Corona virus general questions mega thread

[Danijel Gorupec]

2 hours ago, gib65 said:

I don't get the strategy the world is using to fight COVID19. I get that social distancing and social isolation are ways to reduce the chances of catching and spreading COVID, but what's the ultimate goal? Are we trying to eradicate the virus? Prolong the eventuality of catching it? Are we waiting for a vaccine? What's the criteria for considering the pandemic over so that we can resume our lives?

...

I share your concerns and thinking. We discussed some of it even in this thread and it seems that the plan is "slow down the spread of the disease and hope for a cure/vaccine". I am not sure if this can be called a 'plan' at all as it includes the 'hope for' component.

As I see it, there are two general strategies governments are going for:

a) keep the spread as low as possible; wait for cure/vaccine... This is a bet that cure/vaccine will be found quickly. If cure/vaccine is indeed found quickly, this will save most lives. However it imposes heavy toll on economy and might only be possible for a short time. Some countries that started this way are already reconsidering.

b) keep the spread within tolerable levels; increase capacity of hospital system; wait for cure/vaccine... This is a bet that cure/vaccine will only be found after some time. Disruption of economy is lower and can be tolerated longer. I think that this is a more complex strategy and would be difficult in some societies (it depends a lot on citizen discipline; police enforcing is not that effective).

We cannot eradicate the virus any more by quarantining people or by social distancing.

As far as I know, no country is implementing a 'plan' that does not include finding the cure/vaccine eventually. The 'heard immunity' plan may take too long to realize (countries may not be capable to increase its hospital capacity ten fold and speed up the process). Even if the number of cases is 50 times more than is reported, the 'heard immunity' is not close yet (Italy has 200 thousands confirmed; say, 10 million infected. But it needs about 40 million for 'heard immunity'. So, one more year of current heavy measures). And this only if we bet that the 'heard immunity' is possible.

If the cure/vaccine is not available in 1-2 years, I think we will simply learn to live with the disease. The average life-span might shorten a bit.

If the vaccine is found sooner, it should be administered by priority (it might also depend how rich is your country). Medical staff is probably first to be vaccinated. Seniors too... But even knowing that there is a cure/vaccine, will cause a relaxation of measures before the cure is available to general population.

 

[J.C.MacSwell]

First of all good post and graphics gib65.

Keep in that your second graphic, while far less ideal, is still orders of magnitude better than a third one where everyone was free to contact anyone and freely move anywhere they like.

 

Edited April 26, 2020 by J.C.MacSwell

[gib65]

Thanks for the replies everyone.

So what's involved in creating a vaccine?

Also, CharonY said that the number of deaths would be much higher if we were to "rip the bandage off now". I can see how the death rate would be higher, but why the absolute number of deaths. Is a virus that spreads slowly less deadly than a virus that spreads quickly?

[zapatos]

28 minutes ago, gib65 said:

Thanks for the replies everyone.

So what's involved in creating a vaccine?

Also, CharonY said that the number of deaths would be much higher if we were to "rip the bandage off now". I can see how the death rate would be higher, but why the absolute number of deaths. Is a virus that spreads slowly less deadly than a virus that spreads quickly?

The idea is to not overwhelm the healthcare systems so that they can save as many lives as possible. If we infect everyone in a short period of time the healthcare systems will have more patients than they can handle, and the absolute number of deaths will be higher.

In addition, some will be infected and die who might otherwise have received a future vaccine if the infection rate was slowed.

And of course there is testing. When we do finally get up to speed we can better track who has been exposed and quarantine them before they are able to infect others.

[J.C.MacSwell]

Presumably radiation from whatever part of the spectrum could be introduced to the surfaces of the lungs or upper respiratory tract...

It (higher end of spectrum) has been used to combat lung cancer, I expect with the intention of damaging cancer cells more than healthy ones to gain benefits, and of course we all have essentially black body radiation in our lungs "centred" at somewhere between ambient temperatures and 37C, or slightly higher with fever.

The physical placement of any emitting device can't be any more invasive than intubation for ventilation. (the air is also sometimes heated during ventilation)

Has this ever been attempted as a therapy for any flu like disease? Any reason to expect more benefit than side effects for the most beneficial regimens? 

(the fact that Trump's "spitballing" made me think of this is irrelevant to the questions)

I doubt it would help produce melatonin or vitamin D, as does sunlight exposure to the skin, but are there any plausible benefits that could be expected?

[Alex_Krycek]

Some interesting analysis of Hydroxychloroquine data from Roger Seheult, MD.  Seems the jury is still out on the efficacy of the drug.  (Hydroxychloroquine segment starts at 5:43)  Seheult has advocated from the beginning that a randomized, double blind trial is needed to see if HC works or not.  

 

 

[CharonY]

I think the need was never in question (as well as for the other treatments). Due to the ongoing situation, often the designs are less than optimal and/or part of emergency/mercy treatments. 

22 hours ago, J.C.MacSwell said:

Presumably radiation from whatever part of the spectrum could be introduced to the surfaces of the lungs or upper respiratory tract...

I have a hard time imagining how it would work. Most of the viral particles are not just sitting on tissue, but are inside the cells (or after leaving cells would circulate). I would assume radiation that is damaging to them, would also be harmful (probably more so) to live tissue. After exiting they also disseminate via body fluids so point sterilization does not seem to be the right strategy to me.

[J.C.MacSwell]

1 hour ago, CharonY said:

I think the need was never in question (as well as for the other treatments). Due to the ongoing situation, often the designs are less than optimal and/or part of emergency/mercy treatments. 

I have a hard time imagining how it would work. Most of the viral particles are not just sitting on tissue, but are inside the cells. I would assume radiation that is damaging to them, would also be harmful (probably more so) to live tissue. After exiting they also disseminate via body fluids so point sterilization does not seem to be the right strategy to me.

Thanks CY. Radiation does penetrate below the surface to some extent (extent depending on wavelength), but I expect your thinking is correct.

[swansont]

15 hours ago, J.C.MacSwell said:

Thanks CY. Radiation does penetrate below the surface to some extent (extent depending on wavelength), but I expect your thinking is correct.

Inside the lungs even surface-level effects will be damaging. Radiation that only penetrates the top level of cells has been tested (this came up here or in a related thread) - it's in the deep UV. In one sense it's like alpha radiation. Externally not a problem because it's attenuated by the top layer of cells, but very damaging if ingested/inhaled. You would, in effect, be getting a sunburn inside your lungs.

[J.C.MacSwell]

7 minutes ago, swansont said:

Inside the lungs even surface-level effects will be damaging. Radiation that only penetrates the top level of cells has been tested (this came up here or in a related thread) - it's in the deep UV. In one sense it's like alpha radiation. Externally not a problem because it's attenuated by the top layer of cells, but very damaging if ingested/inhaled. You would, in effect, be getting a sunburn inside your lungs.

So as you reduce the intensity and/or frequency, is there potentially a point of more good than harm before it becomes simply negligible in effect either way?

Presumably the expectation is that this would be unlikely?

What effect would a relative drying out of the lungs have? This doesn't necessarily have to fight the virus directly but if it reduced the conditions promoting pneumonia (viral or bacterial) that would be a potential benefit.

I'm not arguing for it but just trying to understand it. I have no reason to expect it to be beneficial other than it would create different conditions (generally this is likely to be detrimental), and that it has had some limited success with lung cancer.

[MigL]

Anything that damages ( in any way ) the lining of the lungs will lead to chronic pulmonary fibrosis.
IE scarring and thickening of the lining, making respiration more difficult ( pneumonia ), and impossible in extreme cases ( you die ).
Heavy doses of steroids taken concurrently/subsequently may alleviate some of the effect, but steroids have their own issues.

[swansont]

2 hours ago, J.C.MacSwell said:

So as you reduce the intensity and/or frequency, is there potentially a point of more good than harm before it becomes simply negligible in effect either way?

Outside of my area of expertise, but unless the tissue is coated with whatever you’re trying to kill, I’d guess “no”

 

 

[StringJunky]

2 hours ago, J.C.MacSwell said:

So as you reduce the intensity and/or frequency, is there potentially a point of more good than harm before it becomes simply negligible in effect either way?

Presumably the expectation is that this would be unlikely?

What effect would a relative drying out of the lungs have? This doesn't necessarily have to fight the virus directly but if it reduced the conditions promoting pneumonia (viral or bacterial) that would be a potential benefit.

I'm not arguing for it but just trying to understand it. I have no reason to expect it to be beneficial other than it would create different conditions (generally this is likely to be detrimental), and that it has had some limited success with lung cancer.

I would think moisture would be needed on the alveoli surfaces to permit gas exchange.

[CharonY]

8 hours ago, J.C.MacSwell said:

What effect would a relative drying out of the lungs have? This doesn't necessarily have to fight the virus directly but if it reduced the conditions promoting pneumonia (viral or bacterial) that would be a potential benefit.

It would most likely damage lung tissue more. Remember, in the lung all the lining are living cells, unlike skin, which has a protective layer of dead cells. As such physical treatment has an immediate effect on tissue health and integrity.

In case of cancer, the goal is to introduce tissue damage, with the hope that cancerous tissue is destroyed faster than the rest. In case of viral particles the issue is more whether you do more damage to the tissue than to the viral particles, which in turn might continue to proliferate and penetrate more as lung tissue degrades.

[Joeb]

I’m not a biology or immunology student or professional. I have a question that I hoped someone could help me understand that does know microbiology/immunology.

In relationship to finding an “answer” to sars-Cov-2, if the millions of people who have been infected and recovered, as well as what appears to be tens of millions who have been infected and recovered with evidence mounting of that nature through serology antibody testing, my question is about antibodies and B memory cells.

If it’s true that antibodies and memory cells can equip an immune system to fight the infection, and it’s true that with most all other viruses including other corona viruses, these antibodies and memory cells will offer a level of immunity short term as well as longer term memory so that reinfection isn’t as severe.

Is there any reason that antibodies and memory cells can’t be taken from the  plasma of recovered people and not only given to the currently ill to mount a recovery,  BUT also given to those who are not ill in order to give everyone a leg up on short term “herd immunity” ?

Just simple logic seems like such an approach could have similar effects to that of a vaccine, if you equip everyone’s immune system with antibodies and memory cells from those who have recovered, would this not stop the spread of the virus rather quickly even if the effects weren’t as long lasting as ones own body producing the antibodies by way of infection or vaccine, could this elicit any layer of immune protection in people enough that it could stop the rampant spread of the disease?

Its something I wanted to find a place to ask, where people who know biology and immunology might be able to answer, and that brought me to this site, I appreciate any input or response greatly.

Just seems like if there is so much time needed to develop therapeutics and a vaccine, couldn’t plasma from recovered patients be a viable short term answer to stopping the spread if synthesized on massive levels and given not only to the ill but to everyone to help stop the spread quickly and give everyone’s immune system a leg up on a novel virus? 

[StringJunky]

46 minutes ago, Joeb said:

I’m not a biology or immunology student or professional. I have a question that I hoped someone could help me understand that does know microbiology/immunology.

In relationship to finding an “answer” to sars-Cov-2, if the millions of people who have been infected and recovered, as well as what appears to be tens of millions who have been infected and recovered with evidence mounting of that nature through serology antibody testing, my question is about antibodies and B memory cells.

If it’s true that antibodies and memory cells can equip an immune system to fight the infection, and it’s true that with most all other viruses including other corona viruses, these antibodies and memory cells will offer a level of immunity short term as well as longer term memory so that reinfection isn’t as severe.

Is there any reason that antibodies and memory cells can’t be taken from the  plasma of recovered people and not only given to the currently ill to mount a recovery,  BUT also given to those who are not ill in order to give everyone a leg up on short term “herd immunity” ?

Just simple logic seems like such an approach could have similar effects to that of a vaccine, if you equip everyone’s immune system with antibodies and memory cells from those who have recovered, would this not stop the spread of the virus rather quickly even if the effects weren’t as long lasting as ones own body producing the antibodies by way of infection or vaccine, could this elicit any layer of immune protection in people enough that it could stop the rampant spread of the disease?

Its something I wanted to find a place to ask, where people who know biology and immunology might be able to answer, and that brought me to this site, I appreciate any input or response greatly.

Just seems like if there is so much time needed to develop therapeutics and a vaccine, couldn’t plasma from recovered patients be a viable short term answer to stopping the spread if synthesized on massive levels and given not only to the ill but to everyone to help stop the spread quickly and give everyone’s immune system a leg up on a novel virus? 

This is happening:

Quote

As part of the national research effort against coronavirus, we are leading a programme to collect convalescent blood plasma from people who have recovered from COVID-19.

There is some evidence globally that COVID-19 patients may benefit from being given convalescent plasma. However, the safety and effectiveness of convalescent plasma transfusions needs to be confirmed by robust clinical trials.

We are recruiting people who have recovered from a confirmed case of coronavirus or had symptoms to donate plasma (convalescent plasma) at our main 23 blood centres. 

This plasma is planned for use in a number of national COVID-19 clinical trials, and if successful, widespread use as a treatment in hospitals.

https://www.nhsbt.nhs.uk/covid-19-research/plasma-programme/

 

Edited May 3, 2020 by StringJunky

[Phys1]

There is a lot of investigations now regarding the links between obesity and covid-19 as I heard on itv3 today. 

[Phys1]

2 hours ago, Phys1 said:

There is a lot of investigations now regarding the links between obesity and covid-19 as I heard on itv3 today. 

I posted in April 19 a question about the links of Covid-19 and Obesity. Sorry I do not know how to quote it here. It is on page 16 of this forum section.

Edited May 5, 2020 by Phys1

[CharonY]

7 hours ago, Phys1 said:

There is a lot of investigations now regarding the links between obesity and covid-19 as I heard on itv3 today. 

Yes there is a high prevalence of obese folks among the hospitalized folks. It is likely that obesity puts a strain on the cardiovascular system. However, there are also reports of many folks just being overweight, here it is a bit more difficult as in many countries there are a lot of overweight folks and it may be difficult to figure out whether the connection is spurious or not.

[studiot]

5 hours ago, Phys1 said:

I posted in April 19 a question about the links of Covid-19 and Obesity. Sorry I do not know how to quote it here. It is on page 16 of this forum section.

Obesity is a large risk factor for many medical conditions, both physical and mental.

So it is surely not a surprise that a virus that attacks so many different parts of the body should be especially harmful in obese persons.

[invasive-feces]

Anyone hear of cases in which persons may be tested for multiple virus infections concurrently?

E.g. Let's say I got the seasonal flu and then COVID-19.

How common are multiple (concurrent) viral infections? 

[invasive-feces]

3 hours ago, invasive-feces said:

Anyone hear of cases in which persons may be tested for multiple virus infections concurrently?

E.g. Let's say I got the seasonal flu and then COVID-19.

How common are multiple (concurrent) viral infections? 

Let clarify a bit. Most species -- incl. scientists -- are probably walking around with multiple (non-serious) viral infections, day in day out.

Supposedly, 90% of humans are herpes positive. 

That said, if a person with a seasonal flu also contracted COVID-19, how could you tell which virus was causing which symptoms? For all the cases of COVID-19 tested, were the subjects ALSO tested for other viruses? 

 

[CharonY]

I suspect the question is aimed at respiratory disease. I believe it has been asked and answered a few times, though knowledge is of course evolving. There are handful of studies who have tested COVID-19 positive patients for e.g. influenza, other coronaviruses an so on. In one study from Wuhan the co-infection rate was about 20%. In other regions such as Italy I have seen some higher estimates but with fewer tests. The general consensus seems to be that it co-testing does not change clinical practice and is probably not terribly helpful with few exemptions. 

[invasive-feces]

2 hours ago, CharonY said:

I suspect the question is aimed at respiratory disease. I believe it has been asked and answered a few times, though knowledge is of course evolving. There are handful of studies who have tested COVID-19 positive patients for e.g. influenza, other coronaviruses an so on. In one study from Wuhan the co-infection rate was about 20%. In other regions such as Italy I have seen some higher estimates but with fewer tests. The general consensus seems to be that it co-testing does not change clinical practice and is probably not terribly helpful with few exemptions. 

Say an elderly person shows up at the hospital with a moderate case of pneumonia. Assume this occurs during the current pandemic in a state like Calif. That person -- because of his symptoms -- is tested for CV. And, yes, he tests positive for CV.  But the person shows NO OTHER Covid-19 symptom. That is, the person is asymptomatic (or mildly symp) for CV, but is suffering from another  respiratory disease. Maybe, given the man's age, the pneumonia will kill him. But the COD may be reported as CV19.

Hypothesis on this scenario ... how common it may be?

EDIT: I just scrolled a few pages back in this thread and found the co-infection topic already discussed; 

 

On another note, might deliberately co-infecting the COVID-19 patient with another virus (say common cold) help somehow with build up of COVID-19  antibodies? Has anything like this been investigated?

 

 

Edited May 6, 2020 by invasive-feces

[CharonY]

2 minutes ago, invasive-feces said:

Say an elderly person shows up at the hospital with a moderate case of pneumonia. Assume this occurs during the current pandemic in a state like Calif. That person -- because of his symptoms -- is tested for CV. And, yes, he tests positive for CV.  But the person shows NO OTHER Covid-19 symptom. That is, the person is asymptomatic (or mildly symp) for CV, but is suffering from another  respiratory disease. Maybe, given the man's age, the pneumonia will kill him. But the COD may be reported as CV19.

Hypothesis on this scenario ... how common it may be?

Most studies focus on COVID-19 but looking at the papers it does not appear to be common at all. The reason mostly being that in mildly symptomatic cases the person still would be positive, though one can probably not be absolutely certain which virus is the actual cause (or their relative contribution). After all symptoms for infections of lower respiratory tracts are very similar.

The only other thing I can think of are infection with bacteria, which often indicates treatment with antibiotics. But at this point we are looking at more serious symptoms.