Originally Posted by Bwana:
Once again, don't come in this thread with some kind of political agenda, or you will be shown the door. If you want to go that route, there is a thread about this in DC.
Originally Posted by Dartgod:
People, there is a lot of good information in this thread, let's try to keep the petty bickering to a minimum.
We all have varying opinions about the impact of this, the numbers, etc. We will all never agree with each other. But we can all keep it civil.
Thanks!
Click here for the original OP:
Spoiler!
Apparently the CoronaVirus can survive on a inanimate objects, such as door knobs, for 9 days.
California coronavirus case could be first spread within U.S. community, CDC says
By SOUMYA KARLAMANGLA, JACLYN COSGROVE
FEB. 26, 2020 8:04 PM
The Centers for Disease Control and Prevention is investigating what could be the first case of novel coronavirus in the United States involving a patient in California who neither recently traveled out of the country nor was in contact with someone who did.
“At this time, the patient’s exposure is unknown. It’s possible this could be an instance of community spread of COVID-19, which would be the first time this has happened in the United States,” the CDC said in a statement. “Community spread means spread of an illness for which the source of infection is unknown. It’s also possible, however, that the patient may have been exposed to a returned traveler who was infected.”
The individual is a resident of Solano County and is receiving medical care in Sacramento County, according to the state Department of Public Health.
The CDC said the “case was detected through the U.S. public health system — picked up by astute clinicians.”
Officials at UC Davis Medical Center expanded on what the federal agency might have meant by that in an email sent Wednesday, as reported by the Davis Enterprise newspaper.
The patient arrived at UC Davis Medical Center from another hospital Feb. 19 and “had already been intubated, was on a ventilator, and given droplet protection orders because of an undiagnosed and suspected viral condition,” according to an email sent by UC Davis officials that was obtained by the Davis Enterprise.
The staff at UC Davis requested COVID-19 testing by the CDC, but because the patient didn’t fit the CDC’s existing criteria for the virus, a test wasn’t immediately administered, according to the email. The CDC then ordered the test Sunday, and results were announced Wednesday. Hospital administrators reportedly said in the email that despite these issues, there has been minimal exposure at the hospital because of safety protocols they have in place.
A UC Davis Health spokesperson declined Wednesday evening to share the email with The Times.
Since Feb. 2, more than 8,400 returning travelers from China have entered California, according to the state health department. They have been advised to self-quarantine for 14 days and limit interactions with others as much as possible, officials said.
“This is a new virus, and while we are still learning about it, there is a lot we already know,” Dr. Sonia Angell, director of the California Department of Public Health, said in a statement. “We have been anticipating the potential for such a case in the U.S., and given our close familial, social and business relationships with China, it is not unexpected that the first case in the U.S. would be in California.”
It is not clear how the person became infected, but public health workers could not identify any contacts with people who had traveled to China or other areas where the virus is widespread. That raises concern that the virus is spreading in the United States, creating a challenge for public health officials, experts say.
“It’s the first signal that we could be having silent transmission in the community,” said Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law. “It probably means there are many more cases out there, and it probably means this individual has infected others, and now it’s a race to try to find out who that person has infected.”
On Tuesday, the CDC offered its most serious warning to date that the United States should expect and prepare for the coronavirus to become a more widespread health issue.
“Ultimately, we expect we will see coronavirus spread in this country,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. “It’s not so much a question of if, but a question of when.”
According to the CDC’s latest count Wednesday morning, 59 U.S. residents have tested positive for the new strain of coronavirus — 42 of whom are repatriated citizens from a Diamond Princess cruise. That number has grown by two since Messonnier’s last count Tuesday, although the CDC was not immediately available to offer details on the additional cases.
More than 82,000 cases of coronavirus have been reported globally, and more than 2,700 people have died, with the majority in mainland China, the epicenter of the outbreak.
But public health leaders have repeatedly reminded residents that the health risk from the novel coronavirus to the general public remains low.
“While COVID-19 has a high transmission rate, it has a low mortality rate,” the state Department of Public Health said in a statement Wednesday. “From the international data we have, of those who have tested positive for COVID-19, approximately 80% do not exhibit symptoms that would require hospitalization. There have been no confirmed deaths related to COVID-19 in the United States to date.”
CDC officials have also warned that although the virus is likely to spread in U.S. communities, the flu still poses a greater risk.
Gostin said the news of potential silent transmission does not eliminate the possibility of containing the virus in the U.S. and preventing an outbreak.
“There are few enough cases that we should at least try,” he said. “Most of us are not optimistic that that will be successful, but we’re still in the position to try.”
Originally Posted by O.city:
Immunity is measured in levels (sort of) though. In this case, the patient had enough immunity to sterilize the infection with no symptoms. If we tested for other things we have immunity to, I'm guessing we'd find alot of asymptomatic patients carrying.
If we have HI to the common cold, why do we get millions of cases a year? [Reply]
Originally Posted by Donger:
If we have HI to the common cold, why do we get millions of cases a year?
As I said earlier, there are levels of immunity. As wiht the common cold, it's usually not anything to worry about in terms of symptoms and deaths. I wasn't specific about it earlier, thats my fault.
Thats what we should, theoretically, have HI do for this one. It will also slow it down as we have some neutralizing immunity in the chain of transmission.
I'm gonna wait for sure, there's some weird things with this press release so we can hold this for a minute. [Reply]
Originally Posted by petegz28:
So wasn't covalescent plasma considered a fairly effective treatment until last night?
I don't have a problem with CP and we have been using it for months. For all treatments etc. we need to follow the science wherever it leads and let the doctors\scientists make those determinations. [Reply]
Originally Posted by :
President Trump announced on Sunday that the U.S. Food and Drug Administration has allowed for the emergency use of an unproven treatment known as convalescent plasma therapy for COVID-19 patients, stating it can reduce the chances of dying in some by 35 percent. But scientists were quick to cast doubt on the claim, with one calling it "outrageous."
Originally Posted by :
In June, the Mayo Clinic released a safety report involving 20,000 people that suggested the treatment was safe. This was followed by a study released as a pre-print on the server medRxiv earlier this month which indicated that giving convalescent plasma to patients with severe COVID-19 within three days of them being diagnosed could lower their risk of death.
Just like everything else Covid, depends on who you ask. [Reply]
Originally Posted by TLO:
Positive cases and deaths seem to be declining across much of the country. Hopefully we get this thing squashed down and can keep it down.
As the world wearies of trying to suppress the SARS-CoV-2 virus, many of us are wondering what the future will look like as we try to learn to live with it.
Will it always have the capacity to make us so sick? Will our immune systems learn — and remember — how to cope with the new threat? Will vaccines be protective and long-lasting?
These pressing questions gained even greater urgency Monday with the news that scientists in Hong Kong have confirmed a 33-year-old man was reinfected with Covid-19; his second infection as diagnosed — by airport screening — came 4.5 months after his first infection in March.
“I’ve been thinking about it a lot,” Malik Peiris, a coronavirus expert at the Hong Kong University who was one of the co-discoverers of SARS-1, said when asked about the question of immunity.
Peiris isn’t alone. STAT asked a number of experts to map out scenarios of how we might come to coexist with this new threat. In a time of uncertainty, the scenarios they sketched were actually hopeful, even if the relief most envisage is not immediately around the corner.
“I don’t think we’ll be wearing masks in two to three years — for this virus,” said Vineet Menachery, a coronavirus researcher at the University of Texas Medical Branch in Galveston.
Menachery laid out four possible scenarios for how humans might interact with SARS-2 over time — in other words, what kind of immunity we might expect.
Some of the terms are of his own creation, so they may not be instantly recognizable to people who have studied immunology. They also cover a spectrum, and the lines between some of the scenarios can be blurry in spots. But they provide a useful discussion starter.
As Menachery sees it, the possibilities for the future when it comes to Covid-19 and human immunity break down as follows: sterilizing immunity, functional immunity, waning immunity, and lost immunity.
Please remember: These are educated guesses, based on what’s known about the way the immune system works in general, and how it responds to other coronaviruses.
Sterilizing immunity
Sterilizing immunity would be a best-case scenario. It describes an immune system that is armed against a foe, able to fend it off before infection can take hold.
Diseases that we think of as “one-and-done” infections induce such a robust and durable immune response in a single encounter that we cannot be reinfected. In general terms, measles fits into this category, although there are rare reports of people contracting measles more than once.
The bad news is that viruses that infect via the mucus membranes of the nose and throat, like SARS-2, typically don’t induce sterilizing immunity.
“Sterilizing [immunity] in my view is out of the question, as with any respiratory virus,” said Marion Koopmans, head of virology at Erasmus Medical Center in Rotterdam, the Netherlands. Stanley Perlman, a coronavirus researcher at the University of Iowa, called this option “not so likely.”
But Florian Krammer, a professor of vaccinology at the Icahn School of Medicine at Mount Sinai Hospital in New York, does believe some people will develop sterilizing immunity after a bout of Covid-19.
One last observation about sterilizing immunity: If infection doesn’t trigger it, there is reason to be concerned that vaccines may not either. Peiris noted that so far most of the experimental vaccines, when tested in primates, protect the lungs from severe disease but don’t block replication of virus in the upper airways.
If the primates predict how the vaccines will work in people, these studies would suggest that people may still be able to be infected and they may emit viruses that potentially could infect others, but the type of Covid-19 disease that lands people in ICUs and that sometimes kills them would be prevented.
“Of course, what we’d all like is immunity that protects the individual — protects from infection and protects from transmission. We may not achieve that,” Peiris said. “Because protecting from infection of the upper respiratory tract and then transmission is quite a challenge.”
Functional immunity
Functional immunity, on the other hand, may be within reach. In fact, it’s the scenario Menachery sees as most likely.
Under this scenario, people whose immune systems have been primed to recognize and fight the virus — whether through infection or vaccination — could contract it again in the future. But these infections would be cut short as the immune system’s defenses kick into gear. People infected might not develop symptoms or might have a mild, cold-like infection.
“I’m a believer that if you’ve gotten Covid-19, then your likelihood of dying from a second Covid-19 case is very low, if you maintain immunity,” Menachery said.
Peiris agreed. “It won’t have the impact it has now. … It becomes manageable.”
There’s been enormous amounts of debate — and concern — about how long-lasting or “durable” immune responses to this virus will be, based on a few scientific papers that suggest some people don’t develop many antibodies to the virus and others that report that those antibodies appear to decline quickly.
The experts who spoke with STAT all felt that the immune responses to this virus are exactly what you would expect to see. And the case of the Hong Kong man who appears to have been reinfected underscore that, several said.
“The fact that somebody may get reinfected is not surprising. But the reinfection didn’t cause disease,” said Peiris, who knows about the case but was not one of the authors reporting it.
Angela Rasmussen, a virologist at Columbia University in New York who studies human responses to viral infections, said it is hard to be definitive, given the limited human experience with this new coronavirus, but she said she could see no reason to believe the immune system would behave differently to this respiratory virus than to others.
“So far, anyway, the evidence supports functional immunity, but the only way to see how long that will last is to follow people over time and see if those responses diminish,” she said.
“The idea there is that, yes, your antibodies might wane, but your memory responses aren’t absent,” said Menachery, noting that when a primed immune system re-encounters the virus, production of antibodies would kick into gear.
Christian Drosten, who is another co-discoverer of SARS-1, describes a future that fits into this category.
“I clearly expect lasting and relevant immunity that is almost sterilizing immunity against SARS-2 in almost every person infected with SARS-2,” Drosten, director of the Institute of Virology at Berlin’s Charité University Hospital, said via email.
“It may be possible to become infected again, without any change in the virus. The resulting infection will be mild or asymptomatic, with significantly lower levels of virus replication and onward transmission.”
Drosten’s last point would be a big bonus. If people who are reinfected don’t generate high levels of SARS-2 viruses in their respiratory tracts and therefore don’t contribute much to the spread of the virus, Covid-19 may become, over time, not just less dangerous, but also less common.
“It may become a rare infection, although that is difficult to foresee given the size of the global population,” Koopmans said.
Another hopeful part of this scenario relates to young children, who are far less likely than adults to develop severe disease. Krammer expects that children who first encounter the virus when they are very young may end up being infected several times over their lifetimes, but those later infections won’t lead to severe illness, even when they are elderly.
“I think that’s kind of how, in the long run, it would play out without the intervention of vaccines,” Krammer said. “I think with vaccines, we just basically speed up that process.”
A big question mark here relates to people who were infected and developed no symptoms, or who had very mild infections. Perlman said it’s not clear if their immune systems were sufficiently “tickled” to induce a long-lasting response, though he said he would guess — and he stressed it was a guess — that they would have enough protection to ward off severe disease.
While this scenario sounds truly hopeful, Perlman sounded a note of caution. This type of protection, if it comes to pass, will exist on the individual level. There will likely remain pockets of people who have never been infected and who haven’t been vaccinated. If they contract the virus, “we should still see bad disease,” he said.
Waning infection
Waning infection, the third scenario, is a variation of functional immunity. In this scenario, people who have been infected or vaccinated would lose their protection over time. But even if immunity wanes, reinfections would be less severe, Menachery said.
“You will never get as sick as you were the first time,” he said.
The man from Hong Kong may be an example of this phenomenon, though details of his immune responses to his first and second infections are not yet public.
This is the pattern seen with the four coronaviruses that cause about 15% of what we consider common colds — OC43, 229E, NL63, and HKU1. People can be reinfected with these viruses after a relatively short period of time.
Thirty years ago, British scientists reported that a year after deliberately infecting a small number of volunteers with 229E, two-thirds became reinfected when again exposed to the virus. “However, the period of virus shedding was shorter than before and none developed a cold,” they wrote.
In another ambitious study, Dutch researchers followed 10 healthy individuals for decades, measuring antibody levels to the four human coronaviruses at regular intervals. Rises in antibodies were interpreted as evidence of recent infections. Most of the subjects had multiple infections with each of the viruses.
The shortest period between infections was six months, though the median period between reinfections was 30 months. “We saw frequent reinfections at 12 months post‐infection and substantial reduction in antibody levels as soon as six months post‐infection,” they wrote. The paper is a preprint, meaning it has not yet undergone peer review.
The senior author of the paper, Lia van der Hoek of Amsterdam University Medical Center, said via email that she felt waning immunity was the most likely scenario for what will happen with SARS-2, but wouldn’t be drawn on what that would mean for people who are reinfected.
“It is completely unknown what the symptoms will be when reinfection occurs. This could be less, or worse, or equal. We scientists cannot make a prediction on that,” she said.
Krammer believes the overall picture will be mixed. Some people will have sterilizing immunity, but most will fit into either the functional or waning immunity categories. The net outcome: less of the type of disease that prompted most countries to take the extraordinary steps of locking down this spring.
“What I think is going to happen with the majority of people who have natural infections, but also the majority of vaccinees, is that they will be protected from disease and might have much less virus if they get infected. They might not know that they’re infected,” he said.
Lost immunity
Lost immunity describes a scenario in which people who have been infected would lose all their immune munitions against the virus within some time frame. A reinfection after that point would be like a first infection — carrying all the same risk of severe disease now seen with Covid-19.
None of the experts who spoke to STAT felt this was a possibility.
“I can’t imagine this being a situation where I get infected and then in 10 years, I get infected again and I have zero immunity,” Perlman said.
“If you generate a response to clear the virus, I think you will maintain that immunity long term,” Menachery added, though he raised a question about people who have had symptom-free or mildly symptomatic infections. “For people with mild or asymptomatic infection, it may not be lost immunity, but rather no immunity generated.”
If these experts are correct, and the worst-case scenario is off the table, humans can expect to see a waning of the threat SARS-2 poses to people over time. Our immune systems will know how to deal with it. It could become the fifth human coronavirus to cause common colds.
Dan Barouch, director of the Center for Virology and Vaccine Research at Boston’s Beth Israel Deaconess Medical Center, sounded a note of caution, though. The journey from where we are to that more manageable situation won’t be a quick one, he said. Most of the world’s population still has no experience with this virus and even if vaccines work, vaccinating billions of people around the world is the work of years, not months.
He didn’t agree that what might happen could fit neatly into one of four categories listed above, saying he sees immunity more in terms of shades of gray that shift depending on the person’s immune status and the nature of their exposure to the virus.
As Barouch sees it, some people’s immune responses might be able to ward off infection entirely in some circumstances, but other types of exposures might result in infection — for instance, if they were exposed to a large amount of the virus.
“The short answer is we don’t know. So, anyone who gives you a scenario is providing a hypothesis,” he said.
FDA chief issues mea culpa for his plasma treatment claims
FDA Commissioner Stephen Hahn issued a mea culpa late Monday, conceding that he had overstated the benefits of convalescent plasma as a treatment of coronavirus at a press conference last weekend with President Donald Trump.
Hahn had been the subject of intense criticism following his appearance Sunday alongside the president........
“I have been criticized for remarks I made Sunday night about the benefits of convalescent plasma. The criticism is entirely justified,” the commissioner said in a string of tweets. “What I should have said better is that the data show a relative risk reduction not an absolute risk reduction.”
While the therapy is considered safe, plasma has not yet been proven effective against the coronavirus.
But in announcing FDA’s granting of an emergency use authorization for the treatment on Sunday, the White House billed the decision as a “historic announcement.”.................... [Reply]
FDA chief issues mea culpa for his plasma treatment claims
FDA Commissioner Stephen Hahn issued a mea culpa late Monday, conceding that he had overstated the benefits of convalescent plasma as a treatment of coronavirus at a press conference last weekend with President Donald Trump.
Hahn had been the subject of intense criticism following his appearance Sunday alongside the president........
“I have been criticized for remarks I made Sunday night about the benefits of convalescent plasma. The criticism is entirely justified,” the commissioner said in a string of tweets. “What I should have said better is that the data show a relative risk reduction not an absolute risk reduction.”
While the therapy is considered safe, plasma has not yet been proven effective against the coronavirus.
But in announcing FDA’s granting of an emergency use authorization for the treatment on Sunday, the White House billed the decision as a “historic announcement.”....................
Blatant politics, Stump
Never mind back in June when Mayo was talking about this everyone was cool with it. [Reply]
FDA chief issues mea culpa for his plasma treatment claims
FDA Commissioner Stephen Hahn issued a mea culpa late Monday, conceding that he had overstated the benefits of convalescent plasma as a treatment of coronavirus at a press conference last weekend with President Donald Trump.
Hahn had been the subject of intense criticism following his appearance Sunday alongside the president........
“I have been criticized for remarks I made Sunday night about the benefits of convalescent plasma. The criticism is entirely justified,” the commissioner said in a string of tweets. “What I should have said better is that the data show a relative risk reduction not an absolute risk reduction.”
While the therapy is considered safe, plasma has not yet been proven effective against the coronavirus.
But in announcing FDA’s granting of an emergency use authorization for the treatment on Sunday, the White House billed the decision as a “historic announcement.”....................
Originally Posted by petegz28:
Blatant politics, Stump
Never mind back in June when Mayo was talking about this everyone was cool with it.
Daily new case 7 day average is at June 30th levels, daily deaths are dropping not peaking, it appears we are on the backside of the second spike. Mortality rate continues to drop steadily looking at daily new case averages vs deaths over the last month.
But of course the usual suspects will be in to claim everything will certainly go to hell soon because schools are opening and the fall spike is coming even though they also claim Covid has no seasonality.
What appears to be happening is the virus is running its course while being slowed by mitigation. We also clearly have better treatments available. [Reply]