COVID-19 (f/k/a "the Coronavirus")

[rocket surgeon]

   "If a person dies after being administered the vaccine, even if they were at risk from other disease, they then have to definitively prove that the vaccine did not play a part in that death. All testing has to cease until that is complete, and it can take forever."


   correct me, but i was just thinking, are vaccines of any use once the person is infected?  would it be too late?  at that point, what we really need would be something to treat the symptoms, i.e. compromised breathing.  the causes of death, pneumonia, heart issues related to diminished O2 etc. 

the vaccines would be to prevent new people from getting infected, no? 

my original thinking, which i am second guessing now, is that if someone is really ill, to the point of death, a vaccine is going to do nothing for them.  fast tracking a vaccine under these circumstances does not make sense so i stand corrected

[Hards Alumni]

   "If a person dies after being administered the vaccine, even if they were at risk from other disease, they then have to definitively prove that the vaccine did not play a part in that death. All testing has to cease until that is complete, and it can take forever."


   correct me, but i was just thinking, are vaccines of any use once the person is infected?  would it be too late?  at that point, what we really need would be something to treat the symptoms, i.e. compromised breathing.  the causes of death, pneumonia, heart issues related to diminished O2 etc. 

the vaccines would be to prevent new people from getting infected, no? 

my original thinking, which i am second guessing now, is that if someone is really ill, to the point of death, a vaccine is going to do nothing for them.  fast tracking a vaccine under these circumstances does not make sense so i stand corrected

Correct.  Hopefully a mixture of antivirals and breathing assistance seems to help people quite a bit.  But if we run out of them, that's where we run into trouble... mostly the ventilators.

[forgetful]

   "If a person dies after being administered the vaccine, even if they were at risk from other disease, they then have to definitively prove that the vaccine did not play a part in that death. All testing has to cease until that is complete, and it can take forever."


   correct me, but i was just thinking, are vaccines of any use once the person is infected?  would it be too late?  at that point, what we really need would be something to treat the symptoms, i.e. compromised breathing.  the causes of death, pneumonia, heart issues related to diminished O2 etc. 

Agreed.

Where you would see some fast-tracking of a vaccine, would be in testing it in patients at high risk of death if they were to become infected. Those are the individuals though that are most likely to have possible co-morbidities, which is why it is so high risk to go that route.

Correct.  Hopefully a mixture of antivirals and breathing assistance seems to help people quite a bit.  But if we run out of them, that's where we run into trouble... mostly the ventilators.

Also agreed.

[rocket surgeon]

They can't fast track them, its extremely dangerous.  I used to do GMP testing at a lab.

edit:  Well, I guess they could, but the blowback on mistakes would be... uhhh... real bad.

 full agreement, but there are are "mistakes"even following proper protocol and testing including however many phases they require.  keeping in mind these are special circumstances-desperate times, desperate measures?

[Hards Alumni]

full agreement, but there are are "mistakes"even following proper protocol and testing including however many phases they require.  keeping in mind these are special circumstances-desperate times, desperate measures?

While I agree, can you imagine the fallout if they fast track a vaccine and it kills a bunch of people?  Who signs up for the next round of vaccinations?

Also wanted to post this

[rocky_warrior]

Hm, maybe this is what Eng had been hearing ...

https://www.militarytimes.com/news/pentagon-congress/2020/03/14/dod-bans-all-domestic-travel-for-troops-employees-in-response-to-coronavirus-threat/

Pentagon officials late Friday announced a total domestic travel ban for all troops, civilian personnel and their families until May 11 in an effort to limit their potential exposure to the coronavirus.

In addition, troops will be granted “only authorized local leave” for the duration of the travel restrictions, limiting their ability to visit family and friends in far away states.

[ZiggysFryBoy]

The Freedom To Try Act was passed by congress.  This bill allows patients to take a medication prior to ful FFA approval.   Why not use humans early in the trials?

[StillAWarrior]

Also wanted to post this

Looks like a real-time example of the “flattening the curve” we’ve been hearing so much about.

[MU Fan in Connecticut]

I'm betting most of us do get infected. But the great majority of those won't ever officially know they were infected

+1

[MU Fan in Connecticut]

Local news today.

Yale New Haven replicates COVID-19 test; hopes to use it on 200 samples a day
By Mary E. O’Leary Updated 9:15 pm EDT, Friday, March 13, 2020

www.nhregister.com/news/coronavirus/amp/YNNH-replicates-the-COVID-19-test-will-be-able-15129666.php

[Eldon]

I'm betting most of us do get infected. But the great majority of those won't ever officially know they were infected

Nailed it.

There are lots of people out there who were sick last week who are just now realizing that their strange combination of fever and shortness of breath was the Coronavirus.  These people have been going about their daily routines, completely oblivious that they were carriers.

[Hards Alumni]

The Freedom To Try Act was passed by congress.  This bill allows patients to take a medication prior to ful FFA approval.   Why not use humans early in the trials?

Did some thinking this morning, but what might actually happen is that another country fast tracks a vaccine, and we just wait and see what happens.  Hopefully production scale up of vaccines start alongside Phase II so we don't have to wait as long either way... especially since money shouldn't be a barrier.

And The Freedom to Try Act won't help with vaccines. :-P  But it will help people try new antivirals, etc.

[forgetful]

Nailed it.

There are lots of people out there who were sick last week who are just now realizing that their strange combination of fever and shortness of breath was the Coronavirus.  These people have been going about their daily routines, completely oblivious that they were carriers.

Right now there is very little evidence to support this being true. Is it possible, yes, is it likely no. I guess it partly depends on what you mean by "lots". If you mean another 3-5k people nationwide. Probably true. If you mean 100's of thousands, almost assuredly false.

[skianth16]

Nailed it.

There are lots of people out there who were sick last week who are just now realizing that their strange combination of fever and shortness of breath was the Coronavirus.  These people have been going about their daily routines, completely oblivious that they were carriers.

The common cold, bronchitis, the flu, etc. have to still be substantially more prevalent. Like thousands or tens of thousands of times more prevalent. These conclusions that we're all going to have it do not seem at all possible, and don't seem to be supported by any actual facts/data. Sure, there are infected people that have not tested positive, but that doesn't mean it's everywhere, and that we're all being exposed to it.

I still haven't seen anything presented with actual data that would suggest these high infection rates. Yet this narrative continues to build. I just don't understand.

[Hards Alumni]

Right now there is very little evidence to support this being true. Is it possible, yes, is it likely no. I guess it partly depends on what you mean by "lots". If you mean another 3-5k people nationwide. Probably true. If you mean 100's of thousands, almost assuredly false.

What?  We are already wayyyyy past 3k infected nationwide.  Its likely 10k plus considering we have done so little, and the R0 probably is much larger than realized.

I'm guessing you misunderstood what he is saying.

[forgetful]

What?  We are already wayyyyy past 3k infected nationwide.  Its likely 10k plus considering we have done so little, and the R0 probably is much larger than realized.

I'm guessing you misunderstood what he is saying.

Your statement of 10k+ requires that R0 is much larger than realized. Although there has been some super-spreaders (see NYC attorney). There isn't any evidence to support it, in fact the only concrete data I've seen says it doesn't spread that easily. You may be right, but there isn't data to support it right now.

By all data, if there are 10k active cases, we should be expecting 1k cases in hospitals. Those don't exist right now. I think we have about 5k total cases right now, with 1/2 of them in the early stages before it gets severe. That would put about 200 cases in hospitals and expecting to increase to 500 hospitalizations in the next several days.

That is consistent with what is being observed at the hospital level right now.

To be significantly above 10k cases, the vast majority would have to be early stage, which would require an R0 in the 3-4 range. That isn't supported by data, but maybe its just due to a lack of data. I hope I'm right, but basing it off very limited amount of data at the moment.

[Hards Alumni]

The common cold, bronchitis, the flu, etc. have to still be substantially more prevalent. Like thousands or tens of thousands of times more prevalent. This conclusion does not seem at all possible, and doesn't seem to be supported by any actual facts/data. I still haven't seen anything presented with actual data that would suggest these high infection rates. Yet this narrative continues to build. I just don't understand.

Mathematics.  We won't have statistically representative case numbers until we test more, and outstanding tests come back.   Which is probably why the media and government should reframe the message.

Confirmed cases / tests with results = one type of information

Confirmed cases / (outstanding+tests with results) = another type of information

Total confirmed cases is essentially meaningless without proper context... its just a number that people will say should be higher or lower based on their current knowledge/beliefs.

If results come back at a 3% of those tested are infected, that is amazing news.  Currently, we are looking at a rate of 17.3% of SPECIMENS (note: not people) in the US that have been tested are coming back positive (as of 3/13).  That is HORRIBLE news.  I can't stress that enough.  Now, of course we are only testing people within a very specific set of symptoms... so the numbers will trend high.  But also, as I mentioned earlier, that is number of SPECIMENS tested, not people tested.  Meaning, that there have been several specimens per person.  So less people tested than you think.

Hopefully, we get out testing ramped up as soon as we can, because that will give us information.  Information is power.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html
Currently, 2175 people confirmed cases in the US / 12584 specimens collected in the US.

And actually, I forgot to include the fact that of those 2175 cases, people have been tested multiple times...  so... forget my 17.3% number, its not reliable either... its much higher.

Basically, we are still flailing around in the dark here.  We have no clue what we are dealing with, and my guess is that we are actually around 20-40k infected throughout the US currently... and if that is the case, we are supremely screwed.

Sorry for being Doom guy again.

[Hards Alumni]

Your statement of 10k+ requires that R0 is much larger than realized. Although there has been some super-spreaders (see NYC attorney). There isn't any evidence to support it, in fact the only concrete data I've seen says it doesn't spread that easily. You may be right, but there isn't data to support it right now.

By all data, if there are 10k active cases, we should be expecting 1k cases in hospitals. Those don't exist right now. I think we have about 5k total cases right now, with 1/2 of them in the early stages before it gets severe. That would put about 200 cases in hospitals and expecting to increase to 500 hospitalizations in the next several days.

That is consistent with what is being observed at the hospital level right now.

To be significantly above 10k cases, the vast majority would have to be early stage, which would require an R0 in the 3-4 range. That isn't supported by data, but maybe its just due to a lack of data. I hope I'm right, but basing it off very limited amount of data at the moment.

Yeah, that's the problem.  Lack of data.  I'd be ecstatic to be wrong.  My numbers are pretty speculative.

[mu_hilltopper]

In honesty, I don't think it matters whether the numbers are 3k, 30k or 300k infected.

While the comment to that might be "well, we need to plan" -- I'll tell you the plan right now:  Pedal to the metal.   If it's not floored, then work on why not.

[pbiflyer]

The cdc has tested less people than the nba did this week.

[skianth16]

If results come back at a 3% of those tested are infected, that is amazing news.  Currently, we are looking at a rate of 17.3% of SPECIMENS (note: not people) in the US that have been tested are coming back positive (as of 3/13).  That is HORRIBLE news.  I can't stress that enough.  Now, of course we are only testing people within a very specific set of symptoms... so the numbers will trend high.  But also, as I mentioned earlier, that is number of SPECIMENS tested, not people tested.  Meaning, that there have been several specimens per person.  So less people tested than you think.

US test results have to be artificially high. We've essentially restricted testing to people we think have the virus. So of course the positive rate is pretty high. South Korea, on the other hand, has a much lower rate, pretty close to the 3% you referenced. The article below says they've testing about 240,000 people and have about 8,000 cases. To me, that's a much more relevant rate to use than the US rate.

https://www.latimes.com/world-nation/story/2020-03-14/south-koreas-rapid-coronavirus-testing-far-ahead-of-the-u-s-could-be-a-matter-of-life-and-death

[The Hippie Satan of Hyperbole]

Went to the store today, and...

It was largely fine.  We went early but the crowds were picking up.  Plenty of fresh foods available.  Shortages on some of the frozen and dry goods.  No toilet paper.  Very few cleaning supplies...which is a good thing.  My wife tends to be an over-buyer anyway so we are usually well stocked.

Also the liquor section had no lines or anything!

[Hards Alumni]

US test results have to be artificially high. We've essentially restricted testing to people we think have the virus. So of course the positive rate is pretty high. South Korea, on the other hand, has a much lower rate, pretty close to the 3% you referenced. The article below says they've testing about 240,000 people and have about 8,000 cases. To me, that's a much more relevant rate to use than the US rate.

https://www.latimes.com/world-nation/story/2020-03-14/south-koreas-rapid-coronavirus-testing-far-ahead-of-the-u-s-could-be-a-matter-of-life-and-death

But it isn't.  They took precautions and isolated people.  We have done so little, and have a significantly larger amount of community spread than they have ever have. 

[jesmu84]

Did some thinking this morning, but what might actually happen is that another country fast tracks a vaccine, and we just wait and see what happens.  Hopefully production scale up of vaccines start alongside Phase II so we don't have to wait as long either way... especially since money shouldn't be a barrier.

And The Freedom to Try Act won't help with vaccines. :-P  But it will help people try new antivirals, etc.

Money will be a barrier

https://twitter.com/mqmq_mmqq/status/1236751849769676801?s=19

Sad

We're a better nation because Jonas Salk thought that way

[Hards Alumni]

Money will be a barrier

https://twitter.com/mqmq_mmqq/status/1236751849769676801?s=19

Sad

We're a better nation because Jonas Salk thought that way

Gilead actually owns an antiviral called Remdesivir.  It isn't a vaccine, so that person is full of doo doo.