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*** OFFICIAL *** COVID-19 CoronaVirus Thread. Fresh epidemic fears as child pneumonia cases surge in Europe after China outbreak. NOW in USA (10 Viewers)

Not necessarily. For every virus that normally confers immunity after first infection, there are a small number of people who don't get immune. Sometimes it takes more than one infection. Sometimes, it never happens.


Maybe, maybe not. There’s a small percentage of people with every virus that end up being able to catch it again. So one person getting it again isn’t necessarily unexpected or concerning on its own.
:hifive:

 
Appleton is not a college campus...Brown Co not just huge college town either.

Yeah, its just a vacation. 

Seriously...whats the point of such a post.
Appleton has Lawrence University and Green Bay has UWGB and St. Norberts. Don't think this is the source of the skyrocketing numbers in Outagamie and Brown County. But, hey, its a party. Don't believe everything you read.

 
Maybe, maybe not. There’s a small percentage of people with every virus that end up being able to catch it again. So one person getting it again isn’t necessarily unexpected or concerning on its own.
38 million cases in 8 months and this is the 2nd I’ve heard of a person catching it again (might be the same person). If people didn’t get immunity in most cases then we’d have a whole lot more than 2 cases. This is one of those exceptions that proves the rule. 

 
Appleton has Lawrence University and Green Bay has UWGB and St. Norberts. Don't think this is the source of the skyrocketing numbers in Outagamie and Brown County. But, hey, its a party. Don't believe everything you read.
I i ow they have colleges...but they aremt college towns.

Lawrence has all of 1,400 students.

GB has under 7,000 total attending.

St Norberts just over 2,000.

Which was my point...claiming it was just colleges was not a very good assertion considering how things have blown up in those cities.

 
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Hopefully not a honda...excellent article from The Lancet reviewing the public health strategies implemented in 9 different countries with reviews of results and decent (but broad) guidelines drawn from the results.

Countries should be able to learn a lot about what they should or shouldn't do based on the documented experiences of other countries. I'm aware of the argument that the US is too large and diverse to for any national strategy, but some of these things should be doable at least on a regional basis.

Link: Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe
Awesome article and a great rebuttal to the ill-advised Great Barrington Declaration. Thanks.

 
38 million cases in 8 months and this is the 2nd I’ve heard of a person catching it again (might be the same person). If people didn’t get immunity in most cases then we’d have a whole lot more than 2 cases. This is one of those exceptions that proves the rule. 
Not necessarily. Maybe immunity wanes after a few, say six months? Or immunity is incomplete from the get-go. Not saying that is the case, but long term immunity isn't guaranteed at this point either.

Not about coronavirus specifically (I linked an article detailing immunologic problems with coronaviruses in this thread several hundred pages ago), but respiratory viruses have well known issues with incomplete immunity:

In measles, poliomyelitis and other systemic viral diseases, small amounts of serum neutralizing antibody are very effective in preventing the development of the disease on subsequent exposures. In infections of the respiratory tract, on the other hand, serum neutralizing antibodies are much less effective in modifying the disease. There are two well known explanations for this difference in susceptibility to reinfection of the respiratory tract. In the first place, respiratory viruses invade primarily the superficial respiratory epithelium, which has a rapid turnover rate. Presumably, resistant epithelial cells are constantly replaced by new sensitive cells. Secondly, serum neutralizing antibodies usually do not reach the superficial epithelial cells. Secretory IgA, which is produced locally,44 on the other hand, is more effective because of its direct accessibility to invading viral particles. The resistance to reinfection, therefore, depends much more on secretory IgA than on the serum neutralizing antibodies

 
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https://news.harvard.edu/gazette/story/2020/10/covid-survivors-may-have-four-months-of-protection/?utm_source=twitter&utm_campaign=hu-twitter-general&utm_medium=social

The study, published in Science Immunology, offers hope that people infected with the virus will develop lasting protection against reinfection. The study also demonstrates that measuring antibodies can be an accurate tool for tracking the spread of the virus in the community.

The immune system produces proteins called antibodies in response to SARS-CoV-2, the virus that causes COVID-19. “But there is a big knowledge gap in terms of how long these antibody responses last,” said Richelle Charles, an investigator in the Division of Infectious Diseases at MGH and a senior author of the paper. To find out, she and her colleagues obtained blood samples from 343 patients with COVID-19, most of whom had severe cases. The blood samples were taken up to four months after a patient’s symptoms emerged. The blood’s plasma was isolated and applied to laboratory plates coated with the receptor-binding domain (RBD) of the virus’ “spike” protein, which attaches to cells, leading to infection. The team studied how different types of antibodies in the plasma bound to RBD. The results were compared to blood samples obtained from more than 1,500 individuals prior to the pandemic.

The researchers found that levels of an antibody called immunoglobulin G (IgG) remained elevated in infected patients for four months and were associated with the presence of protective neutralizing antibodies, which also demonstrated little decrease in activity over time.

“That means that people are very likely protected for that period of time,” said Charles. “We showed that key antibody responses to COVID-19 do persist.”
This continues with the general theme here that outside of some exceptions, immune systems are working as they should: https://www.nytimes.com/2020/10/13/health/coronavirus-reinfection.html

In a vast majority of known infected patients, experts said, the immune system functions as it should against other pathogens.

“There are a lot of different infections where you can get re-exposed to the virus, and we would probably not know because you don’t have symptoms,” Dr. Pepper said. “And that might be an important part of boosting immunity.”

When the body is exposed to an unfamiliar virus, it’s normal first to develop some immunity and then to increase that response with each additional exposure. This phenomenon is well known among children, but it is less often seen in adults because they rarely encounter new viruses, Dr. Mina said.

“I think it’s important to recognize that reinfections are literally embedded in the evolution of our immune system,” he added. “We sometimes lose track of that with so many people talking about this who really haven’t studied the immune system.”

 
I don't think anyone is arguing the immune system isn't working. People are questioning the durability of the immune response, not only because this is a novel virus, but in light of suboptimal immunity for other respiratory viruses, including non-SARS coronaviruses.

Hopefully immunity is both potent and long lasting, but IMO it's a little too early to make those assumptions.

 
Another study from Arizona suggests antibodies are still present up to 7 months after illness. 

https://www.upi.com/Health_News/2020/10/13/Study-COVID-19-patients-produce-high-quality-antibodies-up-to-7-months-after-recovery/9741602619576/

 
Derek Lowe (essential reading) comments on the Arizona study and on re-infection. https://blogs.sciencemag.org/pipeline/
Good link. As more time passes and few reinfections are reported, the more confident we can be it isn't a huge concern. Still don't think we're out of the woods though, in part because of inadequate immunity to some respiratory viruses despite the presence of neutralizing antibodies.

 
Hopefully not a honda...excellent article from The Lancet reviewing the public health strategies implemented in 9 different countries with reviews of results and decent (but broad) guidelines drawn from the results.

Countries should be able to learn a lot about what they should or shouldn't do based on the documented experiences of other countries. I'm aware of the argument that the US is too large and diverse to for any national strategy, but some of these things should be doable at least on a regional basis.

Link: Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe
Thanks for posting. 

 
Yeah, world?  We jump to over 380,000 new cases today, per Covid worldometers, easily a new high after a few new records just last week.  High counts again in Europe and Russia.  43 countries with over 1,000 new cases. 

For now at least, deaths are not spiking from prior levels (about 6,000 new deaths today). 

 
Mask mandates are extremely helpful but they’re not an end all solution when people remain defiant or willfully ignorant about while they’re doing it. The presence of constant contradictory messages and inconsistencies from experts leave people with only partial understanding.

They hear that being outdoors is better but understand it as being little or no chance of spreading it while outdoors. Countless times I’ve seen people rip their mask off when they leave the store and proceed to approach someone and have a face-to-face conversation inches alway. Or have a large barbecue but it’s ok because they mainly stayed outside.

Or when at a restaurant or bar, they can’t require you to wear a mask while eating, so it’s fine to meet up with your friends and take no further precautions. If you’re not required to wear a mask, it must be a safe environment.

Common sense is a requirement to control the virus that is sorely lacking. I certainly haven’t been perfect and human nature sets in for everyone for time to time. We don’t need to be 100% to be successful, we just be to be a whole lot better than we are now and it starts with proper education and messaging.

 
Mask mandates are extremely helpful but they’re not an end all solution when people remain defiant or willfully ignorant about while they’re doing it. The presence of constant contradictory messages and inconsistencies from experts leave people with only partial understanding.

They hear that being outdoors is better but understand it as being little or no chance of spreading it while outdoors. Countless times I’ve seen people rip their mask off when they leave the store and proceed to approach someone and have a face-to-face conversation inches alway. Or have a large barbecue but it’s ok because they mainly stayed outside.

Or when at a restaurant or bar, they can’t require you to wear a mask while eating, so it’s fine to meet up with your friends and take no further precautions. If you’re not required to wear a mask, it must be a safe environment.

Common sense is a requirement to control the virus that is sorely lacking. I certainly haven’t been perfect and human nature sets in for everyone for time to time. We don’t need to be 100% to be successful, we just be to be a whole lot better than we are now and it starts with proper education and messaging.
You're over complicating things.  People are stupid.  You can't cure stupid.

 
Bought 200 n95 masks for my DC and my safety guy won't tell anyone or even let me hand them out to a few managers because HR would freak out.

China can act just a bit more decisively.

 
Bought 200 n95 masks for my DC and my safety guy won't tell anyone or even let me hand them out to a few managers because HR would freak out.

China can act just a bit more decisively.
We're limited by what's acceptable in the US.  France is starting to kick on again and they just issued a nationwide curfew for 9pm.  If we tried that in the US I can't even imagine what would happen.

 
Mask mandates are extremely helpful but they’re not an end all solution when people remain defiant or willfully ignorant about while they’re doing it. The presence of constant contradictory messages and inconsistencies from experts leave people with only partial understanding.

They hear that being outdoors is better but understand it as being little or no chance of spreading it while outdoors. Countless times I’ve seen people rip their mask off when they leave the store and proceed to approach someone and have a face-to-face conversation inches alway. Or have a large barbecue but it’s ok because they mainly stayed outside.

Or when at a restaurant or bar, they can’t require you to wear a mask while eating, so it’s fine to meet up with your friends and take no further precautions. If you’re not required to wear a mask, it must be a safe environment.

Common sense is a requirement to control the virus that is sorely lacking. I certainly haven’t been perfect and human nature sets in for everyone for time to time. We don’t need to be 100% to be successful, we just be to be a whole lot better than we are now and it starts with proper education and messaging.
While the messaging from the public health community has been far from ideal, people hear what they want to hear. And pandemic fatigue has clearly set in. It will be interesting to see what a change in leadership 🤞+ winter resurgence does to refocus our efforts.

 
Got both kids tested yesterday because a few of my son's hockey teammates were in close contact with another hockey player friend who has it. Also, my daughter went to an indoor sweet sixteen party where there was supposed to be social distancing and mask wearing but later turned out to be seriously lacking. I told them both no more going to friends houses without testing negative.

 
So my kids school has teachers that have had exposure and positives in a single grade level.  They couldn't get anyone to sub so they had to send the whole grades home for remote for 2 weeks.  

The sub crisis is not unique to my kids school, hearing reports of this anecdotally all over the area.  

 
So my kids school has teachers that have had exposure and positives in a single grade level.  They couldn't get anyone to sub so they had to send the whole grades home for remote for 2 weeks.  

The sub crisis is not unique to my kids school, hearing reports of this anecdotally all over the area.  
My mom said her district has about a tenth of the subs as last year. My daughter's school had to increase class sizes a few weeks in so regular teachers could sub for call ins.

 
Cross Posted in the PSF:

Here's a Lancet opinion article in opposition to the Barrington Declaration: https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)32153-X

from the text (bolded emphasis mine)

Scientific consensus on the COVID-19 pandemic: we need to act now

... The arrival of a second wave and the realisation of the challenges ahead has led to renewed interest in a so-called herd immunity approach, which suggests allowing a large uncontrolled outbreak in the low-risk population while protecting the vulnerable. Proponents suggest this would lead to the development of infection-acquired population immunity in the low-risk population, which will eventually protect the vulnerable.

This is a dangerous fallacy unsupported by scientific evidence. Any pandemic management strategy relying upon immunity from natural infections for COVID-19 is flawed. Uncontrolled transmission in younger people risks significant morbidity and mortality across the whole population. In addition to the human cost, this would impact the workforce as a whole and overwhelm the ability of healthcare systems to provide acute and routine care. Furthermore, there is no evidence for lasting protective immunity to SARS-CoV-2 following natural infection, and the endemic transmission that would be the consequence of waning immunity would present a risk to vulnerable populations for the indefinite future.

Such a strategy would not end the COVID-19 pandemic but result in recurrent epidemics, as was the case with numerous infectious diseases before the advent of vaccination. It would also place an unacceptable burden on the economy and healthcare workers, many of whom have died from COVID-19 or experienced trauma as a result of having to practise disaster medicine. Additionally, we still do not understand who might suffer from long COVID. Defining who is vulnerable is complex, but even if we consider those at risk of severe illness, the proportion of vulnerable people constitute as much as 30% of the population in some regions. Prolonged isolation of large swathes of the population is practically impossible and highly unethical. Empirical evidence from many countries shows that it is not feasible to restrict uncontrolled outbreaks to particular sections of society. Such an approach also risks further exacerbating the socioeconomic inequities and structural discriminations already laid bare by the pandemic. Special efforts to protect the most vulnerable are essential but must go hand-in-hand with multi-pronged population-level strategies...

---------------

This is also known as the John Snow Memo: https://www.johnsnowmemo.com/

 
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All right ... I never watched Game of Thrones, but I know that John Snow is a character on that show. Right? Nevertheless, I don't get the reference in this memo's title. Was the other memo's name also a GoT character?
John Snow was the first scientist to really study and design a public health intervention.  https://www.rcseng.ac.uk/library-and-publications/library/blog/mapping-disease-john-snow-and-cholera/

He removed a pump handle from a well in London, which caused Cholera to drop.  He mapped and used quantitative data to prove it worked.

It has nothing to do with GoT, but it did get your attention.

 
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John Snow was the first scientist to really study and design a public health intervention.  https://www.rcseng.ac.uk/library-and-publications/library/blog/mapping-disease-john-snow-and-cholera/

He removed a pump handle from a well in London, which caused Cholera to drop.  He mapped and used quantitative data to prove it worked.

It has nothing to do with GoT, but it did get your attention.
This guy was the first to map an outbreak. He’s essentially the founding father of my profession (not Epidemiology)

 
Just asking, did they change things up or not?  And is it to be trusted?
The data scientist who was in charge of tracking Covid numbers in Florida was fired and the data made much more secretive after that.

She alleges that they asked her to manipulate the data, she refused, and was fired. Specifically they asked her to calculate the positive rate by counting positive cases once, but counting someone who tests negative on multiple tests as multiple points of data, thus skewing the data.
And since this time there have been tons of testing sources saying they don't understand why their number says X when they sent Y in.  We have a segment on our news every couple weeks about this and talking through discrepancies that continue to go unaccounted for.  

 
Just one anecdotal experience - my friend who spent 12 days in ICU with COVID last spring has been closely monitored since recovering.  He provides data regarding antibodies to multiple healthcare entities.  He was able to make a bit of side money by selling his blood, but only for 4 weeks because that's when he no longer showed any antibodies.

 
So my kids school has teachers that have had exposure and positives in a single grade level.  They couldn't get anyone to sub so they had to send the whole grades home for remote for 2 weeks.  

The sub crisis is not unique to my kids school, hearing reports of this anecdotally all over the area.  
Where my daughter teaches the rule is only people in their "bubble" can sub meaning no outside random subs. They have administrative staff and "extra" teachers that don't have an everyday workload that are being used. They recently had the whole admin staff out on quarantine so not sure how they would have handled it if the need for more than 1 or 2 subs arose. So far it hasn't.

 
You guys who may have the virus, I hope you feel better, but please stay at least 6 feet away from your computer.  I don't want to get sick too.

 
Not necessarily. Maybe immunity wanes after a few, say six months? Or immunity is incomplete from the get-go. Not saying that is the case, but long term immunity isn't guaranteed at this point either.

Not about coronavirus specifically (I linked an article detailing immunologic problems with coronaviruses in this thread several hundred pages ago), but respiratory viruses have well known issues with incomplete immunity:


What is the long term plan if this is the case? What will we be doing 1-4 years down the road if immunity and vaccines only last for the short term?

At that point to we just accept the high death toll or do the at risk people get vaccinated every few months. Does getting a vaccine lower the protection of the next vaccine and if so, what then?

My wife and I are trying to decide what to do next spring, can we go skiing in february, and if we decide that is a possibility do we need to drive there. What about other vacations for next year. This year for our vacations we went to the beach on weekdays when it was uncrowded, we quarantined prior to visiting our also quarantining family, went camping in low population areas, etc. Those are all lower risk vacations, but when can plan on taking more traditional vacations. Can we start planning normal vacations next year.

I did not see any of my friends this year. Think about that for a minute, can I plan on boating with my friends next year?

There are many questions that normal people have and there are no good answers. If immunity and vaccine are both only short term that will complicate these decisions.

 
Frustrated to say the least. 

I spent 7 months, no job, living alone in strict quarantine. (which did a number on my mental health, see the suicide thread for more info on that) 

Just started to have a social life again in a responsible manner, dating a great woman and wanting to introduce her to some friends and vice versa but we seem to be going backwards. And I live in a state who "got it" initially about how to act. 

But now I actually am seeing less and less masks on a daily basis, less and less social distancing. 

It's anecdotal, I know but I live in the inner city and do see a lot of street and foot traffic daily. 

Just frustrated. That's it. 

I was supposed to go spend Thanksgiving with my girlfriends family in Pittsburgh, but to be honest, I'm now nervous to go. Backing out would probably ruin our relationship but I don't know. 

Grrr. 

 
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Woman at our church just passed away from Covid.  She was in her mid 70’s.  Was on a ventilator for the last 2 weeks.  She tested negative the last few days and her family was at least able to see here before she passed.  While still on a ventilator, she was improving somewhat but suddenly got worse and died a day later.  I’ve been texting her daughter every other day asking how she was doing.  Recent texts were all positive until last night when I texted her and she told me she died a few hours ago.  She was such a sweet person.   I’m so pissed at this anti-mask mindset which also exists with some people in our church.  I hope this changes their outlook but I don’t bet on it 

 
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What is the long term plan if this is the case? What will we be doing 1-4 years down the road if immunity and vaccines only last for the short term?

At that point to we just accept the high death toll or do the at risk people get vaccinated every few months. Does getting a vaccine lower the protection of the next vaccine and if so, what then?

My wife and I are trying to decide what to do next spring, can we go skiing in february, and if we decide that is a possibility do we need to drive there. What about other vacations for next year. This year for our vacations we went to the beach on weekdays when it was uncrowded, we quarantined prior to visiting our also quarantining family, went camping in low population areas, etc. Those are all lower risk vacations, but when can plan on taking more traditional vacations. Can we start planning normal vacations next year.

I did not see any of my friends this year. Think about that for a minute, can I plan on boating with my friends next year?

There are many questions that normal people have and there are no good answers. If immunity and vaccine are both only short term that will complicate these decisions.
The vaccine can be reformulated and readministered periodically, possible every year like flu. And like flu, we can hope being vaccinated against one strain attenuates the severity of subsequent infections. Lastly, an effective therapeutic may eventually be developed.

In the meantime, practice all the standard NPI. Consider creating social “bubbles” with a few close friends, which will be easier as rapid tests become widely available. 

I renewed my epic pass this year, and am tentatively planning on skiing at some point. Will have to re-evaluate as Winter cases likely surge. Regardless, I think boating with a friend or two should be relatively low risk. But I wouldn’t plan a “normal” vacation just yet. Maybe invest in VR headsets?

 
I’m not familiar with the latter study. Are you saying people are putting credence in a p value of 0.86? 
The congressman in the twitter post I linked is putting credence in a 0.86 p value. 

That study is also circulating on other fantasy football off topic forums and on the texas fishing forums I post at.

https://mobile.twitter.com/RepAndyBiggsAZ/status/1315449047709216768?ref_src=twsrc^tfw|twcamp^tweetembed|twterm^1315449047709216768|twgr^share_3%2Ccontainerclick_0&ref_url=https%3A%2F%2Fwww.fftodayforums.com%2Fforum%2Findex.php%3Fapp%3Dcoremodule%3Dsystemcontroller%3Dembedurl%3Dhttps%3A%2F%2Ftwitter.com%2FRepAndyBiggsAZ%2Fstatus%2F1315449047709216768%3Fs%3D19

 
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So basically, 14% confidence in the data.  Yeesh.
That’s not how the data would be interpreted. The numbers show no significant difference in self-reported cloth mask use between cases and controls. Any p greater than 0.05 suggests the two groups are within an acceptable level of variability to be accounted for by chance alone. As reported, mask use doesn’t appear to be correlated with risk of infection.

But there are a lot of confounding variables which make interpreting that chart In a vacuum problematic. Notably, the behavior of the two groups likely created different exposure risk:

In this investigation, participants with and without COVID-19 reported generally similar community exposures, with the exception of going to locations with on-site eating and drinking options. Adults with confirmed COVID-19 (case-patients) were approximately twice as likely as were control-participants to have reported dining at a restaurant in the 14 days before becoming ill. In addition to dining at a restaurant, case-patients were more likely to report going to a bar/coffee shop, but only when the analysis was restricted to participants without close contact with persons with known COVID-19 before illness onset. Reports of exposures in restaurants have been linked to air circulation (7). Direction, ventilation, and intensity of airflow might affect virus transmission, even if social distancing measures and mask use are implemented according to current guidance. Masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use.
Also of note:

Fourth, participants were aware of their SARS-CoV-2 test results, which could have influenced their responses to questions about community exposures and close contacts.
I’d argue knowing one’s infection status could influence reporting of mask usage as well.

But none of that was discussed when the chart was plucked from the MMWR paper. Funny how that works.

 
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In case anyone still supports the idea of getting herd immunity to this

8 million Americans now have, or have had, Covid-19. 

Over 210,000 are dead, and more of the currently infected will die.  

There are 328 million people in the US. 

328 million divided by 8 million is 41. 

One in 41 people have been infected.  That is a huge number. 

But it also means that 40 out of 41 people have not yet had this. 

So if you're sick, and contagious, it's extremely likely that the person you bump into has not yet been infected.  Over 97 percent of Americans have not yet had this. 

Herd immunity only works when sick people ars unable to infect many other people because most people they come into contact with have already had it or been vaccinated.  

Without a vaccine, getting to herd immunity would mean that about 70 percent of Americans had been infected. Compared with 2.5 percent right now.  That's almost 30 times as many people as are already infected. 

30 times 210,000 dead is about 6 million people. 

Herd immunity without a vaccine would be monstrous on a scale similar to the holocaust.  

Wear your mask

 

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