COVID-19/Coronavirus thread

[StrangeSox]

1 hour ago, Texsox said:

I've been thinking  that this thing will run it's course before a vaccine is commercially viable. 

And by run it's course it will be at an infection rate that is manageable for the local health infrastructure. 

This is either very optimistic about how widespread this already is and how long natural immunity lasts, or pretty pessimistic on vaccine development

[Texsox]

Just now, StrangeSox said:

This is either very optimistic about how widespread this already is and how long natural immunity lasts, or pretty pessimistic on vaccine development

Perhaps both. We're handling 1,000 infections per day here in Bexar county  (San Antonio). In 18 months that's about 500,000 more patients. Will we have a vaccine that quickly? I'm not certain what is pessimistic and what is optimistic. 3 months? 12 months? 24 months? 

[bmags]

I think this board often forgets about treatment advancements, which will also continue. Even in the world where we don't get a small pox-like eradication with a vaccine, it may be one where we get greater immunity + a much less devastating infection.

[Balta1701]

6 minutes ago, Texsox said:

Perhaps both. We're handling 1,000 infections per day here in Bexar county  (San Antonio). In 18 months that's about 500,000 more patients. Will we have a vaccine that quickly? I'm not certain what is pessimistic and what is optimistic. 3 months? 12 months? 24 months? 

Google lists Bexar county's population as just over 2 million, so at that rate you're talking 3 to 4 years before you had enough people infected to start approaching herd immunity, and that's under the assumption that the infection provides long-lasting immunity which we know in some cases it doesn't. 

[Texsox]

What I predicted is a stabilization of the infection rate that is at or below health care capacity before a vaccine is commercially available. 

[StrangeSox]

46 minutes ago, Texsox said:

Perhaps both. We're handling 1,000 infections per day here in Bexar county  (San Antonio). In 18 months that's about 500,000 more patients. Will we have a vaccine that quickly? I'm not certain what is pessimistic and what is optimistic. 3 months? 12 months? 24 months? 

Optimistic at this point is that the Oxford/AstraZeneca vaccine flies through Phase 3 trials with continued high rates of success. Emergency distribution could begin as early as October. Widespread availability could be some time early next year or next spring in the US. Experts seem cautiously hopeful on this one. The Moderna one has some more questions. I think the best-case expectations are that we have enough vaccines out there and distributed and injected that things can pretty much return to normal by next summer.

I'm not sure how well you can stabilize if you're still below the threshold for herd immunity stopping Rt from going to 1 or higher. If 40-50% of your population has protective antibodies, the disease could still spread rapidly through the other half at ways that could overwhelm local health care.

49 minutes ago, bmags said:

I think this board often forgets about treatment advancements, which will also continue. Even in the world where we don't get a small pox-like eradication with a vaccine, it may be one where we get greater immunity + a much less devastating infection.

Hey man I can only say "go listen to TWiV" so many times! They regularly have Daniel Griffin from NYC on and discuss clinical updates.

That's something else to keep in mind with whatever vaccine(s) we do get out of this. They may not be fully protective, meaning you might still be able to contract SARS-Cov-2, but it may substantially reduce the risk of serious complications. The flu vaccine works partially like this in that it boosts our general immune system and can take the edge off influenza even if you do get sick.

[caulfield12]

1 hour ago, StrangeSox said:

This is either very optimistic about how widespread this already is and how long natural immunity lasts, or pretty pessimistic on vaccine development

We’re also not considering the impact of it hitting South Africa full bore at the moment and running out of control throughout the rest of sub-Saharan Africa...

 

“While South Africa is experiencing a very, very severe event, I think it is really a marker of what the continent could face, if urgent action is not taken to provide further support,” Dr. Mike Ryan, director of WHO’s Health Emergencies Programme, said Monday during a media briefing in Geneva.

South Africa has the fifth most confirmed Covid-19 infections in the world, according to data compiled by Johns Hopkins University. Ryan said South Africa is experiencing an acceleration in Covid-19 cases, which have increased by about 30% in the last week.

“Sometimes, this disease can take off very quickly,” Ryan said. “And sometimes, in other situations, it takes off more slowly, and then accelerates – and it's difficult to understand fully why that is the case.”

Ryan noted other countries in the region have seen Covid-19 increases, though their total case counts are still lower than South Africa’s. In the past week, cases in countries such as Madagascar, Namibia and Botswana have increased by 50%, 69% and 66%, respectively, according to Ryan.

“I'm very concerned right now that we're beginning to see an acceleration of disease in Africa,” Ryan said. “And we all need to take that very seriously and show solidarity and support to those countries who may now be experiencing increasing numbers of cases and deaths.”

Edited July 20, 2020 by caulfield12

[Texsox]

47 minutes ago, StrangeSox said:

Optimistic at this point is that the Oxford/AstraZeneca vaccine flies through Phase 3 trials with continued high rates of success. Emergency distribution could begin as early as October. Widespread availability could be some time early next year or next spring in the US. Experts seem cautiously hopeful on this one. The Moderna one has some more questions. I think the best-case expectations are that we have enough vaccines out there and distributed and injected that things can pretty much return to normal by next summer.

I'm not sure how well you can stabilize if you're still below the threshold for herd immunity stopping Rt from going to 1 or higher. If 40-50% of your population has protective antibodies, the disease could still spread rapidly through the other half at ways that could overwhelm local health care.

Hey man I can only say "go listen to TWiV" so many times! They regularly have Daniel Griffin from NYC on and discuss clinical updates.

That's something else to keep in mind with whatever vaccine(s) we do get out of this. They may not be fully protective, meaning you might still be able to contract SARS-Cov-2, but it may substantially reduce the risk of serious complications. The flu vaccine works partially like this in that it boosts our general immune system and can take the edge off influenza even if you do get sick.

So again, my prediction is by the time we have a vaccine our health care infrastructure will be able to handle the number of infections. Here in SA we're already handling about 1,000 per day and more resources are coming up to speed. I'm not talking about herd immunity, someone else put those words in my mouth. The argument against my position is we will have more infections than we can handle when a vaccine is commercially available. In your example next spring or summer we will be in worse shape than today. That would mean a loss in infrastructure capacity or a large increase in the rate of infection. It seems like we are getting better at treating the disease which is decreasing the rate and length of hospitalizations. 

[bmags]

4 minutes ago, Texsox said:

So again, my prediction is by the time we have a vaccine our health care infrastructure will be able to handle the number of infections. Here in SA we're already handling about 1,000 per day and more resources are coming up to speed. I'm not talking about herd immunity, someone else put those words in my mouth. The argument against my position is we will have more infections than we can handle when a vaccine is commercially available. In your example next spring or summer we will be in worse shape than today. That would mean a loss in infrastructure capacity or a large increase in the rate of infection. It seems like we are getting better at treating the disease which is decreasing the rate and length of hospitalizations. 

I still don't really understand what you are saying. It comes across like "by the time a vaccine is developed, it will not be needed because it will already be controlled". I'm not sure what your counterargument you are sharing even means. 

But based off of that initial statement, that control is coming at a high cost. Mandated face coverings, gatherings restricted to under 10. The vaccine allows similar control of the virus (if not total) but with much more freedom of movement, business, everything. 

If you are saying by the time the vaccine comes it will not be a raging epidemic and test and trace is in effect so it won't be that big of a deal, I'd be skeptical. Even countries with awesome success still have consistent rollbacks, and as Caulfield says, many still have travel restrictions. There will be nowhere near the same level of typical freedom until there is a very effective treatment or vaccine

 

[StrangeSox]

Yeah. Even if we stay below hospital capacity, that doesn't mean we're on good shape. That's still hundreds of thousands dead and millions or tens of millions seriously ill, some chronically, and trillions upon trillions in health care costs. We're getting better at not having the worst cases die, but there are still a lot of terrible outcomes out there and will be for the foreseeable future.

[Texsox]

I believe that we are getting better at treatment and by the time a vaccine is available (actually if a vaccine is available) we'll be in better shape than we are now. Of course it will be necessary, just like a HIV vaccine is necessary. But if for some reason a vaccine is elusive for this virus I believe we will reach a point with better treatment that the virus will not be crippling us like it is now. 

Or this way, I believe we will be in better shape months down the road and in even better shape a year from now, with or without a vaccine. I'm not sure why I'm confusing people. At worst it's optimism about treatment and infrastructure and pessimistic about a vaccine. 

[StrangeSox]

I just don't think any of the medical/scientific experts expect such dramatic improvements in treatment, especially going forward.  They threw everything they could think of at this thing at the start and now have a much better handle on it than they did in March and April. But by now, a lot of the different possibilities have been tried. It's made a difference, but it didn't suddenly make this not a dangerous and potentially deadly virus for a lot of people.

[bmags]

4 minutes ago, Texsox said:

I believe that we are getting better at treatment and by the time a vaccine is available (actually if a vaccine is available) we'll be in better shape than we are now. Of course it will be necessary, just like a HIV vaccine is necessary. But if for some reason a vaccine is elusive for this virus I believe we will reach a point with better treatment that the virus will not be crippling us like it is now. 

Or this way, I believe we will be in better shape months down the road and in even better shape a year from now, with or without a vaccine. I'm not sure why I'm confusing people. At worst it's optimism about treatment and infrastructure and pessimistic about a vaccine. 

I agree and am bullish on treatments. I was confused because you were talking about local health infrastructure and capacity, which is to date much more controlled by public health policy than, at this point, advances in treatment. Even things like remdesivir have largely been, due to supply, mostly tested in late stages where it has seen improvement. But it's possible at earlier stages it has an even better rate and I'm not sure that's been studied yet.

[bmags]

3 minutes ago, StrangeSox said:

I just don't think any of the medical/scientific experts expect such dramatic improvements in treatment, especially going forward.  They threw everything they could think of at this thing at the start and now have a much better handle on it than they did in March and April. But by now, a lot of the different possibilities have been tried. It's made a difference, but it didn't suddenly make this not a dangerous and potentially deadly virus for a lot of people.

antibody treatments are expected to arrive in September.

[Texsox]

6 minutes ago, StrangeSox said:

I just don't think any of the medical/scientific experts expect such dramatic improvements in treatment, especially going forward.  They threw everything they could think of at this thing at the start and now have a much better handle on it than they did in March and April. But by now, a lot of the different possibilities have been tried. It's made a difference, but it didn't suddenly make this not a dangerous and potentially deadly virus for a lot of people.

The treatments have become more efficient freeing up hospital beds quicker. I'm not suggesting it's not dangerous or deadly. I'm saying we will make improvements even if a vaccine never comes on line. We treat every disease better today than we have in the past. Better procedures and better protocols. A vaccine isn't our only path to a better tomorrow. 

[raBBit]

5 hours ago, Eloy Jiménez said:

Technologically, I think Oxford or Moderna would be the most likely to "stick". The risk with Moderna is the novel vaccine. Side effect profile requires more attention than a more traditional vaccine.

But at least the Oxford one appears to work to some degree.

From what I've read, Moderna has nowhere near the production capacity for this scale. Seems like if they had a breakthrough they'd have to be partnered with another company but there does seem to be some support from the Administration with Moderna through Kushner.  Past that, their recent data release from last week was based off results of n=40 or 45.

I like AstraZeneca as the leader. 

Edited July 20, 2020 by raBBit

[Texsox]

So how fast is everybody going to get in line for a rushed to market vaccine? I'm not an anti vaxx person, but as someone who took a drug that was later pulled from the market for causing an increased in cancer rates, it's not as clear cut as it may appear. But, of course there only humanitarian reasons for working so hard on finding a vaccine. Not profit or politics. 

[Jerksticks]

7 minutes ago, Texsox said:

So how fast is everybody going to get in line for a rushed to market vaccine? I'm not an anti vaxx person, but as someone who took a drug that was later pulled from the market for causing an increased in cancer rates, it's not as clear cut as it may appear. But, of course there only humanitarian reasons for working so hard on finding a vaccine. Not profit or politics. 

My answer for now is hell no.  

 

But if people start dying like crazy I’d definitely give it some serious thought.  I’m hoping people don’t start dying like crazy so I can avoid it. 

[StrangeSox]

14 minutes ago, Texsox said:

So how fast is everybody going to get in line for a rushed to market vaccine? I'm not an anti vaxx person, but as someone who took a drug that was later pulled from the market for causing an increased in cancer rates, it's not as clear cut as it may appear. But, of course there only humanitarian reasons for working so hard on finding a vaccine. Not profit or politics. 

It will depend on what the Phase 3 trials find as far as complications go and how large the trial sizes were and what countries' FDA equivalents have reviewed and approved it.

[bmags]

24 minutes ago, Texsox said:

So how fast is everybody going to get in line for a rushed to market vaccine? I'm not an anti vaxx person, but as someone who took a drug that was later pulled from the market for causing an increased in cancer rates, it's not as clear cut as it may appear. But, of course there only humanitarian reasons for working so hard on finding a vaccine. Not profit or politics. 

Confused why you are bullish on the treatments for covid but skeptical of the vaccine despite it being just as probable some of these new treatments may have long-term side effects.

[Texsox]

6 minutes ago, bmags said:

Confused why you are bullish on the treatments for covid but skeptical of the vaccine despite it being just as probable some of these new treatments may have long-term side effects.

I'm not rushing to be treated either. 😉 My question was genuine. If we are banking on the vaccine fixing everything then everyone is going to have to line up and take the vaccine. I'm wondering how quickly that will really happen. I'm probably going to trust my doctors at MD Anderson and if they say go for it, I'll go for it. I've basically had to put my lifespan in their hands already. But what about the average worker drone? 

Confused? I have cancer (Leukemia) after being on a drug that was recently pulled from the market for an increase in cancers. Using known drugs in new ways seems less risky than a vaccine, but that could just be my ignorance. New drugs, new vaccines, new anything has me skeptical. 

[caulfield12]

1 hour ago, bmags said:

I still don't really understand what you are saying. It comes across like "by the time a vaccine is developed, it will not be needed because it will already be controlled". I'm not sure what your counterargument you are sharing even means. 

But based off of that initial statement, that control is coming at a high cost. Mandated face coverings, gatherings restricted to under 10. The vaccine allows similar control of the virus (if not total) but with much more freedom of movement, business, everything. 

If you are saying by the time the vaccine comes it will not be a raging epidemic and test and trace is in effect so it won't be that big of a deal, I'd be skeptical. Even countries with awesome success still have consistent rollbacks, and as Caulfield says, many still have travel restrictions. There will be nowhere near the same level of typical freedom until there is a very effective treatment or vaccine

 

I’ll give another example.  90% of Thais were surveyed recently and answered they prefer foreign tourists (majority are Chinese) to enter their country.

Keep in mind, Thailand’s tourism sector is roughly 20% of their economy, and they have super-close (some would say incestuous) ties with China over the last five years, not to mention Belt & Road projects like a railway.  Yet they are still afraid of the consequences of another shutdown.

Right now, it’s not even certain we will be able to leave for October (national) holidays, and arguably many simply won’t want to deal with the increased hassles.   You’ve got major airlines (Quantas) not expecting anything like normalcy before next summer, and Australia and NZ have come out of this extremely well so far.   HK/Cathay have been decimated, and that’s one of the biggest Asian hubs, along with Bangkok, Seoul and Tokyo.   More and more, outside of European cooperation, it feels like every country is pretty much on its own, and that’s truly unfortunate consequence for our children and grandchildren, to essentially be cut off from discovering the world for themselves .

IMO, we are headed towards increasing isolation (because of our Covid response and general belligerence)...fortunately, China has overplayed its hand (and too early), so the pushback is already coming from around the world.   It’s hard to imagine two such diametrically opposed superpowers being able to tolerate with each other for more than the next 10-15 years.   On top of all that, international efforts to cooperate and collaborate through entities like the WHO, UN, NATO and the World Bank are at risk...not to mention key areas like climate change and global trade that are increasingly veering towards an “every an country for itself/survival of the fittest mindset”.   No matter what happens in November, you’ll still have an American society increasingly at odds with itself unless bold, transformative leadership emerges to meet the challenge.

Edited July 20, 2020 by caulfield12

[bmags]

5 minutes ago, Texsox said:

I'm not rushing to be treated either. 😉 My question was genuine. If we are banking on the vaccine fixing everything then everyone is going to have to line up and take the vaccine. I'm wondering how quickly that will really happen. I'm probably going to trust my doctors at MD Anderson and if they say go for it, I'll go for it. I've basically had to put my lifespan in their hands already. But what about the average worker drone? 

Confused? I have cancer (Leukemia) after being on a drug that was recently pulled from the market for an increase in cancers. Using known drugs in new ways seems less risky than a vaccine, but that could just be my ignorance. New drugs, new vaccines, new anything has me skeptical. 

But the drugs are new too. There was really only one successfully repurposed drug, remdesivir never ended up proving helpful for what it started as. And obviously even longstanding common drugs can turn out to have terrible effects (talcum powder).

You answered the question, but I didn't understand why you were fine with the medical treatment but skeptical of a vaccine. There will be risks in both, but at least we are dealing with many eyes and multiple countries working at once to provide consumer feedback on risks. From what it sounds like, there are mild side effects for the leading vaccines to date.

But there are risks with the treatments, there are risks with the vaccine, but nothing about this virus has shown it can be tamed without significant intervention and that level of disruption makes those risks more tolerable.

And, in weighing either, you have to weight the significant chance someone would get covid without the population taking the new drugs/vaccines and the significant toll that takes.

Hopefully the vaccine that makes it has no/little side effects, it provides more immunity than a flu shot. But if it is something with mild side effects, yes I will get it when its available and my wife and kids will also get it. 

 

[Texsox]

I'm skeptical of both. I'm more skeptical of a vaccine working based on the promise of a HIV vaccine (and others)  in the 1980s. I've seen more new drugs come on the market to treat diseases than vaccines to prevent them. Perhaps it's ignorance but treatments seem to be easier to develop than vaccines.  

[Texsox]

I don't think I'm any more optimistic or pessimistic on a vaccine than I am on treatments.

Six months ago we were almost no where with treatments. We are better today, and will continue to get better. (I believe)

Today we don't have a vaccine. When one is developed we will be better off that day, and it will continue to get better. It's not one over the other, we're just further down the road with one path.