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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 (7 Viewers)
- Thread starter Big League Chew
- Start date
The Commish
Footballguy
They continue to be in a plateau. Older people ended up getting it in the second wave shooting up deaths
shader
Footballguy
I don't know the specifics. I know they just started allowing pubs to re-open a week or two ago. Their numbers will definitely rise over the coming months.
Doug B
Footballguy
There's a disconnect in the collective information, then.
While I know no health organization is perfect ... the CDC has been saying for three months that fomites -- publicly-touched objects, "germy" groceries, "dirty" mail/packages, etc. -- don't much spread COVID-19. To the extent where it seems that they've all but eliminated fomites as a vector. Maybe that's an exaggeration, or bad CDC messaging, or something. I don't know.
Instead, it's been consistently hammered home that it's "simple breathing in indoor stale air first, simple breathing in indoor stale air second, simple breathing in indoor stale air third." Because, after all, breath aerosols are said to spread all over the dang place, and linger for hours. Then after that, coughing/sneezing/large droplets in fourth. Then maybe fomites a distant fifth?
If all that's true ... how can handwashing be that much more important than face coverings? Granted, this stuff can change rapidly ... and maybe tomorrow, it'll be "Um ... it was fomites after all". But the "it ain't never fomites" guidance has been going strong for three months plus now.
shader
Footballguy
I'd say there's a disconnect.
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
In the first "Know how it spreads" section, no mention of it spreading on surfaces.
But then the first thing to do to protect the spread in the very next section is to Wash Your Hands.
shader
Footballguy
Yikes. 15% positive too, so it's not just a mass testing issue.
I'm wondering when hospitalizations becomes a "less important" stat? Once the hospitals are full, they won't be able to admit as many. I was reading articles yesterday about hospitals that are having to turn patients away now. At this point, every day that these states wait to lock down is potentially killing hundreds, if not thousands of people....unless citizens band together and do what's smart.
I don't recall that being a very common prediction but maybe I am misremembering. Not to drift into the thread on the other forum too much but it seems like that was mostly proposed by people who had been consistently downplaying the threat of the virus and the safety precautions needed, sort of a justification on why doing nothing is a valid strategy. "We don't need to shut down so much, just wait 2 months and it will be gone". Alternatively, optimists wishfully thinking the problem would go away.
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Doug B
Footballguy
So far as I can gather, the part in red is correct. I've been looking for a good layman's-level read on this for a while, but it's been a challenge -- even the Wikipedia article on "Antibody" is difficult for me to parse.
I did find something helpful on ResearchGate.net, an academic website part of which is a repository of research questions with responses from university faculty from around the globe (spoilered for length, but not that long).
Robert Adamu Shey
Université Libre de Bruxelles
Q: How long do memory B cells keep producing antibodies?
Hello every one. My question is based on the definition of memory B cells below:
"The immune system can remember a previously experienced pathogen and can evoke an enhanced response to reinfection that depends on memory lymphocyte populations".
Do memory B cells continue to produce antibodies in the absence of a re-infection? If yes, for how long?
...
Mats Bemark, PhD
University of Gothenburg
A: The paper attached above is old, but (I think) in general describe the situation rather well.
However, the critical thing to understand is that long-term B cell mediated immunity is made up of two separate arms - antigen-specific long-lived plasma cells and long-lived memory B cells that form after a first encounter with antigen.
The long-lived plasma cells occupy specific niches in the bone marrow and mucosal tissues and produce secreted antibodies in serum and body fluids. These antibodies can be measured and the amount is often used to determine if someone is immune or not (i.e. if the titre of antibodies is sufficiently high to protect from infection). Thus, someone that has had measles will produce antibodies against measles for the rest of their life from such long-lived cells, and these antibodies will ensure that you do not get infected again since they bind the pathogen. However, these cells do not appear to respond to antigen, but only passively produce antibodies. For this reason, these are strictly speaking not memory cells, since they do not respond to reinfection, but they still maintain immunity (i.e. protection from infection).
The other arm, the memory cells, do not produce secreted antibodies but have cell membrane-bound antibody receptors that can recognise antigen. If this happens, the cells are rapidly activated and become short-lived (at most weeks) and long-lived (up to for life) plasma cells after a short period of proliferation. This ensures that we respond to a reinfection that has broken through the defence of the pre-existing secreted antibodies, and will result in an increase in antibodies. This "secondary" response is stronger than the "primary" response. These are strictly speaking the only memory cells, since they respond to antigen.
Thus, to answer your question - some long-lived plasma cells may produce secreted antibodies for life, and these are important for protection against disease (immunity). But memory B cells, that are also present for life, only produce small amounts of membrane-bound antibodies that are not secreted. However, they can be activated by a second dose of antigen. In this case, the amounts of antibodies against the infection will increase sharply as the memory cells become plasma cells.
Université Libre de Bruxelles
Q: How long do memory B cells keep producing antibodies?
Hello every one. My question is based on the definition of memory B cells below:
"The immune system can remember a previously experienced pathogen and can evoke an enhanced response to reinfection that depends on memory lymphocyte populations".
Do memory B cells continue to produce antibodies in the absence of a re-infection? If yes, for how long?
...
Mats Bemark, PhD
University of Gothenburg
A: The paper attached above is old, but (I think) in general describe the situation rather well.
However, the critical thing to understand is that long-term B cell mediated immunity is made up of two separate arms - antigen-specific long-lived plasma cells and long-lived memory B cells that form after a first encounter with antigen.
The long-lived plasma cells occupy specific niches in the bone marrow and mucosal tissues and produce secreted antibodies in serum and body fluids. These antibodies can be measured and the amount is often used to determine if someone is immune or not (i.e. if the titre of antibodies is sufficiently high to protect from infection). Thus, someone that has had measles will produce antibodies against measles for the rest of their life from such long-lived cells, and these antibodies will ensure that you do not get infected again since they bind the pathogen. However, these cells do not appear to respond to antigen, but only passively produce antibodies. For this reason, these are strictly speaking not memory cells, since they do not respond to reinfection, but they still maintain immunity (i.e. protection from infection).
The other arm, the memory cells, do not produce secreted antibodies but have cell membrane-bound antibody receptors that can recognise antigen. If this happens, the cells are rapidly activated and become short-lived (at most weeks) and long-lived (up to for life) plasma cells after a short period of proliferation. This ensures that we respond to a reinfection that has broken through the defence of the pre-existing secreted antibodies, and will result in an increase in antibodies. This "secondary" response is stronger than the "primary" response. These are strictly speaking the only memory cells, since they respond to antigen.
Thus, to answer your question - some long-lived plasma cells may produce secreted antibodies for life, and these are important for protection against disease (immunity). But memory B cells, that are also present for life, only produce small amounts of membrane-bound antibodies that are not secreted. However, they can be activated by a second dose of antigen. In this case, the amounts of antibodies against the infection will increase sharply as the memory cells become plasma cells.
![[icon]](/data/avatars/m/5/5167.jpg?1660313464){kind=avatar}
[icon]
Insoxicated
Bar I visited Wednesday for a bite (with a buddy) just had an employee test positive. The positive employee last worked Friday, not sure if they worked Wednesday, as they work the patio.
We had lots of space around us and really were only in contact with the bartender (masked). Wore masks from parking lot, to our seats and back.
Still being responsible and have a test scheduled for 10:30 am Tuesday at a CVS near my place. Going to do the responsible thing and self quarantine until results are in (saying 2-4 days at this point).
No symptoms (4 days in) but exercising an abundance of caution because it's the right thing to do.
We had lots of space around us and really were only in contact with the bartender (masked). Wore masks from parking lot, to our seats and back.
Still being responsible and have a test scheduled for 10:30 am Tuesday at a CVS near my place. Going to do the responsible thing and self quarantine until results are in (saying 2-4 days at this point).
No symptoms (4 days in) but exercising an abundance of caution because it's the right thing to do.
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Terminalxylem
Footballguy
Yup. It was a possibility, but not a given by any means. Like so many other things in the pandemic, naysayers were quick to latch onto any info which enabled a rapid return to business as usual.
In my circle of friends, coworkers and acquaintances, and local celebrities, I know more and more who have tested positive. Only 1 death (the 3 members of the Nicaraguan family who all died), a few hospitalized briefly, and most with mild symptoms or asymptomatic. Herd immunity might beat the vaccine in Miami.
I think the high numbers are discouraging locals from doctor visits and restaurants, which now have only outdoor seating. The grocery stores, Trader Joes, Publix and Costco still seem busy, with 100% compliance with masks, and high compliance with distancing.
Don Hutson
Footballguy
What if they aren't successful in developing a vaccine and herd immunity isn't possible? Will we be dealing with this forever? Is there any other reason for hope other than a vaccine or herd immunity?
NotSmart
Footballguy
I watched. Horrible.
He was confirmed by the Senate on 8/3/17, a few days after he was nominated.
Doug B
Footballguy
Yes -- antiviral treatments that are not vaccines exist. Current treatments for HIV are examples, including some now that act prophylactically**.
Not seeing evidence yet that herd immunity to COVID-19 is a biological impossibility, though.
** EDIT: you've probably seen the commercial by now.
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Drunken Cowboy
Footballguy
[icon]
Insoxicated
Therapeutic treatments are likely to be the first line of defense that's effective. There are quite a few treatment approaches (plasma, monoclonal antibodies, etc) in the works and several are showing promise.
Nothing locked up yet, by any stretch, but if we can find a treatment that stops/reverses the RANTES/Cytokine storm this disease suddenly becomes MUCH more manageable.
In the stock thread a lot of us are backing a company called Cytodyn who have a monoclonal antibody called Leronlimlab that was originally an HIV and cancer treatment.
However, preliminary studies have shown major promise vs moderate and severe COVID cases, bringing people off vents in days, and possibly even eliminating viral load. FDA phase 2 trials wrapped last week and results should be released this month. There are lots of others like them.
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NotSmart
Footballguy
My very sincere condolences to anyone forced to fly right now because of work or other circumstances.
It's one of the last places I would want to be right now.
hagmania
Footballguy
Thank you. I support our nursing care design team (think developing guidelines), and as part of my job I would have to go to the field to help implement. I was in awe of what nurses did in "regular times." What you all are doing now is heroic.
jamny
Footballguy
We are loyal American customers but they have been horrible lo e during this. Delta has been much better with no middle aisle and reverse boarding. In either case. I would not fly if I had to fly coach unless it was absolutely necessary.
Doug B
Footballguy
The overdrive immune reaction appears to be one prong. The other big issue are the blood clots that COVID-19 leaves behind (and the #1 reason it ain't the flu), although perhaps that's reasonably addressed with existing medical interventions.
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RUSF18
Footballguy
That wasn't even close to what you were peddling for months in here, but go ahead and make yourself the victim.I was directly accused of trying to get people killed in this thread a couple months ago over this. That post was liked several times.
Have been chased out of the thread repeatedly over the obvious observation that masks are a distant third place to distancing and hand washing. Do the latter, render masks optional at best.
parasaurolophus
Footballguy
Doug B
Footballguy
So ... what do we think is the deal? Why the apparent disconnect here? Bad info? Good info, but bad messaging? Something else?
hagmania
Footballguy
Our systems were sharing staff within the same geographical divisions. We've made it possible for nurses in Kansas City to go help out in New Orleans, for example.
That was working while the outbreaks were in just a few major locations. A lot of our hospitals are now getting hammered and so I'm not sure if we'll have the same opportunities to shuffle people around.
Terminalxylem
Footballguy
Yes and no. Low titers (levels) of antibodies usually persist in the blood for longer than a few weeks after initial viral infection. For some infections they’re present for decades. While the anamnestic immune response can ramp up production rapidly upon re-exposure, it’s not a given if antibodies are undetectable. Moreover, it’s unclear if SARS-CoV-2 antibodies will effectively fight off reinfection. It’s likely they will, but the short duration of detectable antibodies may signal our COVID immunity is incomplete.
parasaurolophus
Footballguy
I think fomites are mostly not a vector. I think they have stuck with handwashing guidance because it is beneficial for other diseases and they never want to de-emphasize that.
gianmarco
Footballguy
There have been a couple articles that have talked about the fact that this isn't going away anytime soon. As in, years. Get used to masks and intermittent lockdowns for the next 2-3 years at least. I'm beginning to believe that's a conservative outlook.
Don Hutson
Footballguy
I could see us having a yearly month-long lockdown in January that is preplanned ahead of time. It being preplanned would help people stock up on what they need and for businesses to adjust as much as possible.
Doug B
Footballguy
Same.
Still think that if the U.S. would've started a hard shutdown immediately after community transmission in the U.S. was proven (Thurs 2/26/2020 in California, Sat 2/28/2020 in Washington state), and had that shutdown run for six weeks (through Easter weekend) ... this country would be in as good a shape at least as Western Europe. Maybe better, because we'd have been nipping a smaller bud much sooner.
fruity pebbles
Footballguy
Not 100% sure why you consider yourself an expert on this. Personally, given this is a close contact, respiratory droplet virus, I’d put hand washing 3rd and at a minimum none of the three would be a distant anything.I was directly accused of trying to get people killed in this thread a couple months ago over this. That post was liked several times.
Have been chased out of the thread repeatedly over the obvious observation that masks are a distant third place to distancing and hand washing. Do the latter, render masks optional at best.
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Terminalxylem
Footballguy
I think the belief is still primarily droplet spread, with some aerosol (especially superspreaders?), and a little fomite. If it were almost all aerosol, Ro would be closer to that of measles (12+), though certainly other virulence determinants contribute to that number.
The evolving infection control advice comes as we’ve learned aerosol transmission is much more common than flu, and even simple face coverings offer some individual protection in addition to source control.
The unknown degree of aerosolization makes social distancing problematic, as 6 feet won’t effectively contain aerosol spread. Nor will hand washing. But it really isn’t helpful to downplay any of the three key NPIs, despite the repeated efforts of some.
parasaurolophus
Footballguy
This isnt entirely true. Pretty sure masks are required in plenty of places. Public transportation being one of them.
Terminalxylem
Footballguy
Mutation to a less virulent form and effective antivirals, though I wouldn’t hold my breath for either anytime soon.
NotSmart
Footballguy
Historically speaking, is mutation more likely to trend toward less virulent than more virulent?
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MTskibum
Footballguy
I had been quarantining for 2 weeks, my wifes parents were quarantining for 2 weeks, and my brother in laws family was quarantining for 2 weeks so we could all hang out together.
We drove all the way to el paso without going into a single gas station, we peed on the side of the road, etc.
I am good friends with my brother in law and I was looking forward to some social interaction. We were each going to take a few days off work to play some board games, however last night his wife went to a 30 person wedding where no one was wearing masks. So now I am stuck at my wife's parents and my brother in law knows that now he cannot visit.
My brother in laws wife is incredibly selfish, she ruined the week for her husband and he already put the vacation in the system. So now he has to eat the vacation and cannot do anything. Not to mention going to a 30 person wedding is incredibly stupid and puts their family at risk.
We drove all the way to el paso without going into a single gas station, we peed on the side of the road, etc.
I am good friends with my brother in law and I was looking forward to some social interaction. We were each going to take a few days off work to play some board games, however last night his wife went to a 30 person wedding where no one was wearing masks. So now I am stuck at my wife's parents and my brother in law knows that now he cannot visit.
My brother in laws wife is incredibly selfish, she ruined the week for her husband and he already put the vacation in the system. So now he has to eat the vacation and cannot do anything. Not to mention going to a 30 person wedding is incredibly stupid and puts their family at risk.
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matuski
Footballguy
Trained on PPE/BBP/Infection control annually for 13 years now (just last week finished recent course with COVID training included). Work in ORs where aside from product knowledge, my only job is not to screw up PPE/infectious diease/BBP wise.
I haven't claimed to be an expert but, I mean relative to the vast majority? Probably fair.
eta - I have 2 claims - the argument on the necessity of masks when others are adhered to, and the efficacy of north of 50% of the masks I see in public. Combine the two and the mask wearing dogma is severely over emphasized. All of the public and media mask shaming ought to be redirected to distancing.
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fruity pebbles
Footballguy
fruity pebbles
Footballguy
I’ve taken plenty of ppe courses myself being in the OR and I certainly wouldn’t consider myself an expert on infectious disease.
Terminalxylem
Footballguy
Mutation is random, and most mutations do nothing. Sand posted an article suggesting progression to less virulent forms over time was favored from an evolutionary perspective, but I don’t think that is a given.
As long as a virus doesn’t kill off its host before infecting others, it will flourish. That’s one of the nefarious things about asymptomatic/presymptomatic spread, as carriers without symptoms are much more likely to come in contact with people than those confined to a bed.
matuski
Footballguy
Certainly not a claim i have ever made either.
So we can wipe that off of your dispute with me.
parasaurolophus
Footballguy
Assuming that all aerosolized diseases would have similar rates of spread seems very odd to me.
Measles has lifelong immunity. We obviously arent making that assumption for covid.
Doug B
Footballguy
This is a good point, too -- the continuing mystery concerning how COVID Patient A, 103o fever and coughing up lungs, can spread practically no virus to others ... while COVID Patient B can be totally asymptomatic, feel nothing, and yet be a continuing smokestack of viruses as he breathes calmly.
matuski
Footballguy
The Commish
Footballguy
I honestly had no idea who he was. I don't watch much of that stuff. I just assumed he was closer to the CDC side of things than the administration's side of things. It was pretty bad.
matuski
Footballguy
The last time I dipped into this mask conversation I got hit with the WHAT IF SOMEONE WALKED UP AND SPIT IN YOUR FACE, WHAT THEN!? hypothetical.
I found your solution to this ridiculous fear.
I found your solution to this ridiculous fear.
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[icon]
Insoxicated
German Study:
Investigations of those who have recovered dampen hope for vaccine
Blood tests of the first corona patients from Germany show that the concentration of antibodies decreases rapidly. This could affect the effectiveness of a possible vaccination.
--
Scientists worldwide are carrying out antibody studies in connection with the novel coronavirus . The results should provide insights into the course of the disease and immunity, but also help in the development of a possible vaccine. A new examination of recovered Covid-19 patients is now dampening hope for long-lasting immunity and thus for the long-term effectiveness of a possible vaccination.
Blood tests of the first corona patients in Germany, who were treated at Munich Clinic Schwabing at the end of January, showed a significant decrease in the number of so-called neutralizing antibodies in the blood, said Clemens Wendtner, chief physician of the local clinic for infectious diseases.
The possibility of a new infection is indicated
"In four of the nine patients, we see falling neutralizing antibodies in a very special test that can only be carried out in a high-security laboratory," said Wendtner. "The extent to which this has an impact on long-term immunity and vaccination strategies is still speculative, but must be monitored critically as it progresses." However, it suggests that a new infection is possible after the illness.
This must be observed further, said Wendtner. In addition to the so-called B-cell-associated immunity measured via antibodies, the so-called T-cell immunity is also relevant for long-term immunity. If patients lose neutralizing antibodies, they may offer protection. T-lymphocytes can kill virus-infected cells in a targeted manner once they have met their opponent.
Wendtner's findings are in line with the experiences of other scientists and study results . Chinese researchers reported in the journal "Nature Medicine" that the antibodies declined sharply after two months, especially in patients with a symptom-free course, but the values also fell significantly in actually ill patients. Patients with few symptoms also had fewer antibodies and thus a weaker immune response.
Investigations of those who have recovered dampen hope for vaccine
Blood tests of the first corona patients from Germany show that the concentration of antibodies decreases rapidly. This could affect the effectiveness of a possible vaccination.
--
Scientists worldwide are carrying out antibody studies in connection with the novel coronavirus . The results should provide insights into the course of the disease and immunity, but also help in the development of a possible vaccine. A new examination of recovered Covid-19 patients is now dampening hope for long-lasting immunity and thus for the long-term effectiveness of a possible vaccination.
Blood tests of the first corona patients in Germany, who were treated at Munich Clinic Schwabing at the end of January, showed a significant decrease in the number of so-called neutralizing antibodies in the blood, said Clemens Wendtner, chief physician of the local clinic for infectious diseases.
The possibility of a new infection is indicated
"In four of the nine patients, we see falling neutralizing antibodies in a very special test that can only be carried out in a high-security laboratory," said Wendtner. "The extent to which this has an impact on long-term immunity and vaccination strategies is still speculative, but must be monitored critically as it progresses." However, it suggests that a new infection is possible after the illness.
This must be observed further, said Wendtner. In addition to the so-called B-cell-associated immunity measured via antibodies, the so-called T-cell immunity is also relevant for long-term immunity. If patients lose neutralizing antibodies, they may offer protection. T-lymphocytes can kill virus-infected cells in a targeted manner once they have met their opponent.
Wendtner's findings are in line with the experiences of other scientists and study results . Chinese researchers reported in the journal "Nature Medicine" that the antibodies declined sharply after two months, especially in patients with a symptom-free course, but the values also fell significantly in actually ill patients. Patients with few symptoms also had fewer antibodies and thus a weaker immune response.
Doug B
Footballguy
Reading between the lines ... you don't think simple-breathing aerosols (through regular ol' calm breathing through the nose) spreads the virus at all inside of indoor spaces? Is that a line of BS we're being fed by ... whoever? The CDC?
Contrived situation to make a point: You and three others are inside of a large elevator (call it an 8' square). One of the others is a COVID carrier, but is not coughing or sneezing -- just has a low fever and a weakened taste/smell sense. While no one else on the elevator is aware of the COVID carrier, everyone is cognizant of the general COVID risk and thus generally remains in their corners of the elevator for the duration. No one has a face covering, and the elevator's air is not well ventilated.
So ... this elevator stops between floors and it takes about two hours to get everyone out. You feel pretty good about coming out of that elevator without an infection?
Andy Dufresne
Footballguy
For two hours? I have zero faith the typical mask is protecting me from anything in that scenario.
