Coronavirus

[dfwatt]

First correct for co-morbidities as people get older. If any excess morbidity or mortality is left over then look for contributory mechanisms.

How do you hypothesize immunosenscense and exaggerated immune response in the same sentence ?

If you read what I say it's not immunosenescence. Immunosenescence is not present to any significant degree in 60 year olds. It's more likely an exaggerated immune response that's the problem.

 

[dfwatt]

First correct for co-morbidities as people get older. If any excess morbidity or mortality is left over then look for contributory mechanisms.

How do you hypothesize immunosenscense and exaggerated immune response in the same sentence ?

Comorbidities are in a sense proxies for pro-inflammatory process that are already activated in the background. There is a documented role for inflammation in every single disease of Aging. It is a principal if not one of the single most important processes in relationship to cardiovascular disease, cancer, COPD of course, type 2 diabetes, Alzheimer's disease, and virtually every other disease of Aging. So the idea that somehow these comorbidities are somehow separate from an accelerated or disinhibited immune system is a fallacy in itself. Happy to send you a book chapter I wrote on this if you're interested. Scratch that offer. I'm sure you're not interested. You already know all that there is to know about biology. Unlike the rest of us.

 

[Dr. J]

Have you tried salt ?

Garlic, maybe?

 

[Open Interest]

I begged one off the kitchen staff. Just one. I steam sterilize it after each time I go out (on a vegetable steaming rack in my pressure cooker). These days I'm also putting my hair covering in along with it, because it fits and why not?

One good-quality mask per person should be an easily achievable task. When I was out shopping the other day, I was the only person in a mask, but I did see a woman constantly holding her scarf over her mouth and nose. I felt bad for her, as I'm sure that she knows that the scarf will do little, but it's clearly all she had.

Are there any easily obtainable materials that can be sewn into scarves or bandanas to provide some protection for quick errands?

 

[SageBrush]

Comorbidities are proxies actually for pro-inflammatory process that are already activated in the background. There is a documented roll for inflammation in every single disease of Aging. It is a principal if not one of the single most important processes in relationship to cardiovascular disease, cancer, COPD of course, type 2 diabetes, Alzheimer's disease, and virtually every other disease of Aging. So the idea that somehow these comorbidities are somehow separate from an accelerated or disinhibited immune system is a fallacy and itself. Happy to send you a book chapter I wrote on this if you're interested.

I respectfully disagree. You are confusing association with causation. But do not misunderstand me -- inflammation is a double-edged sword, particularly dangerous when vital organs are already compromised by chronic respiratory and CV co-morbidity.

Even this tossed about 'cytokine storm' is one part true and 9 parts red herring. It is like saying that fever kills people. It can, but in most cases it is 1, beneficial; 2, a marker of disease severity. And since fever is in fact a cytokine side - effect the analogy has merit: Over ~ 104C -- it becomes a detriment. At lower values in otherwise healthy people it is an appropriate, beneficial immune response.

 

[UnknownSoldier]

There are reports Germany is closing it's borders? Can anyone in Europe confirm or deny?

 

[SMAlset]

Here’s a link to an ophthalmology academy FYI about COVID-19: Alert: Important coronavirus updates for ophthalmologists

Interesting article. We know one of the whistleblowers in China, Dr. Li Wenliang, the doctor who made the news and later we learned had died from contracting the disease was an ophthalmologist. Came away from website that conjunctivitis may be an indication of c19 infection so people should keep that in mind.

 

[SageBrush]

Garlic, maybe?

LOL !
Karen's co-workers sound difficult to control so I recommend both.

 

[dfwatt]

I respectfully disagree. You are confusing association with causation. But do not misunderstand me -- inflammation is a double-edged sword, particularly dangerous when vital organs are already compromised by chronic respiratory and CV co-morbidity.

Even this tossed about 'cytokine storm' is one part true and 9 parts red herring. It is like saying that fever kills people. It can, but in most cases it is 1, beneficial; 2, a marker of disease severity. And since fever is in fact a cytokine side - effect the analogy has merit: Over ~ 104C -- it becomes a detriment. At lower values in otherwise healthy people it is an appropriate, beneficial immune response.

Respectfully, you have lost the forest for the trees.

 

[Prunesquallor]

I wish I could get away with taping a 2-meter diameter circle on the floor around my desk with a "do not chat within this space" sign in it.

Candles. And a pentagram.

 

[Doggydogworld]

That's what China and Korea did, and it worked.

Korea did not lock down, instead they fanatically traced contacts and tested. When they did quarantine people, they enforced it vigorously. Singapore, Taiwan and Hong Kong have also been fanatical in testing (especially inbound arrivals) and enforcing individual quarantines, with good results.

China had to lock down 60m people and semi-lockdown a billion more because it was burning out of control. Italy is there now.

It's too late for the US to catch it at the border, but we can still test and trace if we have the willpower. And enought #$%@ tests!

 

[Right_Said_Fred]

As of tomorrow all schools, restaurants, pubs and gyms in The Netherlands will be closed for a minimum of three weeks. Shops can still stay open, but that will probably not last long.

One of the main reasons for closing the pubs and restaurants was the fact that this weekend thousands of Belgians, where they are already closed, crossed the border to eat and (especially) drink here. An utterly stupid bunch of alcoholics

 

[pz1975]

Thank you for the informative response. More information than I have been able to find anywhere else.

Somewhat of an irrelevant side question:
So if you had conjunctivitis due to the virus, but did not get the lung infection (I suppose this is unlikely?), you are saying it is possible the virus would never establish itself in your lungs?

Would you develop antibodies to the virus in this case and have immunity even though you never got the lung infection?

It is likely possible to get the conjunctivitis without the respiratory infection. When I see patients with conjunctivitis, I always ask them about recent respiratory illness and a lot of time there is none. And these are almost always caused by the usual cold/flu viruses. I am only speculating that Coronavirus would be similar but obviously I don’t know for sure.

As for developing immunity, good question as well. I would think yes but I’m not an immunologist so I don’t know for sure.

I haven’t heard of any patients yet getting isolated conjunctivitis without respiratory symptoms that tested positive for COVID19.

 

[Right_Said_Fred]

There are reports Germany is closing it's borders? Can anyone in Europe confirm or deny?

As of Monday morning they are closing the border with France, Switzerland and Austria (with the exception of trucks and people who work across the border). No closure yet of the border with The Netherlands, Belgium, Denmark and Poland.

 

[SageBrush]

Respectfully, you have lost the forest for the trees.

Funny, I was thinking the same about you.

Consider the case that someone just stabbed you. I can assure you that the blood coming out is chock full of pro-inflammatory molecules but I advise you to skip further lab analysis and stop the bleeding instead, and I don't mean take immuno-depressants. You may also want to pay attention to knives in the future.

 

[SMAlset]

To our doctor members here, I remember watching a NOVA special or such on how people get infected by others coughing or sneezing and how it can first settle in the back of one’s throat and gain a foothold before moving down to the lungs. Would gargling with Listerine (yellow version) regularly or after exposure from someone who was sneezing/coughing in your vicinity help kill any c19 that found it’s way into your body?

 

[SageBrush]

To our doctor members here, I remember watching a NOVA special or such on how people get infected by others coughing or sneezing and how it can first settle in the back of one’s throat and gain a foothold before moving down to the lungs. Would gargling with Listerine (yellow version) regularly or after exposure from someone who was sneezing/coughing in your vicinity help kill any c19 that found it’s way into your body?

I doubt it. The virus enters cells quickly.

MASK

 

[dfwatt]

Funny, I was thinking the same about you.

Consider the case that someone just stabbed you. I can assure you that the blood coming out is chock full of pro-inflammatory molecules but I advise you to skip further lab analysis and stop the bleeding instead, and I don't mean take immuno-depressants. You many also want to pay attention to knives in the future.

Sagebrush: Caricaturing and in other ways distorting other people's arguments to create straw men that you can then knock down is your favorite tactic on this forum. Unfortunately a lot of people are catching on that that's what you're doing. I'm not going to try to endlessly re clarify my points which you have systematically obfuscated. I'm simply going to ignore you.

 

[bkp_duke]

And they're constantly surrounded by one highly infectious patient after the next, in close range, all day. It's not even remotely the same situation. And even still, most stay protected - even if protection measures fail some, for one reason or another.

Actually, we usually get it. Sooner or later.

First year in pediatrics residency, we came down with everything our patients had, at least twice, if it wasn't something we could vaccinate against. This was despite being as careful as possible in patient rooms with full PPE.

The only airborne diseases we were able to avoid (mostly) were tuberculosis. And I attribute that to the fact that usually only one physician per day entered the room (instead of the entire team) and the PPE protections were at a much higher level.

 

[bkp_duke]

Yes, coronavirus has stronger error-correction:

"Over the length of its 30,000-base-pair genome, SARS-CoV-2 accumulates an average of about one to two mutations per month, Rambaut says. “It’s about two to four times slower than the flu,” he says."​

The aspect I find most troubling about Covid-19 is that in severe cases it apparently creates a cytokine storm, which would make it more difficult to create a vaccine that doesn't trigger a cytokine storm in older patients.

On the other hand this gives a chance for immunosuppressants to be effective treatment, if the infection is caught early enough, or if it's introduced deliberately.

Data to support the cytokine storm hypothesis please.

Many of the newer vaccines are against very specific protein fragments, not the entire virus as we did in the past (i.e. live attenuated viruses). This gives a very specific immune response that can be tailored to remove any potential component that causes an undesired reaction (i.e. like cytokine storm). The downside is that if the virus mutates and changes the key expressed protein fragment used in the vaccine, the effectiveness of the vaccine drops. In live attenuated vaccines, you still have coverage.

Basically:
protein fragment vaccine - very specific immune response that generates a limited spectrum of antibodies
traditional vaccine - broad immune response that generates a wide array of antibodies

You can guess which one provides decades-long protection vs. a few years