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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 (21 Viewers)

The Commish said:
Thanks....I guess this is the part that I struggle with especially with the "rules" in place in many areas, but I guess why they have 10s of 1000s in these things.  I don't understand the need for the placebo in this case though.  Thanks for the explanation :thumbup:  
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You could use historical controls, but the placebo helps mitigate behavioral confounders associated with the type of person who volunteers for research studies. It’s also possible receiving a shot in the arm, even placebo, will alter people’s behavior.

 
BassNBrew said:
What do you think the number of actual cases is when we report 180K in a day?

Very concerned that we are on the cusp of an exponential pop in numbers, but maybe it will be confined in areas and flatten out next week.
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TBH, I have no idea, as the way SARS-CoV-2 spreads is erratic due to the large number of cases associated with super spreader events. This article linked elsewhere helps explain why the disease trajectory is so difficult to predict.

We can think of disease patterns as leaning deterministic or stochastic: In the former, an outbreak’s distribution is more linear and predictable; in the latter, randomness plays a much larger role and predictions are hard, if not impossible, to make. In deterministic trajectories, we expect what happened yesterday to give us a good sense of what to expect tomorrow. Stochastic phenomena, however, don’t operate like that—the same inputs don’t always produce the same outputs, and things can tip over quickly from one state to the other. As Scarpino told me, “Diseases like the flu are pretty nearly deterministic and R0 (while flawed) paints about the right picture (nearly impossible to stop until there’s a vaccine).” That’s not necessarily the case with super-spreading diseases.
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The Commish said:
Thanks....I guess this is the part that I struggle with especially with the "rules" in place in many areas, but I guess why they have 10s of 1000s in these things.  I don't understand the need for the placebo in this case though.  Thanks for the explanation :thumbup:  
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Maybe I'm not understanding your question, but the placebo group  in the Pfizer trial is how they arrived at 90% effective.

>> An external independent Data Monitoring Committee conducted an interim analysis of the trial by evaluating 94 participants who developed COVID-19 after receiving either the vaccine or the placebo — a control measure that has no impact on preventing the infection.

The early analysis revealed that among these 94 participants, fewer than 10% of those who received two injections of the vaccine, 28 days apart, developed COVID-19. In other words, most of the cases, more than 90% of them, were among those who received the placebo<<

Large numbers of enrollees in high risk regions allow them to get sufficient number of people to develop COVID. The study did not recruit in New Zealand, for example.

https://www.google.com/amp/s/www.livescience.com/amp/pfizer-coronavirus-vaccine-early-results-efficacy.html

 
BassNBrew said:
What do you think the number of actual cases is when we report 180K in a day?

Very concerned that we are on the cusp of an exponential pop in numbers, but maybe it will be confined in areas and flatten out next week.
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https://www.cnbc.com/2020/11/06/dr-scott-gottlieb-daily-us-covid-cases-are-at-least-half-a-million.html

This is from Scott Gottlieb from a week ago.  Former commish of the FDA, on the boards of Pfizer and illumina.  As of a week ago--he feels like the numbers reflect 1/5th of the actual number of infections daily. 

 
Returning home from a week in Cabo today.  Washington’s governor is enacting a semi-lockdown for at least 4 weeks.  No indoor service at bars or restaurants;  closed down gyms, theatres, museums.  Retail and groceries can stay open at 25% capacity.  

Panic buying has already started.  Lines at Costco and nearest grocery to my house are both over 2 hours long based on videos and messages I’ve received.

 
I think we will find when the dust settles that viral load will be linked highly to outcomes. From the likelihood of showing symptoms, your ability to spread it and how long your antibodies last.

We keep hearing estimates that actual cases are 5-10x higher than the reported positives because of asymptomatic or missed cases but that doesn’t seem to be reflected in antibody testing. A few months ago a nationwide study estimated that less than 10% of the country and local testing shows less than 20% even in the hardest hit areas. That suggests that those asymptomatic estimates are way off, antibodies don’t last long in general or there’s variability to antibody life based on the viral load.

Antibody duration will be an important part  of the success of any vaccine. If a vaccine requires boosters every 6 months, we’re in trouble.

 
The Commish said:
What means this?
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People who volunteer for studies tend to be more supportive of science than those who don’t, so you might expect their behavior to be different than the general population. I wouldn’t expect any anti-vaxxers to enroll, for example, and I’d also bet they practice NPIs a little better than the average bear. It’s also possible they’re more health conscious, and the very process of receiving an injection, faux or not, influences their behavior.

You said you didn’t understand why the vaccine study needed a placebo. While not mandatory, the placebo arm provides a much better control than comparisons to the community rate of covid during the study period, to balance all the above factors and ensure asymptomatic infection is accounted for. 

Basically you want the study to mitigate as many confounding variables as possible between those who receive the vaccine and those who don’t. Big numbers of participants certainly helps, but a well designed control including a sham inoculation is also important. 

 
jvdesigns2002 said:
https://www.cnbc.com/2020/11/06/dr-scott-gottlieb-daily-us-covid-cases-are-at-least-half-a-million.html

This is from Scott Gottlieb from a week ago.  Former commish of the FDA, on the boards of Pfizer and illumina.  As of a week ago--he feels like the numbers reflect 1/5th of the actual number of infections daily. 
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Yeah, that 1/5 number was derived from seroprevalence (antibody) studies in hard-hit areas, when testing wasn’t as widely available. While that general ratio may still apply, in part reflective of the ratio of asymptomatic:symptomatic cases, I bet it’s gone down with ubiquitous testing. 
 

 
Biff84 said:
I think we will find when the dust settles that viral load will be linked highly to outcomes. From the likelihood of showing symptoms, your ability to spread it and how long your antibodies last.

We keep hearing estimates that actual cases are 5-10x higher than the reported positives because of asymptomatic or missed cases but that doesn’t seem to be reflected in antibody testing. A few months ago a nationwide study estimated that less than 10% of the country and local testing shows less than 20% even in the hardest hit areas. That suggests that those asymptomatic estimates are way off, antibodies don’t last long in general or there’s variability to antibody life based on the viral load.

Antibody duration will be an important part  of the success of any vaccine. If a vaccine requires boosters every 6 months, we’re in trouble.
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The burden of infectious agent correlates with disease severity in just about every other infection, so I wouldn’t expect SARS-CoV-2 to be any different.

Agree that people are applying the 20% number too liberally, for a couple of the reasons you mention. Not sure about durability of immune response yet, but our immune system doesn’t do great with non-SARS coronaviruses.

 
Doug B said:
Why would a second dose cause it to be "much" longer? Aren't the two doses two months apart (being lazy, not tracking this info down right now)?
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I read three weeks between first and second doses. So my thought process is, 21M doses in a month. 7M get two doses, 7M more get first dose only. 14M people treated with 21M doses. But I'm not a statistical guy, so I may be way off of my line of thinking. But if I'm not, 14M a month takes nearly 23 months to treat everyone.

 
If anyone is wondering how bad things are right now...

10% of ALL cases of Covid in the US were diagnosed in the last 7 days.  This is after 9+months of the virus here and spreading.

We are in trouble.

 
gianmarco said:
If anyone is wondering how bad things are right now...

10% of ALL cases of Covid in the US were diagnosed in the last 7 days.  This is after 9+months of the virus here and spreading.

We are in trouble.
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How does that compare to other countries? Worldwide?

 
Terminalxylem said:
People who volunteer for studies tend to be more supportive of science than those who don’t, so you might expect their behavior to be different than the general population. I wouldn’t expect any anti-vaxxers to enroll, for example, and I’d also bet they practice NPIs a little better than the average bear. It’s also possible they’re more health conscious, and the very process of receiving an injection, faux or not, influences their behavior.

You said you didn’t understand why the vaccine study needed a placebo. While not mandatory, the placebo arm provides a much better control than comparisons to the community rate of covid during the study period, to balance all the above factors and ensure asymptomatic infection is accounted for. 

Basically you want the study to mitigate as many confounding variables as possible between those who receive the vaccine and those who don’t. Big numbers of participants certainly helps, but a well designed control including a sham inoculation is also important. 
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Thanks...makes sense now :thumbup:  

 
I don't read this thread as much as I used to, so perhaps this has been discussed. 

Coronavirus emerged in Italy earlier than thought, Italian study shows

ROME (Reuters) - The new coronavirus was circulating in Italy since September 2019, a study by the National Cancer Institute (INT) of the Italian city of Milan shows, signaling that COVID-19 might have spread beyond China earlier than previously thought.

But the Italian researchers' findings, published by the INT's scientific magazine Tumori Journal, show that 11,6% of 959 healthy volunteers enrolled in a lung cancer screening trial between September 2019 and March 2020, had developed coronavirus antibodies well before February.

........

A further specific SARS-CoV-2 antibodies test was carried out by the University of Siena for the same research titled "Unexpected detection of SARS-CoV-2 antibodies in the pre-pandemic period in Italy".

It showed that four cases dated back to the first week of October were also positive for antibodies neutralizing the virus, meaning they had got infected in September, Giovanni Apolone, a co-author of the study, told Reuters.
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worrierking said:
Their CEO says everyone in the US will have access to a vaccine by June. https://www.msn.com/en-us/health/medical/the-ceo-of-moderna-says-every-american-will-likely-have-access-to-a-covid-19-vaccine-by-june-2021/ar-BB1b3yXp?ocid=msedgntp

It could be sooner if other vaccines beside the two already announced as effective come on board.
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I'm sure this is probably already happening, but these vaccines need to be in large-scale production yesterday, and we need to start putting a distribution system in place.  Really multiple distribution systems -- one for health care workers and other critical folks that can be up and running by the end of the year, and one for everybody else.

 
I know I'm preaching to the choir in this thread, but now is also a good time for all of us to redouble our efforts at social distancing.  It's been a while, I'm sure a lot of people are getting a little stir crazy now that winter is arriving, and spring seems like a long way off.  But it would be really dumb to get sloppy now with a vaccine on the horizon.  Don't be the guy who gets shot the day before armistice. 

 
IvanKaramazov said:
I'm sure this is probably already happening, but these vaccines need to be in large-scale production yesterday, and we need to start putting a distribution system in place.  Really multiple distribution systems -- one for health care workers and other critical folks that can be up and running by the end of the year, and one for everybody else.
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I work for a Health District in NoVA. We will be part of the distribution plan. It is going to be a slog.

 
IvanKaramazov said:
I know I'm preaching to the choir in this thread, but now is also a good time for all of us to redouble our efforts at social distancing.  It's been a while, I'm sure a lot of people are getting a little stir crazy now that winter is arriving, and spring seems like a long way off.  But it would be really dumb to get sloppy now with a vaccine on the horizon.  Don't be the guy who gets shot the day before armistice. 
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Haven’t they been producing them for months? I thought that was the Gates plan. Ramp up mass production early in the event they get approved. 

 
Cold Dead Hands said:
I work for a Health District in NoVA. We will be part of the distribution plan. It is going to be a slog.
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Can you share any first hand insight on this one?  I thought I had read somewhere that the military was going to assist with logistics but it's been a while and I might be misremembering things.

 
How do you suggest dealing with someone very close to you that questions the numbers/deaths as they continue to rise? I want to fly off the handle but that would be pointless and just further the divide. How do I present facts to a person who thinks the numbers of COVID cases have been artificially inflated, wonders what happened to the flu all of a sudden and questions all the deaths attributed to COVID?

Really struggling with this.

 
beer 30 said:
How do you suggest dealing with someone very close to you that questions the numbers/deaths as they continue to rise? I want to fly off the handle but that would be pointless and just further the divide. How do I present facts to a person who thinks the numbers of COVID cases have been artificially inflated, wonders what happened to the flu all of a sudden and questions all the deaths attributed to COVID?

Really struggling with this.
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:shrug:  my sister is like this. I’ve just given up. 

 
Capella said:
:shrug:  my sister is like this. I’ve just given up. 
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Yeah, I don’t think you’re going to change anyone’s mind most likely. I think the best stat you can probably use is excess deaths to demonstrate that more people have died this year than would be typically expected under normal conditions which indicates that COVID is real and really killing people. But the odds are they’ll simply question those stats as well. 

 
GroveDiesel said:
Yeah, I don’t think you’re going to change anyone’s mind most likely. I think the best stat you can probably use is excess deaths to demonstrate that more people have died this year than would be typically expected under normal conditions which indicates that COVID is real and really killing people. But the odds are they’ll simply question those stats as well. 
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Anything with math or science is immediately out the window with her. It’s like talking to a caveman. 

 
https://apnews.com/article/pandemics-ap-top-news-coronavirus-pandemic-5575a8a8ca3825a9bf39a5d234aba07b

Some details on the Moderna vaccine:

Early data shows 94.5% effective. They have 30k people in the trial, 95 got an infection after the secondary injection. 90 of those were on the placebo, 5 got the vaccine. None of those 5 had severe cases of coronavirus. 

Uses the same mRNA technique as Pfizer to teach the body to recognize the virus, without actually using the virus itself in the vaccine. Side effects seem to be soreness at the spot of injection, some fatigue, and muscle aches. On par with a flu shot. Unlike other disease vaccines, it's not possible to get the disease itself from the vaccine since this new mRNA technology doesn't introduce the actual virus into the body. 

Can survive 30 days in a normal refrigerator. 

Still unknown for both vaccines is how long protection lasts. 

 
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beer 30 said:
How do you suggest dealing with someone very close to you that questions the numbers/deaths as they continue to rise? I want to fly off the handle but that would be pointless and just further the divide. How do I present facts to a person who thinks the numbers of COVID cases have been artificially inflated, wonders what happened to the flu all of a sudden and questions all the deaths attributed to COVID?

Really struggling with this.
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How important is it to convince this person?  Unless it’s somebody who you live with day in and day out I would suggest avoiding the issue. People get things like that in their head and there’s just no way of talking them out of it because they are also convinced that you are being lied to.

 
Family is in day seven of quarantine. Last Tuesday and had a friend of our daughters over to our house. She tested positive last Friday. We had our whole family tested Saturday here in Minnesota you can get a free test without any symptoms at multiple different sites around the Twin Cities and around the state. None of us are positive but because we had close contact we are required to quarantine for 14 days.

 
mr roboto said:
How important is it to convince this person?  Unless it’s somebody who you live with day in and day out I would suggest avoiding the issue. People get things like that in their head and there’s just no way of talking them out of it because they are also convinced that you are being lied to.
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Lol, I do avoid the issue and it is someone I live with and they do have this in their head and there hasn't been a way to talk them out of it. I just bit my tongue rather than be confrontational, hard not to have a conversation about it and be in agreement but I guess it is what it is.

 
culdeus said:
Moderna also doesn't need -80 storage giving rise to the idea that you give Moderna to the rural areas and Pfizer to the urban areas.  
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Not even. Pfizer will be used for an initial rapid immunization for the highest risk populations and after that, it will fade away. The storage requirements are way too hard to manage outside of mass immunizations. Moderna will be rolled out to every pharmacy with little issues.

 
Spoke with my neighbor who is a nurse here in Missouri.

She says she has been infected with two distinctly separate infections of COVID.  First one was with a positive test and she was symptomatic for 2 weeks.  Then over a month later, another round of symptoms with a positive test and the symptoms lasted 3 weeks this time.  Both times she said she experienced the loss of taste/smell and said that was the worst part of the whole thing.  She is in her late 30's and a bit overweight, but otherwise healthy.

Seems like reports are that reinfection is a distinct possibility due to either different strains of the virus or antibodies not lasting.

 
Biff84 said:
Not even. Pfizer will be used for an initial rapid immunization for the highest risk populations and after that, it will fade away. The storage requirements are way too hard to manage outside of mass immunizations. Moderna will be rolled out to every pharmacy with little issues.
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I'm not sure if we know that for sure yet. Read somewhere that the Pfizer test protocol required the deep freeze, but, it might remain stable at lower temperatures for a useful period of time... They just haven't tested it yet. To be sure it worked for the current trial, they used the super cold storage. It might be just as stable as Moderna's in the long run. 

 
Jayrod said:
Spoke with my neighbor who is a nurse here in Missouri.

She says she has been infected with two distinctly separate infections of COVID.  First one was with a positive test and she was symptomatic for 2 weeks.  Then over a month later, another round of symptoms with a positive test and the symptoms lasted 3 weeks this time.  Both times she said she experienced the loss of taste/smell and said that was the worst part of the whole thing.  She is in her late 30's and a bit overweight, but otherwise healthy.

Seems like reports are that reinfection is a distinct possibility due to either different strains of the virus or antibodies not lasting.
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That’s why I think the concept of herd immunity is very dangerous.  This isn’t like measles or chicken pox. This is like influenza.  You can get it again, the virus will mutate some, and the vaccine is only good for a period of time. 

 
shades said:
I'm not sure if we know that for sure yet. Read somewhere that the Pfizer test protocol required the deep freeze, but, it might remain stable at lower temperatures for a useful period of time... They just haven't tested it yet. To be sure it worked for the current trial, they used the super cold storage. It might be just as stable as Moderna's in the long run. 
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Right it’s possible but when you have competing vaccines, things like that will crush them. They will need to prove that it’s stable and effective outside the trial temps and that will take while and Moderna will take the lead. It may end up being a backup but they’re going to need to prove that temp stability. Until then Moderna will be the focus.

 
IvanKaramazov said:
I know I'm preaching to the choir in this thread, but now is also a good time for all of us to redouble our efforts at social distancing.  It's been a while, I'm sure a lot of people are getting a little stir crazy now that winter is arriving, and spring seems like a long way off.  But it would be really dumb to get sloppy now with a vaccine on the horizon.  Don't be the guy who gets shot the day before armistice. 
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Thanksgiving is coming up... make good choices, people.

 
Wildcat said:
That’s why I think the concept of herd immunity is very dangerous.  This isn’t like measles or chicken pox. This is like influenza.  You can get it again, the virus will mutate some, and the vaccine is only good for a period of time. 
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I think it’s part of why it is so important to get as many people immunized around the world as quickly as possible. The fewer people around the world that get COVID, the less chance it has of mutating into more and more strains.

 
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