Coronavirus: How dangerous a threat?

[djpbaltimore]

This is an interesting modeling study. It basically asks which is the best method to distribute vaccine when it is available in limited quantities. This has been discussed before, but this paper adds a more mathematical approach to the discussion. The model assumes a decrease in transmission by the people vaccinated. One key takeaway is that if you want to lower the incidence of the disease, adults 20-49 should get the vaccine. Giving it exclusively to 60+ leads to the lowest decrease in incidence, but the greatest decrease in mortality. That makes sense as the young are the primary spreaders. The question becomes how much value you put in the debilitating medical issues that fall short of death. No easy answers.

It also raises a point about Ab testing. It is not really talked about much, but you would get the most bang for your buck if you don't vaccinate people who would already be expected to have some prior immunity. Remember, this example assumes vaccine scarcity.

AAAS

science.sciencemag.org

Reading this and I still don't see how COVID can be so damaging to their hospitals. They practically have no Flu.

https://twitter.com/i/web/status/1352331361626030082

View: https://twitter.com/rebeccaballhaus/status/1352331361626030082

 

[Koronin]

Just heard a report that the Eli Lily antibody treatment can work as a short term preventative. Basically it seems they are looking to apply for it be used basically where there may be an out break in people who are negative to keep them from getting it over a shorter period of time. They have said it's not an alternative to the vaccine, just a tool to reduce the number getting infected in an out break in a closed area like nursing homes.

Side note for those who were paying attention to my update on my husband. He had another scan today and met with the doctor he's been assigned as the hospital plus a second doctor who is helping with his case. The mas in the lungs is about a quarter of the size it originally was and the lymph nodes have shrunk except for a few in the chest area where the mass still is. At this point they told him he has less than a 10% likelihood of cancer. Now that they know he whole story, they are sure it's either an allergic reaction or that plus a chemical reaction to something at the hospital he's working at. So they are keeping him out of work for a short time longer and getting him in with a specialist to figure that out and get him back to work. Finally some good news.

 

[Cookster15]

The question becomes how much value you put in the debilitating medical issues that fall short of death.

According to World-O-Meter, nearly 98 Million cases recorded worldwide. About 25 Million active cases of which only 0.4% are listed as serious.

Are we saying a large number of people with no serious symptoms end up with serious debilitating medical issues? I've asked before and will ask again, how many who are positive with Covid-19 end up with debilitating medical issues? I think it would be less than 1% ? The answer is important.

The other point you raise is this ...

Giving it exclusively to 60+ leads to the lowest decrease in incidence, but the greatest decrease in mortality. That makes sense as the young are the primary spreaders

Apologies if this has been dealt with upthread but I assume the young are the primary spreaders simply because they don't think they will get seriously ill so still undertake risky activities? But I do think the strategy is right to vaccinate the elderly first then get to the younger as a lower priority.

 

[djpbaltimore]

According to World-O-Meter, nearly 98 Million cases recorded worldwide. About 25 Million active cases of which only 0.4% are listed as serious.

Are we saying a large number of people with no serious symptoms end up with serious debilitating medical issues? I've asked before and will ask again, how many who are positive with Covid-19 end up with debilitating medical issues? I think it would be less than 1% ? The answer is important.

Apologies if this has been dealt with upthread but I assume the young are the primary spreaders simply because they don't think they will get seriously ill so still undertake risky activities? But I do think the strategy is right to vaccinate the elderly first then get to the younger as a lower priority.

I imagine that is probably about right. You have to imagine there is at least one person who survives with a lasting debility for every one who dies and the IFR is about 0.5%. The lung scans are the part that suggests that there might be more than that. But, it remains to be seen whether that is short term damage or is more permanent.

The young also tend to be more mobile, cohabitate in close quarters, and work in public facing jobs. But the care free attitude espoused by many and the socialization that results is also part of that.

Re-upping what I mentioned earlier that vaccines are still working and should continue to do so for the medium term despite the headlines you read or what you might hear about the variants. Do not give up on vaccination! The info is from Fauci's press conference.

https://twitter.com/i/web/status/1352370845667082241

View: https://twitter.com/EricTopol/status/1352370845667082241

 

[roundabout]

0.4% is a snapshot of one point in time.

Data on how many people have been hospitalized in total (not the number of current people in hospital) is actually hard to find. I have only found it for one country and number of people who have received or are currently receiving hospital care is 6% of the total detected cases.

 

[Koronin]

It appears California is satisfied with their safety review and are releasing the 300,000 doses (batch) of Moderna that were put on hold for a short time.

https://www.yahoo.com/finance/news/moderna-covid-19-vaccine-batch-064414183.html

 

[Koronin]

One other note is that it appears the Eli Lily antibody treatment dose also work as a short term preventative (not vaccine). It appears that it can help to slow out breaks and that appears to be what they are going to ask for approval for it as a preventative.

https://www.yahoo.com/news/more-hope-nursing-home-residents-180430169.html

 

[Merckx index]

Data on how many people have been hospitalized in total (not the number of current people in hospital) is actually hard to find. I have only found it for one country and number of people who have received or are currently receiving hospital care is 6% of the total detected cases.

I don't know what your one country is, but for the U.S., the rate is very similar, about 5.3% of cases, or 0.36% of the population. The total is more than 1.2 million now, The data are hard to find. Most states report hospitalizations, but about a dozen of them don't report cumulative totals.

 

[movingtarget]

Hungary breaks ranks with EU to license Russian vaccine

Order of Sputnik V comes after Viktor Orbán criticises slow speed of EU vaccine distribution

www.theguardian.com

 

[movingtarget]

'Freedom': UK Covid patient returns home after 306 days in hospital

Geoffrey Woolf was admitted in March and his three sons were called in to say their goodbyes

www.theguardian.com

 

[movingtarget]

EU's Covid vaccination debacle is down to institutional inflexibility

Supply delays underline there was no legal or economic justification for central planning

www.theguardian.com

 

[Cookster15]

0.4% is a snapshot of one point in time.

Data on how many people have been hospitalized in total (not the number of current people in hospital) is actually hard to find. I have only found it for one country and number of people who have received or are currently receiving hospital care is 6% of the total detected cases.

I’ve been keeping track on the stats since this started - World-O-Meter. It has always been below 2% serious globally. I think the ratio of serious cases has eased as the disease became better understood and medical people adapted and improved. For example what happened in Italy was learned from globally.

 

[Koronin]

Apparently Pfizer is saying they can update their vaccine for vaccine resistant variants of Covid in about 6 weeks.

My guess is that once most of us are vaccinated we'll eventually need boosters for a few of the variants.

https://www.yahoo.com/news/vaccines-may-not-well-against-001116055.html

 

[Jagartrott]

EU's Covid vaccination debacle is down to institutional inflexibility

Supply delays underline there was no legal or economic justification for central planning

www.theguardian.com

This is mostly BS. The EU didn't want to bet on one or two horses, which is a correct strategy. By now, the EU has acquired 600 million doses of Pfizer's vaccine, all delivered in 2021, which on its own would already enable to vaccinate more than 80% of EU's adults. In Germany, people are apparently angry that 'their' vaccine does not allow them to vaccinate Germans faster than any other nation. That's not how it works. Central planning is essential. You don't want Lithuania to be in a bidding war with Germany etc. Things would get nasty real soon that way.

Edit: also, logistically, the Pfizer vaccine is the least appealing of all options - difficult transport, storage, expensive and 2 doses. If other vaccines are greenlighted with similar efficacy but easier to handle (and cheaper), those will be the preferred choice.

 

[movingtarget]

WHO platform for pharmaceutical firms unused since pandemic began

Exclusive: Covid-19 ‘pool’ to share information has received no contributions since May 2020

www.theguardian.com

 

[Jagartrott]

Google translated article:


Scientists have a better understanding of what goes wrong in severely ill covid patients' lungs

The results of a study into the violent immune response of the own body in covid patients are interesting in light of the search for new drugs.

It is now known that patients who endure a severe form of covid-19 have to deal with a violent immune response of their own body. Additional research was needed to better understand what exactly goes wrong in the immune system of those patients.

The Leuven study therefore examined the lung fluid of 44 patients. 'We immediately saw in the lung fluid that monocytes (white blood cells that are produced in the bone marrow) Are the basis of a violent inflammatory reaction,' says Professor Diether Lambrechts, associated with VIB and KU Leuven. 'Moreover, those monocytes fail to convert into another type of immune cells, called macrophages. The runaway monocytes thus cause further inflammatory damage in the lung, resulting in irreparable scarring. The conversion from monocyte to macrophage is successful in patients with a mild form of the disease, where the macrophages help to clean up dead and infected cells and to form antibodies. '

The analyzes of the lung fluid also showed that other immune cells, such as the T cells and B cells, no longer function in their usual way. Some T cells can no longer develop sufficiently in seriously ill corona patients, while other T and B cells are over-activated, causing them to become exhausted and no longer effective. That is one of the reasons that patients often have difficulty recovering from the disease: T and B cells are necessary to overcome the virus.

'We now have a better understanding of what goes wrong in critically ill covid-19 patients. The data we collected is also unique: we are currently investigating the lung fluid of the largest group of covid-19 patients with pneumonia, 'says Professor Els Wauters, lung specialist at UZ Leuven. 'We can say that our results are very relevant worldwide.'

For the time being critically ill patients seem to benefit only from blood thinners, anti-inflammatory drugs such as dexamethasone and, in the very early phase, also remdesivir.

The results of the study were published in the scientific journal Cell Research.

 

[search]

In Germany, people are apparently angry that 'their' vaccine does not allow them to vaccinate Germans faster than any other nation. That's not how it works. Central planning is essential. You don't want Lithuania to be in a bidding war with Germany etc. Things would get nasty real soon that way.

there may be some that hold a "Germany first" kind of opinion, but in general, that's not what the discussion is about over here. It's more generally about the way things were handled, and why no one insisted on ordering more doses (as Biontech offered double the amount to the EU), although it was long known to be the most promising project for the moment. Apparently, intially the EU still didn't want to pre-order mRNA vaccines at all, because of the high price.

Of course, countries which can not handle that kind of vaccine anyway shouldn't be forced to take (and pay for) them, but then a "same for everyone" kind of approach may just not be the right one. Germany co-financed the development of the Biontech vaccine with 375 million Euro from state funds, so if the EU didn't want it, some kind of preemption wouldn't have sound completely unreasonable to me.

 

[hrotha]

I found The Guardian's article quite puzzling. I'm not sure how exactly vaccination is going elsewhere in the EU, but in Spain at least the supply hasn't been a bottleneck, and most regions have struggled to use up all their allocated vaccines. And I've seen charts where Spain was among the EU countries with the best vaccination ratios. The supply delay is obviously well documented and it has created problems, especially now that vaccination is speeding up as the procedures get more efficient, but still.

 

[search]

I found The Guardian's article quite puzzling. I'm not sure how exactly vaccination is going elsewhere in the EU, but in Spain at least the supply hasn't been a bottleneck, and most regions have struggled to use up all their allocated vaccines. And I've seen charts where Spain was among the EU countries with the best vaccination ratios. The supply delay is obviously well documented and it has created problems, especially now that vaccination is speeding up as the procedures get more efficient, but still.

I can only speak for Germany as well, but as I mentioned the other day, in most parts of the country there currently are no vaccinations anymore due to a lack of supply - and we are just talking about mobile teams vaccinating residents of retirement homes and some high-risk staff. ~ 400 designated vaccination centers in most major cities were built at the end of the year, and are ready to start since mid-December, but almost all are still closed.

 

[Jagartrott]

Supply is definitely a bottleneck here. Our government wants to guarantee the second dose, like for example Norway also does but Denmark doesn't. This means we have to always keep those vaccines in reserve, as we cannot trust Pfizer's delivery schedule. The result is a vaccination rate of 1.8% yesterday, while Denmark has >3%.

Dashboard Covid Vaccinaties België

Actuele corona vaccinatie cijfers voor België in een overzichtelijk dashboard. Dagelijks geüpdatet en onderhouden door vrijwilligers.

covid-vaccinatie.be

Regional vaccination centres will be ready by the beginning of February. There was no need for them up to now, as first it's care homes and hospitals, so all these vaccinations take place on the spot. If we would've had more vaccines, the centres would've been operational earlier.

 

[roundabout]

I’ve been keeping track on the stats since this started - World-O-Meter. It has always been below 2% serious globally. I think the ratio of serious cases has eased as the disease became better understood and medical people adapted and improved. For example what happened in Italy was learned from globally.

Not sure if this has been posted here before

Almost 30% of Covid patients in England readmitted to hospital after discharge – study

Readmission rate for Covid patients 3.5 times greater, and death rate seven times higher, than for other hospital patients

www.theguardian.com

A total of 47,780 individuals who had a hospital episode between 1 January 2020 and 31 August 2020 with a primary diagnosis of Covid-19 were compared with a control group who did not have Covid-19.

Of the 47,780, 29.4% were readmitted within 140 days of discharge and 12.3% died. The rate of readmission was 3.5 times greater, and the death rate seven times higher, than those in the control group, the researchers found.

And then there is this

Long Covid alarm as 21% report symptoms after five weeks

Official UK data suggests nearly 10% still have symptoms 12 weeks after infection

www.theguardian.com

So I do fear that it's more than 1% of cases that have serious lasting medical issues

 

[Koronin]

This is mostly BS. The EU didn't want to bet on one or two horses, which is a correct strategy. By now, the EU has acquired 600 million doses of Pfizer's vaccine, all delivered in 2021, which on its own would already enable to vaccinate more than 80% of EU's adults. In Germany, people are apparently angry that 'their' vaccine does not allow them to vaccinate Germans faster than any other nation. That's not how it works. Central planning is essential. You don't want Lithuania to be in a bidding war with Germany etc. Things would get nasty real soon that way.

Edit: also, logistically, the Pfizer vaccine is the least appealing of all options - difficult transport, storage, expensive and 2 doses. If other vaccines are greenlighted with similar efficacy but easier to handle (and cheaper), those will be the preferred choice.

I've heard that J&J is planning on submitting their trial data to both the FDA and EU once they have it all put together. This is the most recent update I've seen on that one.

Potential 'game-changer': Hopes high for Johnson & Johnson COVID vaccine if authorized

Results are expected soon for Johnson & Johnson's experimental COVID vaccine. Its single dose and simple storage make it much easier to use.

www.northjersey.com

There's this from a European review of the phase 1 and 2 trial data for the J&J vaccine:

Johnson & Johnson’s COVID-19 vaccine safely elicits an immune response

An interim data analysis shows 90 percent of 18-55 year olds had a neutralising antibody response to the vaccine that lasted over two months.

www.europeanpharmaceuticalreview.com

 

[Jagartrott]

I found The Guardian's article quite puzzling. I'm not sure how exactly vaccination is going elsewhere in the EU, but in Spain at least the supply hasn't been a bottleneck, and most regions have struggled to use up all their allocated vaccines. And I've seen charts where Spain was among the EU countries with the best vaccination ratios. The supply delay is obviously well documented and it has created problems, especially now that vaccination is speeding up as the procedures get more efficient, but still.

On the news feed of The Guardian on Spain (the first part was about officials jumping the queue):

Nursing home residents and staff, as well as first-line health workers, are currently receiving jabs as priority groups in the national vaccination plan. The rollout is suffering delays due to a shortage of deliveries by Pfizer/BioNTech, currently the main supplier of vaccines.

Having administered over 86% of the 1.1m vaccine doses received, several regions have halted new vaccinations until fresh supplies arrive.

 

[Koronin]

On the news feed of The Guardian on Spain (the first part was about officials jumping the queue):

Nursing home residents and staff, as well as first-line health workers, are currently receiving jabs as priority groups in the national vaccination plan. The rollout is suffering delays due to a shortage of deliveries by Pfizer/BioNTech, currently the main supplier of vaccines.

Having administered over 86% of the 1.1m vaccine doses received, several regions have halted new vaccinations until fresh supplies arrive.

The bolded part is also happening in places in the US. At this point it appears manufacturing/supply seems to be a bigger issue than anything else. That is likely to be a more difficult issue to solve.

 

[movingtarget]

Covid vaccines: what are the implications of new variants of virus?

UK, South Africa and Brazil variants indicate changes may be needed

www.theguardian.com