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Cont: The One Covid-19 Science and Medicine Thread Part 3

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Latest Covid Antivaxx demand: "If I have to take the shot to remain working here, sign this paper saying that I will sue you if I am harmed by it."
 
Skeptic Ginger said:
Does that include rich countries going all out to stop the pandemic in poor countries?

Whose political will is needed in countries like Brazil, their's or our's?
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Brazil only needs it's own policies to stop the pandemic. It's a developing country. The major problem here, aside Bolsonaro (but US had Trump, does it need help from poorer countries because of him?), was vaccine availability.

In general, vaccine hesitancy is a first world problem. And then you have the LEAST developed countries (see graph below for countries over 80 million people), where they barely got anyone vaccinated by mid September.

Most areas of the country are over 90% of the adult population vaccinated with the first dose.

Full vaccination rates are rising only now because there was a 12 weeks gap mandate between 1st and 2nd doses of Astrazeneca and Pfizer.

I am 42. Had my first shot in 5th July (that's when my age group started being allowed to vaccinate). Got vaccinated with 2nd dose last Sunday. And only because vaccine gap was reduced to 10 weeks. Otherwise my 2nd dose would only come in early October.
 
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Returning to that topic of "vaccinable" population numbers vs % of FULL population that got vaccinated (I don´t think Our World In Data Numbers are based on vaccinable populations. They do their own calculations based on number of vaccinated people vs country population of their own databases))

Here are the numbers for Rio Grande do Sul state, in Brazil. I don´t claim they are appliable for the whole country

92% of the population older than 18 years (8,95 million people out of 11.3 million total state population) got at least 1 shot. 53,9% are fully vaccinated
https://snipboard.io/mo7ELS.jpg

distribution by age group. Again, I must remind people that I am 42 and I was ONLY ELIGIBLE to take my second dose this last weekend.
Those younger age groups that have a % with full vaccination are either people at those ages WITH COMORBIDITIES or younger people who got Coronavac, which has a smaller interval between doses.
https://snipboard.io/IcTBdY.jpg
 
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Llama steak for dinner please!

https://www.bbc.com/news/science-environment-58628689

Prof Naismith, who is one of the lead researchers and director of the Rosalind Franklin Institute in Oxfordshire, explained that coronavirus-infected rodents treated with the new nanobody nasal spray fully recovered within six days.
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Be nice if that carries on to humans.

If it's so successful, it does raise the ethical question of having control patients in human trials - some of them may be consigned to die in the name of research.
 
Remdesivir redux?

"Gilead Sciences, Inc. (Nasdaq: GILD) today announced positive results from a Phase 3 randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of a three-day course of Veklury® (remdesivir) for intravenous (IV) use for the treatment of COVID-19 in non-hospitalized patients at high risk for disease progression...In an analysis of 562 participants randomly assigned in a 1:1 ratio to receive Veklury or placebo, Veklury demonstrated a statistically significant 87% reduction in risk for the composite primary endpoint of COVID-19 related hospitalization or all-cause death by Day 28 (0.7% [2/279]) compared with placebo (5.3% [15/283]) p=0.008." link
 
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Chris_Halkides said:
"Gilead Sciences, Inc. (Nasdaq: GILD) today announced positive results from a Phase 3 randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of a three-day course of Veklury® (remdesivir) for intravenous (IV) use for the treatment of COVID-19 in non-hospitalized patients at high risk for disease progression...In an analysis of 562 participants randomly assigned in a 1:1 ratio to receive Veklury or placebo, Veklury demonstrated a statistically significant 87% reduction in risk for the composite primary endpoint of COVID-19 related hospitalization or all-cause death by Day 28 (0.7% [2/279]) compared with placebo (5.3% [15/283]) p=0.008." link
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No deaths in placebo or treatment arm. So although said to be 'high risk' 0/283 in placebo arm died.

I am a bit puzzled by the use of pre-hospital iv therapy. Must be a US thing. Given risks of iv therapy in the UK it would nearly always be done in hospital. Essentially to prevent one hospital admission you have to give twenty people iv therapy for three days. I am not sure this is cost effective.

The other issue is the study ended in April 2021 so in the US many cases would have been alpha rather than delta.

So remdesivir has an effect, used early, but not much of an effect, and it clearly needs a better method of administration.
 
A lot of people go home with IV ports. No sense in being in the hospital for long-term antibiotics, for example. One might have the first dose or two in an outpatient facility. Generally the patient gets a home-health nurse to make sure they know how to manage the port and all.

But given it was only a 3 day course, I can't imagine the drug company wanted people unmonitored at home. And this note in the link suggests it was not at home:
Veklury should only be administered in a hospital or in a healthcare setting capable of providing acute care comparable to inpatient hospital care.
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It's likely this was administered in an outpatient setting, not at home.
 
The Atlantic has a good piece explaining why unvaccinated are spreading covid-19 more than vaccinated. They point out that the vaccinated are both less likely to get infected and, if infected, are infectious for less time.

https://www.theatlantic.com/ideas/a...-arent-just-as-likely-to-spread-covid/620161/

Also, New York has finally (Yay!) published breakthrough data and compared it between vaccinated and unvaccinated. Better yet, they have published week by week numbers during the Delta wave and graphs going back earlier. It's by far the best data set and presentation I've seen from any state in the USA.

https://www1.nyc.gov/assets/doh/downloads/pdf/covid/covid-19-post-vaccination-data-082321.pdf

The case rate per 100k unvaccinated is 3.1 times the case rate per 100k fully vaccinated.


Looking at the last 4 weeks (Delta heavy) of data, about 1/5 as many vaccinated people are dying than unvaccinated. and about 1/4 as many vaccinated are hospitalized as unvaccinated. Note that the vulnerable, older groups were heavily vaccinated during this time so the vaccines are highly effective.

Added: Of note and unique in all the state reports I've read, the New York report has an expansive definition of breakthrough cases. In addition to the vaccinated, they also include PCR positives that were 3 or more months earlier.

This makes the case for vaccines even stronger because something like 15% of New Yorkers were Covid-19 positive. Not a big factor but nice to see it included.

Which brings up my data thirst. It would be great if they broke down breakthroughs by vaccination and prior infection. There's a great deal of uncertainty about how effective immunity is from prior infection.
 
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marting said:
...snip

Which brings up my data thirst. It would be great if they broke down breakthroughs by vaccination and prior infection. There's a great deal of uncertainty about how effective immunity is from prior infection.
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I thought I had seen a study indicating about 2:1 for prior infection vs. vaccine. So the vaccine is worth it even for people infected before.
 
marting said:
The Atlantic has a good piece explaining why unvaccinated are spreading covid-19 more than vaccinated. They point out that the vaccinated are both less likely to get infected and, if infected, are infectious for less time.
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It’s always good to have hard data, but are those things that need to be pointed out at this stage? Aren’t they pretty much what vaccination does?
 
zooterkin said:
It’s always good to have hard data, but are those things that need to be pointed out at this stage? Aren’t they pretty much what vaccination does?
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Sure but the New York info database clearly has relative efficacy data on breakthrough re-infections v vaccinations. This is needed in part to fill in information gaps as discussed in this accepted, pre-proof paper on the transition to endemicity:

Transition to endemicity: Understanding COVID-19

https://www.cell.com/immunity/pdf/S1074-7613(21)00404-0.pdf

Clearly written paper discussing these various factors that play into our future of living with SARS-CoV-2.

Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (CoV-2) and its associated disease, COVID-19, has caused a devastating pandemic worldwide. Here, we explain basic concepts underlying the transition from an epidemic to an endemic state, where a pathogen is stably maintained in a population. We discuss how the number of infections and the severity of disease change in the transition from the epidemic to the endemic phase, and consider the implications of this transition in the context of COVID-19
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India has vaccinated about 14% of their people. Their mortality numbers have leveled off.

India's government issued home medicine kits include:
Ivermectin 12mg tablets,
Multivitamn tabets with zinc,
Vitamin D3 tablets,
Vitamin C tablets,
Paracetamol tablets,
Doxycycline 100mg tablets,
Pulse Oximeter,
Digital Thermometer,
Masks, sanitizer, and gloves.

India's northern border state Uttar Pradesh (population 204 million) reported greatly improved numbers.

- John Campbell
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The key parts of UP government's plan to tackle Covid-19 included contact tracing, early detection, isolation and free and timely provision of medicine kits and treatment to the rural populace.

By hindustantimes.com
PUBLISHED ON SEP 14, 2021
https://www.hindustantimes.com/indi...ian-mp-praises-yogi-govt-101631606229422.html

The number of daily cases of coronavirus disease (Covid-19) have been on a downswing in Uttar Pradesh. In the last 24 hours, no new case was identified in 59 of the state's 75 districts, according to UP a government release.

Moreover, recoveries continue to outnumber new cases in the state. Out of the 1,91,446 samples tested in the last 24 hours, 33 samples tested positive for the Covid-19 infection and as a result the Test Positivity Rate (TPR) slumped to lower than 0.01 per cent in Uttar Pradesh, the state government data showed.

In the same period, 25 patients recovered from the infection. The active caseload in the country's most populous state has been reduced to 187 from a high of 3,10,783 in April, pushing the recovery rate up to 98.7 per cent, the state government said in a release.
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Efficacy of the home kits was not rated.
 
zooterkin said:
It’s always good to have hard data, but are those things that need to be pointed out at this stage? Aren’t they pretty much what vaccination does?
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That might depend upon which definition of vaccine you have in mind.

CDC and others have been making changes to definitions of words like vaccine, pandemic, herd immunity....


Some articles:


https://duckduckgo.com/?q=cdc+changed+the+defnition+of+the+word+vaccine&t=hy&va=g&ia=web



https://media.mercola.com/ImageServ...dc-changes-the-definition-of-vaccines-pdf.pdf
 
Bubba said:
That might depend upon which definition of vaccine you have in mind.

CDC and others have been making changes to definitions of words like vaccine, pandemic, herd immunity....
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Just to keep you up to date. C19 vaccines, to get EUA required they demonstrate >50% efficacy at preventing symptomatic disease. It was way more than that. Still is.

Back in Dec. 2020 herd immunity seemed achievable. R0 was estimated at 2.5 and >60% vaccinated, together with about 30% of the population having already recovered from C19 made herd immunity possible. But then came Alpha with a higher R0 and estimates of herd immunity were raised to >70%.

And then came Delta. R0 estimates are much higher and worse, breakthrough infections also increased with efficacy against symptomatic disease dropping to about 80% or so. Lower than that for asymptomatic infection. And those vaccinated people can also transmit to others. So herd immunity is no longer considered likely or even possible by most. Even if vaccination rates exceed 90% which will probably not be possible.

So that means C19 is going to become endemic. Which means everyone will be exposed to it at some point. Those that are vaccinated or previously recovered will, in general, have mild or asymptomatic cases. That that aren't, will be more impacted. And the older you are the more likely to be seriously ill. In the coming years it will just be another circulating common cold type coronavirus as the population will have significant immunity as they currently do for the cold coronaviruses.
 
marting said:
Just to keep you up to date. C19 vaccines, to get EUA required they demonstrate >50% efficacy at preventing symptomatic disease. It was way more than that. Still is.

Back in Dec. 2020 herd immunity seemed achievable. R0 was estimated at 2.5 and >60% vaccinated, together with about 30% of the population having already recovered from C19 made herd immunity possible. But then came Alpha with a higher R0 and estimates of herd immunity were raised to >70%.

And then came Delta. R0 estimates are much higher and worse, breakthrough infections also increased with efficacy against symptomatic disease dropping to about 80% or so. Lower than that for asymptomatic infection. And those vaccinated people can also transmit to others. So herd immunity is no longer considered likely or even possible by most. Even if vaccination rates exceed 90% which will probably not be possible.

So that means C19 is going to become endemic. Which means everyone will be exposed to it at some point. Those that are vaccinated or previously recovered will, in general, have mild or asymptomatic cases. That that aren't, will be more impacted. And the older you are the more likely to be seriously ill. In the coming years it will just be another circulating common cold type coronavirus as the population will have significant immunity as they currently do for the cold coronaviruses.
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Thanks

It was about the definitions according to dictionaries and health agencies rather than according to recent percentages.

Apparently some people mistakenly thought herd immunity was a function of natural process.

The WHO cleared it up, as this outlet explained:

https://www.cbs19.tv/article/news/v...cret/507-f90c0199-c88e-4c66-8313-b4ae6e2a72ad
 
Bubba said:
Thanks

It was about the definitions according to dictionaries and health agencies rather than according to recent percentages.

Apparently some people mistakenly thought herd immunity was a function of natural process.

The WHO cleared it up, as this outlet explained:

https://www.cbs19.tv/article/news/v...cret/507-f90c0199-c88e-4c66-8313-b4ae6e2a72ad
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Like other words, they can mean different things to different people and groups. In an epidemic where there are not vaccines, it's when enough people have recovered that the effective R drops below 1. In an epidemic where vaccines have been introduced, it's also when R drops below 1 from a combination of vaccination and those previously recovered. For things like measles, it's all from vaccination. BTW, influenza vaccines are pretty marginal. 50-60% efficacy and wanes quickly. As bad as they are they are still called vaccines. No idea where the notion vaccines were supposed to be 100% effective came from though measles is close and long lasting too. I didn't bother with a flu vaccine last year as it was pretty obviously going to be nearly non-existent. Remember the hype around a twindemic? See this

https://www.nytimes.com/2020/08/16/health/coronavirus-flu-vaccine-twindemic.html

NPIs dropped flu R by the same factor they dropped C19 R and since flu is barely above 1 during flu season, the C19 NPIs were obviously going to drive flu to record lows. Which they did. Everywhere.

This winter is likely to be different. There's a bit more susceptibility because of no recent exposure and people are out and about far more than any time since April 2020. My current estimate is that Covid-19 will have nearly run it's course in the USA by Dec. though pockets may occur here and there. It then transitions to endemic like cold coronaviruses. Good chance we'll have a worse than average flu season. So I'm getting a flu shot this year. Probably around late Nov. to minimize waning.
 
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Bubba said:
Apparently some people mistakenly thought herd immunity was a function of natural process.
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Its not a mistake per se. Herd immunity can be a function of a natural process. How do you think populations of humans survived plagues and pandemics before we had vaccines?

Herd Immunity occurs when you get a sufficiently large proportion of the population that are immune to a disease, such that non-immune infected members of the remaining population have little no chance of spreading the disease to other non-immune members of the same population. This is why you may have heard people talking about how the vaccinated population can protect those who cannot, or will not take the jabs.

Herd Immunity can be achieved by...

1. A vaccination programme
The efficacious use of widespread vaccination to increase the immunity of as many people as possible. This is how smallpox and polio were eradicated. This way costs the smallest number of lives - if Covid had been properly managed in the US before the vaccines became available, and vaccinations had not been politicised by the political right, we would be talking about less than 20,000 to 30,000 deaths in the US, instead of almost 700,000.

2. Let the virus run wild
Allowing the disease to spread so that your large proportion of the population become immune by getting the disease and surviving it. However, while this method might be financially cheaper, it would result in horrific toll in lives. The disease appears to have a morbidity rate in the US of between 1.4% and 1.6%. It has been estimated that natural herd immunity in the US could have cost between 4½ million and 5¼ million lives.
.
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smartcooky said:
It has been estimated that natural herd immunity in the US could have cost between 4½ million and 5¼ million lives.
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Not to mention the multi-millions that would suffer long term pulmonary and neurological problems, many of whom were asymptomatic and never even knew they had the virus. Only a sociopath or cement-headed fool would think this is a good idea.
 
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