SARS-CoVID-2/ CoVID-19/ CoronaVirus: Information Only from Well Informed Members

Baal · May 14, 2020

Here is a sobering video. Imagine if a waiter at a restaurant is infected?

https://youtu.be/6tjKx_JofG0

Takkyu_ga_suki · May 15, 2020

Baal said:
Here is a sobering video. Imagine if a waiter at a restaurant is infected?

https://youtu.be/6tjKx_JofG0

Same vid with an English explanation and with a follow-up:
https://www.cnn.com/2020/05/13/heal...periment-coronavirus-trnd-wellness/index.html

Dr Evil · May 15, 2020

Some encouraging news on the vaccine front. According to a pre-print (ChAdOx1 nCoV-19 vaccination prevents SARS-CoV-2 pneumonia in rhesus macaques), the Oxford vaccine works in monkeys. What it did -- reduce viral load and prevent pneumonia -- is important. Equally important is what it didn't do, which is to make the disease worse rather than better, which has been a problem in past years for other vaccines. If all goes according to plan, human trials of this vaccine could start to show positive results as early as June, and emergency use authorization could be granted by September. That's a big if, but it's starting to look like a real possibility.

And here's a summary (T cells found in COVID-19 patients ‘bode well’ for long-term immunity) of some more encouraging research: "...two new studies reveal that infected people harbor T cells that target the virus—and may help them recover. Both studies also found that some people never infected with SARS-CoV-2 have these cellular defenses, most likely because they were previously infected with other coronaviruses... Although the studies don’t clarify whether people who clear a SARS-CoV-2 infection can ward off the virus in the future, both identified strong T cell responses to it..."

Michal_Z · May 15, 2020

I would like to ask about the side effects of wearing the mask..
I heared some stuff.. You breathe more CO2 because of wearing the mask.. That is not good for health.
You dont share other bacteria and viruses with people around you and therefore your imunity goes down.
(because by sharing these viruses and bacterias you build imunity against them)
You lose huge amount of interaction or communication, because lot of your mimics are hidden which is pretty bad for building relations.. specially between little kids and other people..

I am only wondering and would like to know, these are side effects I can think about, but I am no expert..

And - question to lockdowns - not enough sport .. not enough sun .. not enough fresh air .. also not good for your imunity, right?

UpSideDownCarl · May 15, 2020

Michal_Z said:
I would like to ask about the side effects of wearing the mask..
I heared some stuff.. You breathe more CO2 because of wearing the mask.. That is not good for health.
You dont share other bacteria and viruses with people around you and therefore your imunity goes down.
(because by sharing these viruses and bacterias you build imunity against them)
You lose huge amount of interaction or communication, because lot of your mimics are hidden which is pretty bad for building relations.. specially between little kids and other people..

I am only wondering and would like to know, these are side effects I can think about, but I am no expert..

And - question to lockdowns - not enough sport .. not enough sun .. not enough fresh air .. also not good for your imunity, right?

It does sound like you are trying to answer your questions before you have even asked them.

But, I will let these guys answer as though you asked the questions you sort of tried to answer.

Baal · May 15, 2020

Not things to fear. The masks you can source are not going to restrict breathing enough to have ANY effect on blood gasses. Recall that healthcare workers wear quite restrictive N95 masks for hours at a time while performing complex demanding surgeries with no ill effects. They are hot and uncomfortable but not dangerous. Any mask you would probably be able to play TT in is far less restrictive than an N95 or KN95. I can wear a mask on my road bike at a zone 2-4 heart rate averaging 19 mph for 2 hours without a problem. I did it on Weds. (About 32 miles or 50 km). TT is less exertion than that.

Regarding immune effects, that's just not how it works. You are an adult, you have been exposed to many antigens already in your life and you don't need constant exposure at this point to new antigens to be able to mount an immune response to a virus. I've heard that fear expressed by people before but it is simply not an issue. Unless your immune system is compromised for OTHER reasons it should work fine even if you often wear a mask.

Baal · May 15, 2020

I do recommend getting outside for exercise if you can. Aerobic exercise increases immune surveillance. Take Vitamin D and get sun. Try to stay in contact with friends even by zoom etc.

Without doubt the situation sucks but only worry about things that need worrying about.

rainneverever · May 16, 2020

This study in Cell tested the immune response (not necessarily antibody response) against COVID from people never exposed to COVID and observed cross-reactivity as people were infected with common cold coronaviruses.

https://www.lji.org/news-events/news/post/first-detailed-analysis-of-immune-response-to-sars-cov-2-bodes-well-for-covid-19-vaccine-development/

"The teams also looked at the T cell response in blood samples that had been collected between 2015 and 2018, before SARS-CoV-2 started circulating. Many of these individuals had significant T cell reactivity against SARS-CoV-2, although they had never been exposed to SARS-CoV-2. But everybody has almost certainly seen at least three of the four common cold coronaviruses, which could explain the observed crossreactivity.
It is still unclear, though, whether the observed crossreactivity provides at least some level of preexisting immunity to SARS-CoV-2 and therefore could explain why some people or geographical locations are hit harder by COVID-19."

Takkyu_ga_suki · May 16, 2020

rainneverever said:
... which could explain the observed crossreactivity.
It is still unclear, though, whether the observed crossreactivity provides at least some level of preexisting immunity to SARS-CoV-2 and therefore could explain why some people or geographical locations are hit harder by COVID-19."

That is what really intrigues me. Japan is a case in point, especially Tokyo. High density population (Roughly 9 million in Tokyo). Yet, very low fatality rate and new cases rate. Sure there is less testing there. Also, the elderly population probably has fewer co-morbidities than many western nations, better hygiene, cleaner public restrooms, and a mask wearing culture. Many variables, of course, but it would be great if the different confounding factors could be analyzed/isolated to some degree.

Some have attributed these inter-regional differences to the BCG vaccination (TB). Many are skeptical. But at least they have started trials to see whether that vaccination could be a factor. (Nobody is expecting it to be a miracle cure, but at best, a temporary stop-gap measure, eg., less severe complications from pneumonia). https://www.statnews.com/2020/04/14...icism-as-a-potential-weapon-against-covid-19/

I live in Los Angeles County with a population of 10 million. It currently runs around 900 new cases per weekday. This sounds so crazy for a County that is supposedly doing self-isolation, except for essential services.
http://www.publichealth.lacounty.gov/media/Coronavirus/locations.htm (Analyzing data from that link, almost 50% of the fatalities occurred in congregate living settings!)

Last Tuesday, Tokyo had "28 new cases of coronavirus infections Tuesday, Fuji News Network reported, marking a seventh straight day of single-day tally below 40."
https://www.japantimes.co.jp/news/2020/05/12/national/tokyo-28-coronavirus-tuesday/

That is quite a contrast. I hope it can be accounted for in the not so distant future.

rainneverever · May 16, 2020

A study in Israel looked at COVID patients born +/- 3 years from 1982 because they stopped nationwide BCG vaccination since 1982. The result didn't show statistically significant difference between vaccinated and unvaccinated groups. It doesn't mean BCG vaccine trials won't work at all, because the trials give immune system an "acute" challenge, which may help defend against other pathogens to some extent. Let's wait and see the trial results.
https://jamanetwork.com/journals/jama/fullarticle/2766182

TTHopeful · May 16, 2020

In the UK tennis and golf is starting back up as it's outdoors. Sports halls is a long way off at the moment I think.

UpSideDownCarl · May 16, 2020

Takkyu_ga_suki said:
That is what really intrigues me. Japan is a case in point, especially Tokyo. High density population (Roughly 9 million in Tokyo). Yet, very low fatality rate and new cases rate. Sure there is less testing there. Also, the elderly population probably has fewer co-morbidities than many western nations, better hygiene, cleaner public restrooms, and a mask wearing culture. Many variables, of course, but it would be great if the different confounding factors could be analyzed/isolated to some degree.

Some have attributed these inter-regional differences to the BCG vaccination (TB). Many are skeptical. But at least they have started trials to see whether that vaccination could be a factor. (Nobody is expecting it to be a miracle cure, but at best, a temporary stop-gap measure, eg., less severe complications from pneumonia). https://www.statnews.com/2020/04/14...icism-as-a-potential-weapon-against-covid-19/

I live in Los Angeles County with a population of 10 million. It currently runs around 900 new cases per weekday. This sounds so crazy for a County that is supposedly doing self-isolation, except for essential services.
http://www.publichealth.lacounty.gov/media/Coronavirus/locations.htm (Analyzing data from that link, almost 50% of the fatalities occurred in congregate living settings!)

Last Tuesday, Tokyo had "28 new cases of coronavirus infections Tuesday, Fuji News Network reported, marking a seventh straight day of single-day tally below 40."
https://www.japantimes.co.jp/news/2020/05/12/national/tokyo-28-coronavirus-tuesday/

That is quite a contrast. I hope it can be accounted for in the not so distant future.

TTHopeful said:
In the UK tennis and golf is starting back up as it's outdoors. Sports halls is a long way off at the moment I think.

UpSideDownCarl said:
So, I just want this to be clear. I closed the last 2 threads on the Novel CoronaVirus Pandemic as it seemed that each, at some point went off into unsubstantiated territory. Nevertheless, with this global crisis, I still feel, having useful information on the subject available to our members will be valuable.

So, we are going to try something different here.

The rules of this thread are not the rules of most threads.

Baal, RainNeverEver, Dr Evil, and Passifid will be the well informed members or "Experts" on the thread since they all have science and medical related backgrounds. They can post as they see fit to provide information and to answer questions.

Other members can ask questions but cannot simply post thoughts, opinions, answers.

I will HEAVILY MODERATE the thread so that, if a member, unaware of the rules for this thread, posts content rather than a question, I will delete and inform that member of the special rules for this thread.

Thank you for you understanding and cooperation in this endeavor. I am looking forward to seeing how this thread turns out.

So, I am reposting the OP because we sort of need to keep the original format I explained in the Original Post.

I am going to leave these posts. But it is clear that these are not questions for the guys listed who can post in the thread. And in the last two threads, things started going wrong as a result of people posting things that were comments and opinions.

If you have a question for Baal, Rain, Dr Evil or Passifid you can ask. But this thread is not for everyone to post content. The only people who can post content are Baal, Rain, Dr Evil and Passifid. For everyone else, you can ask questions of those four. But you cannot post content.

There have been some followup comments after someone asked a question and it was answered. I have also let those slide. But I want you guys to do your best to stick to the format.

I just don't want another thread that is meant to provide people with information since, we do all need this, to slip back into conspiracy theories.

Thanks for understanding.

Free bird · May 16, 2020

https://www.gurufocus.com/news/1138...-vitro-virus-infection-in-preclinical-studies

[h=1]STI-1499, A Potent Anti-SARS-CoV-2 Antibody, Demonstrates Ability To Completely Inhibit In Vitro Virus Infection In Preclinical Studies[/h]
This is a very encouraging news. Hopefully an antibody cocktail will be available by the end of the year.

Baal · May 16, 2020

Yes, that is another human monoclonal antibody that neutralizes the virus in isolated cells. I mentioned another one near the top of the thread. The company's strategy of developing a cocktail of antobies will increase effectiveness of the ultimate product. The good news (not surprising, but good) is that it does not appear particularly difficult to develop antibodies against exposed SARS-COV-2 antigens, and even better, neutralization can help even critically ill people (based on blood transfusion results). Hopefully they can get this done quickly!

UpSideDownCarl · May 16, 2020

UpSideDownCarl said:
So, I am reposting the OP because we sort of need to keep the original format I explained in the Original Post.

I am going to leave these posts. But it is clear that these are not questions for the guys listed who can post in the thread. And in the last two threads, things started going wrong as a result of people posting things that were comments and opinions.

If you have a question for Baal, Rain, Dr Evil or Passifid you can ask. But this thread is not for everyone to post content. The only people who can post content are Baal, Rain, Dr Evil and Passifid. For everyone else, you can ask questions of those four. But you cannot post content.

There have been some followup comments after someone asked a question and it was answered. I have also let those slide. But I want you guys to do your best to stick to the format.

I just don't want another thread that is meant to provide people with information since, we do all need this, to slip back into conspiracy theories.

Thanks for understanding.

Free bird said:
https://www.gurufocus.com/news/1138...-vitro-virus-infection-in-preclinical-studies

STI-1499, A Potent Anti-SARS-CoV-2 Antibody, Demonstrates Ability To Completely Inhibit In Vitro Virus Infection In Preclinical Studies

This is a very encouraging news. Hopefully an antibody cocktail will be available by the end of the year.

This is good information. But, based on the post directly before it and the rules for this specific thread, in the future I will have to ask you to stick to the format. I am sure what you presented can be framed in the form of a question for these guys to give an educated opinion on. And Baal did that. But I will need everyone to stick to that format where, if you are posting, you are asking a question for Baal, Rain, Dr Evil and Passifid to answer.

Thank you.

Brs · May 16, 2020

So last week the WHO said something about a possibility of this virus becoming endemic. The reporting I saw mentioned for the first time a chance that no effective vaccine can/will be developed. I had sort of been assuming the only vaccine question was when and not if.

Is that what WHO meant?

What is the probability of no vaccine?

Dr Evil · May 16, 2020

Brs said:
So last week the WHO said something about a possibility of this virus becoming endemic. The reporting I saw mentioned for the first time a chance that no effective vaccine can/will be developed. I had sort of been assuming the only vaccine question was when and not if.

Is that what WHO meant?

What is the probability of no vaccine?

Short answer: I think the probability of no vaccine is very small. However, the virus could become endemic even with an effective vaccine, although that wouldn't necessarily be a disaster.

Long answer: A virus becomes endemic when the number of infected people remains constant at a baseline level. This happens when the basic reproduction number R0 and the fraction of susceptible people S balance out (R0 X S = 1). So if an infected person tends to infect about 2 other people in a fully susceptible population (R0 = 2), but around 50 percent of the population is immune at any one time (from recent infection or vaccination), then the virus will hover at a constant prevalence in the community.

So will SARS-2 become endemic? Maybe. It depends on the factors that affect R0 and S. R0 depends the rate of contacts in the population (decreased by social distancing measures), the probability of infection being transmitted during a contact (decreased by wearing masks), and the duration of infectiousness (which could be decreased by an antiviral medication for example). S depends on how many people have gained immunity via recovery from infection or vaccination, how much protection immunity typically provides, and how long that protection lasts.

Recent estimates of the basic reproduction number for SARS-2 average around 2.6. If that's not too far off, and if we get to a point where S is around 40% (i.e., 40% susceptible, 60% immune), then SARS-2 might hit endemic steady state. Sixty percent immunity is plausible (flu shots are typically 50% to 60% effective for healthy adults). So even with a reasonably effective vaccine, it's possible COVID-19 might be with us for a while.

If the virus does become endemic, it wouldn't necessarily be a catastrophe. It could become just another seasonal virus that causes problems for a small percentage of patients. No more big outbreaks, very few of the alarming but rare critical cases. The H1N1 flu strain of 1918-19 (the pandemic that killed 100 million people) hung around as a milder seasonal virus for 40 years.

As far as the chances for an effective vaccine, nobody can say for sure. All the research I'm aware of has been encouraging. For what it's worth, I think we've already developed several vaccines that will work, and now it's a question of establishing safety and efficacy. The financial markets -- including ex-scientist/investors who are paid to guess when we'll have a vaccine -- seem to agree. It makes sense to be skeptical -- it's completely plausible that vaccines currently in development will crash and burn -- but I think the extreme skeptics are ignoring the unprecedented nature of the situation. We know more than we ever did, and we're investing more time and resources, by orders of magnitude, than we ever have before. If we don't have a vaccine in record time, it will be a big upset. But a lot of ways this can go. It's conceivable that in the near term we'll have a vaccine that's safe enough for people in high risk categories, but not safe enough for the general population.

Baal · May 16, 2020

I also think it is highly likely that a vaccine will be developed based on what is coming out these days (and may well already exist). But proving safety and effectiveness, establishing dosing regimen, gearing up production, all that takes a long time.

As Dr. Evil said, vaccine technology has gotten quite advanced, and there doesnt seem to be anything about this virus that makes it especially challenging (unlike, say, HIV). People are clearly able to develop effective immune responses to it.

I'm not knowledgeable enough about epidemiology to comment on whether it will become endemic.

Baal · May 18, 2020

Let me write something about why it takes a long time to test a vaccine.

Drugs and vaccines are tested in three phases but the process for a drug and for a vaccine is a little different because of the nature of how they work. In Phase 1 you give the drug or vaccine to a few healthy volunteers to make sure it does not immediately produce some really bad effect. In the case of the vaccine you also look to see if you can detect some antibodies the patient has generated to the vaccine. A Phase 2 clinical trial for a drug is carried out in a relatively small group of people with the disease, but not a lot, and you are looking at preliminary data for effectiveness. A Phase 2 test for a vaccine is more to identify the dose and number of injections needed to optimize the immune response in case you need to adjust the formulation a bit.

A full scale randomized double-blind clinical trial occurs in Phase 3. If we are testing a drug like remdisivir or chloroquine for Covid-19 you find a bunch of patients, you randomize them into two equivalent groups, one gets the current standard of care plus a placebo, the other gets standard of care plus the drug. You decide in advance what clinical endpoints will indicate success (so-called primary and secondary endpoints), which in Covid-19 might be whether they end up on a respirator, or how long on a respirator, or time to release from the hospital, or how many die, etc. etc., but the key is you have to decide on this in advance. After a few months maybe you have enough patients and clinical outcomes to break the codes of who got drug and who got placebo and analyze what happened and hopefully get a statistically meaningful answer about whether the drug is effective and also what problems it might induce. (Usually a group of statisticians not involved in patient care actually have a look at outcomes about half way through in case there is already a very clear positive or negative result, this is for ethical reasons).

But a vaccine is a different animal because by definition you are giving it to healthy people and the object is to keep them from getting sick (and therefore standards for safety are much higher, plus in the end you will be giving it to children also). So you need a lot more people. You give them the vaccine or a placebo, and then you just let them go about their lives. Now, about a year or more later, you come back and check how many in each group ended up getting sick. You need a lot of people in these trials because maybe only some small % of even the placebo group will get sick (not everyone will get exposed to the pathogen in their daily life). And you need to allow enough time for (a) the immune system to react to the vaccine, which is usually a few weeks, and (b) enough time for enough people in your control group to actually get sick from the pathogen so you will have something to compare the vaccine group to and get a statistically meaningful result if it is actually effective. Most of the time it would be one year to 18 months based on what I've read about influenza, but maybe it could be a little faster with this pandemic. Of course you want to carry out the trial at multiple locations. People who design these kinds of trials are statistical geniuses and they can usually know pretty well in advance how many people and how much time it takes. The more people, the more it costs and maybe the less time it takes. But the more people, the more you have already scaled up your production capacity. Bear in mind also that vaccines are expensive to produce and require refrigeration.

So this is why we can get information on effective drugs faster than effective vaccines (ESPECIALLY if we are re-purposing already approved drugs). Also some things I heard politicians say about when we can expect to get a vaccine seem unrealistic to me. With that said, I am very confident we will eventually have one.

Baal · May 18, 2020

More about neutralizing human monoclonal antibodies

https://www.nature.com/articles/s41586-020-2349-y

What is cool about THESE is they were derived from a patient who recovered from SARS in 2003 but they work against SARS-COV-2. Also the authors are finding several which means that they will be able to create a therapeutic cocktail of these, and also even if the virus mutates a lot in the future the antibodies should continue to work.

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