Coronavirus: What questions do you have?

[cwbullet]

The whole saving grace about Covid was that the young were scarcely affected, but now there's an article saying that young patients are experiencing more serious complications from Delta. I realize it's early in the curve but what are you seeing, Chuck?
EDIT: here's the link: Young, unvaccinated people are being hospitalized with Covid-19 as delta variant spreads, officials warn (nbcnews.com)

I am seeing more young folks admitted and ventilated. I have low numbers thus far, but this is the fastest I have seen the ICUs fill.

I am interested to see more data. It is not scientific, but our sister facilities are seeing the same.

I think the article from the news is accurate and it makes sense because the young have been resistant to immunizations.

 

[Cl(VII)]

Chuck, what are you seeing on the ground regarding the little folks? I have a 10 yo who obviously can't be vaccinated yet, and he started back to school today. 4 of 22 students plus the teacher in his class wore masks. Fortunately, he is not one to care about being different, but that is a worrisome concentration of petri dishes in a small room with a 4% vaccination rate.

 

[OverTheTop]

We are seeing a spike in Queensland (13 cases today) and more than half of the new cases are under 9 years old.
https://9now.nine.com.au/a-current-...students/52a24389-8ff0-426d-bd4b-f68c7d7aff27

 

[NOLA_BAR]

11,109 new cases reported today (weekend total). Over 2,000 were children.

https://www.theadvocate.com/baton_r...cle_1dae7910-f3ba-11eb-9b6c-734432970ae6.html

 

[cwbullet]

Chuck, what are you seeing on the ground regarding the little folks? I have a 10 yo who obviously can't be vaccinated yet, and he started back to school today. 4 of 22 students plus the teacher in his class wore masks. Fortunately, he is not one to care about being different, but that is a worrisome concentration of Petri dishes in a small room with a 4% vaccination rate.

The good news is that we do know that children are very resilient and are less likely to become seriously ill. We do know that the delta variant appears to cause symptoms in younger folks (no specifics on ages). We do not know the long-term effects of COVID infections in any age group. I am concerned for all of our children but my children would be in school. My son, who is 22, starts back in college a week from Friday - fingers crossed.

 

[cwbullet]

We are seeing a spike in Queensland (13 cases today) and more than half of the new cases are under 9 years old.
https://9now.nine.com.au/a-current-...students/52a24389-8ff0-426d-bd4b-f68c7d7aff27

This will burn itself out again. I tested 120+ with over 1/4 positive. Another 10 or so have RSV. There are a lot of infections in the air and it is hammering the public.

 

[cwbullet]

11,109 new cases reported today (weekend total). Over 2,000 were children.

https://www.theadvocate.com/baton_r...cle_1dae7910-f3ba-11eb-9b6c-734432970ae6.html

Vaccination, Masks, and social distancing are all we have to combat this. I had a lady in public spouting off that the vaccine does not work because people are still getting sick. That just shows her lack of intelligence in the area. Some folks either refuse to accept the facts or have their own agenda. I thought to stop and explain but she would not grasp the concept of what vaccines do and don't do.

 

[Tech 68]

Question for you, Chuck...
My wife and I got both the Moderna shots back in February or so (I had asked you about "Moderna arm" at the time), we're both early seventies.
What's the latest on follow-up/"booster" shots? Have you heard anything definite?

 

[tab28682]

Modera has a new trial underway for a booster vaccine. My daughter, who was in the initial Moderna trial, is one of 800 participants in this new trial. Each person gets either 50 micrograms or 100 micrograms of the new vaccine. Dose size unknown to the participant.

My daughter indicated that this booster is supposed to be more effective against variants.

Chuck, have you heard of any other booster trials?

 

[Marc_G]

I've got one too, Chuck!

My wife and I just got back our covid antibody lab test results (run by Labcorp), and I scored 2047 u/ml, and she got 354 u/ml. So, both positive (anything greater than 0.8 u/ml is positive).

She was vaxxed in early April with the J&J shot; I got the two dose Pfizer shots with the second shot also being in April.

I understand that "more antibodies are better" but what are you seeing in terms of translating u/ml into actionable insights? My wife has a complicated health history and gets sick easily. She is going to talk to her doctor to see if her doc would recommend a "booster" of Pfizer at this time, if that is even possible, or enrolling (again, if possible) in an NIH mix-n-match trial.

The source of our concern comes from multiple reports that J&J is less protective against Delta; whether this is due to it being just one shot or something specific to the J&J methodology is unclear.

Is there any evidence out there supporting or disproving that for the antibody concentration tests, "hundreds is good, but thousands is definitely better?" Maybe you've come across some data relating antibody titer to likelihood to get subsequent infection? (Yeah, I'm reaching here!!).

Any insights appreciated; while she will take any actions based on her doctor's guidance, I'm trying to get my wife as much info as possible to have a productive discussion with her.

 

[cwbullet]

Question for you, Chuck...
My wife and I got both the Moderna shots back in February or so (I had asked you about "Moderna arm" at the time), we're both early seventies.
What's the latest on follow-up/"booster" shots? Have you heard anything definite?

No definite on boosters but it is probably likely.

the question is if the new classes of vaccines are released first.

 

[cwbullet]

Modera has a new trial underway for a booster vaccine. My daughter, who was in the initial Moderna trial, is one of 800 participants in this new trial. Each person gets either 50 micrograms or 100 micrograms of the new vaccine. Dose size unknown to the participant.

My daughter indicated that this booster is supposed to be more effective against variants.

Chuck, have you heard of any other booster trials?

There is a Moderna, Pfizer, and another shot in trials. The question is which will be approved first. You might be able decided which on to get. More to come.

 

[cwbullet]

I've got one too, Chuck!

My wife and I just got back our covid antibody lab test results (run by Labcorp), and I scored 2047 u/ml, and she got 354 u/ml. So, both positive (anything greater than 0.8 u/ml is positive).

She was vaxxed in early April with the J&J shot; I got the two dose Pfizer shots with the second shot also being in April.

I understand that "more antibodies are better" but what are you seeing in terms of translating u/ml into actionable insights? My wife has a complicated health history and gets sick easily. She is going to talk to her doctor to see if her doc would recommend a "booster" of Pfizer at this time, if that is even possible, or enrolling (again, if possible) in an NIH mix-n-match trial.

The source of our concern comes from multiple reports that J&J is less protective against Delta; whether this is due to it being just one shot or something specific to the J&J methodology is unclear.

Is there any evidence out there supporting or disproving that for the antibody concentration tests, "hundreds is good, but thousands is definitely better?" Maybe you've come across some data relating antibody titer to likelihood to get subsequent infection? (Yeah, I'm reaching here!!).

Any insights appreciated; while she will take any actions based on her doctor's guidance, I'm trying to get my wife as much info as possible to have a productive discussion with her.

Higher is usually better, but numbers might not equate to effective. Low number might still be effective if the memory cells remember the alien products. My levels were 3540. I might have had COVID more than once.

 

[cwbullet]

Today was a rough day for GA. We tested double yesterday and GA topped 6400 new infections.

 

[John Kemker]

I received the Pfizer vaccine series in April. My employer just announced masks required in all vans and inventories until further notice. Is it likely that I will need a second round of vaccination with the Delta-specific vaccine when it comes out? Also, what about boosters for the currently-available vaccines?

 

[BABAR]

Higher is usually better, but numbers might not equate to effective. Low number might still be effective if the memory cells remember the alien products. My levels were 3540. I might have had COVID more than once.

You do seem to be an overachiever!

 

[rocketsaway]

In an episode of "The Chosen" there's a scene where Jesus and his disciples encounter a man with leprosy. The disciples warn Jesus about approaching the leper, saying to keep 4 cubits away. This is part of their Jewish religious law. 4 cubits equals 72 in. equals 6Ft. (I had to look that up)

Interesting, I thought. 6ft, just a coincidence ?

Is 6ft social distancing a result from past biblical law ? or does it come from actual scientific research on viruses ?

 

[ThirstyBarbarian]

In an episode of "The Chosen" there's a scene where Jesus and his disciples encounter a man with leprosy. The disciples warn Jesus about approaching the leper, saying to keep 4 cubits away. This is part of their Jewish religious law. 4 cubits equals 72 in. equals 6Ft. (I had to look that up)

Interesting, I thought. 6ft, just a coincidence ?

Is 6ft social distancing a result from past biblical law ? or does it come from actual scientific research on viruses ?

Thou shalt maintaineth a distance of four cubits, no more, no less. Four shall be the number of the cubits thou shalt maintain, and the number of the cubits shall be four. Five shalt thou not maintain, neither maintaineth thou three, excepting that thou then proceed to four. Six is right out!

 

[cwbullet]

You do seem to be an overachiever!

In more than one way! 23 years ago, I graduated from medical school. I have no intent on staying in the Army or serving in a position of leadership. I have done far more than I would have expected. Friday, I was offered another job with much more responsibility and the sky is the limits with it. I have elected to decline to start focusing on retirement.

I am blessed to be where I am.

 

[cwbullet]

In an episode of "The Chosen" there's a scene where Jesus and his disciples encounter a man with leprosy. The disciples warn Jesus about approaching the leper, saying to keep 4 cubits away. This is part of their Jewish religious law. 4 cubits equals 72 in. equals 6Ft. (I had to look that up)

Interesting, I thought. 6ft, just a coincidence ?

Is 6ft social distancing a result from past biblical law ? or does it come from actual scientific research on viruses ?

It is a coincidence. The 6 feet distance is just a starting point. Scientists have researched this and the virus passed at 6 feet is so greatly reduced that you would be unlikely to catch COVID. Each pathogen is different. This 6 foot is based on studies of aerosolized pathogens.

.

 

[mo2872]

Chuck- my apologies if this has been addressed in the last 133 pages, it's hard to keep up. What exactly is antibody dependent enhancement? Tried doing the ole Google Foo, and found this article from last year: https://www.nature.com/articles/s41564-020-00789-5 but it is way above my pay grade. Are they saying that the vaccines could cause our bodies to become dependent on those vaccines?

Thanks!

 

[boatgeek]

In more than one way! 23 years ago, I graduated from medical school. I have no intent on staying in the Army or serving in a position of leadership. I have done far more than I would have expected. Friday, I was offered another job with much more responsibility and the sky is the limits with it. I have elected to decline to start focusing on retirement.

I am blessed to be where I am.

It’s great that you have choices and great that you’re choosing to focus on retirement!

 

[cwbullet]

Chuck- my apologies if this has been addressed in the last 133 pages, it's hard to keep up. What exactly is antibody dependent enhancement? Tried doing the ole Google Foo, and found this article from last year: https://www.nature.com/articles/s41564-020-00789-5 but it is way above my pay grade. Are they saying that the vaccines could cause our bodies to become dependent on those vaccines?

To be honest, I had to look it up. It is not a term that we have used. Antibody-dependent enhancement or ADE is when an illness such as SARs, MERs, or COVID ramps up your immune response and can result in damage and death. It is suspected to be one of the causes of death and injury. The worry is that it will come to fruition with treatments such as convalescent plasma. I think it might be more theoretical because I have not seen any evidence of this with vaccinations.

 

[mo2872]

Ah, I misunderstood the dependent part of that. Thank you, sir.

 

[boomtube-mk2]

One of the horrors of the Spanish Flue was its propensity for killing the young and healthy including infants.
Grandparents had to watch as their children and grandchildren died while they lived on.

Perhaps the worst of it were the soldiers who survived the killing fields of Europe only to die from the flue.

In relation to U.S. populations then and now, the U.S. would have close to two million dead from Covid19 by this point in time, most of them in below the age of forty.

 

[Marc_G]

One of the horrors of the Spanish Flue was its propensity for killing the young and healthy including infants.
Grandparents had to watch as their children and grandchildren died while they lived on.

Perhaps the worst of it were the soldiers who survived the killing fields of Europe only to die from the flue.

In relation to U.S. populations then and now, the U.S. would have close to two million dead from Covid19 by this point in time, most of them in below the age of forty.

I sometimes imagine I could go back in time. Imagine you could go back to 1918 (or whenever it really started), with one giant sack of tylenol and another giant sack of whatever antibiotic would have been effective on the bacterial pneumonia of the time. Presuming you had enough of just these two simple medicines, imagine how many lives could have been saved?

 

[boomtube-mk2]

The Spanish Flu was a virus so antibiotics wouldn't have been effective against it but I agree as to how many people could have been saved with just those two simple meds.

The biggest killer, especially of infants and children, in sub-Sahara Africa isn't Ebola or Dengue Fever or some such it is simple Dysentery which can be easily treated with modern medicine and Gatorade . . . and yet.

 

[ThirstyBarbarian]

The Spanish Flu was a virus so antibiotics wouldn't have been effective against it but I agree as to how many people could have been saved with just those two simple meds.

The biggest killer, especially of infants and children, in sub-Sahara Africa isn't Ebola or Dengue Fever or some such it is simple Dysentery which can be easily treated with modern medicine and Gatorade . . . and yet.

Just having access to hand soap and clean water would save millions of lives worldwide every year. People die of diarrhea all the time.

If this new coronavirus had hit us at a time when our medical technology was what we had at the time of the Spanish Flu, it would be worse than the Spanish Flu. A lot of lives have been saved with simple oxygen. Back then, we would have had no hope for a vaccine.

 

[RobCamele]

Today was a rough day for GA. We tested double yesterday and GA topped 6400 new infections.

What is the definition of an "infection" as related to Covid19? Is it the same as a "case"?

What percentage of the "new infections" are asymptomatic?

What percentage of the "new infections" have been fully vaccinated?

What test is there to determine if the "infection" is just garden variety Covid19 or the Delta (or any other) variant?

Sorry for all the questions at once, but I am just trying to make sense of all this so I can make an informed decision about vaccination and other issues related to the pandemic.

 

[BABAR]

Short versions

how close are we to delta and lambda specific mRNA vaccines?

would such vaccines require such prolonged testing?

have we developed mRNA technology that produces effective vaccines that do not require such extreme refrigeration?

Pfizer and Moderna pulled off a near miracle in getting out the original mRNA vaccines As quickly as they did. Since we now have the specifics for the spike proteins for both Delta and Lambda, not saying it is easy but how fast could we engineer, test, and employ vaccines specified to go after those proteins?

if All we are doing is changing the protein target, would we need as much testing? (my guess is yes, as as soon as you change the target, you have potential with cross reactivity with NORMAL body proteins, so the chance of autoimmune complications like Guillain Barre syndrome are higher. I are just a radiologist so I am far from an expert, but it seems like the next step would be to shotgun it and go with a new mRNA vaccine that targets the three major variants of concern. Hopefully we can do it with something that isn’t as refrigeration dependent as current vaccines.

I thought this article from American Society for Microbiology was good

https://asm.org/Articles/2021/July/How-Dangerous-is-the-Delta-Variant-B-1-617-2
Made the point that there is only so much mutation of the spike protein before it stops being an effective spike protein, so maybe there are limits on the maximum number of advantageous mutations available to the virus. Don’t know it that’s correct, we can hope.