jollyroger's picture

    Only a fully Federally funded economy til vaccine makes sense

    By jollyroger on Mon, 04/27/2020 - 12:40am |

    The amalgam of Brix who posits a shutdown bit by be ameliorated when testing is available  (LOL)

     

    The WHO casting serious shade on big time natural immunity post first infection.

     

    A revised upwards R 0 that gets to 6 or so, which is only half as contagious as Measles in a naieve population  (Ask the Native Americans...

     

    The utter failure of the "gated" reopening which always mentions somewhere in there the need for testing  blah blah blah and plus they don't follow the gates anyway.

     

    There will be no safe return to work till there is a vaccine. ' 

     

    That's 12-18 months,

     

    That, not some dollar figure, is the measure of relief needed,

     

    To paraphrase Reagan "I'm from the Federal Government, and I'm here to pay".

     

    All rent and utilities should simply be paid by the Federal Government, and  then mortgages and all that can go  right on.

     

    Everyone gets $500 food stamps a month and $$1000 to walk around.e

     

    It goes on till there is a vaccine.

    Comments

    They print the fuckin' money, that's how.


    by jollyroger on Mon, 04/27/2020 - 12:42am

    It may well be, like some vaccines I remember from being a kid, that we'll get a booster every so often, because the expressed diffidence of the WHO vis a vis even taking a position on adequacy of antibody response is disturbing.  I would have thought that epidemiology alone would be sending strong signals one way or another.

     

    I don't get why someone can't just covid up a bunch of mice, let it rip, and then see if the last ones standing can catch it twice.

     

    Doctors (real and fake) asembled, what gives?  Why are we still so in doubt as to the threshold level of learned response that follows the first infection?


    by jollyroger on Mon, 04/27/2020 - 12:56am

    Have you seen a vaccine for the common cold yet? For AIDS?

    It's complicated, why not start with Mayo Clinic if you haven't read up on how complicated it is:

    https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859

    There's 100's of entries already working as fast at they can. They want to win the race. It's not like they are going "ho hum" when we get around to it. It's not like they are being extra careful either. Some humans have already been "trialing" one

    You do know that they have no proof that if you have had it you can't get it again, right? They know that little, it is generally admitted that few scientists think that it's proven that if you have antibodies, you are pemanently immune. They don't in fact know that. It is quite possible someone who has had it is not permanently immune, all the antibodies means all that you have had an initial immune response. That can last as little as a month, or can be a few months. (I saw an economist essay using that, suggesting people work in cycles of a few months after having it, then go back into isolation, on to the next set of workers.)


    by artappraiser on Mon, 04/27/2020 - 2:09am

    p.s. From a quick google, here's a recent story about the UK human trials, you could move on from there find stories on how it's doing and how long it may take:

    https://www.theguardian.com/world/2020/apr/26/uk-coronavirus-vaccine-trial-subject-doing-fine-online-death-rumours-elisa-granato

    Here's about another one just starting that I didn't know about

    https://www.cnn.com/2020/04/24/health/coronavirus-vaccine-speed-sanjay-gupta/index.html

    Lots of them are going to fail, not be any good!


    by artappraiser on Mon, 04/27/2020 - 2:14am

    oh and I should share something I recently found out--you mention booster shots "like when we were kids". Guess what, a booster for tetanus is sitll required! At City M.D., presenting with some burns, they asked me, I hadn't a clue, then she said "OIC I gave you one a couple years back." I had no idea one was supposed to keep track of that!

    And then there's "shingles", is viral, is actually the return of the chickenpox you had as a kid which lies dormant in your body for decades! They don't totally understand why it re-activates. They worked on a vaccine for decades. They came out with one like, I dunno, maybe 10 yrs. ago, was both expensive and shitty, had like a 40% ineffective rate and often bad side effects. I know most primary care docs advised "don't bother." But then a couple years ago finally a new improved one came out and it works pretty good. I have a brother call me about it, asked me if I knew anything. I looked on NYTimes.com and found rave review in health section. (main reporter Gina Kolata?) New York Times/health is actually a SUPERB resource that does not get indexed by google! I have found very clear answers about many things there after having googled for hours and just got further confused. You have to search on the NYTimes site. And bingo, often as not, NYTimes has a complete excellent article in the archive on the symptom, syndrome, disease, treatment etc. Can't recommend enough using it.


    by artappraiser on Mon, 04/27/2020 - 2:31am

    Elite news org alert.

    Now if only Grey Lady would hold off on her Lysol/bleach both siderisms.


    by PeraclesPlease on Mon, 04/27/2020 - 9:01am

    There's a few epidiomological points sketching things in.

     

    The antibody titer post infection, seems low, albeit higher for older survivors (they got sicker, "what doesn't kill you..."?)

     

    There seem to be huge cohorts of convicts in State Prisons who test positive for antibodies, never missed a beat. (It's hard to be obese in Prison?  There have been BMI associations )

     

    The R 0 is now reckoned to be around 6--getting into Measles territory.

     

    A "testing" based re opening comes back to the spit in the cup technology that we have not got.

     

    No test that comes back in a day is worth shit--it has to be one or two hours at most.  

     

    If there is no herd immunity via natural infection and none from a vaccine we are well and truly fucked, but we might sure want to  put every cent into testing and tracing, considering the cost of an outbreak in lives..

     


    by jollyroger on Mon, 04/27/2020 - 9:02am

    NYT has reporting on U Oxford vaccine that is "sprinting fastest" of them all:

    In Race for a Coronavirus Vaccine, an Oxford Group Leaps Ahead. As scientists at the Jenner Institute prepare for mass clinical trials, new tests show their vaccine to be effective in monkeys. https://t.co/B0kCnpxCCU

    — alain servais (@aservais1) April 28, 2020

    Though I have noted in other news elsewhere that Fauci has been Debbie-Downer-ing again today about a vaccine taking at least 18 months....he clearly wants that message out there.

    What I'd like to know when he says that but he would probably never say: whether he's thinking pure science or whether he's thinking there'd be no way to scale up production so that everyone can have it, not just the powerful, rich people and celebs.

    If it's the latter kind of thinking, I say: don't be such a nattering nabob of negativism. Don't say it can't be done, say it's never been done before. Make it a challenge to do what's never been done before. Tell it to Rosie the Riveter that there's no way we can make enough bombers in time...

    Scientists with life work in bureaucracies are too often negative. I recall there was that kind of problem back in the day with AIDS activits vs. Fauci. He was not always considered a friendly in the fight to get drug treatments for AIDS approved. People actually set up illegal ways to get things to go around him.

     


    by artappraiser on Tue, 04/28/2020 - 7:52pm

    What I'd like to know when he says that but he would probably never say: whether he's thinking pure science or whether he's thinking there'd be no way to scale up production so that everyone can have it, not just the powerful, rich people and celebs.

     

    My Rep. Ms. Pelosi, of whom I only with the most begrudging aggrievement find myself obliged to speak any good, delivered herself of a world class bit of Trump Trolling on Nicole today, central to which was the need to address the very problem you raise...

     

     


    at 2:25 if you can't stand to listen to her for too long...(altho to be frank, the first part ends with a nicely deboned bird

     


    by jollyroger on Tue, 04/28/2020 - 10:04pm

    here's some opining that the optimistic view is getting to scale a year from now:

     


    by artappraiser on Tue, 04/28/2020 - 11:29pm

    holy shit, just alerted to this by someone I follow on twitter (he's in CA). $119 antibody test, no prescription needed! They got offices allover NYC where one can go-been to 2 of them over the years for blood tests ordered by doctor--have no idea whether they are open now. Wonder if it's a good one. I do know they are #`1 use by docs round here for lab work:

    https://questdirect.questdiagnostics.com/products/covid-19-immune-response/b580e541-78a5-48a6-b17b-7bad949dcb57

    What do you think, Rog?


    by artappraiser on Wed, 04/29/2020 - 12:27am

    I registered. This "Quest Direct" tests paid for by patient use the exact same facilities as all the doctors do, there is no difference 

    About half their NYC offices seem to be open, with reduced hours. Lots in Westchester,too. Their past rules were they prefer you make an appt. but walk ins were always okay too (Common practice now: Dr. writes script, tells you to go get test, so that he doesn't have to employ aides to draw blood and label and have picked up by Quest.) I would think because of coronavirus, they wouldn't like walk-ins anymore in order to stagger people in waiting room.

    So yeah in NYC area now, it's possible to get an antibody test from a good medical lab for $119. (Other tests available without prescription now, too! Finally!!!!!) What I don't know is the quality of this one.


    by artappraiser on Wed, 04/29/2020 - 1:41am

    Found a review. It's a full blood draw test, and Quest is using two systems: the Abbott machines and the EuroImmun/Perkin/Elmer system. What I didn't know, thought they were just in this area, they have 2,200 patient service centers.. around the U.S. $119 to know whether you have the antibodies while avoiding the begging your busy doctor problem! You can show to your doctor later. Heck if you get positive for antibodies, you can show to the police officer who is harassing you.

    https://www.massdevice.com/quest-diagnostics-launches-patient-ordered-covid-19-antibody-test/

    Maybe insurer would even reimburse part if you submit the bill!

     


    by artappraiser on Wed, 04/29/2020 - 1:50am

    I heard about it--there's a free study from the NIH soliciting people also.

     

    I think the more iimportant test is the one you don't want to want...


    by jollyroger on Wed, 04/29/2020 - 3:22am

    Indeed no individual should be desiring it.More like they should be forced to, it should be required and paid for by gummint.

    But that test is not going to help an individual in the very least.

     Either you're sick or you're not, and if you are sick you just have to hope your symptoms are treatable. All they can do is treat symptoms. What diff does it make to the patient? The difference is that you'll be treated in quarantine hell ward if you get real sick and test positive. While regular uninfected stroke and pneumonia etc. patients would be elsewhere.

    I think the free study is for people who have already been tested positive for antibodies? That they want samples of their antibodies to study.

    Why wouldn't you want to know if you already had antibodies? Much less anxiety knowing that. There's still a chance to catch it, but far far lessened. Relief from paranoia.


    by artappraiser on Wed, 04/29/2020 - 3:39am

    Uh, either you're sick but detectable, sick but not detectable, or not sick.


    by PeraclesPlease on Wed, 04/29/2020 - 6:33am

    Or not sick yet, but detectable. Or not sick yet and undetectable today.  Or not sick at all AND detectable.  
     

    The possibilities are almost endless!


    by CVille Dem on Wed, 04/29/2020 - 10:50am

    By "sick" I meant infected. So I think my 3 scenarios cover. Except if recovery/immunity is or isn't possible.


    by PeraclesPlease on Wed, 04/29/2020 - 12:33pm

    And I meant sick as in sick, whatever the cause. 

    Because there's that plenty of people don't get sick enough for hospitalization with infection. They get well and recover on their own, at home. (CNN anchor Chris Cuomo is an excellent  example, he's on TV reporting from his basement nearly every night, even with 103 fever. A different example is a curator I follow on Twitter who apparently went through a horrific illness at home, alone, in quarantine in a Manhattan apartment,  and is still in quarantine, and is so bitter about his experience that all he tweets is bitter anger and vitriol at those spreading the virus. Mentally, he clearly cannot get over what happened to him.)

    One question there is no answer to yet is: do those people, especially those with even milder cases than my two examples, produce a sufficient number of antibodies in sufficient strength to protect them against re-infection? This is where antibody testing admittedly falls very short for the patient. No guarantees, not enough knowledge yet. No real guarantees that the person cannot still be a spreader, either.


    by artappraiser on Wed, 04/29/2020 - 2:34pm

    In a  sort of " moderate" tracing regime, you get a call outta nowhere, you feel fine, but a guy is coming in the morning to test you for active virus,


    by jollyroger on Wed, 04/29/2020 - 10:14pm

    Being framed like the space race:

     


    by artappraiser on Mon, 04/27/2020 - 7:12am

    Mass inoculating may be a bridge too far. Bill Gates in a discussion with Zeke Emanuel suggested a vaccine that

    was 95% effective   would be a game changer. We  easily fly to the moon even tho  90% of us have zero becoming astronaughts.

    I ' d say that 60% effective would be enough to restart the economies. Maybe forever. 

    Given  my medical knowledge is zilch I  grant that there may be some reason why any partial   protection is a contradiction in terms.  But In most of live´s endeavors 10% ¨good enough" is actually  good enough.


    by Flavius on Mon, 04/27/2020 - 9:15am

    The 60% number is a guess

    “So what about COVID-19?  Estimates are that one person may infect as many as 2-3 others, on average, meaning herd immunity should kick in at 50 – 67% of the population immune.  And so in the absence of a vaccine, there would appear to be nothing to stop the spread of the virus until 50-67% of us have had it; and at that point herd immunity will kicks in and transmission will decline or stop.  This is where the 60% of the population statistic has come from.  And this is deeply concerning – taking the low fatality rate estimate of 1%, even 50% of the UK population infected by COVID-19 is an unthinkable level of mortality.


    https://www.sciencemediacentre.org/expert-comments-about-herd-immunity/

    It also assumes that infected survivors are immune. It would also mean that the virus does not mutate.


    by rmrd0000 on Mon, 04/27/2020 - 9:35am

    If you reach 60% effectiveness, AND EVERYONE GETS THE VACCINE, you have herd immunity.  That means that even if someone gets sick, his/her cohorts will likely not get it and life goes on.


    by CVille Dem on Wed, 04/29/2020 - 10:54am

    Very clear on the current state of development of vaccines and possible treatments, @ New York Mag this evening, by James D. Walsh Q & A with this guy: As a clinician working on the Ebola outbreak on the border of Uganda and the Democratic Republic of Congo in 2018, Dr. Nahid Bhadelia was injected with an experimental vaccine which was going through an open-label trial, but had not yet been approved by the FDA. Intelligencer spoke to Dr. Bhadelia, who is the medical director of the Special Pathogens Unit at Boston University’s National Emerging Infectious Diseases Laboratories

    [....]

    What are you following closest right now in vaccine news? 
    Last I checked, there were six vaccine candidates at phase-one trials. U.S.-based companies have two: Moderna is doing the RNA-based vaccine, and Inovio is doing the DNA-based vaccine. There are three now from China, including one that showed pretty good promise in animal models that I saw the results of at the end of last week. And there is one in Oxford, which uses a platform that reviews for other diseases called chimp adenoviruses. The lag time for figuring out if vaccines work or not is because you have to see their efficacy in animal models before you take them into healthy humans, which is phase one. The phase-two and phase-three trials are meant to show you efficacy, because you’re vaccinating a certain portion of the population and not vaccinating another portion — you’re letting natural infections happen. That gives you an idea of whether or not it’s safe in a larger group of people, because it’s bigger than the phase-one trials and it gives you a sense over time if they are at a greater or lesser risk than the control arm of this disease. That’s what takes time.

    I think you’re going to see multiple vaccines move on to the next phase. That was the case with Ebola. In that case, an emergency vaccine was deployed before it was FDA approved. It was the middle of a crisis in the Democratic Republic of Congo and Uganda and elsewhere. I got that vaccine because I was volunteering on the border of Uganda and DRC. It was not FDA approved, but it had gone through a phase-three trial already in Guinea. As people talk about emergency deployment, I think you still need a certain amount of human data to feel comfortable deploying it in the emergency setting.

    It looks as if Japan is considering deploying remdesivir before the U.S. has approved it. Could that provide the sort of human data that moves it closer to use in the U.S.? 
    I think it’s worth going into what viral diseases generally do. Viral diseases are generally a one-two hit on your body. The first hit is basically the damage the virus itself does to the body. The second wreaks havoc on your immune system and activates your immune system in an uncontrolled fashion, in such a way that your own soldiers are attacking your body. The secondary damage of inflammation comes from that. You have to think about those two phases as you think about what might work in those scenarios. One presumes that most of the antivirals will work if you’re early enough in the disease — once you have the virus but its level is not very high.

    I say this because we’ve had these conversations in the press about whether or not the remdesivir trial is going to be successful. There are signals now that say it’s not going to be successful in severely ill patients, but we still have to wait and see what the data is going to be for moderately ill patients. That’s going to be important data. And what will that mean for the U.S.? If we don’t have enough doses, it won’t matter; it’s a downstream problem.

    Anything else you’re following closely this week? 
    You might have seen there’s an interim French study that just came out on tocilizumab, which is a drug that’s used in autoimmune diseases, an IL-6 blocker — it calms down your immune system. It’s something that is going into trials. The French trial that just came out is a randomized-control trial that shows efficacy. I haven’t seen the data itself, but it was 65 patients in placebo and 65 patients in tocilizumab, and it showed improvement in people who got tocilizumab. We’re just starting a trial on it at Boston Medical Center, and other places have been doing trials on it as well.

    The thing I’m really holding out for is a whole other class of drugs that I think will move forward: monoclonal antibodies. With Ebola, there was a four-armed study in DRC that compared an antiviral, which is remdesivir, against three monoclonal antibodies. With monoclonals, you look at a survivor’s body, you take their blood, you find those antibodies that are very good at blocking virus activity, and then you clone those antibodies and try them out in animals and humans. Monoclonal antibodies ended up being the most successful therapy in Ebola because they serve this function of blocking all viral activity earlier or later in disease.

    On Thursday, there was a study from China that showed that they have identified two very effective monoclonal antibodies. It was just bloodwork. Nothing else has been done — it hasn’t been tested in animals, hasn’t been tested in humans. But Regeneron, a company that has been working on other things, is working on a model for those monoclonal antibodies, and there might be other companies that pick it up. I’m hoping that is the third kind of treatment, aside from convalescent plasma, that will provide some answers. We have a long way to go on that, though.

    earlier in article talks about NYC herd immunity, contact tracing. (Though I have hit the paywall with them, I found that I could read the full article if I stopped the loading of the page in time before the popup notice.)


    by artappraiser on Mon, 04/27/2020 - 8:18pm

    "There are signals now that say [remdesiver is] not going to be successful in severely ill patients, but we still have to wait and see what the data is going to be for moderately ill patients." - I didn't see that important caveat in the failure announcement about remdesiver a few days ago, which had surprised me since the there had seemed to be positive practical results before. So it's as much about when/where you use it, not a cure-all but a cure-some maybe.


    by PeraclesPlease on Tue, 04/28/2020 - 5:05am

    Oddly enough, the best immediate suggestion to emerge from the epidimiological noise is the possible use of Nicotine both for it's ability to block at a receptor the name of whcih I will recall shortly_ and to downregulate the syndrome that culnimates in a cytokine storm.

     

    Tobacco was a terrific drug--you could call it Shakespeare/s Adderall  lighting up 9 distinct and specific Nicotinic receptors in the brain to this day--as long as everyone agrees to die around or before 50, ie, pretty much until 1900.


    by jollyroger on Tue, 04/28/2020 - 10:17pm

    The idea that we are slouching towards a future where basically a souped up (and deadly) common cold imposes the current distancing regime on a permanent basis is stupefying, and clearly very possible if not likely.

     

    Yikes!


    by jollyroger on Tue, 04/28/2020 - 3:51pm

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