Coronavirus: What questions do you have?

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Ez2cDave

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CHUCK,

I have some questions about testing . . .

( 1 ) Is there a "Delta variant" COVID-19 test ?

( 2 ) If there is no specific "Delta variant" test, exactly how are people being Diagnosed with the Delta variant, at the "local" level ( Doctor's offices and Hospitals ) ?

( 3 ) According to the CDC, 80% of new COVID-19 cases in the USA are being caused by the Delta variant . . . How is this being determined, accurately ?

Dave F.
 

Marc_G

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CHUCK,

I have some questions about testing . . .

( 1 ) Is there a "Delta variant" COVID-19 test ?

( 2 ) If there is no specific "Delta variant" test, exactly how are people being Diagnosed with the Delta variant, at the "local" level ( Doctor's offices and Hospitals ) ?

( 3 ) According to the CDC, 80% of new COVID-19 cases in the USA are being caused by the Delta variant . . . How is this being determined, accurately ?

Dave F.
I too am interested by Chuck's response but I can provide some info to kick it off. The major testing labs either sequence internally or send out for sequencing a certain portion of their positive samples. This gives a complete picture of a substantial number of samples on a continual basis to track spread of variants and identify new variants. This information is reported to state and federal agencies to build the national picture of what is going on.

I don't believe most commercial tests report to the patient which variant is present in positive tests. The variant is identified only through sequencing of a fraction of the samples from the total tests performed.
 

cwbullet

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

What percentage of the "new infections" are asymptomatic?
I think this is a tough question to answer. I think it comes down to the known knowns, known unknowns, and unknown unknowns. I know we have about 8-15% of patients that test positive are asymptomatic. We know that 80% of those that asymptomatic at test will develop symptoms. The point I am making is that this is not as clear as you might think.


What percentage of the "new infections" have been fully vaccinated?
This is a moving target. Now, I am seeing about 25% are fully vaccinated, but that is increasing. Some srease are seeing levels as high as 75%.

What test is there to determine if the "infection" is just garden variety Covid19 or the Delta (or any other) variant?
Yes. It takes 3-4 weeks right now and is of limited significance.
 

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how close are we to delta and lambda specific mRNA vaccines?
I am not tracking a specific vaccine, but these are covered well with the mRNA vaccines.

would such vaccines require such prolonged testing?
I trust our current testing.

have we developed mRNA technology that produces effective vaccines that do not require such extreme refrigeration?
mRNA is very sensitive to time and temperature and breaks down easily. I am not sure it is possible.

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?
Now sure it is needed at this time. I could be wrong, but time will tell.


I thought this article from American Society for Microbiology was good

I concur. I do think the Delta and Lamda variant are more dangerous for those that have skipped the vaccine.
 

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from PM said:
( 1 ) Is there a "Delta variant" COVID-19 test ?
There is but it takes 3-4 weeks and is of limited significance.

from PM said:
( 2 ) If there is no specific "Delta variant" test, exactly how are people being Diagnosed with the Delta variant, at the "local" level ( Doctor's offices and Hospitals ) ?
See above

from PM said:
( 3 ) According to the CDC, 80% of new COVID-19 cases in the USA are being caused by the Delta variant . . . How is this being determined, accurately?
Some of this is an educated estimate based on testing.
 

Marc_G

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Folks,

I want to stress that I am learning as we go. You are helping me do so.
Thank you for all your efforts! You have a tough job and I can only imagine how exhausted you must be, yet you still keep us informed and answer these questions.

You are a rockstar!
 

mo2872

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Thanks Chuck! We are living in historic times, whether we want to, or not. Let’s get it together, and whip this microscopic Hitler, yeah?
 

OverTheTop

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Hi Chuck. Thanks for your answers.

FYI down here they seem to be able to sequence genomics in a day or so for the virus.
 

BABAR

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Of the unvaccinated people sick enough for admission, what percentage have already HAD Covid before? Seems some people are saying, “I’ve already survived the virus once, so I am permanently immune and don’t need the vaccine.”

put another way, is the breakthrough rate for immunity acquired by infection different from that acquired by vaccination?
 

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Of the unvaccinated people sick enough for admission, what percentage have already HAD Covid before? Seems some people are saying, “I’ve already survived the virus once, so I am permanently immune and don’t need the vaccine.”

put another way, is the breakthrough rate for immunity acquired by infection different from that acquired by vaccination?
A low number of people are admitted and or die from a second infection. There is some immunity from a prior infection that is survived. We do know that immunity wanes faster than the vaccine. I data is pending on what that means. We are fairly certain that there is no permanent immunity based on the waning antibody levels. I have no data to comment on the breakthrough infections between the two groups, but I am seeing a high rate of breakthrough infection in the prior infection rate, but need more data to determine the significance.
 

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dhbarr

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Of the unvaccinated people sick enough for admission, what percentage have already HAD Covid before? Seems some people are saying, “I’ve already survived the virus once, so I am permanently immune and don’t need the vaccine.”
Anecdotally I observe a correlation between people who are "pretty sure" they had COVID-19 and those who also take fewer precautions, including getting proper diagnoses.

Are these numbers typically reported as two-confirmed-cases, or a mix of self-reported and clinically confirmed?
 

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[
Anecdotally I observe a correlation between people who are "pretty sure" they had COVID-19 and those who also take fewer precautions, including getting proper diagnoses.

Are these numbers typically reported as two-confirmed-cases, or a mix of self-reported and clinically confirmed?
Two confirmed cases. I try not to operate on anecdotal.
 

blackwing94

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Any comment on Epsilon and Lambda variants of covid-19?

How many variants do we know about at this time?
 
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cwbullet

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Any comment on Epsilon and Lambda variants of covid-19?

How many variants do we know about at this time?
  1. Initial wild variant - appears to be from China.
  2. B.1.1.7 (Alpha): This variant was first detected in the United States in December 2020. It was initially detected in the United Kingdom. I am not too concerned about this variant at this time. I think it has been supplanted by other variants.
  3. B.1.351 (Beta): This variant was first detected in the United States at the end of January 2021. It was initially detected in South Africa in December 2020.
  4. P.1 (Gamma): This variant was first detected in the United States in January 2021. P.1 was initially identified in travelers from Brazil, who were tested during routine screening at an airport in Japan, in early January.
  5. B.1.617.2 (Delta): This variant was first detected in the United States in March 2021. It was initially identified in India in December 2020. This variant ravished India and is currently the predominant variant worldwide.
  6. B.1.525 (Eta): Found in multiple countries in December of 2020. Significance?
  7. B.1.526 (Iota): Found in the United States of America, Nov-2020. Significance TBD.
  8. B.1.617.1 (Kappa): Found in India in Oct-2020. Significance?
  9. C.37 (Lambda): Found in Peru, Dec-2020. Significance TBD.
  10. B.1.429 (Epsilon): Found in California in the summer of 2020. Significant is evolving.
There are at least 20-25 more. Above is the most significant today. It will change tomorrow. I am seeing mostly delta variants at this time. I can test for it and the rest I have to send off. I do have a BSL-3 lab at my disposal and can send off unknown variants to other locations.
 

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I have had a number of questions about native vs vaccine immunity. A lot of the stuff is conjecture from the Mayo and Cleveland Clinics. The evidence does not really back the statements.

Research:

The evidence shows a superior Antibody response with both infection and vaccine. That being said, I think there is some protection from a live infection but I would not risk death to not be immunized.

Also, infected individuals will probably produce antibodies for the rest of their lives, but will they produce enough to be effective, and will new variants make the question mute.
 

Ez2cDave

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  1. Initial wild variant - appears to be from China.
  2. B.1.1.7 (Alpha): This variant was first detected in the United States in December 2020. It was initially detected in the United Kingdom. I am not too concerned about this variant at this time. I think it has been supplanted by other variants.
  3. B.1.351 (Beta): This variant was first detected in the United States at the end of January 2021. It was initially detected in South Africa in December 2020.
  4. P.1 (Gamma): This variant was first detected in the United States in January 2021. P.1 was initially identified in travelers from Brazil, who were tested during routine screening at an airport in Japan, in early January.
  5. B.1.617.2 (Delta): This variant was first detected in the United States in March 2021. It was initially identified in India in December 2020. This variant ravished India and is currently the predominant variant worldwide.
  6. B.1.525 (Eta): Found in multiple countries in December of 2020. Significance?
  7. B.1.526 (Iota): Found in the United States of America, Nov-2020. Significance TBD.
  8. B.1.617.1 (Kappa): Found in India in Oct-2020. Significance?
  9. C.37 (Lambda): Found in Peru, Dec-2020. Significance TBD.
  10. B.1.429 (Epsilon): Found in California in the summer of 2020. Significant is evolving.
There are at least 20-25 more. Above is the most significant today. It will change tomorrow. I am seeing mostly delta variants at this time. I can test for it and the rest I have to send off. I do have a BSL-3 lab at my disposal and can send off unknown variants to other locations.
Chuck,

So, there are AT LEAST 30 - 35+ different variants circulating, at present !

This just keeps getting better & better, doesn't it ?

Is there any truth to a virus beginning to weaken, when it starts going through rapid / numerous mutations ?

Dave F.
 

cwbullet

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Chuck,

So, there are AT LEAST 30 - 35+ different variants circulating, at present !

This just keeps getting better & better, doesn't it ?

Is there any truth to a virus beginning to weaken, when it starts going through rapid / numerous mutations ?

Dave F.
I cannot comment on how many are being actively passed at this time. I have some of that data but some are incomplete. I can say that I am seeing primarily 3 major variants locally and the biggest of the 3 is the delta variant. It does not even matter which variants are being spread. They are all covered by the vaccine. The variants at this stage of a public health interest, btu for the front line clinician, the variants do not change treatment.
 

Ez2cDave

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I cannot comment on how many are being actively passed at this time.
Chuck,

Does that mean insufficient data exists or not permitted to disclose ?

ALSO . . .

Is there any truth to a virus beginning to weaken, when it starts going through rapid / numerous mutations ?

Dave F.
 

ksaves2

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Chuck,

Does that mean insufficient data exists or not permitted to disclose ?

ALSO . . .

Is there any truth to a virus beginning to weaken, when it starts going through rapid / numerous mutations ?

Dave F.
It can go either way. In the 1918 flu epidemic it was surmised that the influenza virus gradually mutated up to virulence and then petered out towards then end. Although it must be mentioned the survivors were immune and those that didn't make it, were gone.
The animal reservoirs can maintain the flu until a variant jumps to humans.
Flu virus is a totally different animal than covid. Me thinks this is a virus that maybe is going to be around in a cyclical fashion with us from here on out like the flu.
That would behoove us to get a "Covid" booster every year but that has not been determined as of yet.
If anyone want to gain some insight of the last great epidemic that killed more people than Covid-19 (so far), read John Barry's "The Great Influenza". It also gives a neat history of medical education in the U.S. One doesn't need to be a science geek to enjoy it. It has been out long enough a copy might be found in your local library.

Kurt Savegnago
 

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Does that mean insufficient data exists or not permitted to disclose ?
Not enough data on the delta variant. The numbers are going up and the data collection is rough and choppy. Heck a lot of states stopped collecting data on weekends.

Is there any truth to a virus beginning to weaken, when it starts going through rapid / numerous mutations ?
I am not seeing any evidence of that.
 

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It can go either way. In the 1918 flu epidemic it was surmised that the influenza virus gradually mutated up to virulence and then petered out towards then end. Although it must be mentioned the survivors were immune and those that didn't make it, were gone.
The animal reservoirs can maintain the flu until a variant jumps to humans.
Flu virus is a totally different animal than covid. Me thinks this is a virus that maybe is going to be around in a cyclical fashion with us from here on out like the flu.
That would behoove us to get a "Covid" booster every year but that has not been determined as of yet.
If anyone want to gain some insight of the last great epidemic that killed more people than Covid-19 (so far), read John Barry's "The Great Influenza". It also gives a neat history of medical education in the U.S. One doesn't need to be a science geek to enjoy it. It has been out long enough a copy might be found in your local library.

Kurt Savegnago
I think this is fairly accurate. I am concerned were are in a circular spiral around the toilet bowl and it will not get better until we get enough immunity.
 

BABAR

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Thanks Chuck!
 

cwbullet

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It can go either way. In the 1918 flu epidemic it was surmised that the influenza virus gradually mutated up to virulence and then petered out towards then end. Although it must be mentioned the survivors were immune and those that didn't make it, were gone.
The animal reservoirs can maintain the flu until a variant jumps to humans.
Flu virus is a totally different animal than covid. Me thinks this is a virus that maybe is going to be around in a cyclical fashion with us from here on out like the flu.
That would behoove us to get a "Covid" booster every year but that has not been determined as of yet.
If anyone want to gain some insight of the last great epidemic that killed more people than Covid-19 (so far), read John Barry's "The Great Influenza". It also gives a neat history of medical education in the U.S. One doesn't need to be a science geek to enjoy it. It has been out long enough a copy might be found in your local library.

Kurt Savegnago
One other thing I would add is that I would not rest my laurels on this thing petering out. We are far more advanced than in 1917 and we should take advantage of the changes.
 
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ksaves2

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I think this is fairly accurate. I am concerned were are in a circular spiral around the toilet bowl and it will not get better until we get enough immunity.
I whole-heartedly agree with that Chuck. Still not as great as the great influenza of 1917-1918 where estimates were up to 1/3 of the world was infected with conservatively 20 to 50 million deaths occurred or liberally between 17 to 100 million deaths happened.

Hey, they didn't do statistics as well back then and in very rural isolated areas they likely didn't keep a good count of how many people they put into the ground.

Nowadays, the epidemiologists and health departments are going to keep track and the raw data will likely be analyzed for years to come. Probably a few Phd's are going to come out of this.

Kurt Savegnago
 

cwbullet

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To be honest, I don’t think we will get anywhere near 1917. We are so much better at medicine.

Then again, who knows the real numbers in China?
 

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