COVID-19 Research, Drug trials and Pathophysiology

Warning contains traces of Australian accent

 

This is correct, with just a little caveat: with Delta, vaccinated people who develop a breakthrough infection can actually start by having a similar viral load to that of unvaccinated people. However, the viral load of the vaccinated people drops much faster, indeed resulting in decreased odds of passing it on to others and shorter contagious period. Also, a very interesting study in the UK looked at people who are vaccinated but live in a household where everybody else is unvaccinated, and then they catch a case of breakthrough Covid. Well, sometimes they don't pass it on to anybody in their household, while unvaccinated people who catch it and live in a household with other unvaccinated people, pretty much pass it on to almost everybody. So, the idea to explain the difference, was to have the hypothesis that maybe the vaccinated person is shedding defective viruses that are less infectious, given that they still count for the viral load but are not fully functional because they are already half-knocked out by the vaccinated person's antibodies.

Also, to pass it on to others one needs to catch it in the first place, and some vaccinated people have enough neutralizing antibodies that they don't actually catch the virus in the sense of a replicating infection; the virus is zapped right away and never takes hold. So, it's been recently shown that even with Delta, vaccinated people are 5 to 6 times less likely to catch the virus than unvaccinated people.

So vaccination cannot STOP transmission but does reduce it, like you said.

 

We've heard a lot from them about their rights. They seldom talk about their responsibilities.

 

What do anticipate from third shots? Improved protection for vulnerable groups?

 

Yet another unprincipled attack from the forces of darkness.

 

So my next question is, in these cases where the persons life is so fragile that any kind of virus can kill them. What is the average life days/months/years lost?
I have no desire to play down the figures, simply to understand them, so I can feel comfortable seeing our lives return to normal.

We live alongside many things that kill us and sacrifice lives in order to live as we want. For instance 606,000 people died of cancer in the US in 2020. That's 11,600 a week. We know that research has lead to saving many lives. Yet we don't introduce economy crippling taxes to raise money to increase this research and rid us of cancer.
So; I agree that we needed the lockdowns and the closures and the masks and limits on travel etc etc. But at what point do we say we have to live with this new disease?

 

Thanks, and this answers the other black and white statement people make. That the vaccine doesn't even stop you getting the virus.
No it doesn't, its not a force field. But it does often stop you catching it in any meaningful way.

 

Thank you very much however my ego shrinks as my prostate grows in old age. Lol.

 

Examples of Exaggeration
Related to the fallacy of oversimplification is the fallacy of exaggeration. An exaggeration fallacy is committed when an argument tries to include additional causal influences that may be irrelevant to the matter at hand. We can say that committing a fallacy of exaggeration is a consequence of failing to heed Occam's Razor, which states that we refrain from adding unnecessary "entities" (causes, factors) to an explanation.

https://www.thoughtco.com/oversimplification-and-exaggeration-fallacies-3968441

 

Despite all goods and benefits of medicine we have to remember that doctors in the United States represent most corrupt and most lobbied American industry.
So any information that is coming from the doctors need to be researched and questioned, because, by default their main motivation is profit.

 

To some degree. About one third of the immunocompromised don't respond to a third shot either. The other third responds partially. One third does respond. So in any case, it's good to try, but the results are not great. For some, they results are better than nothing and for some the results are nothing.

But the other side of this, is that if immunocompetent people get a third shot, thus reversing the fading titers of neutralizing antibodies back to full protection, they will be more likely to pass the virus onto the vulnerable people. Vaccination is not just good for the individual; it's good for the community, too.

 

These are all excellent questions. The answer to your first question is possible, but hard to get at. If you try to look into it for every individual patient, there is too much variation and unpredictable parts. We see all the time a terminal patient beating the odds and surviving much longer than expected; we also see people we think have a few years left, succumb rapidly to an illness. But there is another way to get at it; comparing the number of deaths for each age group that we're seeing during the pandemic, with the same age groups in years prior to the pandemic. I don't have the answer on me, and it would involve some complex calculations and modeling, but I guess the answer can be found, if someone invests the time and energy to browse the databases and harvest the data.

I don't think the cancer example is very good, because interventions to find means to cure or delay cancer would have a slow effect in a slow moving train and would take a good while to produce a life expectancy benefit, while an intervention like a vaccine in the middle of a pandemic of an infectious disease can have an immediate impact, saving lives. The same can be said of the epidemiological, non-pharmacological interventions. We are in the middle of a dangerous pandemic. I think that efforts to contain it are justified, including those that partially hurt the economy, because if we are left to deal with sequelae among the survivors, for the next couple of decades, the long-term economic impact will be much bigger than the temporary impact of the containment measures. What hurts the economy is a dangerous virus out there, not the measures to contain it.

But yes, we'll have to learn to live with the SARS-CoV-2 and its mutations, for the next several years, I'm afraid. We'd like to bring the numbers down as much as possible so that the disease can be managed and partially contained. A stalemate that involves too high a death toll and sequalae toll is not acceptable.

 

Great questions.

Well to start with normal is a world full of congenital and genetically inherited medical limitations, fungii, bacteria, viruses, exposures to chemicals, and environmental, socio-economic and other conditions that can trigger or exasperate negative medical conditions not to mention aging itself brings inevitably related illnesses.

So given the above, the idea you can be isolated from the above or put in a bubble is not realistic. We know for example lock downs might help temporarily but can not be permanent nor are they a panacea for pandemics.

So what we do have are scientists, doctors, pouring over research from studying patterns of emerging cause and effect phenomena trying to predict continuing patterns of creation of illnesses and how they are transmitted. Yes its a never ending process to try come up with procedures, protocols, risk management methods to try identify and prevent things that raise the risk of exposure as well as containing and managing illnesses once obtained. So there is no one answer to it. The guidelines that will be issued will always be subject to continuing changes as we learn more and more about each illness or disease or virus, etc. So we will never have AN answer but we will have many on-going temporary ever changing guidelinest hat err on the side of caution in the given moment.

Medicine does use worst case scenarios but it is because it errs on the side of caution-its not meant to scare but to educate but unfortunately the inherent subject matter-illness, necessarily scares people.

So all I can say is as the world evolves and news is more immediate, intense and in your face confusing you, intimidating you, making you stress about issues you have no control over (stress is of course worrying about things you have no direct control over) develop a sense of humour and concentrate on things you can control.

Think of it as practicing safe sex. You have to decide how safe you want to be. Ultimately the decisions are decided by you but do impact on others.Look you know, no one can force you to wear a bathing suit if you choose to be nude. Me I wear one because at my age, 65, I do not want to frighten people because of gravity. Also I wear boxer shorts not bikini briefs given what I work with. Everyone has to decide what measures to take. Not all of us can wear thongs or speedos but being completely nude in certain situations is just not possible in today's environment.

(p.s. global warming....will make everyone want to take their clothes off..resist the temptation or you will get sun burned and get skin cancer)

 

Phenomenal. It's the kind of thing that we don't have here. We've never had a campaign to inform the people, like I've seen in other countries. I like to post this; it comes from England; I've posted it over and over but it is so good that I always enjoy posting it again:



The girls look so serious, the lyrics are perfect, and they do sing very well. It's a very compelling piece, and I imagine that some people who were hesitant did accept the vaccines after listening to this.

 

Everyone needs to be informed that "Health Care" industry needs profit.
Their profit will save our lives.

 

I found an article that has some answers for you:

https://www.yahoo.com/news/life-expectancy-fell-sharply-u-223226859.html

 

Not here - we have a UHC and the government is REALLY interested in keeping costs down since they are paying for the darn thing.

 

I have to confess the video is actually a mock-up for a program called Gruen. It is not a program that could ever be supported by anything other than a government sponsored media channel (ABC Aust). I have learnt so much about the psychology of advertising from that program………. And it is still essentially a comedy.

the thread I started on this has the video of the real government ad and Todd Sampson explaining why government ads are “bland”

http://www.politicalforum.com/index.php?threads/australia-trolls-joe-rogan.593846/#post-1073048072

 

Sure, but regardless of the source, comedy also gets results. Regardless of this video being linked to an official campaign or not, it gets to the public. The Marsh family (the ones who did the clip I posted) also take a comedic approach to their parodies (there are many more, almost all, Covid-related). This one I posted above is maybe the most serious one they've produced although there are still some funny jabs - pun intended.

Over here, we don't even get that (instructive comedy). We get pundits like the idiot known as Tucker Carlson bashing the vaccines on TV. We just had a woman reporter from one of the right wing TV channels saying that the vaccines have a fluorescent material in them that is intended for the Devil to find the person's soul. I kid you not.

 

Can you generalize about, say, a 75-year-old in reasonably good health in terms of your one-third, one-third, one-third analysis for the immunocompromised? Is there a significant difference? How about a 65-year-old?

Many people are struggling with figuring out how to mitigate risk. That 65-year-old is assessing whether or not he can go to a restaurant, take a vacation or just visit the supermarket.

Of course, it is. I appreciate doctors who take the time to go on tv and explain why we should get vaccinated.

 

I don't think there is a way to generalize. Each case is different, regarding how that person came to be immunocompromised, and how affected that person's immune system is. People should consult with their doctors who are treating them for the condition that is making them immunocompromised, or are giving immunosuppressing medications for other conditions.

How to mitigate risk: Get the vaccine + booster (you may be among the third that respond well, or at least the third that respond partially) and if the FDA approves it (they should but haven't, unfortunately) get a prophylactic infusion of monoclonal antibodies. Wear a high-quality, American-made N95 respirator and make sure you achieve a good seal. Consider goggles for eye protection too (optional, transmission through eyes is possible but rare). Stay at least 6 ft from people, if not 10. Avoid indoor spaces where people of unknown status are unmasked and there is poor ventilation. Wash your hands, avoid touching mouth, nose, or eyes with soiled hands (no need for germophobia; transmission through fomites is only 2% of all transmissions). Avoid outdoor spaces when they are filled up with a large crowd of unmasked people (such as a concert or sports stadium). Have rapid antigen test kits at home for fast screening in case of symptoms. If you get infected (or have a confirmed exposure), go immediately to get an infusion of monoclonal antibodies (they are free for Americans, courtesy of our government, and effective). Sleep well, hydrate, eat right, exercise, lose weight if you're above a BMI of 25. Make sure you have good vitamin D level; if not, take a supplement (minimum level, 30; maximum, 75 to 100). Maybe, take 250mg of Quercetin twice a day + 50mg of Zinc Picolinate twice a day + 500mg of Vitamin C twice a day + 3mg of Melatonin nightly, to improve a bit your immune system (low-grade evidence but over-the-counter and totally harmless, so, why not?). Do not forget that at home, if you're immunocompromised, your household members even vaccinated, can also spread the virus to you, so the immunocompromised person should wear an N95 respirator too, in the presence of household members, who should at least wear a facemask in the presence of the immunocompromised person. Transmission at home is common and people usually don't take precautions at home which is a mistake. Change your N95 every day, don't reuse (brand new ones filter better due to electrostatic charges).

Go to a restaurant: if you're immunocompromised, in the middle of a pandemic? Indoors, no. Too risky. People will have to unmask to eat and drink. Ventilation is not always great. If you must go, then pick one with outdoor space, masked waiters, and tables that are sufficiently spaced out. Consider curbside take-out instead. Instead of going to the restaurant, you can bring the restaurant to your home... and you won't be paying wine mark-up.

Visit the supermarket - as long as you wear a high quality N95 with good seal and you give yourself a wide berth from others, you go in, rapidly make your purchases, and go out, you should be fine, especially in large, well-ventilated stores (as opposed to a crowded neighborhood market) but do pick times when the store is pretty much empty, not peak times when it's crowded. But you can also explore delivery services or curbside pick-up services that some supermarkets have.

Vacation? It depends. If you must, I'd drive to the location instead of flying (probably the airplane is fine but the airport is not), check into a hotel that has contactless check-in (those you can go directly to your room and open the door with a digital key that they email to you), order room service for breakfast (buffet style indoor spaces are risky), and when you visit touristic points, pick the outdoor ones, eat in outdoor restaurants. Beware of elevators. If possible, get a room that doesn't need an elevator for access. If you do need an elevator, avoid riding it with a bunch of maskless people. Get the next one. If you are alone and the elevator stops and a bunch of maskless teenagers get in, get out and wait for the next one.

Before any funny member here says that the above is overkill, this advice is for someone who is immunocompromised. This category of people will need to be extra-careful; it's literally a life-and-death situation.

 

Thank you, but I was thinking of since we all got vaccinated. I was not, nor would be one of those arguing we didn't need lockdowns and restrictions before the vaccine became available. I often try and imagine how we would go forward if we hadn't found a vaccine.
Re, your other post and @Death. I want to do them justice so I will read them properly at the weekend.
Regards Tigger.

 

But will we get our old lives back? If we have an endemic SARS-CoV-2 prevalent enough for people to mitigate a fear of getting sick, we'll lose a lot of "places with faces."--restaurants bars, clubs, gyms, planes, trains, hotels, etc. as some people stay away and jobs disappear for good. More virus, more fear and more mitigation. We have a lot of capital and jobs tied up producing impacted services.

Our ports are jammed because imports from China have increased 25%. We're going to feel a greater impact when government stops the handouts if the virus continues circulating.

I don't think we'll have it like we did in 2019 as long as covid is around. Maybe we'll get lucky and develop an effective treatment.

Living with covid might be the worst outcome for the economy.

We may pay a frightful price for putting up with the unvaccinated. Do they care? I doubt it.

 

Very good news if confirmed when the full data are available: Pfizer's oral antiviral had preliminary phase 2/3 results. It's been diffused by the company but it hasn't been published yet in a scientific journal. The results for now appear to be superior to molnupiravir's (the latter cuts hospitalizations and deaths by 50%). Pfizer's Paxlovid apparently cuts hospitalizations and death by 89% when taken up to 3 days after the person is diagnosed with the infection. If confirmed, this will become a major tool to fight Covid-19. Antivirals by the mouth that can be taken at home have a potential to dramatically reduce the dangers of Covid-19. Fingers crossed.

 

An advancement like the one I just mentioned above (Paxlovid) could go a long way in mitigating things. So in this regard I remain cautiously optimistic. Many epidemiologists are saying that by the end of 2022 the SARS-CoV-2 will likely become endemic, will flare up every winter, will kill about 100,000 Americans per year, and will require at least yearly vaccination. This is not good for the economy. But if very efficient antivirals by the mouth hit the market, and the numbers above are confirmed, a reduction by 89% would mean that we'd be left with 11,000 deaths per year, a number that is smaller than what is estimated for most flu seasons. I think that if this is the case, then life will go back to normal. Of course, to achieve the full potential of this 89% reduction, we'll need fast and readily available diagnosis, and good access to care so that people can rapidly get a prescription for the antiviral. We won't be able to get everybody to have this timely access, so likely it will be more than 11,000 deaths. But, this is just one antiviral. There are two others. Maybe a cocktail like we do for HIV will have even better results, and this, added to vaccines and monoclonal antibodies might practically eliminate hospitalizations and deaths from Covid-19.