Cont: The One Covid-19 Science and Medicine Thread Part 4

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marting

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marting
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Puppycow said:
"Age Discrimination" is a funny term to use there. I understand what they mean of course, but it's a virus; it doesn't discriminate. It's just that younger, healthier bodies are generally better prepared to survive it.
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Headline writers do like clickbait. :)

Seasonal influenza and many other diseases have a similar age gradient though not quite as pronounced as Covid-19.


Continued from here.
Posted By: zooterkin
 
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angrysoba said:
You think you should open up, because one shot is enough, but not until the adults have had boosters?
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The current lockdown is costing the country over a billion dollars a week. The scales have swung towards moving away from that and onto mitigation while opening the economy up.

And it's not adults needing boosters, it's old people. I'd made that quite clear.

All high-risk groups have got much higher double shot rates than other people.

angrysoba said:
Totally contradictory!
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Nope. You just aren't reading it properly, as evinced by your continually making statements that haven't been suggested, and have nothing to do with the thread.

angrysoba said:
And yes, children can spread the virus so excluding them from the figures of total vaccinated means you are relying on misleading figures.
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They aren't going to be vaccinated, so there's little point in including them.

And that's another of the points that have never been made - nobody's suggesting kids don't get it. They're very rarely harmed, and vaccines may not be approved for kids; and until they are, including them would be the misleading part.
 
The Atheist said:
The current lockdown is costing the country over a billion dollars a week. The scales have swung towards moving away from that and onto mitigation while opening the economy up.
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The numbers are going down all the time. Then if you open up when you have zero infections, you can do so far more than other countries.

That makes perfect sense, and would give NZ more time to get completely vaccinated as opposed to the low rate it is now.

Again, you criticize the New Zealand government for letting the virus in, yet you also claim it cannot be stopped from getting in, and have claimed you cannot stamp out Delta, yet the NZG seem to be doing a good job of getting back to zero from what I can see.

The Atheist said:
They aren't going to be vaccinated, so there's little point in including them.
And that's another of the points that have never been made - nobody's suggesting kids don't get it. They're very rarely harmed, and vaccines may not be approved for kids; and until they are, including them would be the misleading part.
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It doesn't matter if they are going to be vaccinated or not. What matters is whether they can transmit. Again, it is weird that you think something so obvious is now meaningless.
 
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Planigale said:
First thought, 13% lung function is dire. A sniffle and they would be dead! Yes a coincidence. Pneumonia is due to an infection, Pfizer is an mRNA virus it does not cause an infection.
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"A sniffle and they could be dead" makes me think that a case of side effects just a little worse than usual, i.e. when people with ordinary lung function need to lie down for a day or two and then are up and about again, may be enough to kill somebody like that.
 
I was sent a link to a youtube vid of a recent event called 'Press Conference: Death by Vaccination. Undeclared components of the COVID-19 vaccines'.

Anyone else checked it or heard about it? An article about the press conference is found here.
In their autopsies, the scientists went into great detail and used the latest technology. This is because it is the only way to link the vaccines, Burkhard said in the introduction.

Specifically, Prof. Dr. Burkhard said:

“Among what I am showing you, there are many things I have seen for the first time. Some things I can’t name yet because I’m still looking for names for them. We’re doing a peer review here with a lot of colleagues.”

“Severe effects are probably misdiagnosed by many pathologists as myocardial infarction.
“Lymphocyte collections are found everywhere”.

In all cases, the immune system has been attacked. Some diagnoses are difficult and often misinterpreted.

This press conference will give further impetus to the arguments of the opponents of vaccination. On the other hand, the pharmaceutical companies involved must urgently answer the questions posed by these top scientists, they say.

The results of the investigation have led to legal and political demands, for example, for the immediate collection of information by the authorities in order to be able to assess the health risk posed to the population by the Covid-19 vaccines.

For example, early signals of impaired fertility in vaccinated individuals can be examined by consulting IVF registries. Through the cancer registry, insights can be gained into the development of cancer due to the genetic modifications of the viral RNA. Suspension of Covid-19 vaccination should be considered, the researchers say.

Until then, everyone should ask themselves whether they are taking the risk of such a “vaccination” and exposing their immune system to this danger, they warn.
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Propaganda, Jono!
A lot of damage caused by vaccines is implied in sentences like, "early signals of impaired fertility in vaccinated individuals can be examined" or "insights can be gained into the development of cancer."
Yes, it can be examined and it should be examined, so please do so instead of implying a risk when you haven't actually found any.
It is obviously meant to scare people without making any specific claims.
 
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angrysoba said:
The numbers are going down all the time. Then if you open up when you have zero infections, you can do so far more than other countries.
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I seriously doubt we will ever get to zero infections again.

We're now six weeks into lockdown and while the numbers are low, we aren't even close to eradication.

angrysoba said:
Again, you criticize the New Zealand government for letting the virus in, yet you also claim it cannot be stopped from getting in,...
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And I'm right on both counts. The current system the government is using is doomed to fail. Lots of their own experts are on that page as well. They screwed up by letting it in, and they've done nothing to remove the chances of getting across the border again.

angrysoba said:
... and have claimed you cannot stamp out Delta, yet the NZG seem to be doing a good job of getting back to zero from what I can see.
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That's because you're looking at limited information. We currently have several clusters not linked to the original clusters, and there are cases popping up daily in unexpected locations. What's happening at the moment is the harshness of the lockdown is keeping it at bay, but will not eradicate it. We are in the identical position to Victoria, which is now at 1000 cases a day.

dann said:
Your 77% is what is considered to be 65% in most countries. And only 37% of the population (unlike the percentage of those eligible for vaccination) is fully vaccinated. That is way too early to reopen.
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I did note that re-opening is not throwing everything out like UK - that would clearly be a disaster. What we need to do is get as many people as possible back to work, while using other mitigation measures - masks, no crowds, distancing, etc.
 
John Campbell has been flogging vaccine injection aspiration for quite a while. Evidence he's right pops up in a new paper in Clinical Infectious Diseases. Aspiration is an injection technique to reduce the risk of accidently injecting into a blood vessel.

Intravenous Injection of Coronavirus Disease 2019 (COVID-19) mRNA Vaccine Can Induce Acute Myopericarditis in Mouse Model
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab707/6353927

Very complete study where they compared IM v IV results in mice.

RESULTS
Intravenous SARS-CoV-2 mRNA Vaccine Administration Induced Grossly Visible Pathology in Heart
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They also observed increased severity of effects after the second dose much as observed in the rare instances of myocarditis after vaccination.

Eric Topol links to John's discussion which takes to task CDC WHO Green Book etc. recommendations not to aspirate.
https://twitter.com/EricTopol/status/1442525607426867200
 
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This is a YouTube channel I recently came across, and he seems to a no-nonsense guy who tries to present just the facts and stick to that without political commentary or stuff that might alienate some people who are not disposed to listen to people who they consider to be on the opposite political side.



Title of the video:
COVID Transmission | Do vaccinated transmit as much as unvaccinated?

He discussed recent studies that bear on that question. (Bottom line is that the best currently available evidence says no, the vaccinated do not transmit as much as unvaccinated.)

Here is the video description and links to the studies:

When it comes to COVID Transmission to vaccinated individuals really transmit as much is unvaccinated? i will review several studies that answer this question one from Singapore and one from the Netherlands. They looked at vaccine breakthrough infections and compared viral loads to look at COVID transmission.

Mayo Clinic study: https://pubmed.ncbi.nlm.nih.gov/34401884/


UK study: https://www.medrxiv.org/content/10.1101/2021.08.18.21262237v1


Singapore study: https://www.medrxiv.org/content/10.1101/2021.07.28.21261295v1


Netherlands study: https://www.medrxiv.org/content/10.1101/2021.08.20.21262158v1.full.pdf
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The Atheist said:
The Atheist said:
I seriously doubt we will ever get to zero infections again.
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And proven right again just now, as the 1 pm update records 45 new cases today.

Melbourne here we come!

(Not a good thing)
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Too bad. NZ was so close: Daily new confirmed COVID-19 cases
But to be expected when restrictions are loosened too soon:
Two of the country's leading epidemiologist says today's high Covid-19 case numbers are simply the result of Auckland moving down alert levels which has seen more contact between people.
Covid 19 Delta outbreak: 'I would expect this number to continue,' Professor Baker says of 45 cases (NZ Herald, Sep 29, 2021)
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The Atheist said:
And proven right again just now, as the 1 pm update records 45 new cases today.

Melbourne here we come!

(Not a good thing)
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It's fine if NZ doesn't get to zero again. The goal now should be to keep the case count from exploding before get ~85% of the population fully vaccinated. At it's current vaccination rates and as transmissible as delta is New Zeeland could be in the thousands of cases per day 4-6 weeks from now if it's not careful.
 
dann said:
But to be expected when restrictions are loosened too soon:
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When 5 weeks of strict lockdown had failed, there was no choice but to get people working again.

lomiller said:
It's fine if NZ doesn't get to zero again. The goal now should be to keep the case count from exploding before get ~85% of the population fully vaccinated. At it's current vaccination rates and as transmissible as delta is New Zeeland could be in the thousands of cases per day 4-6 weeks from now if it's not careful.
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That's the page I'm on - keep people working, but with mitigation tactics in place.
 
http://www.internationalskeptics.com/forums/showthread.php?postid=13612229#post13612229
An excellent article in NyMag's Intelligencer on rather extreme age skew of Covid-19. We've touched on it from time to time here but it's worth a read. In particular since the media seems to give a lot of coverage to the relatively rare younger person that dies of Covid-19. The Public Continues to Underestimate COVID’s Age Discrimination https://nymag.com/intelligencer/2021...imination.html
But in small type, King County included some other data that paint what seems at first blush like a very different picture: Fully 25 percent of deaths were among vaccinated people, the county reported. How can this be? If the vaccines are so effective that they reduce mortality 42 times over, how could the vaccinated account for such a large proportion of the deaths? The answer is actually quite simple: the overwhelming age skew of the disease, which — in the time of vaccines, breakthrough cases, and Delta — we are still, as a public, hugely underestimating and which is governing the post-*vaccine pandemic landscape as clearly as it did the pre-vaccine landscape.
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To comment on this. I think it is more than the increased rate of co-morbidities. The presence of a co-morbididty is lesson a risk than age. There is an almost linear increase in risk from childhood. This is unusual, usually there is a J shape curve, increased risk in young infants, flat in adolescence and young adulthood then accelerating away in old age.

The very constant linear relationship implies there is something that changes with age in a consistent manner. One explanation is the viral receptor expression (ACE2) in the lung rises with age.
 
The Atheist said:
When 5 weeks of strict lockdown had failed, there was no choice but to get people working again.

That's the page I'm on - keep people working, but with mitigation tactics in place.
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Me too.

First get people vaccinated as much as possible. Then mitigation as needed such that regular medical procedures can be done. Between vaccination and those already recovered, most of the damage in the USA is behind us and future damage, as the bug becomes totally endemic where most infections are re-infections or vax breakthroughs, will be similar to influenza and also likely seasonal. At that point NPIs will fade away. This has already happened in may places This is/was pretty much the plan in most of Europe and lots of others like Singapore. The latter, similar to NZ, is now trying to modulate NPIs as it transitions to endemic from zero Covid. Will take them a bit of time because Delta is so damned infectious that case rates are soaring even with 80% vaxxed but virtually no prior recovered. About half the new cases are in vaxxed. They are generally mild or asymptomatic. The other half is getting clobbered. So they are temporarily increasing NPIs to limit hospitalization.
 
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sphenisc said:
https://www.rferl.org/a/day-by-day-how-the-coronavirus-spread/30552844.html

Time for a reminder of how we got where we are today...
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Even better than that is this entire thread. It's been ahead of the game almost the entire way. Note your video starts two days before this thread labelled it as a global pandemic, when there were about six cases outside of China.

I need to get myself organised and copy all of it as a matter of record.

If there's a more complete, dad-by-day (and even hour by hour, in the early stages) internet record of the pandemic, I'd love to know where it is.
 
San Diego has a rather detailed Covid19 summary issued every week.

But Good grief. I know a foolish consistency is the hobgoblin of small minds but really! There is a complete disconnect on page 2 of this Covid update from San Diego.

https://content.govdelivery.com/att...an Diego County COVID-19 Watch_2021.09.29.pdf

At the top is Figure 1, at the bottom is Table 1. Figure 1 is a histogram of daily new cases. Table 1 is a summary of the current and prior weekly case totals.

Figure 1 has declines in cases while Table 1 has fairly large increases in cases in the same time frames.

Maybe numbers were transposed.

There are other strange things. Hospitalizations of vaccinated are down more than one would expect from vaccinated cases while vaccinated deaths are pretty consistent with vaccinated cases a few weeks earlier.
 
The Atheist said:
Even better than that is this entire thread. It's been ahead of the game almost the entire way. Note your video starts two days before this thread labelled it as a global pandemic, when there were about six cases outside of China.

I need to get myself organised and copy all of it as a matter of record.

If there's a more complete, dad-by-day (and even hour by hour, in the early stages) internet record of the pandemic, I'd love to know where it is.
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If you only are interested in Australia then look at this https://www.health.gov.au/resources...s-covid-19-at-a-glance-infographic-collection. It has daily counts, by state, of the number of new cases. The only downside is that it does not say the source of the cases. This was at one stage mostly overseas.
 
Preprint study of forward transmission from vaccinated persons. AZ and Pfizer.

The impact of SARS-CoV-2 vaccination on Alpha & Delta variant transmission
https://www.medrxiv.org/content/10.1101/2021.09.28.21264260v1.full.pdf

Protection against onward transmission waned within 3 months post second vaccination. For Alpha this still left good levels of protection against transmission, but for Delta this eroded much of the protection against onward transmission, particularly for ChAdOx1, which by 3 months post second vaccine had no evidence of difference in transmission compared to that seen in unvaccinated individuals
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Also noted that transmission reduction only slightly correlated with Ct counts. Suspect vaccinated have more rapid clearance and more dead virus particles than viable virions. Many other caveats including confounders such as behavior differences between vaccinated and unvaccinated.

Note that this study was about transmission, not efficacy which is still quite good.
 
Well, it is a preprint, so I do wonder whether all of the appropriate statistical controls were applied.

So their conclusion is that the Oxford, AstraZeneca vaccine is ineffective for preventing transmission of Delta after 3 months?


One thought that occurs to me is that over time, more and more unvaccinated people will inevitably be exposed to the virus and, if asymptomatic, or otherwise undetected, they will likely acquire natural immunity due to previous exposure. In other words, the proportion of "naive" unvaccinated will fall while the proportion who have natural immunity will rise.

If you use this group as a control group or a reference group to gauge vaccine effectiveness, it would seem that as the control group acquires more and more natural immunity, it will appear that the vaccines are losing their effectiveness over time.

Perhaps this is a factor in what we are seeing now?
 
Big news perhaps:

New antiviral is highly effective, study finds, and is stirring hope that COVID-19 could be treated by a pill

An experimental drug prevented half of COVID-19 infections that would otherwise have sent people to the hospital, according to a study released Friday, offering promise that the virus could soon be treated by a pill.

The antiviral drug molnupiravir, made by Merck & Co. and Ridgeback Biotherapeutics of Miami, was given to 385 people within five days of their diagnosis with COVID-19. Another 377 volunteers who tested positive were given a placebo.

All the participants had at least one risk factor for severe COVID-19. They were either over 60 or had diabetes, obesity or heart disease, the companies said.

Molnupiravir, originally created by researchers at Emory University in Atlanta, is given as four pills taken twice a day for five days.

Of the participants who received molnupiravir, 28 or 7.3% were hospitalized during the month-long trial. In the placebo group, 53 people – or 14% –were hospitalized and 8 of them died.
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The trial was ended earlier than planned because of how strong these results are.
The study was supposed to enroll another 750 participants, but an independent monitoring board decided the drug was so effective it would be unethical to continue giving anyone a placebo.
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That is like hitting the jackpot. The signal is so clear and strong that the trial can be ended early.
 
sphenisc said:
No mention of the number of deaths in the active drug group?
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Here's a different article:
https://www.cnbc.com/2021/10/01/mer...uthorization-for-oral-covid-19-treatment.html

An interim analysis of a phase 3 study found that 7.3% of patients treated with molnupiravir were hospitalized within 29 days. Of the patients who received a placebo, 14.1% were hospitalized or died by day 29. No deaths were reported in patients who were given molnupiravir within the 29-day period, while eight deaths were reported in placebo-treated patients.

All 775 trial participants had laboratory-confirmed symptomatic Covid-19 and were randomly given molnupiravir or a placebo within five days of symptoms.
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No deaths in the treatment group vs. 8 in the placebo group. Not sure what happened after day 29, but it sounds pretty promising.
 
Puppycow said:
Well, it is a preprint, so I do wonder whether all of the appropriate statistical controls were applied.

So their conclusion is that the Oxford, AstraZeneca vaccine is ineffective for preventing transmission of Delta after 3 months?
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There are two factors involved in vaccinated transmission. Relative efficacy at preventing infection to a vaccinated person then the efficacy of transmission from that person. The former is still significant with AZ.

One thought that occurs to me is that over time, more and more unvaccinated people will inevitably be exposed to the virus and, if asymptomatic, or otherwise undetected, they will likely acquire natural immunity due to previous exposure. In other words, the proportion of "naive" unvaccinated will fall while the proportion who have natural immunity will rise.

If you use this group as a control group or a reference group to gauge vaccine effectiveness, it would seem that as the control group acquires more and more natural immunity, it will appear that the vaccines are losing their effectiveness over time.
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Yes. I've mentioned this too and it does reduce apparent vaccine efficacy. I haven't seen any studies that account for this but it's a large, and increasing effect in many places like the USA and UK. It's likely that significantly more than 50% of the unvaccinated people over 60 in the USA have been previously infected. Another side effect is that the IFR and CFR will decrease as that proportion becomes larger.

The Delta wave in the USA is already well on the decline after having picked off much of the remaining vulnerable over 60. Decline most rapid in places like Florida which were hit hardest over the last 2 months.

We in the USA, are probably near the end of Covid-19 since there is no evidence of a more fit variant. Unlike when Delta was obviously on the move back in May and about to eat Alpha's lunch.
 
Puppycow said:
Here's a different article:
https://www.cnbc.com/2021/10/01/mer...uthorization-for-oral-covid-19-treatment.html

No deaths in the treatment group vs. 8 in the placebo group. Not sure what happened after day 29, but it sounds pretty promising.
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That's pretty stark! Now the only question is safety as it's a new drug. Probably it will be used for high risk people until more data is in. With good results might be of value in exposed, at risk, people not yet testing PCR positive.
 
molnupiravir

Link1. From the structures shown in link 1, It is an ester-type prodrug that resembles pyrimidine nucleosides. Here is an abstract from a paper from August in Nature:

Abstract
"Molnupiravir is an orally available antiviral drug candidate currently in phase III trials for the treatment of patients with COVID-19. Molnupiravir increases the frequency of viral RNA mutations and impairs SARS-CoV-2 replication in animal models and in humans. Here, we establish the molecular mechanisms underlying molnupiravir-induced RNA mutagenesis by the viral RNA-dependent RNA polymerase (RdRp). Biochemical assays show that the RdRp uses the active form of molnupiravir, β-D-N4-hydroxycytidine (NHC) triphosphate, as a substrate instead of cytidine triphosphate or uridine triphosphate. When the RdRp uses the resulting RNA as a template, NHC directs incorporation of either G or A, leading to mutated RNA products. Structural analysis of RdRp–RNA complexes that contain mutagenesis products shows that NHC can form stable base pairs with either G or A in the RdRp active center, explaining how the polymerase escapes proofreading and synthesizes mutated RNA. This two-step mutagenesis mechanism probably applies to various viral polymerases and can explain the broad-spectrum antiviral activity of molnupiravir."

From a quick perusal of this paper, the fact that active form can form either of two tautomers (and therefore base pair with different nucleosides) looks to be critical to its success.

EDT
"This antiviral mechanism is conceptually similar to the recently suggested mutagenesis mode of action of favipiravir47,48, but is entirely distinct from that of remdesivir, which impairs RdRp progression23. However, like remdesivir, molnupiravir escapes viral RNA proofreading because M incorporation and M-directed misincorporation are apparently not recognized by the viral exonuclease18,19. Such proofreading escape may also be due to the stability of the M-G and M-A base pairs, which are predicted not to induce or favor backtracking of RdRp, which is probably required for exposing the RNA 3′ end to the proofreading exonuclease49,50."
 
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Quick question, maybe someone can give me an answer.

I had a J&J shot earlier this year, and I am eligible for a booster of either Moderna or Pfizer.

Any argument to pick one over the other?
 
Large outbreak in hospital setting with 96% vaccinated.

Nosocomial outbreak caused by the SARS-CoV-2 Delta variant in a highly vaccinated population, Israel, July 2021

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.39.2100822#html_fulltext

We present an investigation of a coronavirus disease (COVID-19) outbreak that started from one unidentified COVID-19 patient, with extensive, rapid nosocomial spread among vaccinated, including individuals wearing surgical masks.
...
The calculated attack rate among all exposed patients and staff was 10.6% (16/151) for staff and 23.7% (23/97) for patients, in a population with 96.2% vaccination rate (238 vaccinated/248 exposed individuals).
...
We have investigated a nosocomial COVID-19 outbreak involving the SARS-CoV-2 Delta variant among a highly vaccinated population. The attack rate among exposed individuals reached 23.3% in patients and 10.3% in staff, with 96.2% vaccination rate among exposed individuals. Moreover, several transmissions probably occurred between two individuals both wearing surgical masks, and in one instance using full PPE, including N-95 mask, face shield, gown and gloves.

(Discussion)In a recent publication by Bernal et al., the effectiveness of full vaccination with the Comirnaty vaccine against the Delta variant was high, although lower than against the Alpha variant (88% vs 93.7%) [9]. This was not the experience in Israel, with a rapid increase in cases since June 2021 despite a high vaccination rate [1].
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The Atheist said:
Likely outstanding news here - new drug reduces severe disease & death by half. https://www.stuff.co.nz/world/ameri...s-covid19-hospitalisations-and-deaths-in-half

So good they've aborted the trial and are in the process of asking for approval around the world.
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It is worth remembering the previous trial of this drug was stopped early due to lack of benefit, that study was in hospitalised patients. This study was done in patients with mild disease pre hospital. The absolute risk reduction in hospitalisation was from 14% to 7%. So a 7% absolute risk reduction. Mortality figures were small, 8 in control arm and none in treatment arm. With small numbers of events one has to be careful about over interpreting. This is an interim analysis of the first half of the study with roughly double the number currently in the study. So further results will become available.

The problem is that this drug appears to need administration early to be effective, this means giving to large numbers of people, initially supplies will be limited so I expect it will be rationed, Only given to the highest risk patients on diagnosis if not yet seriously ill. There may be another hospital study planned.
 
Planigale said:
It is worth remembering the previous trial of this drug was stopped early due to lack of benefit, that study was in hospitalised patients. This study was done in patients with mild disease pre hospital. The absolute risk reduction in hospitalisation was from 14% to 7%. So a 7% absolute risk reduction. Mortality figures were small, 8 in control arm and none in treatment arm. With small numbers of events one has to be careful about over interpreting. This is an interim analysis of the first half of the study with roughly double the number currently in the study. So further results will become available.

The problem is that this drug appears to need administration early to be effective, this means giving to large numbers of people, initially supplies will be limited so I expect it will be rationed, Only given to the highest risk patients on diagnosis if not yet seriously ill. There may be another hospital study planned.
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Apparently very expensive too. Dare I say it, but I think I would be interested to see how the Oxford study of ivermectin compares to this result and I’m pretty ivermectin-skeptic to say the least.
 
How it works has to be addressed, sooner or later

At least the mechanism of action makes sense. That was not quite a deal breaker for me regarding ivermectin, but it did not help.
 
Chris_Halkides said:
At least the mechanism of action makes sense. That was not quite a deal breaker for me regarding ivermectin, but it did not help.
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I’be been put off by ivermectin backers given their use of terrible data that has in many cases been shown to be outright fraud and the association with many of its proponents with outright anti-vax cranks. That said, I’ll be interested in the findings of the Oxford study.
 
Puppycow said:
Big news perhaps:

New antiviral is highly effective, study finds, and is stirring hope that COVID-19 could be treated by a pill



The trial was ended earlier than planned because of how strong these results are.


That is like hitting the jackpot. The signal is so clear and strong that the trial can be ended early.
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Since you were the first to poke at this drug...

I think that I'll advise caution for the moment, as a matter of course. There's good reason for hope, but, as far as I understand it, Merck hasn't yet released much in the way of the raw data and nor has the wider medical or scientific community had a chance to review the experiment or findings. How much more important those things are than hype is hard to overstate.
 
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