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    1. Top | #141
      Baal is offline
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      I agree with Dr.. Evil. My best guess is that monoclonal antibody cocktails will end up being more effective. Several are in Phase 3 trials and hopefully we find something soon. They have been carefully designed and you would know exactly what you are giving the patient. As for the plasma, there are so many variables and so hard to control. Evidence so far with that approach is not as encouraging as I was expecting. No proper clinical trials as yet and you might see very different effects depending on the donor.

      What will get us back to normal is a safe and effective vaccine. Convalescent plasmas and infused monkclonal antibodies cannot provide more than transient protection, but I could imagine the antibody being administered in people who test positive on an outpatient basis.

      Meanwhile, there are some very preliminary but encouraging results on a drug that mimics vasoactive intestinal peptide (VIP). This peptide seems to have a pretty strong effect on lung cells and lung blood vessels and it has been used in critically ill Covid-19 patients. Nothing
      peer reviewed yet, so not to get too excited, but several patients on death's door here at Houston Methodist Hospital recovered after receiving it.
      Last edited by Baal; 4 Weeks Ago at 11:00 PM.

    2. Top | #142
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      What about the one and only confirmed case of reinfection with a different strain. Just a freak thing, or not so much?

    3. Top | #143
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      Quote Originally Posted by Brs View Post
      What about the one and only confirmed case of reinfection with a different strain. Just a freak thing, or not so much?
      Not a freak thing. Reinfection will happen, but how common it is and how long after initial infection it becomes more likely are open questions. We'll need to track many patients for a long time to get answers. A single case report won't do it. Interesting that the patient had no symptoms the second time around. Could be that he's effectively immune to getting sick but doesn't have sterilizing immunity. If this turns out to be typical, the virus may become endemic but mostly harmless like most other coronaviruses we know about. On the other hand, more than six months into the pandemic there have been notably few reports of reinfection, so it may turn out to be uncommon. We'll just have to wait and see.

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    5. Top | #144
      Baal is offline
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      I was encouraged by th e lack of symptoms rhe second time. But not surprised that it is possible.

    6. Top | #145
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      I have a question about vaccine efficacy. The US FDA has stipulated that for approval of a vaccine, it must be at least 50% effective. That means that infection rates in a vaccinated group would be 50% less than the rates in a placebo control group. So if 1% of a population is typically infected, with vaccination only .5% would be infected. In a region of 100,000 people, that is still a lot of infections in a vaccinated group (.5% x 100,000 = 500 people) if everyone was vaccinated, which is not likely.

      From a public health perspective, this is good, as I assume the incidence of the virus will gradually continue to decrease, reducing risk for everyone, but from an individual perspective, how does that change my risk initially? If I get vaccinated, that does not mean I am automatically immune from the virus, it just means my chances of getting it have been reduced. So once a vaccine has been developed and I get it, is there a way to see if I am one of the lucky 50% who develop immunity?

      And all these vaccine efficacy studies will be conducted in an environment where masks and social distancing are recommended or required. Do those results translate to a society that then relaxes these restrictions?

      After reflecting on this, I am more interested in seeing effective treatments for COVID-19 rather than vaccines, as this would seem to be more helpful from an individual comfort level, knowing if I get infected, I can get treatment that will mitigate some of the seriousness of the infection.

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    8. Top | #146
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      Quote Originally Posted by zeio View Post
      .....
      Zeio, is there a question with your link? I have deleted your post. If you have a question to add to the link for these guys to answer, I can undelete it. If I don't here from you at a certain point, I will just delete this post as well since it contains your link. [edit: I decided to remove the link without removing this post. I decided a reminder about the rules of this thread was fine to keep up here.]

      I am sure you already know the rules of this thread. But, here they are for anyone who does not know them:

      Quote Originally Posted by UpSideDownCarl View Post
      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.
      Quote Originally Posted by UpSideDownCarl View Post

      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.
      Last edited by UpSideDownCarl; 4 Weeks Ago at 12:10 AM.
      Spin Everything.

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    10. Top | #147
      Dr Evil is offline
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      Quote Originally Posted by allencorn View Post
      I have a question about vaccine efficacy. The US FDA has stipulated that for approval of a vaccine, it must be at least 50% effective. That means that infection rates in a vaccinated group would be 50% less than the rates in a placebo control group. So if 1% of a population is typically infected, with vaccination only .5% would be infected. In a region of 100,000 people, that is still a lot of infections in a vaccinated group (.5% x 100,000 = 500 people) if everyone was vaccinated, which is not likely.

      From a public health perspective, this is good, as I assume the incidence of the virus will gradually continue to decrease, reducing risk for everyone, but from an individual perspective, how does that change my risk initially? If I get vaccinated, that does not mean I am automatically immune from the virus, it just means my chances of getting it have been reduced. So once a vaccine has been developed and I get it, is there a way to see if I am one of the lucky 50% who develop immunity?

      And all these vaccine efficacy studies will be conducted in an environment where masks and social distancing are recommended or required. Do those results translate to a society that then relaxes these restrictions?

      After reflecting on this, I am more interested in seeing effective treatments for COVID-19 rather than vaccines, as this would seem to be more helpful from an individual comfort level, knowing if I get infected, I can get treatment that will mitigate some of the seriousness of the infection.
      A vaccine that's 50% effective by FDA standards wouldn't necessarily reduce your personal risk by the same amount. It would depend on many factors including your age, health, the prevalence of the virus where you live, etc. What it would do is reduce the effective reproduction number (the average number of new cases generated by each case) by a roughly predictable amount in populations matching the clinical trial population. A good vaccine might be able to get R below 1 without any social distancing measures. Of course enough people would have to get vaccinated, and the required number would be higher with a less effective vaccine. I agree that a good treatment, especially one that keeps people out of the hospital, could be as much of a game changer as a vaccine.

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    12. Top | #148
      Baal is offline
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      Clearly we need both: effective treatments and an effective vaccine. Of course the word effective is vague. However a vaccine that makes someone asymptomatic or mildly symptomatic instead of critically ill or dead is effective by my way of thinking but maybe hard to tease out of clinical trials. Dr. Evil has pointed out the cricial population effect on R.

      Regarding drugs, a lot of effective drugs fail on some patients. Look at any randomized clinical trial for anything and you can see that.

      An effective orally bioavailable small molecule antiviral would be ideal and from what I can discern we are nowhere near that for any coronavirus.

      I remain optimistic that vaccines will eventually provide some definite protection but there are people who know more than I do on both sides of that prediction and we will just have to see.

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    14. Top | #149
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    16. Top | #150
      Baal is offline
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      Not tripe and almost certainly right. Might be useful. It's an antibody fragment, an unusually small one, but it can neutralize the virus. Anything that can do that is worth looking at. The idea is (I think) that small pieces can get to more places (which is probably good). It might be safer because it doesn't form aggregates. Probably a lot cheaper to produce. Stil, needs intravenous infusion. I'm not sure how big a breakthrough this is (for example compared to antibody cocktsils) but I might be missing something. University PR units like to put out press releases. But the editors of Cell were convinced, and they are not easy to persuade and this article was extensively peer reviewed by people more knowledgeable than I am. Also the data in the animal model are a lot more convincing than experiments done in a culture dish. Still, it's not yet in even a Phase 1 tfial. Maybe slightly hyped.
      Last edited by Baal; 1 Week Ago at 01:47 AM.

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    18. Top | #151
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      I have noticed that today almost every day there are some "brilliant" discoveries, but careful research turns out to be only remote assumptions from real products.

    19. Top | #152
      Baal is offline
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      You noticed correctly.

      The reality is that biomedical research, especially the kind of lab research I do, always takes awhile to lead to a new therapy (if it does at all, and when it does it is from a lot of work by many labs, never just one study). And even then there are a few years or a decade wherein there are many new clinical trials to really confirm that it IS an advance. I'm still hoping that what I do could lead to a drug. Its a cool idea, might lead to nothing.

      But then there is the hype aspect. I personally have come to dislike it intensely. My very old school mentor used to say don't ever do it. Publish your articles and move on. Like I said, old school British style or so I figured. But later a clinician colleague who works on ALS once explained to me why he would never hype his own research, since it leads to false hopes. His comment had a big impact on me. It actually came after the university released something about one of my papers. It was a a nice paper (he told me), but come on, get real. He was right. I felt properly chastised and a bit embarrassed.

      But university PR departments ALWAYS have another agenda. They are all about (1) attracting philanthropic gifts or other $$$ and (2) convincing young people they think are the best students to enroll. So every paper in a high visibility journal generates a press release (they constantly want us to send them content) and newspapers pick it up uncritically. Science journalism is sometimes excellent, but too often just reprints these PR blurbs. And even within a university, different colleges compete for limited funds. One college at my university would appear to be on the verge of solving EVERY problem afflicting humanity -- if you believe their press releases.

      I personally think it is damaging to science and medicine at a lot of levels. So I'm actually glad you made that comment. My opinion on this might make me a bit of a dinosaur, I'm not sure. I haven't discussed it with younger colleagues. But anyway, that is what drives this.

      Press releases from drug companies are often much closer to an actual product (before that secrecy is the rule) but again, they have multiple agendas (which vary depending on many considerations such as size of company, stock price etc.).
      Last edited by Baal; 6 Days Ago at 02:00 PM.

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    21. Top | #153
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      Quote Originally Posted by souza13alex View Post
      I have noticed that today almost every day there are some "brilliant" discoveries, but careful research turns out to be only remote assumptions from real products.
      I see you are newer to the forum and have not made too many posts. So, I just want to remind you (maybe inform you): this thread has different rules than all other threads. Baal, Dr Evil, Passifid and RainNeverEver can post content as they choose and can answer questions.

      All other forum members, if they post in this thread need to be asking questions.

      Now, Baal responded in a way that makes your post fine. But, in the future, please pose questions in this thread rather than statements or information meant as useful content.

      Feel free to read the OP from the thread with the information on how this particular thread is supposed to work which I am including below.

      Quote Originally Posted by UpSideDownCarl View Post
      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.

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