Coronavirus

[bassman2546]

Oh boy, here we go again.

Do we remember that flu vaccine is widely available? Do we remember that many people already have flu immunity?

How many lives does COVID-19 have to claim before you'll consider it a threat?

I'm not saying it's not a threat, just being handled so poorly it's beyond belief. And did you read the rest of my post? I agree there will be a second wave, worse than the first. If that doesn't spell out 'threat' then I don't know what else to tell you. And yes there's a flu vaccine. Do you know how many people get the vaccine and STILL get the flu? I've never had a flu vaccine and never had the flu. I wouldn't go all-in on vaccines. Mic drop. lol

[broncofan]

I'm not saying it's not a threat, just being handled so poorly it's beyond belief. And did you read the rest of my post? I agree there will be a second wave, worse than the first. If that doesn't spell out 'threat' then I don't know what else to tell you. And yes there's a flu vaccine. Do you know how many people get the vaccine and STILL get the flu? I've never had a flu vaccine and never had the flu. I wouldn't go all-in on vaccines. Mic drop. lol

Wave? There cannot be a second wave until this first deadly period comes to an end. 2000 people died today in the U.S. so far. That's 60,000 in a month with social distancing, which is 720,000 annualized compared to 60,000 in a year for flu at the high end.

Getting the flu vaccine makes people less likely to get the flu and makes it less severe if they do get the flu. Every year scientists at the CDC have to reformulate the flu vaccine because the flu mutates. We don't know how effective the covid vaccine will be or how long people will have immunity, but if it's very effective it can save hundreds of thousands of lives a year and if it's only somewhat effective it can still save hundreds of thousand given the rate at which it spreads and kills people.

Mic drop? The only thing you've shown is dangerous ignorance.

[broncofan]

And why wouldn't there be another wave in the fall? With people imprisoned in their own houses, their immune systems will weaken over the months. Release them into the outdoors and they'll be infested with Covid as well as the flu. Do we remember the flu? Apparently, the governments have forgotten how many lives it claims. When all this goes down, expect a lot more deaths to control that world population that Bill Gates preaches. Let us out now in the good weather to keep our antibodies at a peak will keep those deaths from happening. But why would we want to save lives that way when we can pay out of pocket for a vaccine in a year and help make the pharmaceutical companies trillions - yes trillions!

One reads about the history of witch burnings and of communities being murdered en masse during the bubonic plague and may wonder how human beings can be so juvenile and superstitious and stupid and then you see modern examples of it. Do conspiracy theorists really think people are going to read their uninformed rantings and conclude they're intelligent or possess some secret knowledge? I see a pathetic person who thinks the entire field of immunology is a hoax and that Bill Gates has donated billions of dollars to combat infectious disease because he wants to control people. Who knew?

[Stavros]

And why wouldn't there be another wave in the fall? With people imprisoned in their own houses, their immune systems will weaken over the months. Release them into the outdoors and they'll be infested with Covid as well as the flu. Do we remember the flu? Apparently, the governments have forgotten how many lives it claims. When all this goes down, expect a lot more deaths to control that world population that Bill Gates preaches. Let us out now in the good weather to keep our antibodies at a peak will keep those deaths from happening. But why would we want to save lives that way when we can pay out of pocket for a vaccine in a year and help make the pharmaceutical companies trillions - yes trillions!

On the last point, our reliance on the pharmacy to improve our lives and deal with illnesses means that Pharmaceutical companies will always make a handsom profit, though along with computing science they also pay for and conduct more original R&D than most other industries. Solution to those evasive trillions? Corporation tax!

Your post implies that you think a more flexible, Swedish-style approach will create a 'herd immunity' that will lessen the impact of the 'next wave' when it comes, assuming Covid 19 will become a seasonal-based illness. On the face of it, this is an appealing concept, but in detail it might not be, for two reasons.

One, is that we still do not know enough about Covid 19, and in particuar, whether it has the ability to adapt to threats to its survival in humans by mutating. Current evidence suggests that men are most at risk from Covid 19, but note that in the early stages it was men over the age of 70. When men like 55-year old Boris Johnson were infected the age-range of vulnerable men was lowered. I assume there is a fear that a mutant strain of Covid 19 could affect children so that with these 'unknown unknowns' the scientists are not going to take a risk with by letting people free to become infected, as if that were all that there is to herd immunity.

For the second point is that in most contagious disease, herd immunity is most effective when it is established through immunisation, because the concept that underpins it is that the more people who are immunised with a synthetic vaccine, the greater the chance of survival, thus the spike in cases of Measles in the US alone over the last year or two is derived from the absence of immunisation -just because the majority of American children have herd immunity does not prevent others from dying, because the immunity is given by the immunisation, not by natural exposure, which in the case of measles can be and otherwise is, fatal. We do not know if there is a natural form of herd immunity in humans, just because young people may be infected and not suffer is not the key point, that they may infect older people is -this is considered too great a risk.
In this case and on the basis of what we know so far, herd immunity only makes sense if there is a vaccine to create it.

Here is a good summary of what herd immunity is-
"Herd immunity describes how a population is protected from a disease after vaccination by stopping the germ responsible for the infection being transmitted between people. In this way even people who cannot be vaccinated can be protected. For example, the bacteria meningococcus and pneumococcus can cause blood poisoning (septicaemia) and meningitis. In most people the bacteria live harmlessly in the throat and do not causes disease, but sometimes they get into the bloodstream leading to these severe infections. They can live harmlessly in the throat of one person but if they spread to someone who is particularly susceptible (such as a young baby) they can cause severe disease. By being vaccinated an individual is not only protected from being infected themselves but they then also cannot pass this infection onto other people, where it may cause severe disease. However, for herd immunity to work a large proportion of the population need to be vaccinated."
https://www.ovg.ox.ac.uk/news/herd-i...w-does-it-work

It is a tough call, but I think a phased end to the lockdown will happen as rates of infection decline, and coincide with the trials of the first vaccine though I don't know when this will happen, and I think ending the lockdown in one part of the country rather than another is a major risk.

[Stavros]

If you don't mind me asking, what kind of job do you think your leaders in the UK are doing with Covid? Like our numbers, your number of infections and deaths per capita do not look great. But that doesn't always tell the entire story because while I do think policy is the most important factor, chance can play some role in these outbreaks based on when you had your first infection, the layout of your cities etc. I also noticed that testing numbers in the UK are not good on a per capita basis. Again, this doesn't tell the entire story because the timing of tests matters, but the very high case fatality rate and low number of tests per capita paint a picture of insufficient testing.
Stay safe!

I refer you to previous posts, which referred to Exercise Cygnus in particuar, an exercise in the UK in 2016 in response to a 'flu-like pandemic. The full report has not been published, so we do no know precisely what the recommendations were. There may have been some purchases of PPE and Ventilators, whereas Anthony Costello who may have been told what is in the report, claims the Government position on preparation was to prefer a reliance on the purchase of PPE and Ventilators on existing supply chains rather than a stockpile.
In terms of preparedness this might have been the financially preferable option but if in a pandemic too many States want the same product from limited existing supply chains, the system is going to break down. If you add in that perennial need not to spend money on a hypothesis, then you can understand the ease with which Governments decide to 'wait and see what happens' in the hope it won't happen.
In the US there are contrasting opinions on what happened to the Global Health Security and Biodefense Unit that the Obama administration set up in the NSC in 2015 -see link- and whether this impaired the US response. On one level I think the changes the new admnistation made weakened the Unit, but I think in any case the new President would not have acted differently than he did.
https://www.reuters.com/article/uk-f...-idUSKBN21C32M

That said, I think we have a once in a century event, almost literally as the last pandemic on this scale was the Influenza Pandemic of 1918-20, and the human scale, and the medical impact of Covid 19 has exceeded expectations, though this is not a reason to excuse the lack of preparedness that advanced economies could have had, and which did have, in the cases of South Korea, Taiwan, China and Singapore -though one notes cases are recurring in Singapore.
Also, now the medics have actually had to treat Covid 19 on real patients, it is known that some -I don't if that means 'many'- can be treated without ventilators. This doesn't mean that stockpiling ventilators would not have been necessary, it just means we know more about the infection now because it is now longer hypothetical, and that PPE has become the more urgent item of need, even more so than the emergency treatment units -in the UK 'Nightingale' hospitals- erected in days which have taken in so few patients.

The two areas of critical concern have been the slow response to the viral outbreak, and the extent of the 'lockdown' with as yet no date for its end.
The UK shares with the US a sloppy response to the first notices from China and the WHO, and one assumes that the Governments simply hoped that what happened there would not happen here. Either way, existing instruments existed which could have minimised the first impact -some form of test ought to have been designed similar or exactly the same as that which was used in South Korea, devised from the tests they had created during the SARS incidents earlier this century. Testing and a tracing mechanism would at least have been able to ascertain who was being infected and where they were and had been, so that a geographical profile could have shaped policy, almost certainly leading to an immediate closure of points of entry into the country -as happened in the US on 9/11- and happened in New Zealand- but did not happen in the US or the UK.

As we know now the first cases arrived in the US by air (not clear in the case of the UK) and this would have been crucial in halting all air traffic. In the UK it would have meant an immediate halt to air traffic and the closure of ports and the Channel Tunnel.
That none of these things happened before the end of January, even though the WHO did not declare Covid 19 a pandemic until late in the month suggests the WHO and other Governmens were slow to act -and in the cases of the UK and US just as slow after the declaration, so that whatever scepticism there was in Janaury ought to have been swift action in February. That said, it is a major event for the WHO to declare a pandemic is in progress, and it is not something they can do without being certain, and they did not do so I think until they had proof the virus had left China.

Other than the details, which concern the way data on infections is collected, the lack of data in the early stages of infections and deaths in care/nursing/residential homes, the data on which members of society are or may be most vulnerable, the NHS has had to cope as best is can, and the general view is that they have done well in the clinical treatment of the illness, but the managers do not appear to have done well in supplying their hospitals and staff with PPE; the absence of PPE in care homes is even worse than it is in hospitals.

The more vexing problem lies with the social and economic consequences of self-isolation or 'lockdown' or 'quarantine'. The UK was already, like the US (but at a slower pace) sliding into recession, the first quarter results from major corporations now showing the UK and the rest of the world facing an economic depression as bad or even worse than the slump of the 1930s.
Factor in frustrations over freedom of mobility and the argument that it has been to extensive and too strict, and one can understand the need to set a date for an end to the 'lockdoown' but I think by comparison, the UK and most European states like France, Spain, Italy, Netherlands, Germany either have more compliant or more patient people than in the US, though I think the majority there do understand the risks too.

It means the public discourse is more measured, and we have a National leadership -I assume the Scotish Government co-ordnates its policy with the Government in London- whereas in the US there does not appear to be any leadership at all, no co-ordination between states, while the official attitude to science and medicine in the UK is, shall we say 'adademic' when in the US the 'academic' advice is often undermined by senseless, worthless and dangerous garbage, escaping without restrait from the mouth of the one man who ought to know when to shut it.

Mistakes on both sides with caution when urgent action was needed.
Outstanding -at times heroic- performance from health care workers on both sides of the Atlantic.
Poor management of ancillary needs in testing and tracing, possibly due to weak leadership, and a lack of a commitment at early stages to the financial needs of an unfolding pandemic whose vicious nature was underestimated in its medical, social and economic impact. Indeed, on all three of those levels we have yet to calculate the true cost of Covid 19 -I don't think it could have been stopped, but the question is -could we have minimized the impact? In the UK I think the answer is yes, but that now becomes a 'what if?' in history, because we failed to take action sooner, and will pay more for it as the next 5-10 years unfold with Covid 19 adding to the UK's Brexit woes.

[sukumvit boy]

Because of the enormous risk in time and money required to develop a bespoke vaccine for every new seasonal or novel virus this "whack a mole" approach needs to be modified. We need a broad spectrum anti viral and the political will and financing to launch a national/international "Manhattan Project" to that end. Here are some excellent recent New Yorker magazine articles on that topic :
https://www.newyorker.com/magazine/2...-pandemic-pill
https://www.newyorker.com/magazine/2...mericas-doctor
Such a drug ,Remdesivere is now demonstrating dramatic results.
https://www.gilead.com/purpose/advan...out-remdesivir

[Stavros]

https://www.gilead.com/purpose/advancing-global-health/covid-19/about-remdesivir[/URL]

As well as the US efforts, John Bell, Regius Professor of Medicine at Oxford, told Channel 4 News this evening that Oxford's collaboration with AstraZenica could yield a basic vaccine by the end of Sepember/early October, but warned that it takes up to 8 years to develop a vaccine capable of neutralizing an infection as powerful as Covid 19. In the interim it may be possible to create some level of immunity or reduction of threat, pending the development of antibodies- and the assumption that the current trials actually work.
The medical challenge is one that I think we can deal with, because the international expertise and the money is there.

As for the political will -well let's just say that if the politicians in key positions of authority trust the science we are half-way there. Boris Johnson, also on TV this afternoon, sounded both upbeat about the trajectory of cases -downwards- but warned against any early lifting of quarantine measures in case they spike a second wave. Tempering his usual reliance on bombastic rhetoric, his sober presentation of the facts stands in stark contrast to the President of the USA, and the frankly despicable retort from the President of Brazil-
"on Tuesday night Brazil’s president shrugged off the news. “So what?” Jair Bolsonaro told reporters when asked about the record 474 deaths that day. “I’m sorry. What do you want me to do?” "
https://www.theguardian.com/world/20...rus-death-toll

Link here to the Oxford/AstraZenica partnership-
https://pharmafield.co.uk/pharma_new...id-19-vaccine/

[broncofan]

Because of the enormous risk in time and money required to develop a bespoke vaccine for every new seasonal or novel virus this "whack a mole" approach needs to be modified. We need a broad spectrum anti viral and the political will and financing to launch a national/international "Manhattan Project" to that end. Here are some excellent recent New Yorker magazine articles on that topic :
https://www.newyorker.com/magazine/2...-pandemic-pill
https://www.newyorker.com/magazine/2...mericas-doctor
Such a drug ,Remdesivere is now demonstrating dramatic results.
https://www.gilead.com/purpose/advan...out-remdesivir

I'm going to read the New Yorker articles in the morning. Thank you. I'm interested in the subject but don't have a science background so I apologize if I get this wrong. In February I read reports that Remdesivir inhibits viral replication in vitro for the coronaviruses SARS, MERS, as well as Sars-cov-2. This is why, despite the fact that it wasn't a successful Ebola treatment, doctors in China were using it experimentally for Covid-19. That experimental use continued in the United States and there have been promising open label studies, but until yesterday there was no evidence from a controlled trial demonstrating efficacy.

Yesterday the results from a controlled trial performed by NIH were released. The endpoint was statistically significant reduction in duration of disease in people with severe Covid. I think the use of Remdesivir resulted in a reduction in the duration of the disease from 15 days to 11 days (which was statistically significant). It also reduced the mortality rate for the treated cohort but the endpoint was days to recovery. This result means it will likely get approval and be the standard treatment for the time being in patients with advanced disease.

Anyhow, most of the virologists I follow say it looks more like a step forward than a game changer. They claim that anti-virals are often most effective early in the course of illness but that Remdesivir is provided by an iv so it is only used in moderate or serious disease.

The other drug I've read about is Favipiravir, which is a flu drug used in Japan. There are ongoing trials for it and clinicians reported some benefits. I understand it's administered in pill form as well, so if it's shown to be effective in trials there is the potential people can take it at the onset of symptoms rather than once hospitalized.

I know there's been at least one negative study for an HIV combo drug called Lopinavir/Ritonavir. I'm not sure if there are more trials ongoing or that dried up all interest.

There has also been some excitement about the use of monoclonal antibodies, with a company called Regeneron preparing to conduct trials this summer. My understanding is that even if this is safe and effective, these drugs tend to be expensive to produce enough of.

Speaking of vaccines, I would not be surprised if Donald Trump endorses the idea of human challenge studies. Most doctors believe Covid-19 is too dangerous and therefore it would be unethical to perform human challenge trials to speed up Phase III testing for a vaccine. There has been some discussion of this subject among academics recently. I can imagine Trump finding this kind of dangerous shortcut attractive.

[Ripjags]

Covid-19 - Just a gentle preview of coming attractions.

[Stavros]

Covid-19 - Just a gentle preview of coming attractions.

Indeed, and while 'threat' is more appropriate outside the comedy store, are we learning how to face the challenges if humans continue to enter pristine wilderness in search of excitement, money -or both?

And for the record, I am not immune from the common cold, as I have in a cabinet the pills and the potions that I can use if I think I have one. If the common cold cannot be defeated by herd immunity, we shall need all the pillls we can get -and afford to buy.