Covid 19 CRISIS

Dr_Grip

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Some much needed good news:
STAT News said:
[Pfizer and BioNTech] said an early analysis of the results showed that individuals who received two injections of the vaccine three weeks apart experienced more than 90% fewer cases of symptomatic Covid-19 than those who received a placebo. For months, researchers have cautioned that a vaccine that might only be 60% or 70% effective.
[...]
There is no information yet on whether the vaccine prevents severe cases, the type that can cause hospitalization and death.
Nor is there any information yet on whether it prevents people from carrying the virus that causes Covid-19, SARS-CoV-2, without symptoms.
Because the vaccine has been studied for only a matter of months, it is impossible to say how long it will protect against infection with the virus.
[...]
Although the estimate of the efficacy of the vaccine could change as the study is completed, it is close to a best-case scenario. That also bodes well for other vaccines in the late stages of testing, including those developed by Moderna, AstraZeneca, and Johnson & Johnson.
https://www.statnews.com/2020/11/09...fective-early-data-from-large-trial-indicate/
 

93Flareside

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Hope you can get one of those blood oxygen saturation monitors. Hope it's a mild case
They got one from a Pharmacy last night. Dad is at 91% this morning, Mom is 96% and little sister is 98%... Thanks for the suggestion to get one of those monitors. That will be key in watching how this goes.

I've also earned a 2 day work from home order. If I don't show symptoms after Tuesday, I will be back at work Wednesday.
 
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Dr_Grip

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Adding Derek Lowe's take because especially for a die-hard research scientist, he really is using big words today:
Derek Lowe said:
What does this mean for the pandemic vaccine effort in general? The first big take-away is that coronavirus vaccines can work. I have already said many times (here and in interviews) that I thought that this would be the case, but now we finally have proof. The worst “oh-God-no-vaccine” case is now disposed of. And since all of the vaccines are targeting the same Spike protein, it is highly likely that they are all going to work.

Derek Lowe said:
It’s obvious that the pandemic is ripping through a long list of countries right now – cases are rising steeply, hospitalizations right behind, and although we’re better at treating the patients than we were, deaths are inevitably going up as well. This is all going to get worse before it gets better – but the good news here is that it really is going to get better. Keeping your head down, wearing masks and keeping your distance is more valuable than ever, because there’s an actual finish line in sight that you have to reach. Hang on for the vaccine – for the vaccines – because they really are coming.


We’re going to beat this. We’re starting to beat it right now. An extraordinary, unprecedented burst of biomedical research – huge amounts of brainpower, effort, money and resources – has come through for the world.
 

Blind_Io

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And none too soon!

For those who are still claiming "it's just the flu" - here's Utah's numbers. And recall that the years for the flu were completely unchecked; no masks, no social distancing.

Ut Stats.jpg
 

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Hopefully we'll have enough supply and competition to keep prices of vaccines somewhat low. Everyone needs to be able to afford this.
 

gaasc

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Hm. Bad news, it seems the commerce section of the multi-sector table arranging restrictions has convinced the state that the emergency is such that they should let everyone roam freely for the time being, trusting that the security measures will be enforced by businesses and the police.

Fuck it, staying at my place this week.
 

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Dr_Grip

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One question that I think will be interesting: Now it's clear that have a working vaccine, and a highly-effective one at that. With Moderna, AstraZeneca, and J&J expected to report back on Phase 3 results within this year as well, within the next three months all developed nations will have a clear perspective of how much vaccine they will have available in which timeframe, and vaccination plans can be set in motion. At some point in the second half of 2021 we can expect a mostly normal life with restaurant visits, packed bars, sports events and concerts to return.

BUT - what to do until then, and especially until the highest-risk groups (the elderly, medcial and care personell) are vaccinated? While we did not know how long this would drag on, there was a huge incentive for politics to take risks in order to enable normal life and support the economy. But now, with "normal" being only a year or so away, is this high-risk path still worthwhile? Or should we rather play it safe, keep more of the economy closed/on government subsidies and focus on vaccination first, re-opening second? I am thinking for example about allowing fans back into soccer stadiums after the winter break, or about allowing large open air concerts and festivals to take place. With an unclear vaccination timeline, using covid quick testing to throw these things a lifeline and let them take place in some way or another was almost inevitable. But now, it might make sense to keep mass gathering suspended until, say, September 2021 (which features the start of the 21/22 soccer season, Oktoberfest, and the general election in Germany), just to play it safe.

I am really happy not to be in the shoes of politicians having to make that call.
 
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jack_christie

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Michael Osterholm was on AC360, one question he had was, what percentage of the severe cases is the vaccine effective against? Data still to come on that.
 

Dr_Grip

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Michael Osterholm was on AC360, one question he had was, what percentage of the severe cases is the vaccine effective against? Data still to come on that.
Of course, it would be an added bonus if in addition to preventing 90% of cases the 10% that are not fully prevented would be mild cases. And it would be slightly worse if the 10% not prevented actually all are severe cases, for example because the vaccine is less efficient in the elderly. This then would have an impact on vaccination strategies, putting a focus on vaccinating highly mobile younger people and maybe treating the elderly with monoclonal antibodies instead... But in the bigger picture, it's details.
 

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I just got an internal email from my work; all our major hospitals are 90% full across our system. They are adding ICU beds and staffing as fast as they can to stay ahead of the surge. Since ICU usage tends to lag behind positive tests by about 10 days, this is going to get even worse as my state continues to break records for positive tests.
 

Dr_Grip

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Shit. That's indeed awful.

It seems like (fingers crossed!) Germany once again made the right call at the last moment and, by closing down bars, restuarants and most other leisure activities, stopped the growth in new infections just before overwhelming hospitals - we are at day 8 after measures were introduced now and week over week new infections have stopped growing. Given the current delays in testing this should represent the first days or days of the new measures being in effect. Now, to get numbers down...
 
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DanRoM

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Actually, since it takes a few days to almost two weeks to develop symptoms and thus to have a reason to get tested, and then a couple of days to a week (!) to get the results, the slowing numbers we are seeing currently are more likely to represent the beginning of a downturn in infections even before the "lockdown light" that's been in effect for exactly a week now.
 

narf

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Actually, since it takes a few days to almost two weeks to develop symptoms and thus to have a reason to get tested, and then a couple of days to a week (!) to get the results, the slowing numbers we are seeing currently are more likely to represent the beginning of a downturn in infections even before the "lockdown light" that's been in effect for exactly a week now.
It's quite likely that a good chunk of people were already influenced by the increase in numbers and talks about the lightdown before the lightdown came into effect... obviously not everyone, but I'm sure a lot of people are somewhat responsible.
 

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93Flareside

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They got one from a Pharmacy last night. Dad is at 91% this morning, Mom is 96% and little sister is 98%... Thanks for the suggestion to get one of those monitors. That will be key in watching how this goes.

I've also earned a 2 day work from home order. If I don't show symptoms after Tuesday, I will be back at work Wednesday.

So, dad's blood oxygen went up to 96% yesterday and fever went down a little. It went up today and I'm waiting to hear from mom where he's at today. Mom has low-grade fever now too.
 

93Flareside

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So far breathing is ok, but I'm concerned with what my sister has been telling them. "I'm concerned f you go to the hospital that they'll admit you and you'll get worse because you won't be up walking around. Please get up and walk around so you don't get pneumonia."

I'm not pushing them and neither is their doctor. The doctor has only said "if you have shortness of breath, go to the hospital." I see my sister sewing doubt in them getting help.
 

Dr_Grip

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So, you may have read about covid mutation named "N439K" that depending on the quality of media you consume either "evades some antibodies" or "dooms us to a cycle of lockdowns and mask-wearing" (actual headline).

I initially was pretty scared about this and went into a doomscroll hole of research. Here's what I found out:
  • Yes, there is a strain of covid that evades some antibodies, among them one in the cocktail Trump received
  • No, it is not evading all defenses, and all acquired immunity.
  • It seems like journalists only reload the daily nature.com covid update, remove all the "mights" and "coulds", and then write an article, leaving it to a Philosopher like me to actually put in some research.
So, what does this mean for the vaccine effort?
  • N439K is not new. The first mention in a published paper I could find goes back to June. The paper that started the current craze is "only" a deep dive into how this mutation works.
  • N439K was part of a covid mutation panel study published in peer-review by Cell as far back as July. It's antibody-evading qualities were noted back then. Unlike the twitter sphere, I do not expect Pfizer & Co to put millions of dollars behind a Phase III study without checking stuff like this - Cell is a highly visible AAA journal, not some backwater outlet.
  • I remember a paper back in summer where one of the vaccine frontrunners (might be Pfizer, might be J&J) was tested against a range of covid mutations, among them one of the antibody-evading ones. It worked against all of them. I can't find the paper right now so can't check whether N439K was part of the panel, but it is good news in principle.
  • The new paper goes as far as calling N439K "widespread" - this means that we can assume that if it would evade vaccines, the Phase III trials would show
  • After we now have proved without a doubt that covid vaccines work very well in principle, regulatory approval for updates/boosters should be a formality
  • Christian Drosten says it's no reason to worry right how.
But - what don't we know?
  • As mentioned above (and, actually, back in June in a paper by vets working on the many coronavirus vaccines in lifestock) the t-cell response is super important with covid. Right now, we don't know whether there's any influence of N439K on these. This is all antibodies extracted from people run against viruses in a vat, not actual data from actual immune systems.
  • If the selection pressure on the virus gets higher, say, because we vaccinate, fully vaccine-evading mutations may actually arise, leading to a need for yearly booster shots. We don't know this yet, so the very paper that started the craze sums it up best: "Immune evasion mutations that maintain virulence and fitness such as N439K can emerge within SARS-CoV-2 S, highlighting the need for ongoing molecular surveillance to guide development and usage of vaccines and therapeutics."
One thing I want to emphasize - I am not criticizing or questioning any of the research, I am not qualified to do this. What I am questioning is the quality of reporting on the research: In a sane world, N439K would be of interest to the scientific community, but not popular news.
 
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