*** OFFICIAL *** COVID-19 CoronaVirus Thread. Fresh epidemic fears as child pneumonia cases surge in Europe after China outbreak. NOW in USA (19 Viewers)

Biff84 said:

I’m all for shutting down bars and restaurants to sit down indoors but this is just stupid especially because it’s a mom and pop store.

Click to expand...

stbugs said:

There won’t be HS sports this Fall. Our county is 1 day a week in school (so far) and 4 days remote to split the kids up and reduce class size. There’s also options to be completely remote. No chance that they’re going to allow Football players to practice/play 5 days a week in close contact. Just won’t happen.

Click to expand...

the rover said:

Washington’s order makes no sense.  If you’re a restaurant that serves alcohol, you can have indoor dining for members of the same household.  If you’re a bar that serves food you can’t have any indoor dining at all.  What’s the difference?

Click to expand...

krista4 said:

the rover said:

Washington shutting down all indoor dining and indoor service at all bars, including those that serve food.  This means that my local grocery store also has to shut down because they have a taproom.

Click to expand...

Where are you seeing this?  Everything I'm reading says you can still eat indoors if you're part of the same household.

Click to expand...

the rover said:

Washington’s order makes no sense.  If you’re a restaurant that serves alcohol, you can have indoor dining for members of the same household.  If you’re a bar that serves food you can’t have any indoor dining at all.  What’s the difference?

Click to expand...

krista4 said:

Maybe update your original post, btw.

Click to expand...

the rover said:

Smacks of effort.  As a practical matter, it’s shutting down restaurants.  That can’t afford to stay open under those conditions.  The restaurants here that don’t have patio dining are already announcing they’re closing to everything but take-our.

Click to expand...

krista4 said:

I've just seen you (with good cause) jump on others in this thread for misstatements, but  

Your experience in your area is not the same as I'm seeing.  I don't understand how they enforce the "same household" bit, though.  Maybe you have to bring in utility bills.   

Click to expand...

shader said:

I'll take her first hand experience over your word as an internet expert who has absolutely zero knowledge of her situation, where she works, where her suppliers are, and what her situation was.  She's as reputable and trustworthy as they come.  

Click to expand...

krista4 said:

And on the local grocery store part, I'd expect it depends how they are classified by the health dept.  The edict on closing indoor activities applies to bars, breweries, taverns, and wineries.  I was talking to the owner of my favorite bottle shop last week, and he had been allowed to stay open even when these are closed, because he'd gotten classified as a grocery when the first set of restrictions went into effect, because he sold cheeses and chocolates and other stuff.  A wine shop.  

ETA:  Just found this:  "As far as what defines a “bar” — since many cocktail dens, taverns, and beer bars also have restaurant licenses in Washington — Mike Faulk, the governor’s deputy communications director, says those details are “still being finalized and we’ll share them with stakeholders and the public as soon as possible.”

Click to expand...

Terminalxylem said:

The initial advice was bad, but it wasn’t a conspiracy to lie to the public. The New England Journal of Medicine is arguably the most respected medical journal in the world, and this perspective appeared in its pages in April:

Despite your best efforts to slander medical professionals, the science of mask wearing was far from settled back in April, and arguably there still are uncertainties regarding how effective masks are outside of source control. Most of the early public health advice emphasized (correctly) the evidence was lacking. In the absence of evidence, it’s problematic to issue mandates about universal mask-wearing. And yes, N95 masks need to be allocated to those at highest risk, even though in theory we’d limit spread even further if everyone wore a fit tested N95 appropriately.

Public health advice has been modified as data accumulates suggesting masks are effective - data that wasn’t available at the start of the pandemic. Since you’ve repeatedly suggested the need for masks was readily apparent from the get-go, and refused to acknowledge the change in policy occurred as our understanding of viral transmission improved, I have trouble believing you truly grasp how science works. 
 

The article I quoted above was discussing the merits of universal mask-wearing in hospitals. If doctors truly believed masks were the answer early in the pandemic, why wouldn’t this have already been the policy? 

Click to expand...

krista4 said:

I've just seen you (with good cause) jump on others in this thread for misstatements, but  

Your experience in your area is not the same as I'm hearing.  I don't understand how they enforce the "same household" bit, though.  Maybe you have to bring in utility bills.   

Click to expand...

the rover said:

I’m in a bar in Tacoma (it’s actually a tavern) right now.  They say they are going to go by the rules for restaurants, even though the order specifically shuts down taverns.  They are enforcing masks, but operating at full capacity.  It’s a mess.

Click to expand...

RUSF18 said:

Like someone from the town already told them specifically that they were going to be closed?

Its obvious intent is to stop bars from being allowed to stay open just because they start serving popcorn. I'd be shocked in this time of making sure people get what they need to live and keeping some people employed isn't an easy exception. 

Click to expand...

Grace Under Pressure said:

Really?

Covid-19 test Wednesday because of pneumonia like symptoms. 

Thursday: “Let’s go to a party for a 76 year old.”

America.

No reflection on the poster. That’s so unbelievable though.

Click to expand...

WDIK2 said:

I concur.  For the last 12-ish years we have had a family camping weekend the last full weekend of July (this weekend).  The idea was being tossed around by a couple family members that they (BIL and sister) could still go, but just stay a distance away.    Thankfully, my sister is finally starting to take this a little more seriously.  Helped by my kids and I asking "WHAT THE #### ARE YOU THINKING!?!"

Click to expand...

matuski said:

I can't believe what I am reading.

So in April 2020 the science was unsettled (only decades/centuries of effort).  In JUNE 2020... data accumulates - (2 WHOLE months worth) - totally settled guys, masks are the key!

This stuff is preposterous. 

Click to expand...

matuski said:

the rover said:

I’m in a bar in Tacoma (it’s actually a tavern) right now.  They say they are going to go by the rules for restaurants, even though the order specifically shuts down taverns.  They are enforcing masks, but operating at full capacity.  It’s a mess.

Click to expand...

At full capacity, I'd leave.

If you can keep distance, drink up.

Click to expand...

renesauz said:

Again...no large scale real life environmental testing, mostly lab testing. This pandemic provided a very different (REAL!) testing environment, which showed earlier skepticsm misplaced

Click to expand...

krista4 said:

Yeah, even before this latest order (which doesn't go into effect for a week anyway), restaurants and taverns were only allowed to be at 50% capacity, so I don't know what's going on there.  Not a place I'd go.

Click to expand...

parasaurolophus said:

Response from them about their own perspectives piece.

Click to expand...

matuski said:

I can't believe what I am reading.

So in April 2020 the science was unsettled (only decades/centuries of effort).  In JUNE 2020... data accumulates - (2 WHOLE months worth) - totally settled guys, masks are the key!

This stuff is preposterous. 

Click to expand...

matuski said:

I guess I have missed it, consider me still skeptical that these folks wearing masks entirely wrong are helping in any way.

Click to expand...

rcam said:

Can't you just admit you have been totally wrong about this thing? Wrong about Texas. Wrong about masks. Please, did every other country in that has this under control have some proper mask wearing seminar and fitting that the US didn't?

Click to expand...

Doug B said:

The linked article is extremely content-rich, full of enlightening laymen-level information about the risk of COVID reinfection. This one, I really have spoilered for length -- but I've pulled a few highlights out of the spoiler box for quick perusal. If anyone is game for a deeper dive, the full text of the article is a click away.

...

Can You Get Covid-19 Again? It’s Very Unlikely, Experts Say (New York Times, 7/23/2020)

Reports of reinfection instead may be cases of drawn-out illness. A decline in antibodies is normal after a few weeks, and people are protected from the coronavirus in other ways.


  Reveal hidden contents
Can You Get Covid-19 Again? It’s Very Unlikely, Experts Say

Reports of reinfection instead may be cases of drawn-out illness. A decline in antibodies is normal after a few weeks, and people are protected from the coronavirus in other ways.

By Apoorva Mandavilli
Published July 22, 2020 | Updated July 23, 2020, 3:33 a.m. ET

The anecdotes are alarming. A woman in Los Angeles seemed to recover from Covid-19, but weeks later took a turn for the worse and tested positive again. A New Jersey doctor claimed several patients healed from one bout only to become reinfected with the coronavirus. And another doctor said a second round of illness was a reality for some people, and was much more severe.

These recent accounts tap into people’s deepest anxieties that they are destined to succumb to Covid-19 over and over, feeling progressively sicker, and will never emerge from this nightmarish pandemic. And these stories fuel fears that we won’t be able to reach herd immunity — the ultimate destination where the virus can no longer find enough victims to pose a deadly threat.

But the anecdotes are just that — stories without evidence of reinfections, according to nearly a dozen experts who study viruses. “I haven’t heard of a case where it’s been truly unambiguously demonstrated,” said Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health.

Other experts were even more reassuring. While little is definitively known about the coronavirus, just seven months into the pandemic, the new virus is behaving like most others, they said, lending credence to the belief that herd immunity can be achieved with a vaccine.

It may be possible for the coronavirus to strike the same person twice, but it’s highly unlikely that it would do so in such a short window or to make people sicker the second time, they said. What’s more likely is that some people have a drawn-out course of infection, with the virus taking a slow toll weeks to months after their initial exposure.

People infected with the coronavirus typically produce immune molecules called antibodies. Several teams have recently reported that the levels of these antibodies decline in two to three months, causing some consternation. But a drop in antibodies is perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University.

Many clinicians are “scratching their heads saying, ‘What an extraordinarily odd virus that it’s not leading to robust immunity,’ but they’re totally wrong,’” Dr. Mina said. “It doesn’t get more textbook than this.”

Antibodies are not the only form of protection against pathogens. The coronavirus also provokes a vigorous defense from immune cells that can kill the virus and quickly rouse reinforcements for future battles. Less is known about how long these so-called memory T cells persist — those that recognize other coronaviruses may linger for life — but they can buttress defenses against the new coronavirus.

“If those are maintained, and especially if they’re maintained within the lung and the respiratory tract, then I think they can do a pretty good job of stopping an infection from spreading,” said Akiko Iwasaki, an immunologist at Yale University.

Megan Kent, 37, a medical speech pathologist who lives just outside Boston, first tested positive for the virus on March 30, after her boyfriend became ill. She couldn’t smell or taste anything, she recalled, but otherwise felt fine. After a 14-day quarantine, she went back to work at Melrose Wakefield Hospital and also helped out at a nursing home.

On May 8, Ms. Kent suddenly felt ill. “I felt like a Mack truck hit me,” she said. She slept the whole weekend and went to the hospital on Monday, convinced she had mononucleosis. The next day she tested positive for the coronavirus — again. She was unwell for nearly a month, and has since learned she has antibodies.

“This time around was a hundred times worse,” she said. “Was I reinfected?”

There are other, more plausible explanations for what Ms. Kent experienced, experts said. “I’m not saying it can’t happen. But from what I’ve seen so far, that would be an uncommon phenomenon,” said Dr. Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine.

Ms. Kent may not have fully recovered, even though she felt better, for example. The virus may have secreted itself into certain parts of the body — as the Ebola virus is known to do — and then resurfaced. She did not get tested between the two positives, but even if she had, faulty tests and low viral levels can produce a false negative.

Given these more likely scenarios, Dr. Mina had choice words for the physicians who caused the panic over reports of reinfections. “This is so bad, people have lost their minds,” he said. “It’s just sensationalist click bait.”

In the early weeks of the pandemic, some people in China, Japan and South Korea tested positive twice, sparking similar fears.

South Korea’s Centers for Disease Control and Prevention investigated 285 of those cases, and found that several of the second positives came two months after the first, and in one case 82 days later. Nearly half of the people had symptoms at the second test. But the researchers were unable to grow live virus from any of the samples, and the infected people hadn’t spread the virus to others.

“It was pretty solid epidemiological and virological evidence that reinfection was not happening, at least in those people,” said Angela Rasmussen, a virologist at Columbia University in New York.

Most people who are exposed to the coronavirus make antibodies that can destroy the virus; the more severe the symptoms, the stronger the response. (A few people don’t produce the antibodies, but that’s true for any virus.) Worries about reinfection have been fueled by recent studies suggesting that these antibody levels plummet.

For example, a study published in June found that antibodies to one part of the virus fell to undetectable levels within three months in 40 percent of asymptomatic people. Last week, a study that has not yet been published in a peer-reviewed journal showed that neutralizing antibodies — the powerful subtype that can stop the virus from infecting cells — declined sharply within a month.

“It’s actually incredibly depressing,” said Michael Malim, a virologist at King’s College London. “It’s a huge drop.”

But other work suggests that the antibody levels decline — and then stabilize. In a study of nearly 20,000 people posted to the online server MedRxiv on July 17, the vast majority made plentiful antibodies, and half of those with low levels still had antibodies that could destroy the virus.

“None of this is really surprising from a biological point of view,” said Florian Krammer, an immunologist at the Icahn Mount Sinai School of Medicine who led that study.

Dr. Mina agreed. “This is a famous dynamic of how antibodies develop after infection: They go very, very high, and then they come back down," he said.

He elaborated: The first cells that secrete antibodies during an infection are called plasmablasts, which expand exponentially into a pool of millions. But the body can’t sustain those levels. Once the infection wanes, a small fraction of the cells enters the bone marrow and sets up shop to create long-term immunity memory, which can churn out antibodies when they’re needed again. The rest of the plasmablasts wither and die.

In children, each subsequent exposure to a virus — or to a vaccine — boosts immunity until, by adulthood, the antibody response is steady and strong.

What’s unusual in the current pandemic, Dr. Mina said, is to see how this dynamic plays out in adults, because they so rarely experience a virus for the first time.

Even after the first surge of immunity fades, there is likely to be some residual protection. And while antibodies have received all the attention because they are easier to study and detect, memory T cells and B cells are also powerful immune warriors in a fight against any pathogen.

A study published July 15, for example, looked at three different groups. In one, each of 36 people exposed to the new virus had T cells that recognize a protein that looks similar in all coronaviruses. In another, 23 people infected with the SARS virus in 2003 also had these T cells, as did 37 people in the third group who were never exposed to either pathogen.

“A level of pre-existing immunity against SARS-CoV2 appears to exist in the general population,” said Dr. Antonio Bertoletti, a virologist at Duke NUS Medical School in Singapore.

The immunity may have been stimulated by prior exposure to coronaviruses that cause common colds. These T cells may not thwart infection, but they would blunt the illness and may explain why some people with Covid-19 have mild to no symptoms. “I believe that cellular and antibody immunity will be equally important,” Dr. Bertoletti said.

Vaccine trials that closely track volunteers may deliver more information about the nature of immunity to the new coronavirus and the level needed to block reinfection. Research in monkeys offers hope: In a study of nine rhesus macaques, for example, exposure to the virus induced immunity that was strong enough to prevent a second infection.

Researchers are tracking infected monkeys to determine how long this protection lasts. “Durability studies by their nature take time,” said Dr. Dan Barouch, a virologist at Beth Israel Deaconess Medical Center in Boston who led the study.

Dr. Barouch and other experts rejected fears that herd immunity might never be reached.

“We achieve herd immunity all the time with less than perfect vaccines,” said Dr. Saad Omer, the director of the Yale Institute for Global Health. “It’s very rare in fact to have vaccines that are 100-percent effective.”

A vaccine that protects just half of the people who receive it is considered moderately effective, and one that covers more than 80 percent highly effective. Even a vaccine that only suppresses the levels of virus would deter its spread to others.

The experts said reinfection had occurred with other pathogens including influenza — but they emphasized that those cases were exceptions, and the new coronavirus was likely to be no different.

“I would say reinfection is possible, though not likely, and I’d think it would be rare,” Dr. Rasmussen said. “But even rare occurrences might seem alarmingly frequent when a huge number of people have been infected.”

Click to expand...

parasaurolophus said:

Sorry sir, we have to cancel your surgery today. We went to Ace hardware to pick up the masks for it and the shelves had been cleared by some guy named Mr. Ham. 

Click to expand...

Osaurus said:

But DeSantis says it’s trending better. Before that it was normalizing, before that it was because of immigrants, and before that it was the press waxing poetically. 

Click to expand...

Terminalxylem said:

I hate to break it to you, but as hospital supplies were (rapidly) used up, healthcare providers were forced to compete with the general public for N95s and surgical masks. That never should have happened, and people who stockpiled them in the face the dire PPE situation deserve all the scorn they received.

That doesn’t mean there aren’t additional entities who deserve blame as well.

Click to expand...

Terminalxylem said:

You’re missing the point: they revised their stance as new data became available. It wasn’t a conspiracy to mislead the public while HCW hoarded masks, or other nefarious intent. We simply didn’t know enough about SARS-CoV-2, and the science of masking was (is) far from settled. So your statement holding doctors, nurses and other HCW to blame for eternity is extremely misguided at the minimum, and pretty offensive to those of us who work in a healthcare setting.

Click to expand...

renesauz said:

Again...no large scale real life environmental testing, mostly lab testing. This pandemic provided a very different (REAL!) testing environment, which showed earlier skepticsm misplaced

Click to expand...

renesauz said:

Again...no large scale real life environmental testing, mostly lab testing. This pandemic provided a very different (REAL!) testing environment, which showed earlier skepticsm misplaced

Click to expand...

matuski said:

I can't believe what I am reading.

So in April 2020 the science was unsettled (only decades/centuries of effort).  In JUNE 2020... data accumulates - (2 WHOLE months worth) - totally settled guys, masks are the key!

This stuff is preposterous. 

Click to expand...

parasaurolophus said:

There wasnt enough PPE in the entire retail market to satisfy even 1/3 of the hospital demand. To blame retail hoarders is just another way medical scammers tried to pull the wool over people's eyes from what the actual problem was. 

Yeah. Sorry. You dont get to do that any more. 

And spare me the hypocritical scorn. I found R95 available for sale for you and you couldnt be bothered with it. So  #1 clearly you were set. And #2 you felt workers in your industry were just fine too or don't care enough about them or #3 you realized that 12 masks didnt make a dent in the needed hospital supply. 

Click to expand...

parasaurolophus said:

They revised? 

We understand that some people are citing our Perspective article (published on April 1 at NEJM.org)1 as support for discrediting widespread masking. In truth, the intent of our article was to push for more masking, not less. 

Click to expand...

Grace Under Pressure said:

Really?

Covid-19 test Wednesday because of pneumonia like symptoms. 

Thursday: “Let’s go to a party for a 76 year old.”

America.

No reflection on the poster. That’s so unbelievable though.

Click to expand...

beer 30 said:

Is it really? You haven't been attention then 

Click to expand...

parasaurolophus said:

There wasnt enough PPE in the entire retail market to satisfy even 1/3 of the hospital demand. To blame retail hoarders is just another way medical scammers tried to pull the wool over people's eyes from what the actual problem was. 

Yeah. Sorry. You dont get to do that any more. 

And spare me the hypocritical scorn. I found R95 available for sale for you and you couldnt be bothered with it. So  #1 clearly you were set. And #2 you felt workers in your industry were just fine too or don't care enough about them or #3 you realized that 12 masks didnt make a dent in the needed hospital supply. 

Click to expand...

shader said:

Not sure where you're going with your conspiracy theory, but it's getting pretty old. 

Click to expand...

Terminalxylem said:

I hate to break it to you, but as hospital supplies were (rapidly) used up, healthcare providers were forced to compete with the general public for N95s and surgical masks. That never should have happened, and people who stockpiled them in the face the dire PPE situation deserve all the scorn they received.

That doesn’t mean there aren’t additional entities who deserve blame as well.

Click to expand...

Terminalxylem said:

While a drop in antibodies over time is an expected response, a drop to undetectable levels with a few months isn’t. Moreover, we have evidence of other RNA viruses, including SARS-CoV-2’s cold-causing cousins, reinfecting people (I linked an article detailing the proposed mechanisms which circumvent immunity several pages ago).

I'm not saying it is a foregone conclusion that we can be reinfected, but I don’t think we should assume it’s impossible either. I can’t read the entire article, but what numeric value do the experts equate with “very unlikely”?

Click to expand...

fruity pebbles said:

We had a few businesses donate N95 masks to us and we used them. We’re fine now but at the beginning of this, we were in very short supply. 

Click to expand...

Doug B said:

Click open the spoiler box for a complete text.

Regarding your numeric value question ... the article doesn't get that specific.

Click to expand...

Terminalxylem said:

I can understand being upset with prominent public health officials, especially policy makers for the CDC and WHO. But to extend that ill will to an entire industry, much less one devoted to helping sick people is bizarre.

Click to expand...

Terminalxylem said:

Doug B said:

Click open the spoiler box for a complete text.

Regarding your numeric value question ... the article doesn't get that specific.

Click to expand...

Ok thx. It looks like some of the experts hedged appropriately

Click to expand...