PlagueWatch 2020-23 - Coronavirus

[sagegrouse]

I don't know if anyone has already linked this information on this thread, but I would highly recommend that everyone read it:

https://www.yahoo.com/news/why-nobel...210318391.html

The article is a fascinating and intriguing account of the progress of the pandemic based on data from China and elsewhere. Actually, it's quite hopeful..

[camion]

The article is a fascinating and intriguing account of the progress of the pandemic based on data from China and elsewhere. Actually, it's quite hopeful..

Interesting. He did say that social distancing is vital to slow the spread. China practiced that with a vengeance.

[SavDukeGrad]

https://www.nytimes.com/2020/03/20/o...sultPosition=1

Excellent opinion piece from a doc at Bellvue.
I'm not sure you can access the site.

Here are the last couple of paragraphs edited: (I don't think this defies the copyright rules, correct me if I'm wrong)


Next month is the 65th anniversary of Jonas Salk’s announcement that his polio vaccine trial was successful, news that was greeted with almost the same depth of emotion as the end of World War II. Albert Sabin’s oral polio vaccine followed in 1961. I wonder how cavalier my vaccine-resistant patients will be if and when a coronavirus vaccine becomes available.

If nothing else, the outbreak gives us a taste of the bone-deep fears our grandparents wrestled with, as well as an appreciation of their profound reverence for science and facts. It shouldn’t escape our recollection that Dr. Sabin was an immigrant and Dr. Salk the son of an immigrant, and that both were effectively barred from many medical schools because they were Jews. If New York University had employed a quota system in the 1930s like Cornell, Yale, Columbia and Harvard, the story of polio might have played out quite differently.

The epilogues of polio, Ebola, H.I.V. and measles — all, alas, still in progress — remind us that public health is an ongoing, never-let-’em-up-from-the-mat effort.

Narrow vision, data ignorance, image-conscious decision-making and truncated memory are the very elements of contagion. No amount of Purell can sanitize that.

Thank you so much for linking this article. My father was a physician who went to medical school and trained at NYU and Bellevue in the 30’s. Dr. Sabin was a few years older than he was, and Dr. Salk was a few years younger I believe. But he knew both of them, especially Dr. Sabin, who was his roommate for 2 years. I grew up listening to his stories about living in NYC in the 30’s, and the practice of medicine before antibiotics etc. Fascinating stuff.

And thank you to all the doctors and health professionals on this board, who are on the front lines of this fight every day.

[kshepinthehouse]

Italy had less deaths yesterday than the day before. Is it too early to say this is good news?

[golfinesquire]

Italy had less deaths yesterday than the day before. Is it too early to say this is good news?

According to a doctor I know, there is a suspicion that the death rare is so high in Italy because they are ascribing all deaths by natural causes to the virus.

[bundabergdevil]

The article is a fascinating and intriguing account of the progress of the pandemic based on data from China and elsewhere. Actually, it's quite hopeful..

Interesting. He did say that social distancing is vital to slow the spread. China practiced that with a vengeance.

I don't know if anyone has already linked this information on this thread, but I would highly recommend that everyone read it:

https://www.yahoo.com/news/why-nobel...210318391.html

I laughed out loud multiple times reading that article, including at the below in below. You mean he calculated the growth rate and whether it's increasing or decreasing?!?! What a stunning and novel approach! We should alert health officials and see if such thinking is useful for their curves! Give that man another Nobel!

There wasn't really any new ground in the article. You either think public officials are over-reacting or you don't. He thinks they are over-reacting even while acknowledging all the measures they are taking are necessary. So...?

"He analyzed 78 countries with more than 50 reported cases of COVID-19 every day and sees "signs of recovery." He's not looking at cumulative cases, but the number of new cases every day — and the percentage growth in that number from one day to the next."

[golfinesquire]

According to a doctor I know, there is a suspicion that the death rare is so high in Italy because they are subscribing all deaths by natural causes to the virus.

sorry. ascribing. i could not find a way to edit the post.

[BD80]

According to a doctor I know, there is a suspicion that the death rare is so high in Italy because they are subscribing all deaths by natural causes to the virus.

sorry. ascribing. i could not find a way to edit the post.

Sounds like Vito Corleone: subscribing deaths. That would skew the stats a bit.

[budwom]

I'll certainly defer to rsvman WRT his amazing virology knowledge and experience, but I'd think exposure to some of the more common coronaviruses would confer varying degrees of immunity to other coronavirus infections, but, with COVID-19 being a new mutation (if I understand somewhat correctly), that serious/critical illnesses and death rates are somewhat based on increased age and/or high risk factors and possibly (probably?) and limited prior exposures.

My personal analogy would be my annual hospital privilege-required influenza vaccines (note: I am NOT comparing COVID-19 to influenza). For the last 20ish years, I've received the vaccines and have had years when I've had "common colds" but no influenza-like illnesses. Other years, I've experienced 12-48 hours of varying degrees of cough, congestion, fever, myalgias and arthralgias and have "cursed" the vaccine as I felt lousy for a brief period, but realized I could have been a *lot* sicker had I not taken the vaccine. I think I've missed two half days of work in that time for an influenza infection, fortunately never having been more than minimally to mildly symptomatic.

speaking of various comparisons with the flu: as we all wait for a vaccine for Covid-19, isn't it possible that the virus will mutate (as the flu does) which MAY or may not require a new vaccine every year? Of course subsequent mutations, if they occur, could prove to be less serious...

[kshepinthehouse]

speaking of various comparisons with the flu: as we all wait for a vaccine for Covid-19, isn't it possible that the virus will mutate (as the flu does) which MAY or may not require a new vaccine every year? Of course subsequent mutations, if they occur, could prove to be less serious...

It apparently already is mutating.

[camion]

Just a reminder, keep your phone safe when you are out and about. Use protection.

The cell phone condom:
cellphone-condom_sm.jpg

[golfinesquire]

Sounds like Vito Corleone: subscribing deaths. That would skew the stats a bit.

I always wanted to be the head of a massive criminal organization.

[MChambers]

If a spate of senators test positive, what are they going to do about some of these votes? This could be a pretty big problem if several key senators can't be in the negotiations or there to vote. They would almost certainly have to start doing some of this via video-conferencing.

Here's an interesting, but dismaying, article from the Post about the potential continuity of Congress issues, which have been ignored by some key members of Congress, sadly.

https://www.washingtonpost.com/opini...y-were-warned/

[Devilwin]

Interesting. He did say that social distancing is vital to slow the spread. China practiced that with a vengeance.

Heard in some cases the Chinese were welding apartments shut with folks inside. Now that's with a vengeance!

[PackMan97]

Heard in some cases the Chinese were welding apartments shut with folks inside. Now that's with a vengeance!

Not true. Just welding the back door and first floor windows shut. Folks could leave via the front door which was monitored by the military.

[Jeffrey]

I need to get a dental bridge impression (scheduled for Thursday) and then a dental bridge installation. Would you get dental work at this time? Not sure how long my temporaries would last, but I’m guessing a few months.

[rsvman]

speaking of various comparisons with the flu: as we all wait for a vaccine for Covid-19, isn't it possible that the virus will mutate (as the flu does) which MAY or may not require a new vaccine every year? Of course subsequent mutations, if they occur, could prove to be less serious...

What follows is a "more than you want to know" about mutation/evolution of RNA respiratory viruses (not for the faint; forewarned is forearmed).

I. All RNA viruses "drift."
Drift is a term that refers to the fact that when RNA-dependent RNA polymerases attempt to replicate a genome, they make mistakes. The rate of such mistakes is predictable. RNA-dependent RNA polymerases have no editing function; that is to say, when they make a mistake, they leave it alone (by way of contrast, DNA polymerases make errors, too, but then they go back and meticulously fix every mistake as best they can). Think of DNA polymerases are a bit obsessive-compulsive, and RNA polymerases as, say, Beavis and Butthead working at the local burger joint.

Interestingly, although all RNA viruses drift, actual change in circulating viruses only occurs when such errors lead to a competitive advantage. Because infection with RSV leads to virtually no protection against reinfection, drifting doesn't help RSV much, if at all; therefore, comparing the genome of RSV that circulated 15 years ago with that circulating today we find they are essentially identical. In contrast, because infection with a specific influenza virus tends to provide more lasting protection, some of these errors lead to a competitive advantage for the nascent influenza virus, and the drifted strain takes over. That is the reason for repeated vaccination against flu.

2. Influenza virus "shifts."
The influenza virus genome is segmented. There are 8 genome segments. If two different influenza viruses infect the same cell at the same time, the segments can be "mixed and matched." In other words, each new virus needs to have one each of segments "one" through "eight," but they aren't particular about getting all those segments from the same place. Think of the virus as a truck and the genome as its payload. Each truck has to have 8 gene segments, and there can't be two of them that are, for example, number four, but otherwise there are no restrictions. So, it would be as though you hired day-laboring stevedores to load up the trucks, and they just toss one through eight as fast as they can into the truck bed and then send the truck on its way.

Through this process, brand new viruses can be instantaneously produced, which is the reason that influenza is the virus we have always talked about with regard to pandemic potential. Pandemics occur when there is no pre-existing immunity in the population. Because shift can produce an entirely new virus, pandemics can be produced via shift.

Note that influenza virus is the only respiratory virus that has a segmented genome; thus, shift cannot occur in any of the other respiratory viruses.

3. Coronaviruses also have unique ways of mutating
Like all RNA viruses, coronaviruses can drift. Since their genome is not segmented, they cannot shift. However, they have there own unique ways of mutating. In addition to drifting, coronaviruses have two other ways of mutating:
i) deletion mutation. The virus is able to omit up to 200 amino acids in the hypervariable region of the S protein, which can significantly alter binding. Some of these deletion mutants are probably at a survival disadvantage, but once in a while a random deletion mutation will provide a survival advantage.
ii) RNA recombination. This method is unique to coronaviruses; it is secondary to a method of RNA synthesis that involves discontinuous transcription and polymerase jumping.

As a result, yes, coronaviruses have significant mutation potential. This probably explains the emergence of the original SARS-CoV back in the early 2000s as well as the emergence of MERS back in 2012, and the emergence of SARS-CoV-2, the cause of the current pandemic.

Note that other coronaviruses have been circulating yearly for decades without causing severe disease. So it appears that drift is likely not a large part of why three much more severe variants have come to light over the past 18 years. With regard to the two different variants that are now circulating, it is not clear whether the second one is a drifted mutant or whether there was either deletion mutation or RNA recombination. Since the disease severity and disease processes are fairly similar, I suspect it was likely due to a small deletion mutation, but I have no solid information either way at this time.

[devildeac]

speaking of various comparisons with the flu: as we all wait for a vaccine for Covid-19, isn't it possible that the virus will mutate (as the flu does) which MAY or may not require a new vaccine every year? Of course subsequent mutations, if they occur, could prove to be less serious...

Deferring to rsvman here, of course, but influenza virus mutation annually is certainly possible (highly likely?) which is why the influenza vaccine is changed/altered/updated annually. So, if/when a COVID-19 vaccine is available, it will very likely have to be modified annually, too. One of the articles I reviewed yesterday suggested mutation/s in COVID-19 were already occurring as it spread from continent to continent. (Sorry, no link here as I've read a lot of articles the last few days. I'll look a bit more.)

Edit:

Found it!

https://medium.com/@tomaspueyo/coron...e-be9337092b56

It's really, really long. Scroll down to Chart 6.

This article/link was sent to me by JStuart, so if you're inclined to handing out sporks, find one of his posts and reward him.

Edit #2:

Just read rsvman's amazing scientific explanation. Thanks!!

[rsvman]

Deferring to rsvman here, of course, but influenza virus mutation annually is certainly possible (highly likely?) which is why the influenza vaccine is changed/altered/updated annually. So, if/when a COVID-19 vaccine is available, it will very likely have to be modified annually, too. One of the articles I reviewed yesterday suggested mutation/s in COVID-19 were already occurring as it spread from continent to continent. (Sorry, no link here as I've read a lot of articles the last few days. I'll look a bit more.)

Edit:

Found it!

https://medium.com/@tomaspueyo/coron...e-be9337092b56

It's really, really long. Scroll down to Chart 6.

This article/link was sent to me by JStuart, so if you're inclined to handing out sporks, find one of his posts and reward him.

For flu virus mutation, see the post just above yours.

[devildeac]

For flu virus mutation, see the post just above yours.

Ha! I just read it and gave you praise for it as I typed my second edit.