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Aesma
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 4:45 pm

par13del wrote:
On the trials front, what I fail to understand is for those drugs that were already being used for malaria for example, they went through years of trials before being released and have been in use on humans for a long time, yet they still have to suspend their use to investigate their effects on the human body?
I accept the educated think the general population are lacking, but ....


(hydroxy)chloroquine is given at a low dose, to people with chronic malaria, or to people who go to places where malaria is endemic. Or rather, was given, because nowadays it has lost its effectiveness.

The proposed treatment against COVID implies much higher doses.

Also, what we really want is a treatment that would help people most in danger of suffering badly from COVID, but a large number of these people have weak hearts, and chloroquine is a bad idea if you have that problem.
New Technology is the name we give to stuff that doesn't work yet. Douglas Adams
 
StarAC17
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 5:16 pm

MileHFL400 wrote:
So at the back of my mind, and even more so now since I got tested positive for covid I’ve been wondering when normality will return to the world. The common answer seems to be that will be when a vaccine is found?

I hear that we may see one approved by October?

When will we see a return to normality? End of this year? Begin of next year?


I hope you are well and you recover without any long-term issues.

I think the world waiting on a vaccine for a virus that is not realistic and people are going to start saying f*ck it. Those who are scared say home but be free to live your life as safely as possible. We have to learn to live with this in the meantime and this virus compared to other seems pretty meek to most people. 80% of the death have been seniors who all have underlying health condition. Those who are in nursing homes typically do because they are in nursing homes, most people do not want to go into those facilities willingly

An effective vaccine could be ready by January, in 5 years or never come. I'm betting on an effective treatment first.

casinterest wrote:
I am worried about whether a vaccine will be effective enough. Even the flu vaccine leaves some folks susceptible.

The common cold mutates so fast we never get a vaccine for it, and maybe it doesn't matter as it is rarely deadly.
If Covid is in between these two, we could be in for years of issues.

I think the biggest issue though is getting through this initial wave. We are social distancing for the hospitals because they will not handle the influx of folks that are susceptible to the disease.
In 5-6 months, we may be at a point where we have a vaccine or so many folks have passed on that we go into an immune phase.


I figure once we get to 60-70% having the antibodies, we will have the herd immunity, and it will slow the spread greatly whether we get a vaccine or not.


This virus doesn't seem to have that level of mutation that the common cold has or even the flu. Remember there is more than one virus that causes the common cold. There are 4 endemic coronaviruses that cause about a third of them they provide 3 years of immunity. The remainder come from the influenza virus and the Rhinovirus. This is why it is so hard to vaccinate for the common cold because its not one simple virus and also the symptoms are merely and inconvenience.

frmrCapCadet wrote:
A vaccine has to be established as safe, effective dose determined, over all effectiveness established. October is far too optimistic. We don't even know now if contracting the disease produces immunity.


So if the disease doesn't produce immunity then a vaccine is not possible because that is what a vaccine does without making the host sick.

People with covid19 have immunity I'm sure but the question is how long does it last for, and does the immunity merely prevent the illness again but you can be infected and be potentially contagious but you personally won't get sick.

stl07 wrote:
There had been a return to normalcy in many countries such as New Zealand, Thailand, and Australia. But for that, you need to kick out the virus. This requires a competent government that uses science and requires masks and contact tracing


Not really. They have dealt with is locally but how are they planning to handle tourists and other international traffic again? Requesting everyone self-isolate for 2 weeks works now but long term is completely unrealistic.

fr8mech wrote:
I have a couple of concerns about a vaccine.

The first concerns bringing the vaccine to market. Are we moving too quickly, potentially introducing a “dangerous” vaccine into the equation? What safeguards are we setting aside? And, if they can be set aside in this case, why are they there in the first place? Is it a simple social economic question balancing the potential deaths from COVID-19 against the potential deaths of a vaccine that hasn’t been rigorously tested?

Second, will there be a strain of COVID-19 next “season” sufficiently different from this strain as to render a vaccine ineffective?

The whole idea of flattening the curve has not been to eliminate the virus. The precautions we’ve been taking to flatten the curve serve to prolong the time this pandemic affects us, while at the same time trying to keep the number of folks requiring critical medical care from overwhelming the healthcare system.

It is silly to think there wouldn’t be a 2nd or even 3rd and 4th wave as we open up. I suggest, that barring a quick, effective vaccine, those waves are absolutely necessary to beating this thing.


Well from my perspective, my country's government initially did that and moved the goalposts to elimination frustrating many. Thankfully the clamps are slowly being removed and we can interact with people in small settings.We can't hide forever and people will simply have normal social interactions again with or without the government.

This method of eradication and prolonged social distancing could prolong this pandemic and many health experts say that, you don't save lives, you just move the date. Even the large case loads we see in Florida, Arizona and Texas should be fine if the hospital capacity can deal with it. What we want to avoid is choosing who lives and who dies and if its looking like that will be the case then by all means tighten up the economy and movement of people.

At the end of the day this virus is Darwin at work and that sucks for those who will die themselves or lose loved ones but a coffin in coming for everyone one of us. Also while this might sound heartless it doesn't mean that we purposely infect Grandma (in fact do everything you can to protect her), but society will and has to move on.

Also in Toronto the BLM protests and some newsworthy outdoor gatherings have not caused a spike despite record testing.
Engineers Rule The World!!!!!
 
MileHFL400
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 5:35 pm

Jalap wrote:
MileHFL400 wrote:
I read somewhere that the Oxford University trial may take place in Brazil. I believe they have the fastest growth in cases.

Yes, forgot about Bazil.
I read there’s 2 possible vaccines in the lead. The Oxford one, and Johnson & Johnson.
J&J will start with 1045 humans in Belgium (where it’s being developed) & the USA in July. That’s the phase 1/2 test (see what the reaction is and if the correct antibodies are indeed being generated).
Phase 3 (large scale with vaccine or placebo control group) they hope to start in September. Chance of succes is estimated at 50 percent.
They already started production, they aim to having 1 billion doses in 2021.


Pardon my ignorance. Is that trial in July 2020?
Thanks and best Regards
AA
 
LCDFlight
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 5:42 pm

Jalap wrote:
LCDFlight wrote:
I think NYC was fully exposed and the distancing had a very mild effect, because the city was already so soaked. And as a result, the city will not have significant future COVID hospitalizations. But actual scientists will figure this out. So far, your theory is one viable theory and so is mine AFAIK..

Theories need proof.
Serological testing seem to indicate less than 10 percent infection rates, even in the hardest hit places.
Of course, those tests could be flawed. Yet the numbers are a strong argument for limited exposure and very effective results from distancing. Second argument is that countries without strict distancing have never seen a drop in infections. Sweden, Belarus to name 2. Strong cases for the effectiveness of distancing.

There is zero evidence that there could have been total exposure anywhere.

If I was to make decisions based on 2 theories, I think I would take the one with at least some evidence.

Now, it may turn out that we’re lucky some countries didn’t go for strict distancing. Those will be ideal places to test the new vaccines.


US deaths have gone sharply down. If social distancing was the sole reason (and not herd immunity), deaths will rise after social distancing becomes relaxed. We will see if NYC ever has another substantial wave of COVID deaths. If it is truly endemic to all NYers right now, then that wave is not a possibility. So, we'll see.

The hypothesis that infection is much wider, and herd resistance is already widely in effect, has not been disproven at all. Look at the New Jersey death curve. Do we really think COVID can come back in New Jersey? Name one region where we have seen that. I am scouring all the death curves, but we aren't seeing double waves anywhere. Once death toll reaches 0.1% of total population, there is no record of any big wave after that.

And those deaths appear to be concentrated in the final year of people's natural expected lives. The epidemic is having very little effect on life expectancy, the most important public health metric. Compared to obesity or other diseases, this is not proven to be a serious threat to life expectancy yet. It's a risk though, and precautions are good. I wear a mask to exposure areas.
Last edited by LCDFlight on Sun Jun 21, 2020 5:52 pm, edited 1 time in total.
 
MileHFL400
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 5:50 pm

LCDFlight wrote:
Jalap wrote:
LCDFlight wrote:
I think NYC was fully exposed and the distancing had a very mild effect, because the city was already so soaked. And as a result, the city will not have significant future COVID hospitalizations. But actual scientists will figure this out. So far, your theory is one viable theory and so is mine AFAIK..

Theories need proof.
Serological testing seem to indicate less than 10 percent infection rates, even in the hardest hit places.
Of course, those tests could be flawed. Yet the numbers are a strong argument for limited exposure and very effective results from distancing. Second argument is that countries without strict distancing have never seen a drop in infections. Sweden, Belarus to name 2. Strong cases for the effectiveness of distancing.

There is zero evidence that there could have been total exposure anywhere.

If I was to make decisions based on 2 theories, I think I would take the one with at least some evidence.

Now, it may turn out that we’re lucky some countries didn’t go for strict distancing. Those will be ideal places to test the new vaccines.


US deaths have gone sharply down. If social distancing was the sole reason (and not herd immunity), deaths will rise after social distancing becomes relaxed. Social distancing needs to relax because of the dire human and economic cost of these extreme measures. These restrictions are being relaxed. We will see if NYC ever has another substantial wave of COVID deaths. If it is truly endemic to all NYers right now, then that wave is not a possibility. So, we'll see.


Unfortunately South Korea’s numbers have gone up after social distancing measures were relaxed.
Thanks and best Regards
AA
 
Dieuwer
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 5:54 pm

MileHFL400 wrote:
LCDFlight wrote:
Jalap wrote:
Theories need proof.
Serological testing seem to indicate less than 10 percent infection rates, even in the hardest hit places.
Of course, those tests could be flawed. Yet the numbers are a strong argument for limited exposure and very effective results from distancing. Second argument is that countries without strict distancing have never seen a drop in infections. Sweden, Belarus to name 2. Strong cases for the effectiveness of distancing.

There is zero evidence that there could have been total exposure anywhere.

If I was to make decisions based on 2 theories, I think I would take the one with at least some evidence.

Now, it may turn out that we’re lucky some countries didn’t go for strict distancing. Those will be ideal places to test the new vaccines.


US deaths have gone sharply down. If social distancing was the sole reason (and not herd immunity), deaths will rise after social distancing becomes relaxed. Social distancing needs to relax because of the dire human and economic cost of these extreme measures. These restrictions are being relaxed. We will see if NYC ever has another substantial wave of COVID deaths. If it is truly endemic to all NYers right now, then that wave is not a possibility. So, we'll see.


Unfortunately South Korea’s numbers have gone up after social distancing measures were relaxed.


South Korean deaths are rather stable:. https://www.worldometers.info/coronavir ... uth-korea/
Last edited by Dieuwer on Sun Jun 21, 2020 6:03 pm, edited 1 time in total.
 
LCDFlight
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 6:00 pm

MileHFL400 wrote:
LCDFlight wrote:
Jalap wrote:
Theories need proof.
Serological testing seem to indicate less than 10 percent infection rates, even in the hardest hit places.
Of course, those tests could be flawed. Yet the numbers are a strong argument for limited exposure and very effective results from distancing. Second argument is that countries without strict distancing have never seen a drop in infections. Sweden, Belarus to name 2. Strong cases for the effectiveness of distancing.

There is zero evidence that there could have been total exposure anywhere.

If I was to make decisions based on 2 theories, I think I would take the one with at least some evidence.

Now, it may turn out that we’re lucky some countries didn’t go for strict distancing. Those will be ideal places to test the new vaccines.


US deaths have gone sharply down. If social distancing was the sole reason (and not herd immunity), deaths will rise after social distancing becomes relaxed. Social distancing needs to relax because of the dire human and economic cost of these extreme measures. These restrictions are being relaxed. We will see if NYC ever has another substantial wave of COVID deaths. If it is truly endemic to all NYers right now, then that wave is not a possibility. So, we'll see.


Unfortunately South Korea’s numbers have gone up after social distancing measures were relaxed.


South Korea has very few Covid deaths (way lower % than any US state by a factor of about 10). Their death rate is zero or one death per day recently. In a country of 50 million people, they have recorded 250 deaths. This would be like the USA recording 1,500 deaths. Instead we are at 120,000 deaths. South Korea is talking about still controlling the virus. We're not.
 
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Aesma
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 7:04 pm

Iran ? Brazil ?
New Technology is the name we give to stuff that doesn't work yet. Douglas Adams
 
MileHFL400
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 7:10 pm

LCDFlight wrote:
MileHFL400 wrote:
LCDFlight wrote:

US deaths have gone sharply down. If social distancing was the sole reason (and not herd immunity), deaths will rise after social distancing becomes relaxed. Social distancing needs to relax because of the dire human and economic cost of these extreme measures. These restrictions are being relaxed. We will see if NYC ever has another substantial wave of COVID deaths. If it is truly endemic to all NYers right now, then that wave is not a possibility. So, we'll see.


Unfortunately South Korea’s numbers have gone up after social distancing measures were relaxed.


South Korea has very few Covid deaths (way lower % than any US state by a factor of about 10). Their death rate is zero or one death per day recently. In a country of 50 million people, they have recorded 250 deaths. This would be like the USA recording 1,500 deaths. Instead we are at 120,000 deaths. South Korea is talking about still controlling the virus. We're not.


Still amused that Trump thinks that numbers will go down if he reduces testing.
Thanks and best Regards
AA
 
MileHFL400
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 7:11 pm

Aesma wrote:
Iran ? Brazil ?


Iran is facing one hell of a second wave.
Thanks and best Regards
AA
 
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par13del
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 10:14 pm

Florida reporting inclusive of hospital admissions
https://www.miamiherald.com/news/corona ... 94827.html
 
Jalap
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Re: Covid 19 vaccine and return to normality?

Sun Jun 21, 2020 11:52 pm

MileHFL400 wrote:
Jalap wrote:
MileHFL400 wrote:
I read somewhere that the Oxford University trial may take place in Brazil. I believe they have the fastest growth in cases.

Yes, forgot about Bazil.
I read there’s 2 possible vaccines in the lead. The Oxford one, and Johnson & Johnson.
J&J will start with 1045 humans in Belgium (where it’s being developed) & the USA in July. That’s the phase 1/2 test (see what the reaction is and if the correct antibodies are indeed being generated).
Phase 3 (large scale with vaccine or placebo control group) they hope to start in September. Chance of succes is estimated at 50 percent.
They already started production, they aim to having 1 billion doses in 2021.


Pardon my ignorance. Is that trial in July 2020?

Yes.
Apologies for not being clear enough and not posting a source. It was all over the news in Belgium (read the news in Dutch), but here's the actual Johnson & Johnson press release (in English): https://www.jnj.com/johnson-johnson-ann ... lf-of-july
 
StarAC17
Posts: 3811
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 2:26 am

MileHFL400 wrote:
LCDFlight wrote:
Jalap wrote:
Theories need proof.
Serological testing seem to indicate less than 10 percent infection rates, even in the hardest hit places.
Of course, those tests could be flawed. Yet the numbers are a strong argument for limited exposure and very effective results from distancing. Second argument is that countries without strict distancing have never seen a drop in infections. Sweden, Belarus to name 2. Strong cases for the effectiveness of distancing.

There is zero evidence that there could have been total exposure anywhere.

If I was to make decisions based on 2 theories, I think I would take the one with at least some evidence.

Now, it may turn out that we’re lucky some countries didn’t go for strict distancing. Those will be ideal places to test the new vaccines.


US deaths have gone sharply down. If social distancing was the sole reason (and not herd immunity), deaths will rise after social distancing becomes relaxed. Social distancing needs to relax because of the dire human and economic cost of these extreme measures. These restrictions are being relaxed. We will see if NYC ever has another substantial wave of COVID deaths. If it is truly endemic to all NYers right now, then that wave is not a possibility. So, we'll see.


Unfortunately South Korea’s numbers have gone up after social distancing measures were relaxed.


South Korea's numbers were determined to be at a few specific things one being a nightclub and IIRC were quickly curtailed.

I am not super concerned about rising case numbers as most people will have mild cases and recover on their own, of the active cases 99% are mild and 1% are serious. Any case that recovers on their own is likely immune for at least some time and is one more person who can't be infected at least for now.

https://www.worldometers.info/coronavirus/

What we should be continuing to monitor is hospitalizations and ICU capacity and keep those in check to not be put in position to having to make the choice of who lives and dies. Some factor of social distancing and mask wearing probably be present for some time but hopefully some degree of normalcy can slowly resume such as sports with fans, movies, amusement parks and travel.
Engineers Rule The World!!!!!
 
KFTG
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 3:50 am

The COVID-19 industrial complex and their allies in the media are hell bent on imposing another lockdown.
Amazon, et al. would like nothing more than to see every single brick and mortar retailer closed down.
The media would like nothing more than ever single American locked in their homes watching as much tee-vee and YouTube ads as possible.
It ain't happening.
Deaths are not spiking.
This thing is puttering out just like SARS did, albeit on a global scale.
 
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DocLightning
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 4:05 am

I'll recall the H1N1 pandemic of 2009. The first cases of H1N1 were reported in late March, early April of 2009. Influenza vaccines were already well-studied and their production was well-established with a solid infrastructure and known practices and supply chains.

It took six months for the vaccine to be available to healthcare professionals and another month after that for it to be introduced to the general public.

We now have a new virus that is poorly-understood. The lead candidates for vaccines use some pretty novel systems. Both Oxford and J&J are using adenovirus vectors, which contain a gene encoding the SARS-CoV-2 that will be expressed and displayed on the surface of the cell that the adenovirus vector infects. However, the adenovirus vectors are replication-incompetent, meaning that they lack certain genes required to make more adenovirus particles. They can be grown quickly on cell lines that express these missing genes, so that helps a lot, but such a vaccine has never before been scaled up to produce billions of doses. To put this into perspective, they're going to need ~2.5kg of adenovirus to cover a billion people! Nobody has ever made that much adenovirus before.

Moderna is working on an RNA vaccine. An RNA Vaccine has never been successfully used in humans before, although it does appear that Moderna has most of the pitfalls worked out. This vaccine was the first to be produced because the production process for RNA is so simple. Like the virus vectored approach, it makes cells produce the S protein of SARS-CoV-2. Making cells make the protein simulates a viral infection and should induce a robust immune response. That said, they are still going to need a kilogram of RNA to cover one billion people, and if it turns out that two doses are needed, two kilograms.

Then there are the cardboard boxes, the freezer packs, the styrofoam shipping containers, the syringes, the needles, and all the package inserts. I will be very impressed if I, a physician, have any of these vaccines go into my deltoid before January.

On top of that, there are a lot of people who do not plan to get any such vaccine because of the rushed way in which it is being developed. I can't say I blame them for being cautious. We have been burned by vaccines before (and believe me, I am no anti-vaxxer). I am going to reserve my judgement on the matter until I see the vaccine myself along with its safety and efficacy data.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
flyguy89
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 4:10 am

KFTG wrote:
This thing is puttering out just like SARS did, albeit on a global scale.

I don't think that's the case, not that I hope otherwise. Deaths are a trailing indicator, so we may yet see a substantial spike in deaths...although since it's mostly younger people catching the virus now, many experts are theorizing the number of deaths will remain low. I hope that'll be the case. I don't think there's an appetite for more lockdowns unless we truly do see hospital systems starting to get crushed. What I see as more likely is more states and municipalities mandating mask-wearing as the evidence continues to mount on the benefits of widespread mask usage in mitigating the spread.
 
KFTG
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 4:28 am

flyguy89 wrote:
Deaths are a trailing indicator, so we may yet see a substantial spike in deaths...

Yeah, yeah, yeah. You're like the 100th person to say that here without evidence.
Georgia, for example, re-opened on May 1. Deaths have actually went down.
https://covid19.healthdata.org/united-s ... ca/georgia
 
flyguy89
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 4:32 am

DocLightning wrote:
I'll recall the H1N1 pandemic of 2009. The first cases of H1N1 were reported in late March, early April of 2009. Influenza vaccines were already well-studied and their production was well-established with a solid infrastructure and known practices and supply chains.

It took six months for the vaccine to be available to healthcare professionals and another month after that for it to be introduced to the general public.

We now have a new virus that is poorly-understood. The lead candidates for vaccines use some pretty novel systems. Both Oxford and J&J are using adenovirus vectors, which contain a gene encoding the SARS-CoV-2 that will be expressed and displayed on the surface of the cell that the adenovirus vector infects. However, the adenovirus vectors are replication-incompetent, meaning that they lack certain genes required to make more adenovirus particles. They can be grown quickly on cell lines that express these missing genes, so that helps a lot, but such a vaccine has never before been scaled up to produce billions of doses. To put this into perspective, they're going to need ~2.5kg of adenovirus to cover a billion people! Nobody has ever made that much adenovirus before.

Moderna is working on an RNA vaccine. An RNA Vaccine has never been successfully used in humans before, although it does appear that Moderna has most of the pitfalls worked out. This vaccine was the first to be produced because the production process for RNA is so simple. Like the virus vectored approach, it makes cells produce the S protein of SARS-CoV-2. Making cells make the protein simulates a viral infection and should induce a robust immune response. That said, they are still going to need a kilogram of RNA to cover one billion people, and if it turns out that two doses are needed, two kilograms.

Then there are the cardboard boxes, the freezer packs, the styrofoam shipping containers, the syringes, the needles, and all the package inserts. I will be very impressed if I, a physician, have any of these vaccines go into my deltoid before January.

On top of that, there are a lot of people who do not plan to get any such vaccine because of the rushed way in which it is being developed. I can't say I blame them for being cautious. We have been burned by vaccines before (and believe me, I am no anti-vaxxer). I am going to reserve my judgement on the matter until I see the vaccine myself along with its safety and efficacy data.

I'm not banking on a vaccine until early next year either. But I have to imagine with more than 100 candidates that we'll have something to help wind this down in 1.5-2 years paired with hopefully some effective treatments.
 
flyguy89
Posts: 2902
Joined: Tue Feb 24, 2009 6:43 pm

Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 4:44 am

KFTG wrote:
flyguy89 wrote:
Deaths are a trailing indicator, so we may yet see a substantial spike in deaths...

Yeah, yeah, yeah. You're like the 100th person to say that here without evidence.
Georgia, for example, re-opened on May 1. Deaths have actually went down.
https://covid19.healthdata.org/united-s ... ca/georgia

Georgia also hasn't seen the surge in cases like Florida or Arizona however. Don't cry victory just yet is all I'm saying since we really won't know for a week or so more. With Georgia, I think it all just speaks to the fact that the spread of the virus all comes down to how responsibly individuals ultimately behave with this thing. On one hand you have an early opening state like Georgia where people have clearly been taking their own personal precautions...and on the other you have California where despite strict lockdowns and a slow re-opening people aren't taking precautions and cases have spiked. Wisconsin is another state that re-opened early where many predicted a crush of cases that hasn't materialized...and hopefully it stays that way with people behaving responsibly.
 
KFTG
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 5:08 am

We need to stop using hyperbolic terms like "surge", "spike", and "record number".
 
MileHFL400
Topic Author
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Joined: Sat Dec 05, 2015 11:42 am

Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 8:28 am

flyguy89 wrote:
DocLightning wrote:
I'll recall the H1N1 pandemic of 2009. The first cases of H1N1 were reported in late March, early April of 2009. Influenza vaccines were already well-studied and their production was well-established with a solid infrastructure and known practices and supply chains.

It took six months for the vaccine to be available to healthcare professionals and another month after that for it to be introduced to the general public.

We now have a new virus that is poorly-understood. The lead candidates for vaccines use some pretty novel systems. Both Oxford and J&J are using adenovirus vectors, which contain a gene encoding the SARS-CoV-2 that will be expressed and displayed on the surface of the cell that the adenovirus vector infects. However, the adenovirus vectors are replication-incompetent, meaning that they lack certain genes required to make more adenovirus particles. They can be grown quickly on cell lines that express these missing genes, so that helps a lot, but such a vaccine has never before been scaled up to produce billions of doses. To put this into perspective, they're going to need ~2.5kg of adenovirus to cover a billion people! Nobody has ever made that much adenovirus before.

Moderna is working on an RNA vaccine. An RNA Vaccine has never been successfully used in humans before, although it does appear that Moderna has most of the pitfalls worked out. This vaccine was the first to be produced because the production process for RNA is so simple. Like the virus vectored approach, it makes cells produce the S protein of SARS-CoV-2. Making cells make the protein simulates a viral infection and should induce a robust immune response. That said, they are still going to need a kilogram of RNA to cover one billion people, and if it turns out that two doses are needed, two kilograms.

Then there are the cardboard boxes, the freezer packs, the styrofoam shipping containers, the syringes, the needles, and all the package inserts. I will be very impressed if I, a physician, have any of these vaccines go into my deltoid before January.

On top of that, there are a lot of people who do not plan to get any such vaccine because of the rushed way in which it is being developed. I can't say I blame them for being cautious. We have been burned by vaccines before (and believe me, I am no anti-vaxxer). I am going to reserve my judgement on the matter until I see the vaccine myself along with its safety and efficacy data.

I'm not banking on a vaccine until early next year either. But I have to imagine with more than 100 candidates that we'll have something to help wind this down in 1.5-2 years paired with hopefully some effective treatments.


Also depends on how quick the supply chain can ramp up 7bn units of the stuff.
Thanks and best Regards
AA
 
olle
Posts: 2086
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 3:17 pm

Aesma wrote:
KFTG wrote:
Also, why are you so worried?
I was told you just need a mask.


You need everybody else to wear a mask, big difference.


Most masks shall be replaced every 3 hours if not very expensive ones is used.

The knowledge about how to put them on and of is critical in order to not using fingers that might have virus in the face.

Some doctors I spoken to says bad used mask can increase risk not lower it.
 
Jalap
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Re: Covid 19 vaccine and return to normality?

Mon Jun 22, 2020 5:24 pm

DocLightning wrote:
We have been burned by vaccines before (and believe me, I am no anti-vaxxer). I am going to reserve my judgement on the matter until I see the vaccine myself along with its safety and efficacy data.

Thanks for your enlightening post!
I do wonder if you could elaborate a bit on the "been burned by vaccines before". What events were those? And how come things went wrong?
 
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DocLightning
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 2:43 am

Jalap wrote:
I do wonder if you could elaborate a bit on the "been burned by vaccines before". What events were those? And how come things went wrong?


One of the H1N1 vaccines from 2009 seems to have been associated with a rare neurologic disorder. I think it was used only in Norway and it caused 15 cases.

In the 1960s an attempt at an RSV vaccine resulted in worse disease. We still don't have an RSV vaccine.

In 1995, a new rotavirus vaccine, ROTASHIELD caused an increase in intussusception.

A recent experimental HIV vaccine based on the Chinese Adenovirus 5 vaccine system caused an increase in HIV.

One of the dengue vaccines caused an uncommon worsening in disease severity.

Other vaccines have had more minor issues.

Again, I'm no anti-vaxxer by any means, but this is why large and robust safety and efficacy trials are needed. If we rush out a vaccine and it turns out to have a major safety issue with it, it will push back vaccination in general for decades. We have never before had a commercial vaccine against a coronavirus and this one is getting pushed out in an awful hurry. Looking at the technologies at work here, I think it'll be safe (exactly what "effective" will mean here is a whole different discussion), but just keep in mind that we're looking at a virus that seems to trigger autoinflammatory syndromes. Fortunately, a recent article seems to indicate that accessory and nonstructural proteins, rather than the spike are responsible for this, but still...there are some major pitfalls that we might hit.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
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stl07
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 2:54 am

StarAC17 wrote:

stl07 wrote:
There had been a return to normalcy in many countries such as New Zealand, Thailand, and Australia. But for that, you need to kick out the virus. This requires a competent government that uses science and requires masks and contact tracing


Not really. They have dealt with is locally but how are they planning to handle tourists and other international traffic again? Requesting everyone self-isolate for 2 weeks works now but long term is completely unrealistic.


Who cares about the tourists? I would give up all the tourists in my town in a heartbeat if it meant life could go back to normal. The Kiwis can go to soccer games and concerts, can have large parties, and can eat out without fear of COVID. We in the US could have had that too if we actually bothered about anything other than the reelection.
Instead of typing in "mods", consider using the report function.
Love how every "travel blogger" says they will never fly AA/Ethihad again and then says it again and again on subsequent flights.
 
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DocLightning
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 3:29 am

flyguy89 wrote:
I'm not banking on a vaccine until early next year either. But I have to imagine with more than 100 candidates that we'll have something to help wind this down in 1.5-2 years paired with hopefully some effective treatments.


So that's an interesting topic: What would happen if there never was a vaccine? OK, so this isn't the first novel coronavirus to emerge into the human population, even if we ignore SARS-CoV-(1) and MERS-CoV. There are four other "endemic" (meaning they existed when we discovered coronaviruses) CoVs. They are called hCoV-229E, NL66, OC43, and HKU1 and they cause colds, about 25% of the colds that you've had have been caused by these. So here are two interesting studies.

The first was done around 1990. They took hCoV-229E and infected volunteers with it. This is acceptable to do because it just causes colds. They all developed antibodies against it. Then they followed those volunteers over a one year period and they all lost their antibodies. So they reinfected the volunteers again with -229E and...a few of them got colds. Some of them did not get symptoms. All of them had detectable viral replication. So this gives us an idea of how coronavirus immunity works. We don't develop long-term sterilizing immunity to respiratory coronaviruses in the way that we do to, say, measles. But we do develop some cell-mediated immunity, which allows us to clear the infection more quickly and to ramp up antibody production quickly again. That cell-mediated immunity probably lasts for a very long time.

The second was published in 2012 (IIRC). In this study, they examined the genome of hCoV-OC43. They found that -OC43 is very similar to bCoV, bovine coronavirus. When they did molecular clock analysis on the genome they determined that hCoV-OC43 jumped from cattle to humans around 1890. So they had a look into the history books to see if anything interesting happened around 1890. Now, just to orient you, the very idea of viruses wasn't even discovered until 1892, so they didn't know that viruses existed in 1890, but there was general familiarity with viral diseases even if they didn't know the cause (influenza, smallpox, polio, measles, chickenpox, rubella, mumps, etc.) In 1890 two interesting things happened. First, there was a global pandemic of a respiratory illness that was blamed on a mycoplasma (a kind of bacterium) resulting in the vast culling of herds. And then that year there was an especially bad influenza pandemic in which a lot of patients presented with neurological symptoms, which isn't typical for flu. It's tempting to speculate that what was actually going on that year wasn't some strange coincidence of some mycoplasma and a bad flu, but rather a pandemic of bCoV that then emerged to hCoV-OC43.

Looking to the present situation, we see that this new SARS-CoV-2 seems to cause mild disease in children and young adults. It's mostly the elderly who are severely impacted. So if we look 3-4 years into the future without a vaccine, we would see that most children would be exposed to this new SARS-CoV-2 (which we might rename to "hCoV-WU19" or something) by the time they are around ten years old. The children would then develop long-term cell-mediated immunity, even if their antibody responses tended to wane over time. Then those children would be repeatedly reinfected with SARS-CoV-2 throughout their lives, but because they have already been infected once, each subsequent infection would be mild or even inapparent. We would then see a new equilibrium. How long would this take? Probably 3-4 years, as I said.

So if it takes longer than two years to get a vaccine against SARS-CoV-2, then it will probably be pretty pointless to keep working on it.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
sierrakilo44
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 3:58 am

stl07 wrote:
Who cares about the tourists? I would give up all the tourists in my town in a heartbeat if it meant life could go back to normal. The Kiwis can go to soccer games and concerts, can have large parties, and can eat out without fear of COVID. We in the US could have had that too if we actually bothered about anything other than the reelection.


Who cares about tourists? The workers who work in the tourism sector and hospitality sectors, which contain a large percentage of the workforce who generally run on tight margins and are mostly small businesses. Those who have family and friends overseas who are being denied the right to visit them. Those who enjoy the opportunity to visit other cultures and learn and interact, which provides positives for the human race.

Eventually life and the travel industry will have to go back to normal, the world is too globalised these days to remain an isolated nation in the long run.
 
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Thunderboltdrgn
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 4:10 am

DocLightning wrote:
Jalap wrote:
I do wonder if you could elaborate a bit on the "been burned by vaccines before". What events were those? And how come things went wrong?


One of the H1N1 vaccines from 2009 seems to have been associated with a rare neurologic disorder. I think it was used only in Norway and it caused 15 cases.



Are you thinking about Pandemrix? In Sweden and Finland there were many cases of people who started to suffer from narcolepsy after being vaccinated.against HH1N1.
According to Swedish Socialstyrelsen there is/was a statistical connection between the vaccine and an increased risk became ill with narcolepsy. However there doesn't
see to be any conclusive results as to why this happened. According to WHO it might be a genetic connection.

https://www.socialstyrelsen.se/stod-i-a ... arkolepsi/
https://www.lakemedelsverket.se/sv/beha ... hmainbody1
https://www.cdc.gov/vaccinesafety/conce ... y-flu.html
https://www.who.int/vaccine_safety/comm ... tement/en/
Like a thunderbolt of lightning the Dragon roars across the sky. Il Drago Ruggente
 
StarAC17
Posts: 3811
Joined: Thu Aug 07, 2003 11:54 am

Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 4:22 am

DocLightning wrote:
flyguy89 wrote:
I'm not banking on a vaccine until early next year either. But I have to imagine with more than 100 candidates that we'll have something to help wind this down in 1.5-2 years paired with hopefully some effective treatments.


So that's an interesting topic: What would happen if there never was a vaccine? OK, so this isn't the first novel coronavirus to emerge into the human population, even if we ignore SARS-CoV-(1) and MERS-CoV. There are four other "endemic" (meaning they existed when we discovered coronaviruses) CoVs. They are called hCoV-229E, NL66, OC43, and HKU1 and they cause colds, about 25% of the colds that you've had have been caused by these. So here are two interesting studies.

The first was done around 1990. They took hCoV-229E and infected volunteers with it. This is acceptable to do because it just causes colds. They all developed antibodies against it. Then they followed those volunteers over a one year period and they all lost their antibodies. So they reinfected the volunteers again with -229E and...a few of them got colds. Some of them did not get symptoms. All of them had detectable viral replication. So this gives us an idea of how coronavirus immunity works. We don't develop long-term sterilizing immunity to respiratory coronaviruses in the way that we do to, say, measles. But we do develop some cell-mediated immunity, which allows us to clear the infection more quickly and to ramp up antibody production quickly again. That cell-mediated immunity probably lasts for a very long time.

The second was published in 2012 (IIRC). In this study, they examined the genome of hCoV-OC43. They found that -OC43 is very similar to bCoV, bovine coronavirus. When they did molecular clock analysis on the genome they determined that hCoV-OC43 jumped from cattle to humans around 1890. So they had a look into the history books to see if anything interesting happened around 1890. Now, just to orient you, the very idea of viruses wasn't even discovered until 1892, so they didn't know that viruses existed in 1890, but there was general familiarity with viral diseases even if they didn't know the cause (influenza, smallpox, polio, measles, chickenpox, rubella, mumps, etc.) In 1890 two interesting things happened. First, there was a global pandemic of a respiratory illness that was blamed on a mycoplasma (a kind of bacterium) resulting in the vast culling of herds. And then that year there was an especially bad influenza pandemic in which a lot of patients presented with neurological symptoms, which isn't typical for flu. It's tempting to speculate that what was actually going on that year wasn't some strange coincidence of some mycoplasma and a bad flu, but rather a pandemic of bCoV that then emerged to hCoV-OC43.

Looking to the present situation, we see that this new SARS-CoV-2 seems to cause mild disease in children and young adults. It's mostly the elderly who are severely impacted. So if we look 3-4 years into the future without a vaccine, we would see that most children would be exposed to this new SARS-CoV-2 (which we might rename to "hCoV-WU19" or something) by the time they are around ten years old. The children would then develop long-term cell-mediated immunity, even if their antibody responses tended to wane over time. Then those children would be repeatedly reinfected with SARS-CoV-2 throughout their lives, but because they have already been infected once, each subsequent infection would be mild or even inapparent. We would then see a new equilibrium. How long would this take? Probably 3-4 years, as I said.

So if it takes longer than two years to get a vaccine against SARS-CoV-2, then it will probably be pretty pointless to keep working on it.


Thanks for posting Doc, a few questions.

Is the cell mediated immunity primarily because with a respiratory disease it technically an external infection, meaning that even though the lungs are inside you there is no real barrier from the outside world to the lungs? Where as a disease like measles affects the whole body so the immunity is more effective as blood and immune cells are more more rampant and the antibodies are always circulating? If a vaccine is developed is that enough of a kick to protect people even form future infections enough that they won't get seriously ill with one or two dosages even once the antibodies run out. Or will we need annual shots like the flu shot?

Why do some viruses offer lifetime immunity and some limited? I would have to assume that is because of the level of mutation that the virus is susceptible to is a factor. However I have read from you if you are vaccinated for measles the virus might replicate once before getting squashed where coronavirus immunity needs a level of infection to trigger an immune response meaning that that person could theoretically become contagious.

Furthermore is the longer term weakening of the virulence through mutation actually the case or is partial or cell mediated immunity built up really the reason that the other Corona-viruses only cause colds now and are less dangerous today but could have just been as bad initially. Same with how you get the flu and common cold less and less as you get older until your immune system is on the decline. You are actually not infected less you just have the cell mediated immunity and if you get the flu shot you build that up even further.

Theoretically this mean that the spike we see in younger individuals is actually good for us all provided they don't spread it to Grandma and the deaths and health complications are limited in anyone under 50. This would expedite us to herd immunity with less collateral damage and save the vaccine for the seniors and those with pre-existing conditions.
Engineers Rule The World!!!!!
 
StarAC17
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 4:24 am

stl07 wrote:
StarAC17 wrote:

stl07 wrote:
There had been a return to normalcy in many countries such as New Zealand, Thailand, and Australia. But for that, you need to kick out the virus. This requires a competent government that uses science and requires masks and contact tracing


Not really. They have dealt with is locally but how are they planning to handle tourists and other international traffic again? Requesting everyone self-isolate for 2 weeks works now but long term is completely unrealistic.


Who cares about the tourists? I would give up all the tourists in my town in a heartbeat if it meant life could go back to normal. The Kiwis can go to soccer games and concerts, can have large parties, and can eat out without fear of COVID. We in the US could have had that too if we actually bothered about anything other than the reelection.


That's fine but unless were are going to abandon global air travel and international commerce it isn't technically what I would consider normal.
Perhaps we can and should debate that the normal before 2020 was bad and needs to be redone but most people think air travel is going to be back to basically the same as before sooner than later.
Engineers Rule The World!!!!!
 
StarAC17
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 4:42 am

KFTG wrote:
The COVID-19 industrial complex and their allies in the media are hell bent on imposing another lockdown.
Amazon, et al. would like nothing more than to see every single brick and mortar retailer closed down.
The media would like nothing more than ever single American locked in their homes watching as much tee-vee and YouTube ads as possible.
It ain't happening.
Deaths are not spiking.
This thing is puttering out just like SARS did, albeit on a global scale.


I wouldn't say it is puttering out, the cases are spiking in many places. But you are right that some medical experts want a lock-down because some people honestly can't be trusted and they only care about saving lives. The collateral damage will be dealt with later.

Personally I just don't think raw cases is the biggest factor to create concern (provided they isolate when confirmed positive), it's hospitalizations and deaths. Sensible mask use and reasonable physical distancing should be enough to manage this while opening most things outside of massive gatherings.
Engineers Rule The World!!!!!
 
KFTG
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 4:53 am

Can someone please tell me the definition of a "spike"?
Deaths and hospitalizations are down. Way down.
Put a fork in it. We ain't going back.
 
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OA412
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 3:55 pm

KFTG wrote:
flyguy89 wrote:
Deaths are a trailing indicator, so we may yet see a substantial spike in deaths...

Yeah, yeah, yeah. You're like the 100th person to say that here without evidence.
Georgia, for example, re-opened on May 1. Deaths have actually went down.
https://covid19.healthdata.org/united-s ... ca/georgia

You do realize the source you're providing indicates that deaths is Georgia are rising? And that it projects deaths will continue to rise in Georgia, going from 2700 today to over 10,000 on October 1, an increase of some 7300 deaths?
KFTG wrote:
Can someone please tell me the definition of a "spike"?
Deaths and hospitalizations are down. Way down.
Put a fork in it. We ain't going back.

Can you cite to a single serious ID specialist or epidemiologist saying that COVID is "puttering out" or "over?"
Hughes Airwest - Top Banana In The West
 
kalvado
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 4:30 pm

DocLightning wrote:
flyguy89 wrote:
I'm not banking on a vaccine until early next year either. But I have to imagine with more than 100 candidates that we'll have something to help wind this down in 1.5-2 years paired with hopefully some effective treatments.


So that's an interesting topic: What would happen if there never was a vaccine? OK, so this isn't the first novel coronavirus to emerge into the human population, even if we ignore SARS-CoV-(1) and MERS-CoV. There are four other "endemic" (meaning they existed when we discovered coronaviruses) CoVs. They are called hCoV-229E, NL66, OC43, and HKU1 and they cause colds, about 25% of the colds that you've had have been caused by these. So here are two interesting studies.

The first was done around 1990. They took hCoV-229E and infected volunteers with it. This is acceptable to do because it just causes colds. They all developed antibodies against it. Then they followed those volunteers over a one year period and they all lost their antibodies. So they reinfected the volunteers again with -229E and...a few of them got colds. Some of them did not get symptoms. All of them had detectable viral replication. So this gives us an idea of how coronavirus immunity works. We don't develop long-term sterilizing immunity to respiratory coronaviruses in the way that we do to, say, measles. But we do develop some cell-mediated immunity, which allows us to clear the infection more quickly and to ramp up antibody production quickly again. That cell-mediated immunity probably lasts for a very long time.

The second was published in 2012 (IIRC). In this study, they examined the genome of hCoV-OC43. They found that -OC43 is very similar to bCoV, bovine coronavirus. When they did molecular clock analysis on the genome they determined that hCoV-OC43 jumped from cattle to humans around 1890. So they had a look into the history books to see if anything interesting happened around 1890. Now, just to orient you, the very idea of viruses wasn't even discovered until 1892, so they didn't know that viruses existed in 1890, but there was general familiarity with viral diseases even if they didn't know the cause (influenza, smallpox, polio, measles, chickenpox, rubella, mumps, etc.) In 1890 two interesting things happened. First, there was a global pandemic of a respiratory illness that was blamed on a mycoplasma (a kind of bacterium) resulting in the vast culling of herds. And then that year there was an especially bad influenza pandemic in which a lot of patients presented with neurological symptoms, which isn't typical for flu. It's tempting to speculate that what was actually going on that year wasn't some strange coincidence of some mycoplasma and a bad flu, but rather a pandemic of bCoV that then emerged to hCoV-OC43.

Looking to the present situation, we see that this new SARS-CoV-2 seems to cause mild disease in children and young adults. It's mostly the elderly who are severely impacted. So if we look 3-4 years into the future without a vaccine, we would see that most children would be exposed to this new SARS-CoV-2 (which we might rename to "hCoV-WU19" or something) by the time they are around ten years old. The children would then develop long-term cell-mediated immunity, even if their antibody responses tended to wane over time. Then those children would be repeatedly reinfected with SARS-CoV-2 throughout their lives, but because they have already been infected once, each subsequent infection would be mild or even inapparent. We would then see a new equilibrium. How long would this take? Probably 3-4 years, as I said.

So if it takes longer than two years to get a vaccine against SARS-CoV-2, then it will probably be pretty pointless to keep working on it.

Thank you very much, very informative. I wonder if there will be any interest in recovering 1890 virus - spanish flu of 1921 was sequenced from bodies burried in permafrost, as far as I know.
As for names - I suspect "covid" name was crafted to become a common term. Polio, smallpox, rubella, covid, measles - it just blends into the list...
 
flyguy89
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 5:04 pm

DocLightning wrote:
flyguy89 wrote:
I'm not banking on a vaccine until early next year either. But I have to imagine with more than 100 candidates that we'll have something to help wind this down in 1.5-2 years paired with hopefully some effective treatments.


So that's an interesting topic: What would happen if there never was a vaccine? OK, so this isn't the first novel coronavirus to emerge into the human population, even if we ignore SARS-CoV-(1) and MERS-CoV. There are four other "endemic" (meaning they existed when we discovered coronaviruses) CoVs. They are called hCoV-229E, NL66, OC43, and HKU1 and they cause colds, about 25% of the colds that you've had have been caused by these. So here are two interesting studies.

The first was done around 1990. They took hCoV-229E and infected volunteers with it. This is acceptable to do because it just causes colds. They all developed antibodies against it. Then they followed those volunteers over a one year period and they all lost their antibodies. So they reinfected the volunteers again with -229E and...a few of them got colds. Some of them did not get symptoms. All of them had detectable viral replication. So this gives us an idea of how coronavirus immunity works. We don't develop long-term sterilizing immunity to respiratory coronaviruses in the way that we do to, say, measles. But we do develop some cell-mediated immunity, which allows us to clear the infection more quickly and to ramp up antibody production quickly again. That cell-mediated immunity probably lasts for a very long time.

The second was published in 2012 (IIRC). In this study, they examined the genome of hCoV-OC43. They found that -OC43 is very similar to bCoV, bovine coronavirus. When they did molecular clock analysis on the genome they determined that hCoV-OC43 jumped from cattle to humans around 1890. So they had a look into the history books to see if anything interesting happened around 1890. Now, just to orient you, the very idea of viruses wasn't even discovered until 1892, so they didn't know that viruses existed in 1890, but there was general familiarity with viral diseases even if they didn't know the cause (influenza, smallpox, polio, measles, chickenpox, rubella, mumps, etc.) In 1890 two interesting things happened. First, there was a global pandemic of a respiratory illness that was blamed on a mycoplasma (a kind of bacterium) resulting in the vast culling of herds. And then that year there was an especially bad influenza pandemic in which a lot of patients presented with neurological symptoms, which isn't typical for flu. It's tempting to speculate that what was actually going on that year wasn't some strange coincidence of some mycoplasma and a bad flu, but rather a pandemic of bCoV that then emerged to hCoV-OC43.

Looking to the present situation, we see that this new SARS-CoV-2 seems to cause mild disease in children and young adults. It's mostly the elderly who are severely impacted. So if we look 3-4 years into the future without a vaccine, we would see that most children would be exposed to this new SARS-CoV-2 (which we might rename to "hCoV-WU19" or something) by the time they are around ten years old. The children would then develop long-term cell-mediated immunity, even if their antibody responses tended to wane over time. Then those children would be repeatedly reinfected with SARS-CoV-2 throughout their lives, but because they have already been infected once, each subsequent infection would be mild or even inapparent. We would then see a new equilibrium. How long would this take? Probably 3-4 years, as I said.

So if it takes longer than two years to get a vaccine against SARS-CoV-2, then it will probably be pretty pointless to keep working on it.

Great points. Yes, a vaccine is very much an "if." Obviously if we can develop a safe and effective vaccine relatively quickly that would be great. But the general narrative seems to pin everything on vaccination, and no one's really mentioning the very real possibility that we don't get one.
 
MileHFL400
Topic Author
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 6:09 pm

flyguy89 wrote:
DocLightning wrote:
flyguy89 wrote:
I'm not banking on a vaccine until early next year either. But I have to imagine with more than 100 candidates that we'll have something to help wind this down in 1.5-2 years paired with hopefully some effective treatments.


So that's an interesting topic: What would happen if there never was a vaccine? OK, so this isn't the first novel coronavirus to emerge into the human population, even if we ignore SARS-CoV-(1) and MERS-CoV. There are four other "endemic" (meaning they existed when we discovered coronaviruses) CoVs. They are called hCoV-229E, NL66, OC43, and HKU1 and they cause colds, about 25% of the colds that you've had have been caused by these. So here are two interesting studies.

The first was done around 1990. They took hCoV-229E and infected volunteers with it. This is acceptable to do because it just causes colds. They all developed antibodies against it. Then they followed those volunteers over a one year period and they all lost their antibodies. So they reinfected the volunteers again with -229E and...a few of them got colds. Some of them did not get symptoms. All of them had detectable viral replication. So this gives us an idea of how coronavirus immunity works. We don't develop long-term sterilizing immunity to respiratory coronaviruses in the way that we do to, say, measles. But we do develop some cell-mediated immunity, which allows us to clear the infection more quickly and to ramp up antibody production quickly again. That cell-mediated immunity probably lasts for a very long time.

The second was published in 2012 (IIRC). In this study, they examined the genome of hCoV-OC43. They found that -OC43 is very similar to bCoV, bovine coronavirus. When they did molecular clock analysis on the genome they determined that hCoV-OC43 jumped from cattle to humans around 1890. So they had a look into the history books to see if anything interesting happened around 1890. Now, just to orient you, the very idea of viruses wasn't even discovered until 1892, so they didn't know that viruses existed in 1890, but there was general familiarity with viral diseases even if they didn't know the cause (influenza, smallpox, polio, measles, chickenpox, rubella, mumps, etc.) In 1890 two interesting things happened. First, there was a global pandemic of a respiratory illness that was blamed on a mycoplasma (a kind of bacterium) resulting in the vast culling of herds. And then that year there was an especially bad influenza pandemic in which a lot of patients presented with neurological symptoms, which isn't typical for flu. It's tempting to speculate that what was actually going on that year wasn't some strange coincidence of some mycoplasma and a bad flu, but rather a pandemic of bCoV that then emerged to hCoV-OC43.

Looking to the present situation, we see that this new SARS-CoV-2 seems to cause mild disease in children and young adults. It's mostly the elderly who are severely impacted. So if we look 3-4 years into the future without a vaccine, we would see that most children would be exposed to this new SARS-CoV-2 (which we might rename to "hCoV-WU19" or something) by the time they are around ten years old. The children would then develop long-term cell-mediated immunity, even if their antibody responses tended to wane over time. Then those children would be repeatedly reinfected with SARS-CoV-2 throughout their lives, but because they have already been infected once, each subsequent infection would be mild or even inapparent. We would then see a new equilibrium. How long would this take? Probably 3-4 years, as I said.

So if it takes longer than two years to get a vaccine against SARS-CoV-2, then it will probably be pretty pointless to keep working on it.

Great points. Yes, a vaccine is very much an "if." Obviously if we can develop a safe and effective vaccine relatively quickly that would be great. But the general narrative seems to pin everything on vaccination, and no one's really mentioning the very real possibility that we don't get one.


With 100 trials going in is a vaccine really be an if?
Thanks and best Regards
AA
 
Jalap
Posts: 639
Joined: Thu Oct 18, 2007 4:25 pm

Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 10:27 pm

DocLightning wrote:
Jalap wrote:
I do wonder if you could elaborate a bit on the "been burned by vaccines before". What events were those? And how come things went wrong?


One of the H1N1 vaccines from 2009 seems to have been associated with a rare neurologic disorder. I think it was used only in Norway and it caused 15 cases.

In the 1960s an attempt at an RSV vaccine resulted in worse disease. We still don't have an RSV vaccine.

In 1995, a new rotavirus vaccine, ROTASHIELD caused an increase in intussusception.

A recent experimental HIV vaccine based on the Chinese Adenovirus 5 vaccine system caused an increase in HIV.

One of the dengue vaccines caused an uncommon worsening in disease severity.

Other vaccines have had more minor issues.

Again, I'm no anti-vaxxer by any means, but this is why large and robust safety and efficacy trials are needed. If we rush out a vaccine and it turns out to have a major safety issue with it, it will push back vaccination in general for decades. We have never before had a commercial vaccine against a coronavirus and this one is getting pushed out in an awful hurry. Looking at the technologies at work here, I think it'll be safe (exactly what "effective" will mean here is a whole different discussion), but just keep in mind that we're looking at a virus that seems to trigger autoinflammatory syndromes. Fortunately, a recent article seems to indicate that accessory and nonstructural proteins, rather than the spike are responsible for this, but still...there are some major pitfalls that we might hit.

Thanks!
A little bright side about this corona-situation is that my 10-year old daughter has taken an interest in virology, while before the only professional future she had in mind was either being an actress or a professional badminton player.
Nothing wrong with those, but science may be a safer path to the future. I told her it's perfectly possible to be an actress or have a sports career while also going for a scientific degree :)
 
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cjg225
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Re: Covid 19 vaccine and return to normality?

Tue Jun 23, 2020 11:32 pm

DocLightning wrote:
Then there are the cardboard boxes, the freezer packs, the styrofoam shipping containers, the syringes, the needles, and all the package inserts. I will be very impressed if I, a physician, have any of these vaccines go into my deltoid before January.

This. All of this. And more.

I work for one of the largest and most experienced vaccine manufacturers in the world. We are... not particularly optimistic about all of this. We're in the game to develop a vaccine, but... the supply chain, in particular, will be a massive hurdle.

Take the US alone: we (the pharma industry as a whole) produce enough doses of the flu shot annually for a surprisingly-small portion of the national population. Yet, somehow, we're going to produce hundreds of millions of doses of a brand-new vaccine in a matter of a year? Less than a year? Yeah... not gonna happen.

I'm no scientist; I can't speak terribly intelligently to the likelihood of developing an efficacious vaccine, particularly one that is reasonably safe. But in my position at my company, what I do... I can say that the supply chain for such a vaccine is going to be one of the most daunting challenges in industrial history. Everything from production to packaging to distribution, everything in-between, and much more. I live all these things every day in my job for, again, one of the largest vaccine manufacturers in the world. It bloody sucks. We get it done, but it's rough even in normal times. In the current environment it's much worse. And then if someone does end up producing the winning vaccine, well... godspeed to that company ultimately getting it to the hands of medical professionals to administer it to people.
Restoring Penn State's transportation heritage...
 
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DocLightning
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 2:04 am

MileHFL400 wrote:
With 100 trials going in is a vaccine really be an if?


Given prior research on MERS-CoV vaccines and just what I know about the family coronaviridae, I think that a vaccine is extremely likely (of course, nothing is guaranteed).
Jalap wrote:
A little bright side about this corona-situation is that my 10-year old daughter has taken an interest in virology,


Excellent! Maybe when this is over you could have her walk through a virology lab at a local nearby university.

kalvado wrote:
I wonder if there will be any interest in recovering 1890 virus


It would be almost impossible to recover it. There are no frozen samples from then. Serological studies done in the 1950s suggest that the 1890 influenza (and there was certainly an influenza that year; there's always an influenza every year) is an H2N2, but nobody every looked for coronavirus antibodies and those antibodies might have faded by then. But we can reconstruct it by looking at bCoV and hCoV-OC43.

kalvado wrote:
As for names - I suspect "covid" name was crafted to become a common term. Polio, smallpox, rubella, covid, measles - it just blends into the list...


COrona VIrus Disease-2019, COVID-19. It's easy to pronounce and easy to spell in many languages. But the nomenclature of viruses is a bit more nuanced and there isn't a good system. The virus was originally nCoV-2019 (Novel Coronavirus-2019), but you can't call it "novel" forever because it's no longer novel. Because it is closely related to SARS-CoV, they called it SARS-CoV-2. But if it becomes an endemic coronavirus, then it will probably need to be renamd into the system of human coronaviruses, hCoV-something, and I propose WU19, which should be obvious enough.

KFTG wrote:
Can someone please tell me the definition of a "spike"?
Deaths and hospitalizations are down. Way down.
Put a fork in it. We ain't going back.


Cases are rising rapidly across the USA. Just because you don't want it to be true doesn't make it true. If wishes were horses, we all would ride.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
KFTG
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 2:25 am

Cases are increasing, yes.
Hey Doc, what are deaths doing?
 
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DocLightning
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 4:34 am

KFTG wrote:
Cases are increasing, yes.
Hey Doc, what are deaths doing?


They are not rising as rapidly because we are getting better at saving people with COVID-19. However, hospital admissions are rising and that is the most important metric.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
LOT767301ER
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 4:47 am

DocLightning wrote:
KFTG wrote:
Cases are increasing, yes.
Hey Doc, what are deaths doing?


They are not rising as rapidly because we are getting better at saving people with COVID-19. However, hospital admissions are rising and that is the most important metric.


I dont think that is the whole story.

I'd agree with you 2 months ago but I am not convinced that is the case right now. I submit to you Florida - The average age of infection has now almost halved to the mid-30s, in some metro areas its actually in the high 20s, and hospitals are intaking this demographic of patient now. This means that the average length of stay in the state has dropped from 10 days to 6 due to the fact the acuity of cases is by far less severe than when the cross section of infected was in the mid-60s and above. Your baseline acuity is far lower now than it was before so even without better treatment (which I obviously do agree helps) you would have a far better outcome on the number of deaths. I would opine based on the IFR/CFR data broken down by age that 1000 35 year olds getting admitted to the hospital is nowhere near as bad as 100 80 year olds getting admitted even though on a bar graph it looks worse.
 
KFTG
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 5:15 am

Doc, we aren't going back into lockdown. It isn't happening. California is welcome to and creater their economy however. Better for all of the other states. All of your Karens will feel safe until their unemployment runs out.
 
flyguy89
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 6:03 am

KFTG wrote:
Doc, we aren't going back into lockdown. It isn't happening. California is welcome to and creater their economy however. Better for all of the other states. All of your Karens will feel safe until their unemployment runs out.

Who are you arguing with? No one is talking about going back into lockdown. Wear a damn mask, wash your hands, and avoid large crowds and we can all get through this fine. It's not complicated.
 
MileHFL400
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 6:32 am

DocLightning wrote:
KFTG wrote:
Cases are increasing, yes.
Hey Doc, what are deaths doing?


They are not rising as rapidly because we are getting better at saving people with COVID-19. However, hospital admissions are rising and that is the most important metric.


I’d argue that deaths are still rising rapidly across Latin America.
Thanks and best Regards
AA
 
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Dahlgardo
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 6:57 am

DocLightning wrote:
Looking to the present situation, we see that this new SARS-CoV-2 seems to cause mild disease in children and young adults. It's mostly the elderly who are severely impacted. So if we look 3-4 years into the future without a vaccine, we would see that most children would be exposed to this new SARS-CoV-2 (which we might rename to "hCoV-WU19" or something) by the time they are around ten years old. The children would then develop long-term cell-mediated immunity, even if their antibody responses tended to wane over time. Then those children would be repeatedly reinfected with SARS-CoV-2 throughout their lives, but because they have already been infected once, each subsequent infection would be mild or even inapparent. We would then see a new equilibrium. How long would this take? Probably 3-4 years, as I said.


A quick question, and pardon my ignorance with regard to medical terms.

In this video
https://youtu.be/5i3uHmPv9TE?t=523

they refer to a Chinese study, where they have measured antibody levels of patients who have been in hospital with Covid-19.
The study finds, that for asymtomatic patients and patients with mild symptoms, only 60% had antibodies after 3-4 months.
For patients with severe symptoms the number was around 85% after the same period.
Since it was a study with only 37 patients in each group it has some uncertainties.

My question is then : is it possible that the "dark number" of covid-19 cases that are not found through testing, is somewhat higher than some believe, because the antibodies disappear quite fast and cannot be measured in an antobody test? I assume you cannot measure the long-term cell-mediated immunity in an antobody test?

This might suggest that the disease could be much more wide spread than number suggest, and we are in a better place with regard to mortality rate and herd immunity than we think.
leave your nines at home and bring your skills to the battle
 
KFTG
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 7:26 am

flyguy89 wrote:
KFTG wrote:
Doc, we aren't going back into lockdown. It isn't happening. California is welcome to and creater their economy however. Better for all of the other states. All of your Karens will feel safe until their unemployment runs out.

Who are you arguing with? No one is talking about going back into lockdown. Wear a damn mask, wash your hands, and avoid large crowds and we can all get through this fine. It's not complicated.

If you think there isn't a concerted effort to lock the country down again, you are not paying attention.
 
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OA412
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Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 3:47 pm

KFTG wrote:
flyguy89 wrote:
KFTG wrote:
Doc, we aren't going back into lockdown. It isn't happening. California is welcome to and creater their economy however. Better for all of the other states. All of your Karens will feel safe until their unemployment runs out.

Who are you arguing with? No one is talking about going back into lockdown. Wear a damn mask, wash your hands, and avoid large crowds and we can all get through this fine. It's not complicated.

If you think there isn't a concerted effort to lock the country down again, you are not paying attention.

There isn't a concerted effort to lock the country down. There have been suggestions that certain states where cases are rising rapidly would benefit from a lockdown, but there is no concerted effort to lock the entire country down again. That's fantasy. And no one would be making these suggestions if people stopped being irresponsible and started wearing masks and distancing. Right now we're averaging some 27,000 new cases per day whereas the entire EU is averaging some 5000-7000 per day. We could easily be at 5-7K cases right now with competent leadership and a responsible population. It's really not very difficult. No one likes wearing a mask, but it's a small price to pay to get this thing under control. That's fantasy. In my state where people are being mostly responsible about wearing masks, cases and deaths have fallen and aren't currently rising, at least not appreciably. No one here is calling for another lockdown, because it's just not necessary at this time.

That said, if there is a second wave this fall as predicted, and if it's worse than the one this winter/spring (and we all hope it isn't), then a second lockdown may be necessary. That's just reality. No one wants a lockdown, but Americans have proven themselves too irresponsible to handle this pandemic, and any future lockdown will be the direct result of those who have looked at this pandemic through a partisan lens, rather than a scientific lens.
Hughes Airwest - Top Banana In The West
 
KFTG
Posts: 811
Joined: Sun Apr 28, 2019 12:08 am

Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 3:51 pm

There will not be another lockdown.

Also, no concerted effort?
"New York, New Jersey and Connecticut impose 14-day quarantine on travelers from coronavirus hotspot states"
Completely unenforceable and should be ignored entirely.
 
LCDFlight
Posts: 452
Joined: Wed Jan 01, 2020 9:22 pm

Re: Covid 19 vaccine and return to normality?

Wed Jun 24, 2020 4:14 pm

KFTG wrote:
There will not be another lockdown.

Also, no concerted effort?
"New York, New Jersey and Connecticut impose 14-day quarantine on travelers from coronavirus hotspot states"
Completely unenforceable and should be ignored entirely.


Agreed. It's not enforceable. NY, NJ are embarrassed because of their failure to control a complete saturation with COVID and the unbelievable death tolls that were caused. In part, and this is awkward to talk about, this may have been caused poor personal cleanliness in those states.

Now, they want to lash out at other states that treated them with respect in their time of need. It's ridiculous, because COVID may be endemic to NY/NJ. Visitors should expect to be exposed to it while there...

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