COVID-19 Coronavirus Containment Efforts

[bhobba]

I can offer you a 101% certified free* and totes legit trial. You just have to purchase this small bridge off of me.

Are you associated with the guy who sold me that fantastic park in the middle of New York he inherited from his father, the late Sam Central? Seriously the speed of developing the vaccine is encouraging, fingers crossed, it will more likely be 5 months. The person who said that was an immunologist that was close to the development team. Interestingly he said he was also a pediatrician, and children believe it or not are doing rather well if they catch it. His theory is adults have been exposed to other coronovirus's and their immune system is overreacting. I haven't discussed this with my doctor yet, but I will be seeing him sometime this week for an insulin script. Why do they keep saying people with diabetes like me are at risk - it's very depressing. I have to laugh a bit when experts say everyone will get it - they must be very pessimistic about the vaccine.

Thanks
Bill

 

[AlexCaledin]

... an immunologist ... His theory is adults have been exposed to other coronovirus's and their immune system is overeating.

- is that how immunologists admit that adults are simply over-vaccinated?

 

[StatGuy2000]

This is the answer to reinfection. There is none. Reactivation, maybe.

https://www.japantimes.co.jp/news/2020/02/28/national/coronavirus-reinfection/#.XlsTYLLmiDa

The article you point to only reports speculation among some of the researchers of the possibility of reactivation. Reinfection has not been ruled out, and whether reactivation is possible will require further research.

 

[kadiot]

The article you point to only reports speculation among some of the researchers of the possibility of reactivation. Reinfection has not been ruled out, and whether reinfection is possible will require further research.

Yes, that's why I said there's none. I agree most of the reports carry some "experts" opinion with it.

 

[bhobba]

I just don't know what to say:
https://www.msn.com/en-au/news/australia/anti-vaxxers-terrified-of-a-mandatory-coronavirus-vaccine-in-australia/ar-BB10xPeA

Sorry guys, while I believe in freedom and all that, the government has decided, in a really bad emergency situation, your irrational belief about vaccines does not allow you to put others lives in danger. And yes, generally most people in Australia don't have guns for self defense, but even if you had guns the government has enough resources so it will not make any difference.

Tanks
Bill

 

[kadiot]

When air is humid & warm, droplets gather more moisture, become too heavy to stay airborne & fall to the ground more quickly – this makes transmission harder. (shown in flu in guinea pig models: https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.0030151)

 

[chemisttree]

Are you associated with the guy who sold me that fantastic park in the middle of New York he inherited from his father, the late Sam Central? Seriously the speed of developing the vaccine is encouraging, fingers crossed, it will more likely be 5 months. The person who said that was an immunologist that was close to the development team. Interestingly he said he was also a pediatrician, and children believe it or not are doing rather well if they catch it. His theory is adults have been exposed to other coronovirus's and their immune system is overreacting. I haven't discussed this with my doctor yet, but I will be seeing him sometime this week for an insulin script. Why do they keep saying people with diabetes like me are at risk - it's very depressing. I have to laugh a bit when experts say everyone will get it - they must be very pessimistic about the vaccine.

Thanks
Bill

Not pessimistic but realistic. Even if a working vaccine were developed today it is only experimental until the time-intensive clinical trials demonstrate safety and efficacy. Those are what take the real time. 18 months for that realistically. You take it before it’s proven safe, you’re a guinea pig and bad things could happen. There’s no getting around it... a safe vaccine will come too late for the first wave of this virus and non-pharmaceutical intervention is the only thing we have to work with. Healthcare workers sometimes volunteer to be vaccine guinea pigs because of the hazardous nature of their work during an outbreak.

Diabetics are at higher risk because of their elevated A1C.

 

[kadiot]

I'm aware that mutations are a natural part of the virus life cycle. But I always wonder if mutations impact outbreaks.

 

[chemisttree]

I'm aware that mutations are a natural part of the virus life cycle. But I always wonder if mutations impact outbreaks.

It did during the swine flu 2009 outbreak. It mutated to a less virulent strain.

 

[kadiot]

Not pessimistic but realistic. Even if a working vaccine were developed today it is only experimental until the time-intensive clinical trials demonstrate safety and efficacy. Those are what take the real time. 18 months for that realistically. You take it before it’s proven safe, you’re a guinea pig and bad things could happen. There’s no getting around it... a safe vaccine will come too late for the first wave of this virus and non-pharmaceutical intervention is the only thing we have to work with. Healthcare workers sometimes volunteer to be vaccine guinea pigs because of the hazardous nature of their work during an outbreak.

Diabetics are at higher risk because of their elevated A1C.

I agree. I've heard that it would take 12 to 18 months before vaccine passes through clinical trials, health authority evaluation, registration and the new vaccine would still require production facilities to mass-manufacture and distribute. Vaccine manufacturers cannot create vaccines for all countries who have reported COVID19 cases.

 

[Vanadium 50]

And who do I have to pay off so I don't get the placebo shot?

If I ever get sick, I want those placebos. They seem to be able to cure anything some fraction of the time!

I don't understand why the APS isn't cancelling the meeting because of measles. There are more cases in the US, it has a much, much higher R0, and a slightly higher fatality rate for the non-ederly (there is very little recent data on the elderly and measles for obvious reasons). Why is Coronavirus causing this panic when measles is demonstrably worse in the US along every axis?

 

[BillTre]

I don't understand why the APS isn't cancelling the meeting because of measles. There are more cases in the US, it has a much, much higher R0, and a slightly higher fatality rate for the non-ederly (there is very little recent data on the elderly and measles for obvious reasons). Why is Coronavirus causing this panic when measles is demonstrably worse in the US along every axis?

I can think of a few reasons:

• No vaccine for Coronavirus (unlike measles).
• No pre-existing population of people previously exposed to the Coronavirus who have developed a natural immunity (unlike measles).
• Population of those attending a scientific meeting are probably more likely to have a vaccine to an established disease than the normal (non-scientifically educated public).
• Caution in the face of the unknown (coronavirus not yet well characterized).

 

[Vanadium 50]

The first two points are covered in R0. I'm not so sure about that third point, because it's really the parents' educational attainment that matters (although it is correlated). The fourth point is valid, but I would argue still over-reacting. If coronavirius was known to be twice as risky as measles, would we still cancel? Three times?

 

[bhobba]

Not pessimistic but realistic. Even if a working vaccine were developed today it is only experimental until the time-intensive clinical trials demonstrate safety and efficacy. Those are what take the real time. 18 months for that realistically. You take it before it’s proven safe, you’re a guinea pig and bad things could happen. There’s no getting around it... a safe vaccine will come too late for the first wave of this virus and non-pharmaceutical intervention is the only thing we have to work with. Healthcare workers sometimes volunteer to be vaccine guinea pigs because of the hazardous nature of their work during an outbreak.

Well I think depending on exactly how it develops they may take that risk - the Israeli's think 90 days: https://www.jpost.com/HEALTH-SCIENCE/Israeli-scientists-In-three-weeks-we-will-have-coronavirus-vaccine-619101

Diabetics are at higher risk because of their elevated A1C.

I know. I also take methotrexate and a Biologic - both immune suppressants - so I am in double trouble. I have had a GP, Endocrinologist and Rheumatologist explain it all to me in excruciating detail. If I get through this coronovirus business I have the inestimable pleasure of deciding whether to take the risk with the Pneumonia vaccine everyone in Aus is supposed to get when they turn 65. Trouble is their have been recorded deaths due to it being a live vaccine and those on immune system suppressants. But then again getting Pneumonia is not exactly great for people like me. I finally decided when that comes around to consult an immunologist.

Thanks
Bill

 

[BillTre]

The first two points are covered in R0.

I can't say I have developed a lot of confidence in the R0 values.
They have not yet seemed to settle on a consistent value.

They may also vary between different populations due to genetic differences in immune system capabillities, as well as standard cultural behaviors that could affect transmission, as well as how public health is administered.

 

[Rive]

Why is Coronavirus causing this panic when measles is demonstrably worse in the US along every axis?

I think the panic (is there real panic already?) is due the news.

But I think measles is not worse: not as it is now, at least. It does not have the potential to affect most of the population within the next few years, thanks to vaccination.

 

[chemisttree]

Well I think depending on exactly how it develops they may take that risk - the Israeli's think 90 days: https://www.jpost.com/HEALTH-SCIENCE/Israeli-scientists-In-three-weeks-we-will-have-coronavirus-vaccine-619101

Probably limit the early administration to healthcare workers and the most at-risk population. I think this happens every time something like this comes around.
It is good news that the MIGAL group is so far along https://m.jpost.com/HEALTH-SCIENCE/Israeli-scientists-In-three-weeks-we-will-have-coronavirus-vaccine-619101 and that their chimeric soluble protein technology has passed early clinicals for CHICKENS. The rest of it is just a regulatory decision to bypass the normal safety protocols.

 

[BillTre]

• No vaccine for Coronavirus (unlike measles).
• No pre-existing population of people previously exposed to the Coronavirus who have developed a natural immunity (unlike measles).
• Population of those attending a scientific meeting are probably more likely to have a vaccine to an established disease than the normal (non-scientifically educated public).
• Caution in the face of the unknown (coronavirus not yet well characterized).

The first two points are covered in R0.

It has occurred to me that R0 does not entirely cover the first two points.
They are also reflective in the size of the population that could be reasonably considered "at risk" (the non-immune population).
While, the RO reflects how rapidly a virus could spread though the population, but the total potential population that could be affected is the % of the population that has no immunity to the virus.
This reflects big potential long term differences in the effect the virus might have on public health and on going life.

This is also why people are so interested in how soon a vaccine might be available for different parts of the population. This protects people by:

• Reducing the R0 due to the virus running directly into an immune person and not transmitting
• Reducing the total amount of large scale damage it could do to the population in the longer term (smaller percentage of the population might die of disease).
• Smaller percentage of the population can spread virus to others (reducing the population of the newly infected).

 

[chemisttree]

If I get through this coronovirus business I have the inestimable pleasure of deciding whether to take the risk with the Pneumonia vaccine everyone in Aus is supposed to get when they turn 65. Trouble is their have been recorded deaths due to it being a live vaccine and those on immune system suppressants. But then again getting Pneumonia is not exactly great for people like me. I finally decided when that comes around to consult an immunologist.

Thanks
Bill

Careful not to throw in with the anti-vaxxers! You might consider chloroquine with everything going on in your case. The black box warnings should be reviewed but it might be especially appropriate in your case.

 

[Vanadium 50]

It [measles] does not have the potential to affect most of the population within the next few years

Neither, really does Cov-19.

Let's adopt as a worst-case scenario that this spreads as far and wide as the 1918-1919 flu. Given what we know about mortality rates, this would kill 8-10M people, half above 70, half below. That would move flu and flu-like diseases from the #4 killer to the #2, and bump the overall death rate by 15% (from 57M to ~66M people) This is less than 1% of the population.

This would be a terrible tragedy, and the world should work on avoiding it, but this is not the Black Death. And that's the worst case scenario.

 

[chemisttree]

I don’t think that would be the worst. The worst case scenario is that for whatever reason this disrupts large economies a great deal and causes a global economic and military response.

 

[mfb]

The first two points are covered in R0.

If you consider vaccinations in R0 then measles have a lower R0. So low that it doesn't spread quickly in the US and stays in localized outbreaks (for now), which means R0<1 as soon as people realize there are measles cases somewhere. The R0 in an unvaccinated population is much larger, but that's not the right comparison.

Let's adopt as a worst-case scenario that this spreads as far and wide as the 1918-1919 flu. Given what we know about mortality rates, this would kill 8-10M people, half above 70, half below.

Where do you get these numbers from? The Spanish flu infected ~1/4 of the world population. That would be 2 billion today. With a ~1% case fatality rate we get 20 million deaths.
But this is the fatality rate if everyone can get a hospital bed if needed. If 10% of those infected need a hospital bed then we have ~2.5% of the population needing one. The US has 3 hospital beds for 1000 people, that's about a factor 10 too few. Germany has 8 beds per 1000, Japan is leading among the OECD with 13 beds per 1000. Sure, not everyone will be sick at the same time, but it would still overwhelm the healthcare systems. In addition most of these beds are used already, of course. If not even first world countries can easily accommodate everyone with severe disease, how will third world countries handle this? What I'm saying here: If 1/4 of the population gets infected - as we had it for the 1918-1919 flu - then the case fatality rate will be much higher.
The worst case scenario is tens of millions of deaths.

 

[StatGuy2000]

If I ever get sick, I want those placebos. They seem to be able to cure anything some fraction of the time!

I don't understand why the APS isn't cancelling the meeting because of measles. There are more cases in the US, it has a much, much higher R0, and a slightly higher fatality rate for the non-elderly (there is very little recent data on the elderly and measles for obvious reasons). Why is Coronavirus causing this panic when measles is demonstrably worse in the US along every axis?

@Vanadium 50, you raise a good point in terms of the panic over COVID-19 versus the measles.

At the same time, I would have thought that most people attending the APS meeting would fall into the demographic that would have been vaccinated with the MMR (mumps, measles, and rubella) vaccine.

 

[atyy]

I don't understand why the APS isn't cancelling the meeting because of measles. There are more cases in the US, it has a much, much higher R0, and a slightly higher fatality rate for the non-ederly (there is very little recent data on the elderly and measles for obvious reasons). Why is Coronavirus causing this panic when measles is demonstrably worse in the US along every axis?

It's not panic, it's socially responsible behaviour. About 10% of cases need intensive care, which would overwhelm health systems if large numbers of people get it at the same time. Although it may end up spreading worldwide, slowing its spread can save lives (by making sure that hospitals have enough space, staff and equipment to treat people).

 

[Vanadium 50]

Where do you get these numbers from?

Splitting the population into above and below age 70, where the fatality rate is an order of magnitude different.

Spanish flue is by taking deaths divided by mortality.

 

[OCR]

I just don't know what to say:

Lol. . . well don't say. .

. . . their immune system is overeating.

Yeah, I know you fixed that, but Alex replied to your post before your edit. . .

I guess ? .

.

 

[mfb]

Spanish flue is by taking deaths divided by mortality.

At 1/4 the world population, roughly. More people -> more people infected. If I scale your numbers to the current world population then we would have ~35 millions? And that's still with the case fatality rate of a well-running healthcare system.

 

[chemisttree]

If 10% of those infected need a hospital bed then we have ~2.5% of the population needing one. The US has 3 hospital beds for 1000 people, that's about a factor 10 too few. Germany has 8 beds per 1000, Japan is leading among the OECD with 13 beds per 1000.

I’ve read that Great Britain only has 15 beds available for ECMO right now. It won’t take much to tip the NHS into crisis.

 

[atyy]

And of course, there is the hope that if we slow the spread and allow excellent health care systems to work at their best, maybe the fatalities can even be reduced below 1%, maybe 0.5% if the severe cases can be very aggressively supported.

 

[Pythagorean]

using data from john hopkins github, here's what I got for top 5 countries in terms of mortality (data is two days old now). China's recovered count is converging on active cases and their mortality count is leveling out, but we're seeing cascading outbreaks around the world.

All countries reporting as of the 28th don't fit nicely in an image, but you can see the spread timing here:

This is an interesting opportunity to study rapid disease spread through modern socioeconomic pathways.

Here's some countries that have shown resilience (however note that Germany has jumped to over 100 since Friday, as has France).

Here's the latest reported snapshot from https://www.worldometers.info/coronavirus/

 

[bhobba]

I’ve read that Great Britain only has 15 beds available for ECMO right now. It won’t take much to tip the NHS into crisis.

Australia is taking action now - clearing away all non essential surgery. I have private health insurance so will likely get care anyway - but at a cost - and its a cost all right. It's supposed to be full cover, but you find all sorts of sneaky tricks (I will not go into them) are used so you often get these bills that dribble in for months afterwards. The system needs an overhaul here in Aus, but I feel I am doing my bit for society as I have freed up a bed for someone doing it tough who can't afford private health insurance. Unfortunately others do not look at it that way - they are leaving private health in droves because they are sick and tired of paying all this money for supposedly 100% cover that really isn't 100%.

Thanks
Bill

 

[Rive]

This would be a terrible tragedy, and the world should work on avoiding it, but this is not the Black Death. And that's the worst case scenario.

It is definitely not the Black Death and it was never taken like that. However, around 20% of the cases treated in hospital, and 5% needs ICU to have chance for survival. From admittance to hospital till the case is closed usually takes 2-5 weeks.
With these numbers (and with the number of available ICU beds) you can try to figure out the maximal acceptable number of active cases.
It is not really high.

Wuhan has a population of 10+ million people, with adequate healthcare. Yet, to handle a meager (erm... I mean less than one percent of the population) 50-60000 number of cases they had to scrape together emergency hospitals with full equipment and personnel (with support from the 1.4 billion people country and a centralized government) and only by locking down the city could they manage it at the end.

It is not the Black Death, but bad enough to be taken very seriously.

In Europe we likely have at least half dozen Wuhan-like events brewing, and if/once it blows up I can see no guarantee that anybody here will be able to handle it.

Ps.: regarding the number of cases in Wuhan - the data is not consistent: details depends on source, date of report, terminology and so on. What is a common ground that it is/was exceptionally hard, with even that much background and support.

Ps.: is there some 'admitted to hospital, by age group' type statistics around somewhere?

 

[kadiot]

The first effective COVID-19 vaccine will rake in trillions in profits.

 

[Vanadium 50]

The first effective COVID-19 vaccine will rake in trillions in profits.

Good heavens, this is as ill-considered as the WW3 in Syria thread.

"Trillions" means that a vaccine needs to sell for around $1000/dose. There are about two dozen countries where the total GDP per capita doesn't reach $1000. How does Burundi pay for vaccines?

Furthermore, if you say "well, people shouldn't have to choose between food and vaccines, so we'll make the 'rich' pay for it." OK, let's raise the price to $10,000. Oh snap - only 9% of the people make even that annually.

Maybe you could go to just the top 1% and have them pay $100,000 a dose. Nope. They only make $32,000.

Top 0.1%? Using the US distribution as a proxy for the worldwide distribution of the relatively wealthy, you're at $1M per dose on an income of about $220,000.

You can see the problem - there just isn't enough money in the system for companies to make "trillions". Typical annual profits for the entire sector would today be around $70B. Claiming it will be two orders of magnitude higher is...is...well, I'm struggling to find the right adjective. Perhaps "spectacularly poorly thought out".

 

[Ygggdrasil]

Regarding the revenue from vaccines, here's the data on flu vaccines for comparison ($2.2 billion globally). Note that there are additional financial risks associated with Coronavirus vaccine development given the uncertainties about whether the vaccines will work, how long lasting the immunity will be, and what demand for the vaccine will be.

Total revenue from influenza vaccines is estimated by the WHO to have been about $2.2 billion in 2018. But total pharmaceutical industry revenue was nearly $1.2 trillion – making flu vaccines only about 0.18% of total industry revenue. By comparison, just one drug, Humira, which is used to treat autoimmune conditions, accounted for $20 billion in 2018. Each of the 15 most profitable drugs in 2018 bring in more than double the amount from the entire flu vaccine market each year.

If pharmaceutical companies didn't make a profit off vaccines, they likely wouldn't manufacture them, resulting in thousands more deaths, health care analysts note. Keeping production going also ensures vaccines are available if a pandemic occurs. Meanwhile, influenza itself is quite expensive, costing the U.S. about $4.6 billion annually in direct medical costs and as much as $87 billion annually in all costs.

https://www.npr.org/sections/health...ou-really-need-a-flu-shot-heres-how-to-decide