PlagueWatch 2020-23 - Coronavirus

[cspan37421]

A little clarification regarding Nevada. Gov. Sisolak has still made the drugs able to be prescribed/administered in a hospital setting.

That or a clinical trial makes good sense. Topic was covered by Skeptics Guide to the Universe this week. There are potential serious adverse side effects - physician monitoring/oversight recommended. From what I heard, the evidence is weak and trials poorly controlled, but it's not an unreasonable avenue to pursue. It can have anti-viral properties.

[bedeviled]

A little clarification regarding Nevada. Gov. Sisolak has still made the drugs able to be prescribed/administered in a hospital setting.

Thanks! mea culpa. I think his public relations team might have overlooked the exception in their original statement, lol, but he later issued a clarification and linked the Nevada Board of Pharmacy proposal confirming that they, indeed, intended for an inpatient exception from the beginning.

[sagegrouse]

I think this has already been covered, but couldn't locate the specific post. Here's a note from Duke on testing a treatment for COVID-19. This is probably old news and it's not clear how significant Duke Hospital's role is.

Duke University Hospital has joined the first national study to test a potential therapy for COVID-19. Hospitalized adults with severe symptoms of the novel illness will have the opportunity to participate in the clinical trial. The drug, known as remdesivir, is an antiviral agent that was originally developed as a treatment for Ebola. Duke is set to begin enrolling eligible patients immediately.

And here's an explanation of why it might work (from Chemical and Engineering News):

And researchers point to solid science for why remdesivir might still work against COVID-19.

The SARS-CoV-2 genome is made up of a string of nucleotides that, during replication, are reconstructed, one by one, by the viral polymerase. The RNA-dependent RNA polymerase is a good drug target because it is “almost exclusively associated with the virus,” says University of Wisconsin–Madison virologist Andy Mehle. Polymerase inhibitors will be highly specific for infected cells, sparing healthy ones.

Enter remdesivir, which acts like a mimic for adenosine—one of the nucleotides in that string.

The virus is tricked into incorporating the active form of the drug into its genome, preventing it from making more copies of itself. The mechanism by which remdesivir does that is still unclear, but “polymerase inhibitors primarily work by causing mutations of the genome, or by blocking polymerase function,” Mehle says.

[rsvman]

Chain termination is a very common method of activity of antiviral agents. Simply put, the drug looks like a building block (nucleotide) of the virus genome. As the virus is replicating, it accidentally grabs the drug instead of the next building block, which terminates the chain; no further nucleotides can be added.

Acyclovir and valacyclovir are probably the most commonly used antivirals in the world; they are active against herpes simplex virus. They utilize this exact mechanism of action.

[MChambers]

I think this has already been covered, but couldn't locate the specific post. Here's a note from Duke on testing a treatment for COVID-19. This is probably old news and it's not clear how significant Duke Hospital's role is.



And here's an explanation of why it might work (from Chemical and Engineering News):

Remdesivir apparently wasn't as effective against Ebola as some other treatments, but it worked against MERS in monkeys. Since it's been through testing procedures, it's much ahead of most other treatments.

[devildeac]

Chain termination is a very common method of activity of antiviral agents. Simply put, the drug looks like a building block (nucleotide) of the virus genome. As the virus is replicating, it accidentally grabs the drug instead of the next building block, which terminates the chain; no further nucleotides can be added.

Acyclovir and valacyclovir are probably the most commonly used antivirals in the world; they are active against herpes simplex virus. They utilize this exact mechanism of action.

What's your opinion about other anti-viral agents, specifically the anti-HIV drugs, and their potential usefulness (or uselessness) vs COVID 19? I'd guess the first deterrant might be cost and second might be lack of widespread availability.

(Please don't make me feel too stupid about asking this question as I haven't kept current with viral illnesses, their diagnoses and treatments. )

[rsvman]

The latest information shows virtually no benefit from Kaletra, which is the main HIV drug that was thought to be promising.

[budwom]

The latest information shows virtually no benefit from Kaletra, which is the main HIV drug that was thought to be promising.

Have you seen the Peter Hessler article in The New Yorker in which the observation (and nothing more) was made in China that they were not aware of any Covid transmissions from children to adults? I found that intriguing...might it be true?

[Crisker]

Here is some discouraging but informative news from a CU-Boulder chemistry professor who specializes in aerosol science and is familiar with viruses: the 6 foot rule is not early enough -- he recommends 25 feet.

This may explain why public health authorities are now recommending masks for everyone in public. In the early days of this disaster, I seriously doubted the "no need for a mask" guidance, which I suspect was driven by the need to save masks for health workers.

[BD80]

I think this has already been covered, but couldn't locate the specific post. Here's a note from Duke on testing a treatment for COVID-19. This is probably old news and it's not clear how significant Duke Hospital's role is.



And here's an explanation of why it might work (from Chemical and Engineering News):

And researchers point to solid science for why remdesivir might still work against COVID-19.

The SARS-CoV-2 genome is made up of a string of nucleotides that, during replication, are reconstructed, one by one, by the viral polymerase. The RNA-dependent RNA polymerase is a good drug target because it is “almost exclusively associated with the virus,” says University of Wisconsin–Madison virologist Andy Mehle. Polymerase inhibitors will be highly specific for infected cells, sparing healthy ones.

Enter remdesivir, which acts like a mimic for adenosine—one of the nucleotides in that string.

The virus is tricked into incorporating the active form of the drug into its genome, preventing it from making more copies of itself. The mechanism by which remdesivir does that is still unclear, but “polymerase inhibitors primarily work by causing mutations of the genome, or by blocking polymerase function,” Mehle says.

Is there a chance this can be adapted to cure "carolina fever?"

Of course, another season like this past one might do the trick on its own...

[PackMan97]

Of course, another season like this past one might do the trick on its own...

No, it will just make them think they are a football school instead.

[devildeac]

Is there a chance this can be adapted to cure "carolina fever?"

Of course, another season like this past one might do the trick on its own...

Very likely not as Mack Brown found a temporary cure during his first two seasons there, receiving a Nobel Prize nomination for his efforts:

1988 North Carolina 1–10
1989 North Carolina 1–10

However, the scourge mutated (and cheated) and it has unfortunately recurred in society for the last 30 years and continues to be a public nuisance/danger.

[rsvman]

Here is some discouraging but informative news from a CU-Boulder chemistry professor who specializes in aerosol science and is familiar with viruses: the 6 foot rule is not early enough -- he recommends 25 feet.

This may explain why public health authorities are now recommending masks for everyone in public. In the early days of this disaster, I seriously doubted the "no need for a mask" guidance, which I suspect was driven by the need to save masks for health workers.

Saw the article. A bit dubious, in my opinion.

Sure, a sneeze can travel farther than 6 feet (Mythbusters managed, IIRC, 37 feet or so?). That's not really the issue, though. The issue is whether the virus can be transmitted beyond 6 feet, and we don't really have the answer at this time. Also, it's not feasible for people to be separated by 25 feet; there's not enough room in my workspace for that to happen, and I have to go to work.


If we had unlimited masks, I think it would definitely help to slow the virus if everybody wore one, not to protect THEMSELVES but to protect OTHERS. On the other hand, the way Americans think, if we supplied them all with masks they would almost certainly begin to party/congregate/drink, etc., which would lead to masks not being worn properly, which might actually result in MORE spread rather than less. Given that we don't have masks for everybody, at least a certain subset of the populace is keeping to themselves, which is good.

It is somewhat akin to the head injury discussions about the NFL. Some people say make better helmets. Others say get rid of helmets entirely or go back to just the leather helmets they used to wear. With "better helmets" comes a feeling of invincibility that, the theory goes, leads to more violent collisions, and, therefore, to more head injury rather than less. I feel like masking everybody would lead to a similar thing. We are not the Chinese. You have to remember that in China it is not uncommon for people to wear masks. They wear masks for high pollution days, people wear masks when they have a mild head cold, etc., so they are used to it, and they don't look askance at it.

[bundabergdevil]

Is there a chance this can be adapted to cure "carolina fever?"

Of course, another season like this past one might do the trick on its own...

Fake news! Wait, no...Fake Classes!

[cspan37421]

Have you seen the Peter Hessler article in The New Yorker in which the observation (and nothing more) was made in China that they were not aware of any Covid transmissions from children to adults? I found that intriguing...might it be true?

I'm obviously not the person to whom you directed your query, but I'd point out that the 60 Minutes Australia piece upthread reported (5:53 mark) that China said on January 7 to the WHO that there was no human-to-human transmission - at a time when they knew there was. So I wouldn't say they're a real credible source, at least on stuff that might make them look bad.

[MChambers]

That or a clinical trial makes good sense. Topic was covered by Skeptics Guide to the Universe this week. There are potential serious adverse side effects - physician monitoring/oversight recommended. From what I heard, the evidence is weak and trials poorly controlled, but it's not an unreasonable avenue to pursue. It can have anti-viral properties.

There's an interesting Twitter thread by a NY ER physician that a friend just directed me to. Among other things, she says "Our standard protocol right now is azithro/hydroxychloroquine/zinc but I have little faith in efficacy."

https://twitter.com/leorahorwitzmd/s...95565625487361

[duke79]

Saw the article. A bit dubious, in my opinion.

Sure, a sneeze can travel farther than 6 feet (Mythbusters managed, IIRC, 37 feet or so?). That's not really the issue, though. The issue is whether the virus can be transmitted beyond 6 feet, and we don't really have the answer at this time. Also, it's not feasible for people to be separated by 25 feet; there's not enough room in my workspace for that to happen, and I have to go to work.


If we had unlimited masks, I think it would definitely help to slow the virus if everybody wore one, not to protect THEMSELVES but to protect OTHERS. On the other hand, the way Americans think, if we supplied them all with masks they would almost certainly begin to party/congregate/drink, etc., which would lead to masks not being worn properly, which might actually result in MORE spread rather than less. Given that we don't have masks for everybody, at least a certain subset of the populace is keeping to themselves, which is good.

It is somewhat akin to the head injury discussions about the NFL. Some people say make better helmets. Others say get rid of helmets entirely or go back to just the leather helmets they used to wear. With "better helmets" comes a feeling of invincibility that, the theory goes, leads to more violent collisions, and, therefore, to more head injury rather than less. I feel like masking everybody would lead to a similar thing. We are not the Chinese. You have to remember that in China it is not uncommon for people to wear masks. They wear masks for high pollution days, people wear masks when they have a mild head cold, etc., so they are used to it, and they don't look askance at it.

Excellent point and thank YOU for all of your posts on this thread!!

[sagegrouse]

Is there a chance this can be adapted to cure "carolina fever?"

Of course, another season like this past one might do the trick on its own...

No, it will just make them think they are a football school instead.

Very likely not as Mack Brown found a temporary cure during his first two seasons there, receiving a Nobel Prize nomination for his efforts:

1988 North Carolina 1–10
1989 North Carolina 1–10

However, the scourge mutated (and cheated) and it has unfortunately recurred in society for the last 30 years and continues to be a public nuisance/danger.

Fake news! Wait, no...Fake Classes!

Friends, can we please keep the anti-Carolina chatter out of the Coronavirus thread? Here, instead of being "white noise," which is easily ignored, it sounds more like tinnitus, which is truly annoying.

Kindly,
Sage Grouse

[Mtn.Devil.91.92.01.10.15]

Friends, can we please keep the anti-Carolina chatter out of the Coronavirus thread? Here, instead of being "white noise," which is easily ignored, it sounds more like tinnitus, which is truly annoying.

Kindly,
Sage Grouse

I can't spork, but I agree. I appreciate UNC bashing as much as anyone, but I'd like to keep this thread focused for my own sake rather than discussing the Dump on the Hump, or how many minutes COVID-19 might get if he doesn't transfer.

Thanks.

[swood1000]

FDA issues emergency use authorization for use with coronavirus patients. Have to say I'm surprised. https://www.washingtonpost.com/busin...n-chloroquine/

Apparently, physicians at a hospital in Wuhan, China observed that patients with lupus—a disease for which hydroxychloroquine (HC) is a common treatment—did not seem to develop Covid-19. Of 178 hospital patients who tested positive, none had lupus and none was on HC. None of this Wuhan hospital’s dermatology department’s 80 lupus patients was infected with Covid-19. They hypothesized that this may be due to long-term use of HC, so they treated some Covid-19 patients with it (though not in a controlled trial) and had positive results.