Or the new Ebola outbreak announced yesterday. https://www.who.int/news-room/detail...g-the-response
We've had floods in Michigan; dams broke, leaving behind drying fetid lake beds, flies, dead fish and the works.
Who read from the Book of the Dead and resurrected the Old Testament God? (how's that for a mixed metaphor!)
I was the phone today and a friend led into a new topic with: "You want to hear something weird?" What could possibly qualify as "weird" in 2020?
... I happen to work with some of the top immunologists in the world. This morning I was able to chat briefly with a colleague who is doing a LOT of COVID-19 research. He’s a member of a large, international project and has been tasked with analyzing patient samples from one of the South American countries (can’t remember which one). He’s also analyzing samples from local patients. I asked him a few questions, before he had a big phone conference, and here’s what I learned. Regarding cytokine storms: that happens in the fatal cases (at least, the ones he has seen). THe cardiovascular stuff that was mentioned earlier is a factor in a small number of patients as well. He can’t figure out what’s causing it, nor can anyone else - yet. There’s also a lot of concern about the mysterious disease that’s affecting children. I asked him if the answer might be genomic - more specifically, if knowledge of a patient’s genome might be useful in predicting which set of symptoms that patient will have and what might be the best treatment protocol. He said that several large genomic studies are ongoing; people are indeed mapping individual patient genomes and attempting to correlate that information with disease course. So, it might eventually be possible to have some sort of bio marker that would help determine the best course of action for each individual patient. All hail personalized medicine!! Cool, right?
The other free bit of info I got from him: according to the most recent studies, remdesivir (the Gilead drug) works well if given early in disease progression, somewhat like Tamiflu. It doesn’t work in late stages.
He also thinks a vaccine will be available late this year or early next year.
Yes, but a LOT is known about the virus itself - 3D structure, genome, etc. Heck, scientists have even figured out which receptor the virus uses to enter cells. What isn’t known is why it causes such a myriad of symptoms; the genomics studies should help with that. A vaccine is aimed at the virus, so halting it in its tracks would be good. The goal is to stop the virus before it establishes a foothold in the body. After that is when it starts wreaking the unpredictable (at the moment) havoc.
There are at least two vaccines in clinical trials right now. Unfortunately our current president chose not to participate in the WHO efforts to develop a vaccine, so we are on our own. But, the good news is that we appear to have some candidates.
I heard second hand, from someone I consider to be an extremely reliable source, that the colleague cited in my previous post has developed an antibody that’s extremely effective at neutralizing SARS-CoV-2. I’m not sure what’s happening with it with regard to testing. This colleague was asked by Reuters to comment on work that is currently out for peer review (not the antibody, but something else); he refused to comment because his work hadn’t yet been evaluated by other scientists. Part of the reason there’s so much conflicting info out there is that COVID-19 research is flying through, sometimes without peer review (the guy in France who manipulated his chloroquine/azithromycin data).
Another fun bit of trivia: a former colleague from UTMB tested a drug that was EXTREMELY effective at killing SARS-CoV-2 in a 3D culture of lung tissue. I think that drug is in clinical testing. It was actually developed as a cancer drug but was re-purposed when more was known about how the virus behaves biochemically. I haven’t gotten an update on the work lately, to see where things stand.
There are actually at least 8 vaccines in clinical trials (Phase 1 or Phase 2) as of mid-May, and ~100 vaccines in development overall. Of course, as we still don't know how efficacious these are or how safe they are, things remain to be seen. But there is at least some reason for optimism given the sheer volume of work being done on covid vaccines.
I have a friend at Vanderbilt who has already produced hundreds of antibodies of very slightly different specificity and is screening through them to see which will be most effective at binding the virus. This process may end up providing another treatment option similar to, but hopefully better than, convalescent sera.
Newest COVID-19 numbers in Virginia:
Positive COVID-19 Cases: 46,905 (+666 from Tuesday)
People Hospitalized: 4,884 (+114 from Tuesday)
COVID-19-Linked Deaths: 1,428 (+21 from Tuesday)
Total Tests: 381,539 (+12,231 from Tuesday)
Relating to some upthread comments:
1. If I'm seeing a non-covid hospitalized patient, I wear an N95. I stay away from the bed and make the visit very short. For covid patients, I add a 2nd mask and a face shield and obviously a gown. For work, I use phones and videos whenever possible.
2. A few days ago, I decided to start letting my 10 year old play with 2 other girls (well, we decided; up to then, she absolutely refused to go outside). She wears a tight N95 and uses Purell frequently. They don't touch each other, they stay outdoors in a courtyard that's the size of a football field, and the whole outdoor space has maybe 5-10 people in it (on a typical pre-covid weekend with good weather, there'd be 40). Other than that, she hasn't seen another child in person since mid-March.
3. I'm still considering whether to send that 10 yr old to sleep away camp. The few camps that are going forward are trying to create a hermetically sealed environment that would include testing a few days before and then the day of arrival, and I'd be counting on all the other parents being scrupulous in the week prior to drop off and on kids having a low rate of severity. My hyper and independent kid might just go crazy stuck inside all summer (her father already has), but I'm doubtful she'll go.
4. When walking on an empty NYC street, I pull down my mask; I pull it back up when someone gets close. For walks where I know I'm not going in a store, I wear a snazzy cloth mask. For a quick stop into a grocery store, I bump it up to a hospital mask. If I were to be hiking in the country or golfing, my mask would be nowhere in sight. That'd be awesome and would be zero risk as far as I was concerned.
5. I can't imagine what would entice me to attend a 90 minute meeting in an enclosed space. I view it as wantonly dangerous to go to church, attend large work meetings, etc. Even if you're in a place with no known cases, there could easily be someone asymptomatic but infectious in the row behind you. Even if I were wearing a mask and there were no singing, viral particles from that infected person behind me would be wafting around and through my mask--and it's the accumulation of viral particles that gets you: walking through a church, fine. Sitting in a place for 90 minutes? I'm betting lives on my hope that no one within 10 feet of me is infected. Multiply that low risk event by 1000 or 10,000 places of worship, and you get several new clusters of infections--and they'd generally be occurring among older people who tend to get really sick from covid and in people who aren't taking this seriously, and so they'll likely infect many others.
It's just insane that they're allowing this sort of gathering.
6. Obviously, places of worship are more important than liquor stores. It's not about "importance" or the tax receipts from alcohol sales or the large number of alcoholics in the country or the growing number of lonely, anxious people who use alcohol to self medicate. You can do liquor quicker.
7. Okay, people would debate the relative importance of worship and alcohol, but that's not the debate. Which causes infection? And at the risk of preaching to the choir, attending a single choir practice is a lot more risky than intubating 5 very sick covid patients (assuming you know how to intubate).
8. Meat is not crucial to my life. I've long avoided watching butchery documentaries because then I'd probably have to stop eating hamburgers. If I had to watch humans dying of covid so that I could get cheap meat...
9. One big advantage to public health efforts during the 1918 flu epidemic: antibiotics hadn't yet been invented. People were rightfully scared of contagion and didn't think medicine could fix everything. Even now, people tend not to understand the difference between a virus and a bacterium, or the difficulty in coming up with a quick viral treatment.
10. N95's are better than a hospital mask or a cloth mask, but ANY MASK >>> NO MASK, and it's not close.
11. "Social distancing" has a bad connotation. I prefer "physical distancing."
12. I read articles in newspapers and magazines with the mind of a cultural anthropologist: two different cultures are involved. Scientific culture is careful and prudent. Scientists tend to lead with uncertainty and limitations before they get to a tentative point that is part of an incremental effort towards a broader understanding. They can simplify to make a point, but overall, they get ahead of themselves only when they are trying to get someone's attention (or are showmen). Journalists tend to scan those careful articles, circle the tentative conclusion, and remove the "tentative." The editor then summarizes the tentative conclusion into a headline assertion. And so readers of newspapers and magazines get the impression that science flipflops, which is generally not accurate.
13. A vaccinated America by this time next year? Even if one of the vaccines is perfect, and we happen to have bet the house on that particular vaccine rather than the 99 others, and if development and distribution is awesome, and all 71% of Americans who say they'd get vaccinated do get vaccinated, we might squeak into some sort of herd immunity--IF everyone were equally distributed, but that's not how it works. Birds of a feather. Those pockets of unvaccinated people will ensure that the covid will live on for many years. The government can mandate vaccines for school attendance, though I'd guess antivaxxers tend to congregate among home schooled kids and those who attend a variety of religious schools. At what point would the government try to mandate a brand-new vaccine in children who don't go to public schools? In adults who work for the government or hospitals? In all adults? Politicians who do so would be risking their careers on their certainty that side effects won't emerge when hundreds of millions of people are exposed to a 1st-year vaccine to a novel viral infection.
And of course, there will be visitors from outside the country: how thoroughly will the world get access to mandatory vaccines? We can certainly demand proof of immunization, though borders will stay porous. Further, if/when America normalizes with a low-ish rate of covid, I'd guess we'd pose more of a threat to others than they would to us--how often do you meet someone from Bali or Cancun or Iceland?
((mod redacted political content))
Last edited by JasonEvans; 06-03-2020 at 01:17 PM.
According to the CDC, in years when the vaccine is a reasonably good match for the strain of flu, the vaccine reduces the risk of getting the flu by 40-60%.
That's after many years of work. The big difference is that the flu strains change every year; cross fingers on covid.
https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
Thanks! This thread has been very educational and I will probably start getting an annual flu shot.
My strong compliments on how you’re protecting your daughter. I’m doing the same with my 11 year old daughter. She calls it daddy quarantine and I’ve already promised a very lengthy Disney vacation after we’re vaccinated.