Coronavirus: What questions do you have?

[ksaves2]

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?

Again, I agree with you 100% Chuck. Nobody commonly knew about viruses back then in 1917 and the medical community was totally in the dark about it. They knew it was infectious and that was about it.

What the flu epidemic did lead to was Oswald Avery was able to eventually discover in 1930 that DNA was the "essence of life". He worked feverishly to no avail on the flu epidemic but eventually discovered with bacteria (not viruses) that DNA is what imparted "life" to living things.

He didn't know how that happened and it took Watson, Crick and Franklin to figure out the structure of DNA using x-ray diffraction.

Rosalind Franklin took the x-ray diffraction picture of DNA that really gave the "Eureka" moment to Watson and Crick: ( Am taking this quote off the Internet.)

It totally blew me away when it appeared that the flu epidemic of 1917-1918 started the impetus that lead to the discovery of DNA

At King's College in London, Rosalind Franklin and Maurice Wilkins were studying DNA. Wilkins and Franklin used X-ray diffraction as their main tool -- beaming X-rays through the molecule yielded a shadow picture of the molecule's structure, by how the X-rays bounced off its component parts. Franklin, a shy and inward young woman, suffered from patronizing attitudes and sexism that forced her to do much of her work alone. And her senior partner, Wilkins, showed some of Franklin's findings to Watson in January 1953 without her knowledge. "Referring to Franklin's X-ray image known as "Exposure 51," James Watson is reported to have said, "The instant I saw the picture, my mouth fell open and my pulse began to race." Shortly after, Watson and Crick made a crucial advance when they proposed that the DNA molecule was made up of two chains of nucleotides paired in such a way to form a double helix, like a spiral staircase. This structure, announced in their famous paper in the April 1953 issue of Nature, explained how the DNA molecule could replicate itself during cell division, enabling organisms to reproduce themselves with amazing accuracy except for occasional mutations. For their work, Watson, Crick, and Wilkins received the Nobel Prize in 1962. Despite her contribution to the discovery of DNA's helical structure, Rosalind Franklin was not named a prize winner: She had died of cancer four years earlier, at the age of 37." She should have received the Nobel prize for her work but unfortunately they don't bestow it to deceased persons. She died before the Nobel committee realized she deserved it. Kurt Savegnago. ​

 

[Sooner Boomer]

 

[cwbullet]

New research released today:

https://www.medpagetoday.com/infect...view 2021-08-08&utm_term=NL_DHE_Weekly_Active
Prior infections are twice as likely to catch covid over those that are vaccinated. So vaccines are superior to catching covid to prevent infections.

 

[Bowman]

Wh

New research released today:

https://www.medpagetoday.com/infect...view 2021-08-08&utm_term=NL_DHE_Weekly_Active
Prior infections are twice as likely to catch covid over those that are vaccinated. So vaccines are superior to catching covid to prevent infections.

Is the study conclusion that previously infected and then vaccinated subjects had stronger immunity than vaccinated-only subjects, or just double the immunity of post-infection vaccinated subjects?

 

[BABAR]

I am vaccinated Pfizer x 2. It may be too early to tell, but are vaccinated people who get breakthrough infections more likely, less likely, or equally likely to get “long COVID” symptoms? What frightened me most about getting COVID was not that it would kill me, I was in a relatively low risk group for death or hospitalization, but there seems to be a group called “long covid” or “long haulers.” I am guessing it is hard study as symptoms like “brain fog” and “fatigue” “stomach pain” and joint and muscle aches are hard to quantify. More disturbing is that the frequency and severity of symptoms is NOT proportional to the severity of the initial infection in patients who were infected before vaccine was out.

so I know the vaccine reduces my chance of getting a symptomatic infection, hospitalization , and death. Any data out on the frequency of “long COVID” issues in documented breakthrough infections?

also regarding previous report that non vaccinated COVID survivors are twice as like to get a variant infection. Are the breakthrough infections in non vaccinated COVID survivors the same severity as “new” infections in individuals neither vaccinated or previously infected?

 

[Bowman]

I am vaccinated Pfizer x 2. It may be too early to tell, but are vaccinated people who get breakthrough infections more likely, less likely, or equally likely to get “long COVID” symptoms? What frightened me most about getting COVID was not that it would kill me, I was in a relatively low risk group for death or hospitalization, but there seems to be a group called “long covid” or “long haulers.” I am guessing it is hard study as symptoms like “brain fog” and “fatigue” “stomach pain” and joint and muscle aches are hard to quantify. More disturbing is that the frequency and severity of symptoms is NOT proportional to the severity of the initial infection in patients who were infected before vaccine was out.

so I know the vaccine reduces my chance of getting a symptomatic infection, hospitalization , and death. Any data out on the frequency of “long COVID” issues in documented breakthrough infections?

Is it possible to be a long-hauler based on a previous asymptomatic infection, I.E. before vaccination you are infected but asymptomatic. Subsequently you get vaccinated and all seems to be well.
Is there a way that the previous infection can even be detected post vaccine?

 

[NateB]

I am vaccinated Pfizer x 2. It may be too early to tell, but are vaccinated people who get breakthrough infections more likely, less likely, or equally likely to get “long COVID” symptoms?

It is purely anecdotal, but my wife had some mild long term effects which lingered after her bout with Covid. She was being followed by a pulmonogist, but after her 1st Pfizer shot, her lingering fatigue and shortness of breath improved. Her last CT was clear too and she was dismissed by the pulmonogist. We'll never know if the improvement was caused by the vaccine or the normal immune response.

In my mind, any antibodies and memory cells created because of infection might take a different approach to fighting the virus than the response created by the vaccine. Maybe the dual boost to the immune system is better.

 

[Marc_G]

Interesting information about possible improvements in long haulers after getting vaxxed:

https://www.yalemedicine.org/news/vaccines-long-covid

 

[cwbullet]

Wh

Is the study conclusion that previously infected and then vaccinated subjects had stronger immunity than vaccinated-only subjects, or just double the immunity of post-infection vaccinated subjects?

The second but they are trying to infer the first. I think we can safely assume that vaccination provides superior immunity but more studies are needed. This is data compared to the Mayo and Cleveland Clinics saying it without any data.

 

[Reinhard]

Is there a way that the previous infection can even be detected post vaccine?

With the right antibody test, specifically a nucleocapsid based antibody test, a previous infection can be detected in vaccinated persons.
This works because currently available vaccines will only result in antibodies for the spike protein (the surface of the virus) but a real virus infection will also result in antibodies for the nucleocapsid (the core of the virus).
Antibody levels will fall over time, so there is likely a limit for how long an infection can be detected.

Reinhard

 

[BABAR]

Any reason why we can’t target something other than the spike protein? I am guessing it is convenient as it is outside on the surface, but during replication there must be other parts exposed? Maybe some that aren’t as easily successfully mutated?

a multivalent (if that’s a word) vaccine that targets two or more virus components would be much more difficult for the virus to out-mutate. Sort of a belt and suspenders approach. Or, for the HPR guys, using motor eject as a backup.

 

[NateB]

Any reason why we can’t target something other than the spike protein? I am guessing it is convenient as it is outside on the surface, but during replication there must be other parts exposed? Maybe some that aren’t as easily successfully mutated?

Why was the spike protein the focus for vaccine development? Was it a lucky guess or was that learned from research on other coronavirus? Is targeting the spike protein the reason why the vaccine is effective against the other variants?

a multivalent (if that’s a word) vaccine that targets two or more virus components would be much more difficult for the virus to out-mutate. Sort of a belt and suspenders approach.

Would this belt and suspenders approach explain the theory that a previously infected and vaccinated person has better immunity? If the body is prepared to target the spike protein and the specific virus it has previously seen, would that help ramp up antibody production for the new infection? Are the variants similar enough that the body recognizes them? Are their known mutations where the spike protein is different enough that the immune response is delayed?

 

[cwbullet]

With the right antibody test, specifically a nucleocapsid based antibody test, a previous infection can be detected in vaccinated persons.
This works because currently available vaccines will only result in antibodies for the spike protein (the surface of the virus) but a real virus infection will also result in antibodies for the nucleocapsid (the core of the virus).
Antibody levels will fall over time, so there is likely a limit for how long an infection can be detected.

Reinhard

That is correct. There are some great antibody testes that can discriminate against prior infection vs. vaccination.

 

[cwbullet]

Any reason why we can’t target something other than the spike protein? I am guessing it is convenient as it is outside on the surface, but during replication there must be other parts exposed? Maybe some that aren’t as easily successfully mutated?

a multivalent (if that’s a word) vaccine that targets two or more virus components would be much more difficult for the virus to out-mutate. Sort of a belt and suspenders approach. Or, for the HPR guys, using motor eject as a backup.

The spike protein is an easy target and it is the part that readily allows it to stick and gain entry (over simplification). They are testing a few other vaccines.

 

[cwbullet]

Why was the spike protein the focus for vaccine development? Was it a lucky guess or was that learned from research on other coronavirus? Is targeting the spike protein the reason why the vaccine is effective against the other variants?



Would this belt and suspenders approach explain the theory that a previously infected and vaccinated person has better immunity? If the body is prepared to target the spike protein and the specific virus it has previously seen, would that help ramp up antibody production for the new infection? Are the variants similar enough that the body recognizes them? Are their known mutations where the spike protein is different enough that the immune response is delayed?

You are essentially correct!

 

[BABAR]

Why was the spike protein the focus for vaccine development? Was it a lucky guess or was that learned from research on other coronavirus? Is targeting the spike protein the reason why the vaccine is effective against the other variants?



Would this belt and suspenders approach explain the theory that a previously infected and vaccinated person has better immunity? If the body is prepared to target the spike protein and the specific virus it has previously seen, would that help ramp up antibody production for the new infection? Are the variants similar enough that the body recognizes them? Are their known mutations where the spike protein is different enough that the immune response is delayed?

https://nyulangone.org/news/patients-recovered-covid-19-may-require-just-one-dose-mrna-vaccine
@cwbullet chuck, has this been confirmed? It would actually make a LOT of sense. My limited understanding was that for the mRNA Pfizer and Moderna vaccines, one shot gave some protection (maybe 50%) but the second was needed to get people into the 80-90% range. If the above article and @NateB ‘s logic is correct, a single shot in a previously infected patient acts as the SECOND mRNA dose for the previously NON-infected person, raising immunity to the Spike protein, PLUS the previously infected person also would have (at least for some period of time) antibodies against “the rest” of the virus particles (the core, etc,)

again, if correct, maybe an encouragement to those previously infected who are reluctant to get immunized cuz they already feel “protected” (they ARE, to some extent, but not as good as the average non infected two dose vaccinated person) is to sell it to the previously infect unvaccinated this way, “Hey guys , with just ONE dose of mRNA you will be MORE protected than the others got with TWO doses, and you only have one day with a sore arm and feeling lousy.”

Or, “more than twice the protection for half the pain!” (Maybe less than 1/2, I think most people find the second shot worse cuz they are already “primed” to react)
it’s all in the marketing…….

What percentage of the currently unvaccinated are COVID Survivors?

 

[cwbullet]

https://nyulangone.org/news/patients-recovered-covid-19-may-require-just-one-dose-mrna-vaccine
@cwbullet chuck, has this been confirmed? It would actually make a LOT of sense. My limited understanding was that for the mRNA Pfizer and Moderna vaccines, one shot gave some protection (maybe 50%) but the second was needed to get people into the 80-90% range. If the above article and @NateB ‘s logic is correct, a single shot in a previously infected patient acts as the SECOND mRNA dose for the previously NON-infected person, raising immunity to the Spike protein, PLUS the previously infected person also would have (at least for some period of time) antibodies against “the rest” of the virus particles (the core, etc,)

again, if correct, maybe an encouragement to those previously infected who are reluctant to get immunized cuz they already feel “protected” (they ARE, to some extent, but not as good as the average non infected two dose vaccinated person) is to sell it to the previously infect unvaccinated this way, “Hey guys , with just ONE dose of mRNA you will be MORE protected than the others got with TWO doses, and you only have one day with a sore arm and feeling lousy.”

Or, “more than twice the protection for half the pain!” (Maybe less than 1/2, I think most people find the second shot worse cuz they are already “primed” to react)
it’s all in the marketing…….

What percentage of the currently unvaccinated are COVID Survivors?

Yes, it is somewhat true. The data is evolving and we learn more and more. Two shots are clearly superior. One appears to be better than none.

Native infection provides some immunity and it "may be" superior against some single variants. That was found in a single study versus a single non-mRNA vaccine. It also wanes much faster and does not appear to have wide coverage against multiple variants.

mRNA vaccines appear the have the widest and longest-lasting coverage with the highest antibody coverage.

The Pandemic has taught me more about microbiology and immunology than I learned in medical school and residency.

 

[tab28682]

Chuck, thanks very much for your continued answering of COVID questions with level headed, intelligent and informative fact-based responses.

 

[boomtube-mk2]

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.

Any figures for the 1918/'20 Spanish Flu death toll is a WAG at best because there were huge areas of the world for which there was no reliable data at all.
65 to 75 million is the best guess and remember, this was at a time when the world's population around 1.8 billion.

If Covid19 kills as many people as the flu did back then the death toll will be more than 300 million.

 

[Rocketjunkie]

Any figures for the 1918/'20 Spanish Flu death toll is a WAG at best because there were huge areas of the world for which there was no reliable data at all.
65 to 75 million is the best guess and remember, this was at a time when the world's population around 1.8 billion.
If Covid19 kills as many people as the flu did back then the death toll will be more than 300 million.

I got 2.8% of the world's population at the time. It would take 210 million deaths to match this.

 

[NateB]

If Covid19 kills as many people as the flu did back then the death toll will be more than 300 million.

Medicine has changed a lot in 100 years. I wonder how many people would have died from Covid under the same kind of care as we had during the Spanish Flu.

Intubation was just starting to get used outside of surgery. Ventilation as we know it now wasn't a concept. We have new meds, new tests, new treatments. All of those have saved lives.

One of the common treatments for Covid is Heated Humidified High Flow Oxygen, commercially known as Vapotherm or Airvo. This is a decent bridge to keep people from being intubated and many patients tolerate it better than BiPap. The concept was only first used in adults in the early 2000 and widely adopted in recent years.

 

[boomtube-mk2]

I wonder how many people would have died from Covid under the same kind of care as we had during the Spanish Flu.

It would have been ugly, possibly enough to lead to the collapse of national governments and or civil order.

 

[cwbullet]

I think the difference today is we have a much more active and quicker press. 2 million deaths is treated link 200 million because of the rapid spread of information.

 

[cwbullet]

New data: Data from 50,000 patients in the Mayo Clinic Health System, researchers found the effectiveness of Moderna's vaccine against infection has dropped to 76% in July - when the Delta variant was predominant - from 86% in early 2021. Over the same period, the effectiveness of the Pfizer/BioNTech vaccine had fallen to 42% from 76%, researchers said.

The delta variant is clearly a stronger virus and this explains the new spike in infections.

 

[Jeanette]

New here but Covid has affected my life as well. Much is being talked about for the vaccines but are the way they are testing for it changing as the data we learn about Covid Mutations change. I was told that the tests using the Rapid test are predominantly less accurate because of what they test for yet many companies require you to get the test as fast as possible and if not positive expect you back to work.. If this test is not accurately depicting people as sick this could be bringing it right back in to the work place. Any thoughts on changing the testing ...would it help would it hinder.

 

[Bill S]

New data: Data from 50,000 patients in the Mayo Clinic Health System, researchers found the effectiveness of Moderna's vaccine against infection has dropped to 76% in July - when the Delta variant was predominant - from 86% in early 2021. Over the same period, the effectiveness of the Pfizer/BioNTech vaccine had fallen to 42% from 76%, researchers said.

The delta variant is clearly a stronger virus and this explains the new spike in infections.

Any info on how the J&J vaccine is faring?

 

[ThirstyBarbarian]

New data: Data from 50,000 patients in the Mayo Clinic Health System, researchers found the effectiveness of Moderna's vaccine against infection has dropped to 76% in July - when the Delta variant was predominant - from 86% in early 2021. Over the same period, the effectiveness of the Pfizer/BioNTech vaccine had fallen to 42% from 76%, researchers said.

The delta variant is clearly a stronger virus and this explains the new spike in infections.

Wow. That’s a big drop for Pfizer. Disappointing news. Was there any info on J&J?

This info is only about the effectiveness against infection, correct? Was there any new info about the effectiveness against hospitalization or death?

 

[cwbullet]

Interesting information about possible improvements in long haulers after getting vaxxed:

https://www.yalemedicine.org/news/vaccines-long-covid

I am seeing similar responses in many patients. No all, but many.

 

[Marc_G]

Chuck, question: there were several human challenge trials for the vaccines initiated earlier this year in countries such as they UK where it was legal to conduct them.
I have not yet seen reports of outcomes. Have you?
Specifically what I would hope would be seen is relative infection rates /durations for Delta and other common strains among vaxxed individuals to give some perspective on the spread.

 

[cwbullet]

Wow. That’s a big drop for Pfizer. Disappointing news. Was there any info on J&J?

This info is only about the effectiveness against infection, correct? Was there any new info about the effectiveness against hospitalization or death?

J&J? We already know that the delta variant has reduced coverage by AZ and J&J.

They have seen no change in hospitalizations or deaths, yet.