SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

Wolverine

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https://marlin-prod.literatumonline.com/pb-assets/Lancet/pdfs/S0140673620316044.pdf

Great news. Skimmed it but will read through most of it later. Another candidate for phase III is excellent news and increases our chances of finding something to get to or close to effective herd immunity

Safety is a huge barrier to cross but efficacy is the main one. But if they're testing this out in South Africa and Brazil which aren't doing great in terms of cases then hopefully some of the vulnerable there can benefit alongside establishing proof of concept

A couple of interesting points in there that I can spot
- the only really serious event was in the control group with the meningitis vaccine was one patient getting hemolytic anemia, most of the vaccine candidate group were fine with paracetamol. The aches, pain, headache, myalgia rates are pretty high (even if they are mild and self-limiting) though a lot less with the booster.

- they're highlighting the fact that both antibodies (humoral immunity) and T-cells (cellular immunity) were elevated with initial dose but the latter was not increased with a second, booster dose. Just wondering here for any of the scientists or immunology buffs here whether there is precedence for that in terms of other effective vaccines?

- neutropenia (drop in neutrophil count) was mentioned as a transient response in 46% of the ChAdOx1 nCoV-19 group. They didn't quantify that but just thinking about cancer patients or others who might be vulnerable from a sepsis point of view as to whether that has any clinical implications
 

acnumber9

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Reading today about Blackburn's cases being high and potentially going into local lockdown. Even the BBC acknowledged the poorer, cramped parts of the city are where most cases are emerging.

The UK gov are going to need to do a good PR job spinning this as there's a clear relationship with poverty.
It’s because poor people aren’t wearing masks. That’s the only reason.
 

F-Red

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Reading today about Blackburn's cases being high and potentially going into local lockdown. Even the BBC acknowledged the poorer, cramped parts of the city are where most cases are emerging.

The UK gov are going to need to do a good PR job spinning this as there's a clear relationship with poverty.
Significantly higher case numbers in BAME communities in Blackburn I think is the more accurate relationship here, examples of issues of 250 attendees at a funeral the other day don't help matters at all.
 

fergieisold

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Reading today about Blackburn's cases being high and potentially going into local lockdown. Even the BBC acknowledged the poorer, cramped parts of the city are where most cases are emerging.

The UK gov are going to need to do a good PR job spinning this as there's a clear relationship with poverty.
It makes sense though, cramped conditions in small houses provide a good breeding ground. I don't think there's much anybody can do about that other than focus on trying to prevent outbreaks?
 

berbatrick

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https://www.thelancet.com/lancet/article/S0140-6736(20)31611-1

Results from the early trials of the Oxford vaccine. All participants had a T-cell response with 90% of 1077 producing sustained antibodies over 56 days of observations. They also compared one to two doses of the vaccine with two showing a higher response with little side effects. 70% of participants reported side effects, but among those were headaches, fatigue and tenderness at the injection site, relatively mild symptoms.
Bolded part is interesting, I wonder if there's any use in finding the upper limit for this (where does a higher initial dose mean no more increase in response/too many side effects).
 

Compton22

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Bolded part is interesting, I wonder if there's any use in finding the upper limit for this (where does a higher initial dose mean no more increase in response/too many side effects).
I think the dosage will be very important in finding out if it gives a longer duration of immunity. Side effects appear to be no different in either dosage. Good news is that it is showing the sort of results they would expect for a vaccine of this type.
 

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Bolded part is interesting, I wonder if there's any use in finding the upper limit for this (where does a higher initial dose mean no more increase in response/too many side effects).
That’s one of the main reasons for doing this initial smaller Phase II studies. They’ll try a range of doses to work out the dose with the best balance between effectiveness and toxicity. Then they take the optimal dose and use it in the much larger Phase III trials. Without that step you could risk failure in a huge study just because you gave everyone the wrong dose.
 

sun_tzu

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That’s one of the main reasons for doing this initial smaller Phase II studies. They’ll try a range of doses to work out the dose with the best balance between effectiveness and toxicity. Then they take the optimal dose and use it in the much larger Phase III trials. Without that step you could risk failure in a huge study just because you gave everyone the wrong dose.
That makes sense .... as it looks stage 3 trials will start soon whats your best guess at a time line (assuming the stage 3 trials produce good results / no significant side effects)
 

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That makes sense .... as it looks stage 3 trials will start soon whats your best guess at a time line (assuming the stage 3 trials produce good results / no significant side effects)
Absolutely no idea. Testing vaccines is weird. You need to get a certain % of study subjects exposed to the virus before you can start to generate results. And that % going to vary massively depending where/when the study is run. From a UK perspective, getting the daily case numbers down as low as possible is good news for the health service but bad news for vaccine trials. That’s why they’re preferentially opening up sites in badly affected countries like Brazil.
 

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That makes sense .... as it looks stage 3 trials will start soon whats your best guess at a time line (assuming the stage 3 trials produce good results / no significant side effects)
Phase III trials have already started and they are doing them in Brazil since it's been hit harder by the virus which means they should get results more quickly. They think they are on schedule to have results of that by the end of September although it's difficult to say for sure as it will rely on the virus remaining fairly widespread in Brazil, which it certainly is at the moment. They are already mass producing the vaccine with a view to having it ready for use this winter.
 

sun_tzu

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Phase III trials have already started and they are doing them in Brazil since it's been hit harder by the virus which means they should get results more quickly. They think they are on schedule to have results of that by the end of September although it's difficult to say for sure as it will rely on the virus remaining fairly widespread in Brazil, which it certainly is at the moment. They are already mass producing the vaccine with a view to having it ready for use this winter.
Could it be licenced that quickly?
 

Compton22

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Could it be licenced that quickly?
It all depends on how fast they can get results on efficacy from phase 3 trials. Once that is confirmed I don't think it'll take too long to be approved for use.
 

Compton22

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Pogue Mahone

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But reiterating that they must wait for phase 3 trials results. No one knows how much of an immune response is enough to prevent infection.
No. Although it’s good to get comparable levels to what we see in convalescent samples. Which is what we saw in the mRNA vaccine trial results published earlier in the week.

Sounds as though this vaccine is producing less of a response. Although I haven’t seen any numbers anywhere. I’m not even sure the full results are published?
 

Compton22

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No. Although it’s good to get comparable levels to what we see in convalescent samples. Which is what we saw in the mRNA vaccine trial results published earlier in the week.

Sounds as though this vaccine is producing less of a response. Although I haven’t seen any numbers anywhere. I’m not even sure the full results are published?
Nor have I tbh, not even in the Lancet paper. The T-cell response is the most encouraging part of this imo anyway, that's what gives people long lasting immunity.
 

Simbo

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https://www.thelancet.com/lancet/article/S0140-6736(20)31611-1

Results from the early trials of the Oxford vaccine. All participants had a T-cell response with 90% of 1077 producing sustained antibodies over 56 days of observations. They also compared one to two doses of the vaccine with two showing a higher response with little side effects. 70% of participants reported side effects, but among those were headaches, fatigue and tenderness at the injection site, relatively mild symptoms.
Struggling to find anything concrete on this but a virology podcast I was listening a bit ago stated it is minimum 14 months of human trials to test for side effects before a vaccone can be distributed on mass. Their opinion was that there will be no corners cut when your talking about injected pretty much the entire population of the world with something.

Great to hear progress but I think some people will be mis-lead on what to expect.
 

giggs-beckham

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So cases aren't going down at the moment (uk) they look to be slightly increasing based on the worldometer site I look at. Deaths are still going down but there will be a lag if cases are going up to show in deaths, are we seeing a second spike here? The rate of decrease has been slowing down for a while and im not sure but that seems to me that if that continues then the line as it were will go up at some point. Hopefully I'm misinterpreting the graph.
 

Wibble

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Reading today about Blackburn's cases being high and potentially going into local lockdown. Even the BBC acknowledged the poorer, cramped parts of the city are where most cases are emerging.

The UK gov are going to need to do a good PR job spinning this as there's a clear relationship with poverty.
A very clear relationship.

Australia's first wave was much easier to control because it was primarily wealthy people returning from overseas who tend to live in places where it is easier to isolate and are far less densely packed so there was very little community transmission. Our secind wave is occuring in the community and primarily in poorer far more packed living conditions e.g. social housing tower blocks. Unless stage 3 works soon I can see Melbourne going to stage 4 and the rest of Victoria to stage 3. Mask wearing in public is compulsory in Melbourne and surrounds from Wednesday night.

Annoyingly the entire outbreak almost certainly originated with a quarantine guard having a booty call with someone in quarantine.
 

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Came here to post the John Campbell video, excellent news if true.

In other news, the Oxford people, widely ridiculed over here for stating during the spring that their vaccine could start being distributed in the autumn and that they were 80% confident that it would work, are still sticking to their original timeline.

Is Redcafe still confident that they will fail?
 
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Came here to post the John Campbell video, excellent news if true.

In other news, the Oxford people, widely ridiculed over here for stating during the spring that their vaccine could start being distributed in the autumn and that they were 80% confident that it would work, are still sticking to their original timeline.

Is Redcafe still confident that they will fail?
I think we should all wait and see, as I posted yesterday, Karolinska Institute were not at all impressed with the amount of antibodies produced from the vaccine.
They will await phase iii results, so should the rest of us.
 
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Annoyingly the entire outbreak almost certainly originated with a quarantine guard having a booty call with someone in quarantine.
What? That sounds like a “convenient excuse” to blame it on one individual, where’s the source on this?

As for getting it in poorer areas, we knew this from early doors though, that was the bad luck part of it. Stockholm was a perfect example of how the poor get fecked, and how that in turn can feck the elderly care as many of the poor work in low paid jobs in that sector, lots with contracts that don’t give them full sick pay.
 
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jojojo

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So cases aren't going down at the moment (uk) they look to be slightly increasing based on the worldometer site I look at. Deaths are still going down but there will be a lag if cases are going up to show in deaths, are we seeing a second spike here? The rate of decrease has been slowing down for a while and im not sure but that seems to me that if that continues then the line as it were will go up at some point. Hopefully I'm misinterpreting the graph.
The optimistic view is that it's a lot easier to get tested now. The hotspots are getting mobile testing units nearer to town centres and whole workplaces/families are being tested when one person gets a positive result.

Unfortunately because of the lags across the data, we won't really know if the infection rate is rising until it's seen as rising hospital admissions or in the death figures. It is definitely disturbing though. When the ONS update their random community test analysis we might get a better idea of the national picture, but that won't really show the local hotspots etc.
 
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Unfortunately because of the lags across the data, we won't really know if the infection rate is rising until it's seen as rising hospital admissions or in the death figures.
Yup, the only stats you have been able to trust since day one have been the hospital and ICU stats, that's all I follow here in Sweden and it's gradually declined since the April peak. Just 55 in Swedish ICU now, and just 12 in Stockholm.
Case numbers is an utterly pointless statistic.
 

Wibble

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What? That sounds like a “convenient excuse” to blame it on one individual, where’s the source on this?
It seems highly likely based on serology results. And all the NSW cases are almost certainly also an export from the Melbourne outbreak as well.

And it isn't a convenient excuse as it was a result of poor regulation of quarantine and a lack of training of security staff, not the don't shag people in quarantine which should go without saying, but more general procedures and associated things like not presenting staff from ride sharing. The government are coping flck for that so revealing that isn't in their interests but the Premier Dan Andrews is very opne and actually answers questions honestly. The other factor in this is that there were 2 family groups infected very early on who broke gathering regulations for Eid celebrations so I'd guess they would rather not concentrate on that (quite rightly) when tensions are so high.

As for getting it in poorer areas, we knew this from early doors though, that was the bad luck part of it. Stockholm was a perfect example of how the poor get fecked, and how that in turn can feck the elderly care as many of the poor work in low paid jobs in that sector, lots with contracts that don’t give them sick pay.
It isn't really bad luck as such but more a function of how density of living arrangements, no doubt compounded in colder weather, can quickly spread such an infectious disease. Hopefully lock-down in Melbourne will be enough, 50/50 at the moment with daily new cases between 200-400 and 10-30 in NSW.

Stage 4 lockdown will follow in Melbourne if today's compulsory mask wearing doesn't help enough. No more pubs or restaurants for me until we see how it goes in Sydney and for the first time in ages I've started carrying a mask again as there are always utter feckwits around, particularly in the supermarket, who refuse to keep a decent distance.
 

Wibble

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Yup, the only stats you have been able to trust since day one have been the hospital and ICU stats, that's all I follow here in Sweden and it's gradually declined since the April peak. Just 55 in Swedish ICU now, and just 12 in Stockholm.
Case numbers is an utterly pointless statistic.
New infection data can be trusted and very useful within known bounds as long as testing levels are high enough. Hospital and ICU bed use figures are useful but not independent of other considerations such a treatment regimes and seasonal factors. All figures and statistics need to be considered within their context.
 

Mb194dc

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Swedes at Karolinska Institute unimpressed with the low level of antibodies produced from the Astra Zeneca* Oxford Vaccine (*British-Swedish pharmaceutical and biopharmaceutical company).

Only in Swedish sadly: https://www.svt.se/nyheter/inrikes/professor-det-har-ar-ingen-mirakelmedicin
Sars cov 2 is almost certainly not permanently vaccinable in a very large proportion (80%+?) of the global population, maybe even much higher than that. The body doesn't see it as a particularly serious threat, so not only does the body not produce much of an immune response in a lot of cases, it also doesn't hold immunity for long either, about 3 months according to latest studies.

Even if a vaccine was developed to provide short term immunity, like influenza you then just force the natural selection of a strain for which the vaccine is not effective. So the vaccine would have to be continually changed as the virus mutates.

From a scientific perspective, a better way of looking at sars cov 2 is as "new flu" I think. All the preliminary scientific research points to this, no idea why we're responding to it as we are, totally counterproductive. Just delaying the inevitable.
 

hmchan

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Sars cov 2 is almost certainly not permanently vaccinable in a very large proportion (80%+?) of the global population, maybe even much higher than that. The body doesn't see it as a particularly serious threat, so not only does the body not produce much of an immune response in a lot of cases, it also doesn't hold immunity for long either, about 3 months according to latest studies.

Even if a vaccine was developed to provide short term immunity, like influenza you then just force the natural selection of a strain for which the vaccine is not effective. So the vaccine would have to be continually changed as the virus mutates.

From a scientific perspective, a better way of looking at sars cov 2 is as "new flu" I think. All the preliminary scientific research points to this, no idea why we're responding to it as we are, totally counterproductive. Just delaying the inevitable.
I'm pessimistic to the invention of an effective vaccine too, and I actually agree herd immunity is perhaps one of the most effective and quickest ways to deal with this pandemic. However there are also plenty of solid reasons why we have to respond as we do:
  • SARS CoV-2 is novel which means no one has ever been exposed to and produced antibody. It creates a huge burden to the medical system when many in the society get sick at the same time. We saw that in Italy but luckily most of the countries have taken the right measures and their systems haven't collapsed.
  • There is no known, standard, established treatment for COVID-19, unlike seasonal ordinary flu which has been well studied over the years. Many of the treatments for COVID-19 right now are actually experimental and inconclusive, even including Ribavirin which appears to be the best candidate.
  • The mortality rate of COVID-19 is much higher than seasonal flu, and the percentage of serious cases is also much higher.
  • The transmission rate of COVID-19 is much higher than seasonal flu.
P. S. I'm a healthcare professional working in Hong Kong and there is a third major outbreak here right now.
 

Stack

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what was the other option Stan? Stay closed forever?
There are other options than" Forever"
The tests at countries borders are improving with one that looks like it can give a pretty reliable answer within an hour of the test. So test at the country you leave from and test at the country you arrive in. Contact tracing of new arrivals even after those tests for the first 12 or 14 days of their time in the country. That will reduce the need for quarantines. Prioritising the countries being opened up to, already happening. Mandating masks for new arrivals for their first 2 weeks as well is another layer to assist with opening up.
The faster countries get the virus under control the faster they can repair their economies. Essentially that means protecting its citizens first and foremost.