with COVID-19 during the 3 months after the date of initial symptom onset, if an alternative etiology cannot be identified by a provider, then the person may warrant retesting; consultation with infectious disease or infection control experts is recommended. Isolation may be considered during this evaluation based on consultation with an infection control expert, especially in the event symptoms develop within 14 days after close contact with an infected person.
   • For persons who never developed symptoms, the date of first positive RT-PCR test for SARS-CoV-2 RNA should be used in place of the date of symptom onset.
4. Role of serologic testing
   • Serologic testing should not be used to establish the presence or absence of SARS-CoV-2 infection or reinfection.

[triplehorn 2,664]

12 minutes ago, Sbbruin said:

Interesting.  I am on Remicade for an rheumatological condition called ankylosing spondylitis.  Initially the assumed that the immunosuppressive effects of remicade would put me at high risk.  Now they think, while having a suppressed immune system may create some increased risk, the expectation now is that it would like inhibit the cytokine storms from occurring which tend to take people out.  Still unknown, but that's the thinking according to my rheumatologist. 

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.

[Sbbruin 21,912]

2 minutes ago, triplehorn said:

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.

See, where else can you get this kind of info, coupled with sports info and a little T&A to boot?  Not many places, I tell you.

[utee94 15,878]

4 hours ago, Sbbruin said:

See, where else can you get this kind of info, coupled with sports info and a little T&A to boot?  Not many places, I tell you.

You'd think, with all that shaggy/surly has provided to you, you'd be a little more empathetic and refrain from the postings of videos, memes, and outcomes, from... those hateful games.  But yet, you persist in trying to hurt us.  Why, oh WHY????? 

[Captainant 27,970]

Haven't seen it posted here yet, but a new study was published on Friday on the efficacy of different face masks and materials for blocking COVID droplets, and provides an cheap and open-source testing methodology

link

The notable finding is that fleece face coverings and the popular neck gator option were measured to actually create more droplets than not wearing a mask at all - that is to say they are worse than wearing a mask.

 

[kevwun 15,943]

I got one of the neck gaiters when we went bay fishing in July.  I had thoughts of using it as a mask, but gave them up when I noticed my chin stubble was poking through the material.

[Blotto 23,679]

19 minutes ago, Captainant said:

Haven't seen it posted here yet, but a new study was published on Friday on the efficacy of different face masks and materials for blocking COVID droplets, and provides an cheap and open-source testing methodology

link

The notable finding is that fleece face coverings and the popular neck gator option were measured to actually create more droplets than not wearing a mask at all - that is to say they are worse than wearing a mask.

 

I bought a box of these at Walgreens, after using a bandana for the first few months. I'd like to think they are what is shown on the chart as "surgical" masks, but doubtful. Regardless its what I'm rolling with now.

https://www.walgreens.com/store/c/walgreens-earloop-style-face-mask/ID=prod6172909-product

 

 

[Captainant 27,970]

2 minutes ago, Blotto said:

I bought a box of these at Walgreens, after using a bandana for the first few months. I'd like to think they are what is shown on the chart as "surgical" masks, but doubtful. Regardless its what I'm rolling with now.

https://www.walgreens.com/store/c/walgreens-earloop-style-face-mask/ID=prod6172909-product

 

 

My dude, you should click more links! Here's the masks they used

Mask #1 was their tested "surgical" mask

 

[Bevo 13,633]

2 minutes ago, Blotto said:

I bought a box of these at Walgreens, after using a bandana for the first few months. I'd like to think they are what is shown on the chart as "surgical" masks, but doubtful. Regardless its what I'm rolling with now.

https://www.walgreens.com/store/c/walgreens-earloop-style-face-mask/ID=prod6172909-product

 

 

They should have a rating on them but I can't find the rating in the description or the box photo.

 

Technical question: After exposure to the virus is there an average length of time before someone becomes contagious? Are people contagious before any symptoms appear? Just curious because initially there was thought to be a long incubation period and I don't know if that is still the current thought. So many of the technical aspects have been a moving target.

 

 

[Blotto 23,679]

6 minutes ago, Captainant said:

My dude, you should click more links! Here's the masks they used

Well it looks pretty close to picture number 1, but then again I got mine at Walgreens, so its probably a "sure"gical mask

Edited August 10, 2020 by Blotto

[Captainant 27,970]

22 minutes ago, Blotto said:

Well it looks pretty close to picture number 1, but then again I got mine at Walgreens, so its probably a "sure"gical mask

Lol, to be honest it seems to be more about the number of layers and the type of material based on the data from this study. The study frequently refers to it as a "commonly available" surgical mask, so as long as it looks good it probably is good, if that makes sense.

A close second to # of layers was fit on your face. If there's gaps between the mask and your nose, that's uh not gonna block much lol. I try to find surgical masks with a plastic piece in the section that goes over the bridge of your nose. You can use your fingers to bend/mash the plastic into the shape of your nose and actually get a pretty decent seal

Edited August 10, 2020 by Captainant

[Bevo 13,633]

17 minutes ago, Blotto said:

Well it looks pretty close to picture number 1, but then again I got mine at Walgreens, so its probably a "sure"gical mask

Yeah, in my office I have different earloop masks with different ratings but you really can't tell them apart by looking at them. They are rated ASTM 1 through ASTM 3. Then I have a different mask that looks different for surgeries during COVID that are N95.

[XYZ 2,154]

Is there still speculation that this virus can be transmitted through aerosols? And if so, how do the different kinds of face coverings fare against aerosols?

[Captainant 27,970]

Just now, XYZ said:

Is there still speculation that this virus can be transmitted through aerosols? And if so, how do the different kinds of face coverings fare against aerosols?

That's basically what the above study tested. Aerosols are droplets, and they tested droplet blocking efficacy. 

TLDR: at least a cotton mask, but a 3 layer surgical is nearly as good as N95, assuming a good fit with no gaps. N95 with a valve will protect you like an N95, but isnt as good for protecting others

[Anastasis 23,498]

Aerosols are very very small droplets suspended in air. WHO initially resisted aerosol airborne transmission as being a significant issue, but have relented recently in the face of more evidence suggesting aerosol transmission is possible.

Wear a mask heathens. 

 

[XYZ 2,154]

So I guess that study referenced above covers droplets big and small.

[Bevo 13,633]

That's basically what the above study tested. Aerosols are droplets, and they tested droplet blocking efficacy. 
TLDR: at least a cotton mask, but a 3 layer surgical is nearly as good as N95, assuming a good fit with no gaps. N95 with a valve will protect you like an N95, but isnt as good for protecting others

It is unlikely that an earloop mask fits well. I pinched mine at the nose and got a haircut and I got hair in my mouth. Even when you think you have a good fit, you probably don’t.

[Anastasis 23,498]

28 minutes ago, XYZ said:

So I guess that study referenced above covers droplets big and small.

Yes, but does not appear they can resolve aerosol droplets.  I don't think this undermines the usefulness of the work in any way, at least not from my perspective.  Wear a mask you heathens. 

Third, the use of a single cell phone camera also limits the achievable size resolution (currently 120 μm/pixel), given the large field of view that is required to image as many droplets as possible. This makes it unfeasible to directly measure the size of small (aerosol) droplets in our setup.

[Captainant 27,970]

4 minutes ago, Anastasis said:

Yes, but does not appear they can resolve aerosol droplets.  I don't think this undermines the usefulness of the work in any way, at least not from my perspective.  Wear a mask you heathens. 

Third, the use of a single cell phone camera also limits the achievable size resolution (currently 120 μm/pixel), given the large field of view that is required to image as many droplets as possible. This makes it unfeasible to directly measure the size of small (aerosol) droplets in our setup.

While their resolution is limited, most coughs and talking aren't producing fine aerosols I'd assume. The supplemental materials have some useful graphs to demonstrate measured particle production that demonstrate the gaiters are measurably producing smaller droplets than the other coverings, in addition to producing a larger volume and longer duration of droplets

 

[bluto 4,947]

Internist Dr. I know started a blog where he offers objective reviews of various studies and internet bs claims. I can't vouch for how strong his analysis is, I'll rely on the actual experts on here for that, but he does a decent job of breaking things down into layman's terms. I can vouch with 100% certainty that his analysis and writings are very much free from political bias or some agenda. 

Here's his latest take, reviewing a recent Brazil study of hcq + azith

https://www.beyondtheabstracts.com/post/journal-club-hydroxychloroquine-and-azithromycin-in-mild-to-moderate-covid-infection

[B00M 6,574]

Anyone know how the Russian vaccine (sputnik V?) works? Did they steal research from the west to produce it or is it an original Russian design? 

[Anastasis 23,498]

16 minutes ago, B00M said:

Anyone know how the Russian vaccine (sputnik V?) works? Did they steal research from the west to produce it or is it an original Russian design? 

The one generating the headlines is an an adenovirus vector vaccine.  It is similar to the Oxford approach, except I think that they use human adenovirus vs monkey adenovirus (I may have that backwards).  I think that there are some potential implications wrt reduced efficacy based on that distinction, but someone more knowledgeable can correct that if it is wrong. Something about prior exposure to human type may result in immune response that prevents the vaccine from doing its job.  From my understanding, their tech was originally developed for ebola.  Again, a very similar approach conceptually to Oxford.  

[Brisketexan 105,569]

28 minutes ago, Anastasis said:

The one generating the headlines is an an adenovirus vector vaccine.  It is similar to the Oxford approach, except I think that they use human adenovirus vs monkey adenovirus (I may have that backwards).  I think that there are some potential implications wrt reduced efficacy based on that distinction, but someone more knowledgeable can correct that if it is wrong. Something about prior exposure to human type may result in immune response that prevents the vaccine from doing its job.  From my understanding, their tech was originally developed for ebola.  Again, a very similar approach conceptually to Oxford.  

I presume it is administered via vodka shots, and all recorded on the dashcam of a drunk Russian trucker.

[Liquor and Poker 3,659]

41 minutes ago, Brisketexan said:

I presume it is administered via vodka shots, and all recorded on the dashcam of a drunk Russian trucker.

Waiting on the vid where the jackknifed 18-wheeler skids and narrowly misses the people administering the vaccine as they blindly jaywalk.

According to NYT, "The Gamaleya Research Institute, part of Russia’s Ministry of Health, launched a Phase I trial in June of a vaccine they call Gam-Covid-Vac Lyo. It is a combination of two adenoviruses, Ad5 and Ad26, both engineered with a coronavirus gene."

One thing I haven't heard about is the likely relative efficacy of all the different vaccine vectors.  There are several different "ways" of making a vaccine out there (mRNA, adenovirus, protein, inactive virus, etc).  Are there any thoughts or guesses on whether one type or the other is more likely to get us to a decent level of protection?  I think I'd rather have a February vaccine that's 70% effective than a December vaccine that's 35% effective. 

EDIT - One more thought - is the Russian "approval" effectively a nationwide version of a Phase III trial?  If so, that's good data for the other companies to mine.

Edited August 11, 2020 by Liquor and Poker

[triplehorn 2,664]

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:

Quote

 

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.  

 

Edited August 11, 2020 by triplehorn

[Liquor and Poker 3,659]

As far as vaccines go, the NYT site provides a good balance of information and understandable English to me:

https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html

Looks like the two "approved" vaccines are adenovirus Ad5 /Ad26 (human).  There are 2 mRNA vaccines, a chimp adenovirus vaccine, and an inactivated virus vaccine in Phase III.

[Longhorn94 2,458]

4 minutes ago, triplehorn said:

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.  

 

That "Dr" is a conservative hack who has a tweet about Mike Pence and hydroxychloroquine pinned. come on man...

[XYZ 2,154]

9 minutes ago, Longhorn94 said:

That "Dr" is a conservative hack who has a tweet about Mike Pence and hydroxychloroquine pinned. come on man...

That sounds like an ad hominem fallacy, kind of.

[triplehorn 2,664]

7 minutes ago, Longhorn94 said:

That "Dr" is a conservative hack who has a tweet about Mike Pence and hydroxychloroquine pinned. come on man...

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.

[Longhorn94 2,458]

3 minutes ago, triplehorn said:

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.

Im not putting the blinders on about anything. But i will absolutely discount the advice of a Dr who is STILL tweeting about the efficacy of hydroxychloroquine, making claims about the overstep of government intervention  with regard to wearing masks, and mixes his medical advice with praise for Mike fucking Pence. No thanks.

[Liquor and Poker 3,659]

4 minutes ago, triplehorn said:

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.

But I would prefer not to count on medical expertise from a guy who pins a tweet on hydroxychloroquine.  Just like if he said "masks are causing COVID" or "We have the lowest fatality rate in the world."  Doesn't mean he's wrong on the T-cell thing, but it does give me pause. 

[Brisketexan 105,569]

3 minutes ago, Liquor and Poker said:

But I would prefer not to count on medical expertise from a guy who pins a tweet on hydroxychloroquine.  Just like if he said "masks are causing COVID" or "We have the lowest fatality rate in the world."  Doesn't mean he's wrong on the T-cell thing, but it does give me pause. 

This.  I think the T cell hypothesis is interesting, and I would hope some legit outfits are looking into it.  But when a complete clown is the one advancing it, in an era of charlatans and insane conspiracy theories, I can't give him much weight.

[Anastasis 23,498]

33 minutes ago, Longhorn94 said:

That "Dr" is a conservative hack who has a tweet about Mike Pence and hydroxychloroquine pinned. come on man...

Why listen to infectious disease clinicians and researchers when the block chain guy who happens to also have a medical degree will suffice. 

[Liquor and Poker 3,659]

Just now, Anastasis said:

Why listen to infectious disease clinicians and researchers when the block chain guy who happens to also have a medical degree will suffice. 

I've gotten to the point that the words "blockchain" and "scam" are synonymous to me.  

[Longhorn94 2,458]

5 minutes ago, Anastasis said:

Why listen to infectious disease clinicians and researchers when the block chain guy who happens to also have a medical degree will suffice. 

well i mean i dont want to put my blinders on because i might miss something that the mainstream media is hiding from everyone for no good reason at all! unless you believe in stupid conspiracy theories that big pharma is lying to all of us about herd immunity (like this Dr is arguing) and the need for a vaccine. hell, we should just re-open everything stat! cause whats the worst that could happen? we all have T-cell immunity at this point, amitrite? i mean this EXPERT DR said so! that will FOR SURE show Pharma and the media! and this Dr is completely unbiased and has no political motivations for stating these "theories."

Edited August 11, 2020 by Longhorn94

[Anastasis 23,498]

1 hour ago, Liquor and Poker said:

EDIT - One more thought - is the Russian "approval" effectively a nationwide version of a Phase III trial?  If so, that's good data for the other companies to mine.

I saw it reported as a "conditional approval", or a limited use authorization.  They are rolling it out in high risk groups (healthcare workers, etc.) and collecting and analyzing the information they gain from the limited roll out.  Looks like something that approaches a real world "pragmatic trial" design to me. My read is that they are using this limited use authorization roll out for propaganda purposes primarily, but also to generate more data in parallel to their more traditional Phase III trial(s).  

[JohnLocke 115]

13 minutes ago, Brisketexan said:

This.  I think the T cell hypothesis is interesting, and I would hope some legit outfits are looking into it.  But when a complete clown is the one advancing it, in an era of charlatans and insane conspiracy theories, I can't give him much weight.

You do realize he is simply summarizing the research of others.  I don't know if what he is saying is true or not, but the t-cell immunity theory does help explain why the pandemic is basically over in Sweden:

 

[Brisketexan 105,569]

3 minutes ago, JohnLocke said:

You do realize he is simply summarizing the research of others.  I don't know if what he is saying is true or not, but the t-cell immunity theory does help explain why the pandemic is basically over in Sweden:

Cool.  Then get me a credible person or outfit to do the work, and to actually apply the scientific method and give us an answer.  Like I said, it seems like a reasonable hypothesis, and I would LOVE it to be true.  I'll wait for someone to apply some credible, rigorous analysis to the hypothesis, and then hopefully it shows a positive result.

[Homercles 10,206]

52 minutes ago, Liquor and Poker said:

But I would prefer not to count on medical expertise from a guy who pins a tweet on hydroxychloroquine.  Just like if he said "masks are causing COVID" or "We have the lowest fatality rate in the world."  Doesn't mean he's wrong on the T-cell thing, but it does give me pause. 

Maybe that guy is Triplehorn?   Finkle is Einhorn?  

[triplehorn 2,664]

12 minutes ago, Brisketexan said:

This.  I think the T cell hypothesis is interesting, and I would hope some legit outfits are looking into it.  But when a complete clown is the one advancing it, in an era of charlatans and insane conspiracy theories, I can't give him much weight.

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.

 

[Rip76 4,986]

https://bgr.com/2020/08/10/coronavirus-update-effect-of-ordinary-water-on-covid-19/
 

Scientists from Russia’s VECTOR State Research Center of Virology and Biotechnology have shared a coronavirus update that purports to include a shockingly easy way to kill particles associated with the COVID-19 virus. Are you ready for this? These scientists say the coronavirus has a newly identified weakness, and it’s … water. Just ordinary, room-temperature water, though boiling water works even better.

[triplehorn 2,664]

44 minutes ago, JohnLocke said:

You do realize he is simply summarizing the research of others.  I don't know if what he is saying is true or not, but the t-cell immunity theory does help explain why the pandemic is basically over in Sweden:

 

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:

 

[triplehorn 2,664]

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:

Quote

The findings also offer new insights that could help in developing a vaccine by looking at T cells which help fight the virus.

^^^ 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.

 

Quote

“If you look at it metaphorically as an army with different levels of defense, the antibodies prevent the virus from getting in. So that’s kind of like the first line of defense,” Fauci explained. “For those viruses that do escape and infect some cells, the T cells come in and kill the cells that are infected or block them.”

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.

[Brisketexan 105,569]

52 minutes ago, triplehorn said:

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.

Man, I gotta say....nobody can turn a bare hypothesis into a hard conclusion like you can.  It's your gift.

I like the hypothesis.  I hope that, after it has been exposed to rigorous examination pursuant to the scientific method, it will become a proven theory.  But right now, it's a hypothesis with enough smoke around it that it merits real analysis.  That's it.

We MIGHT be seeing evidence of herd immunity via T-cell immunity taking hold.....but we don't have nearly enough evidence to say that it's likely.