Coronavirus

[dfwatt]

I read the paper, with a focus on the Coronavirus section. I believe that while there is some data to support ADE, the authors make logical leaps, specifically from animal studies, that there is simply not data in humans to support at this time. Having worked in animal models, I have had the unfortunate experience of having fantastic data not translate from animal cells to provide the same effect in human cells (and forget human studies).

In theory, based upon that review article, a vaccine based upon specific epitopes (the Moderna vaccine, or a more traditional antigen-based vaccine) should result in far less likelihood for ADE than a vaccine based upon live-attenuated or inactivated virus particles (i.e. whole-virus based vaccines).

This is another theoretical-based paper that looks at ADE in the context of COVID-19, but I cannot get anything but the first page to load. If you get a copy (and it has NOT been peer reviewed, so take it with a grain of salt), please send it my way.
https://www.nature.com/articles/s41586-020-2538-8_reference.pdf

Appreciate your feedback as always. That looks like a really interesting piece so I'm going to plow through it later today if I can get some time from my own lit review on something else. Thanks for forwarding that.

 

[AlanSubie4Life]

Florida is nearing a local maximum in deaths per day. In the next few days, probably. (To be clear, that's the predicted peak of deaths by date reported, not by date of occurrence.) It's possible the peak deaths by date of death has already occurred, though hard to say as there is some randomness to it.

 

[dfwatt]

At best, Victoria's mandated masks did not help, they may even have contributed to the worsening state down there.

I'm really curious how you explain this comment that masks are making the spread of covid 19 worse. How does that work anyway?

 

[Doggydogworld]

2.5% of Italians test positive for antibodies in national survey. Much lower than I'd expect, about half of Spain's survey though both countries have similar 600/million dead. This about 2.5% IFR in Italy. Hospitals were under severe stress in northern Italy, but that was also true of Madrid.

 

[AlanSubie4Life]

2.5% of Italians test positive for antibodies in national survey. Much lower than I'd expect, about half of Spain's survey though both countries have similar 600/million dead. This about 2.5% IFR in Italy. Hospitals were under severe stress in northern Italy, but that was also true of Madrid.

I do wonder about the falloff of antibody titer in cases like this. To some extent, that is definitely "a thing." How much of a difference it makes, I don't know.

There doesn't appear to be any evidence for an IFR (in a typical population) of more than about 1% (maybe 1.25% worst case?). Italy might be a bit worse off since they're older in general, but 2.5% definitely seems very high, even with stressed hospitals.

It seems like IFR is around 0.6% these days in the US, with everything being a lot more "calm" (probably not the right descriptor...but certainly hospitals under less stress than in Italy).

 

[jerry33]

I'm really curious how you explain this comment that masks are making the spread of covid 19 worse. How does that work anyway?

I've thought about that for a while, and the only thing I can come up with is that masks are not a stand-alone preventive. They need to be combined with distancing, avoiding crowds and public buildings, and good hygiene along with testing and tracing. So if people think that masks alone make them safe and don't follow the other practices they won't work. Also there's the type of mask worn and wearing it properly.

 

[dfwatt]

I've thought about that for a while, and the only thing I can come up with is that masks are not a stand-alone preventive. They need to be combined with distancing, avoiding crowds and public buildings, and good hygiene along with testing and tracing. So if people think that masks alone make them safe and don't follow the other practices they won't work. Also there's the type of mask worn and wearing it properly.

Absolutely. That's the only way in which that comment might be grounded in reality. Otherwise it sounds like Trumperism. But the refusal or the resistance against masks is grounded in the same covid-19 denial that makes people reject social distancing, avoidance of indoor crowds, and an avoidance of all the other classic transmission vector risk factors. So it's all of a piece in that sense. Either you accept the basic science or you don't. If you don't you have a lot of issues to explain away. That hasn't stopped people however.

 

[bkp_duke]

I do wonder about the falloff of antibody titer in cases like this. To some extent, that is definitely "a thing." How much of a difference it makes, I don't know.

There doesn't appear to be any evidence for an IFR (in a typical population) of more than about 1% (maybe 1.25% worst case?). Italy might be a bit worse off since they're older in general, but 2.5% definitely seems very high, even with stressed hospitals.

It seems like IFR is around 0.6% these days in the US, with everything being a lot more "calm" (probably not the right descriptor...but certainly hospitals under less stress than in Italy).

I wonder, more specifically, about the test being used. Does it detect antibodies produced against all 6 strains of SARS-CoV-2, or fewer. We do know from sampling of the virus that the different strains that are prevalent now are much different than those that were around in March and April.

 

[madodel]

I do wonder about the falloff of antibody titer in cases like this. To some extent, that is definitely "a thing." How much of a difference it makes, I don't know.

There doesn't appear to be any evidence for an IFR (in a typical population) of more than about 1% (maybe 1.25% worst case?). Italy might be a bit worse off since they're older in general, but 2.5% definitely seems very high, even with stressed hospitals.

It seems like IFR is around 0.6% these days in the US, with everything being a lot more "calm" (probably not the right descriptor...but certainly hospitals under less stress than in Italy).

They need to break out people who have antibody tests noting those who tested positive in the past 5-6 months on the PCR test. They should have substantial numbers in Italy and Spain from their peak in March. That would give a good feel for the depletion of antibodies.

 

[AlanSubie4Life]

2.5% of Italians test positive for antibodies in national survey. Much lower than I'd expect, about half of Spain's survey though both countries have similar 600/million dead. This about 2.5% IFR in Italy. Hospitals were under severe stress in northern Italy, but that was also true of Madrid.

Some more discussion on this here. It's possibly not way out of line.

https://twitter.com/DiseaseEcology/status/1290754158438387713?s=20

 

[Daniel in SD]

They need to break out people who have antibody tests noting those who tested positive in the past 5-6 months on the PCR test. They should have substantial numbers in Italy and Spain from their peak in March. That would give a good feel for the depletion of antibodies.

Yeah, I don't see that data in the report. https://www.istat.it/it/files//2020/08/ReportPrimiRisultatiIndagineSiero.pdf
However people testing PCR positive in Italy were more severe cases so that would be an overestimate of the sensitivity of the test. I saw a recent study of the Abbott test (the one used in this study) showing it is not as sensitive for mild cases.

They did find that 41.7% of people living with a household member that tested positive for COVID tested positive for antibodies. That's higher than seen in other studies.

 

[renim]

I'm really curious how you explain this comment that masks are making the spread of covid 19 worse. How does that work anyway?

I've thought about that for a while, and the only thing I can come up with is that masks are not a stand-alone preventive. They need to be combined with distancing, avoiding crowds and public buildings, and good hygiene along with testing and tracing. So if people think that masks alone make them safe and don't follow the other practices they won't work. Also there's the type of mask worn and wearing it properly.

Some people can follow 3 ideas from a presentation.

Some people can follow 4 ideas from a presentation.

Some people can even remeber 5 ideas from a presentation.

As per the australian government, the top 4 points are;

"While a mask can be used as an extra precaution, you must continue to:

• stay at home if unwell
• maintain physical distance (more than 1.5m) from other people, when out
• avoid large gatherings and crowded indoor spaces
• practise hand and respiratory hygiene"

Should I wear a face mask in public?

Closer to home I've observed at least one person who seems to think that masks are a ticket for getting back to work. No way, if an activity is too unsafe to do without an unregulated, untested face covering, then its too unsafe to do with an unregulated, untested face covering either.

If covid19 was silica or asbestos, would you wear a piece of cloth mask or a tested product from 3M instead?

Masks are a control measure, the least effective level of control measure. They are not a substitute for any control measures above them. They intended as complementary not subsitutary in relation to the higher control measures.

In Victoria, despite the hope, cases keep rising once masking became mandatory, because there were sufficient Victorians who treated mandatory masking as a subsitutary control measure. This can technically be considered a 'perverse' outcome.

 

[renim]

A more classic 'perverse' outcome is balance between wanting the (at risk) populace to be tested for covid19, and penalising (isolation) them once they are tested for covid19.

Where to draw the line? Not always an easily transferable answer.

 

[Daniel in SD]

A more classic 'perverse' outcome is balance between wanting the (at risk) populace to be tested for covid19, and penalising (isolation) them once they are tested for covid19.

Where to draw the line? Not always an easily transferable answer.

Even more perversely, a positive test could make a person even more likely to infect others because they're no longer worried about getting COVID!
The cynical part of me is a testing skeptic. It sounds like Australian culture is similar to the United States.

 

[renim]

Even more perversely, a positive test could make a person even more likely to infect others because they're no longer worried about getting COVID!
The cynical part of me is a testing skeptic. It sounds like Australian culture is similar to the United States.

That thought had never even crossed my mind, but yeah, It seems reasonable, seems more likely later in the pandamic. Even in Victoria the odds of catching Covid19 are on an absolute level, quite low, even if they are unacceptably high.

 

[renim]

Testing has been a key aspect of the various australian states response. The more clarity where the virus is, the more effective and targetted the response can be.

In extreme it assist to leading to a Qld,SA,WA,Tas level of what is effectively zero community transmission.

 

[madodel]

He doesn't mention checking TMC Coronavirus thread though.
How to Evaluate COVID-19 News without Freaking Out

 

[AlanSubie4Life]

perversely, a positive test could make a person even more likely to infect others because they're no longer worried about getting COVID!
The cynical part of me is a testing skeptic.

Not everybody has to cooperate for it to work.

Make testing not require any insurance paperwork, eliminate any payment requirements, and ensure results in 24 hours to everyone who wants a test, and you’ll be really close to being successful. Obviously there is more to it on the tracing side. But these are necessary steps.

 

[eevee-fan]

... money? Some places have told people who do not have symptoms to not get tested... maybe some people were lining up for free test since they are bored at home.

 

[AlanSubie4Life]

... money? Some places have told people who do not have symptoms to not get tested... maybe some people were lining up for free test since they are bored at home.

Money is something we have no shortage of. That and labor. It is the perfect scenario, so success is guaranteed, assuming we decide we want to eradicate the virus.