The COVID-19 Science and Medicine Question Thread

As the data come in, the efficacy and potency of the vaccines continues to be shown. There are still many more real time studies to be completed, but these data demonstrate that the vaccines are truly home runs.

The higher and faster we get shots in arms, the better we can keep ahead of the virus' mutations. We're already starting to see mutation mutations, ah the "joys" of viral science...

The Moderna and Pfizer-BioNTech vaccines are very effective in real-world conditions at preventing infections, the C.D.C. reported.​


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A mass vaccination site at the Kentucky State Fair and Exposition Center in Louisville this month. Credit...Jon Cherry for The New York Times

The coronavirus vaccines made by Moderna and Pfizer-BioNTech are proving highly effective at preventing symptomatic and asymptomatic infections under real-world conditions, federal health researchers reported on Monday.

Consistent with clinical trial data, a two-dose regimen prevented 90 percent of infections by two weeks after the second shot. One dose prevented 80 percent of infections by two weeks after vaccination.

The news arrives even as the nation rapidly broadens eligibility for vaccines, and the average number of daily shots continues to rise. The seven-day average of vaccines administered hit 2.76 million on Monday, an increase over the pace the previous week, according to the Centers for Disease Control and Prevention.

But the virus may be gaining renewed momentum. According to a New York Times database, the seven-day average of new virus cases as of Sunday was 63,000, an increase of more than 16 percent over the past two weeks.

Similar upticks over the summer and winter led to major surges in the spread of disease, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said at a news briefing on Monday. She said she had a sense of “impending doom” about a possible fourth surge of the virus.

The nation has “so much reason for hope,” she said. “But right now I’m scared.”

Scientists have debated whether vaccinated people may still get asymptomatic infections and transmit the virus to others. The new study, by researchers at the C.D.C., suggested that since infections were so rare, transmission was likely rare, too.

There also has been concern that variants may render the vaccines less effective. The study’s results do not confirm that fear. Troubling variants were circulating during the time of the study — from Dec. 14, 2020, to March 13, 2021 — yet the vaccines still provided powerful protection.

The C.D.C. enrolled 3,950 people at high risk of being exposed to the virus because they were health care workers, first responders or others on the front lines. None had previously been infected.

Most participants — 62.8 percent — received both shots of the vaccine during the study period, and 12.1 percent had one shot. They collected their own nasal swabs each week, which were sent to a central location for P.C.R. testing, the most accurate type of test. The weekly swabs allowed the researchers to detect asymptomatic infections as well as symptomatic ones.

The investigators asked participants about symptoms associated with infection, including fever, chills, cough, shortness of breath, sore throat, diarrhea, muscle aches, or loss of smell or taste. They also analyzed patients’ medical records to detect illnesses.

Fifty-eight percent of the infections were detected before people had symptoms. Just 10.2 percent of infected people never developed symptoms.

Among those who were fully vaccinated, there were .04 infections per 1,000 person-days, meaning that among 1,000 persons there would be .04 infections in a day.

There were 0.19 infections per 1,000 person-days among those who had had one dose of the vaccine. In contrast, there were 1.38 infections per 1,000 person-days in unvaccinated people.

Dr. Walensky urged Americans to continue taking precautions and to waste no time getting the shots as soon as they are eligible.

“I am asking you to just hold on a little longer, to get vaccinated when you can, so that all of those people that we all love will still be here when this pandemic ends,” she said.
 
My wife and I were in a group of 7 yesterday, one was an infant, only one person was vaccinated.

Woke this morning to an early phone call by one of our hosts informing us her husband was ill through the evening with tempature and other symtoms, he was out getting tested. Rapid test was neg but they wanted to do the other test and have him and us quarantine until results Tues or Wed. They also canceled his appointment for vacinne shot scheduled for today.

? If his main test comes back positive, guidelines suggest we then should also quarantine for ten days.......

Do we cancel our appointments for vaccine that would be in that 10 day quarantine or does getting the shot Trump that? ( no pun intended but i did enjoy that word fitting in perfectly).

I thing if he comes back positive, we must quarantine and reschedule....correct?
 
My wife and I were in a group of 7 yesterday, one was an infant, only one person was vaccinated.

Woke this morning to an early phone call by one of our hosts informing us her husband was ill through the evening with tempature and other symtoms, he was out getting tested. Rapid test was neg but they wanted to do the other test and have him and us quarantine until results Tues or Wed. They also canceled his appointment for vacinne shot scheduled for today.

? If his main test comes back positive, guidelines suggest we then should also quarantine for ten days.......

Do we cancel our appointments for vaccine that would be in that 10 day quarantine or does getting the shot Trump that? ( no pun intended but i did enjoy that word fitting in perfectly).

I thing if he comes back positive, we must quarantine and reschedule....correct?
you're doctor will tell you that but I suspect yes - it's one of the questions you have to answer before going in for the shot
 
@WhatKnot - The 95% number means that only 5 folks out of 100 vaccinated ones will get a COVID-19 infection. Of those 5 sick folks, according to all data to date, NONE will be hospitalized or die.
I don't think that's accurate.
E.g., according to livescience.com:
"What the 95% actually means is that vaccinated people had a 95% lower risk of getting COVID-19 compared with the control group participants, who weren't vaccinated. In other words, vaccinated people in the Pfizer clinical trial were 20 times less likely than the control group to get COVID-19. "

Let's assume that in the general population, or more accurately, a control group that got a placebo shot, out of 10,000 people, 100 got covid-19 in a 3 month period.
95% effective means that of 10,000 getting the vaccine, only 5 will get the disease in the same amount of time, corrected for fluctuating infection rates.
that's why it took so long in the beginning to assess efficacy, until infection rates increased.
No?
 
My son just got home from school after the week long Spring break.
He says all sorts of kids are now in quarantine, all related to school sports teams. The entire HS soccer team, a chunk of the football team etc. As we all know, lots of kids involved in many activities. Kids in sports mingle with kids in the band, clubs, etc. Seems like the way they have classrooms set up are the safest place.....
 
My wife and I were in a group of 7 yesterday, one was an infant, only one person was vaccinated.

Woke this morning to an early phone call by one of our hosts informing us her husband was ill through the evening with tempature and other symtoms, he was out getting tested. Rapid test was neg but they wanted to do the other test and have him and us quarantine until results Tues or Wed. They also canceled his appointment for vacinne shot scheduled for today.

? If his main test comes back positive, guidelines suggest we then should also quarantine for ten days.......

Do we cancel our appointments for vaccine that would be in that 10 day quarantine or does getting the shot Trump that? ( no pun intended but i did enjoy that word fitting in perfectly).

I thing if he comes back positive, we must quarantine and reschedule....correct?
That just goes to show how this whole mess is not over and even hanging out with close friends you "trust" doesn't even work.
Hope it all works out for you and your friends
 
I don't think that's accurate.
E.g., according to livescience.com:
"What the 95% actually means is that vaccinated people had a 95% lower risk of getting COVID-19 compared with the control group participants, who weren't vaccinated. In other words, vaccinated people in the Pfizer clinical trial were 20 times less likely than the control group to get COVID-19. "

Let's assume that in the general population, or more accurately, a control group that got a placebo shot, out of 10,000 people, 100 got covid-19 in a 3 month period.
95% effective means that of 10,000 getting the vaccine, only 5 will get the disease in the same amount of time, corrected for fluctuating infection rates.
that's why it took so long in the beginning to assess efficacy, until infection rates increased.
No?
Yes, thanks for keeping me in line. I was over simplifying to keep it easy and didn't normalize for the control group.
 
If you get the vaccine and then get a covid 19 test will it be positive?
The vaccine doesnt make you positive. Having Covid makes you positive.
Depends on the test...

PCR - Diagnostic Test: NO, there's no chance of getting a positive test, unless a person was infected PRIOR to receiving the vaccine.

Rapid Antigen Test: NO, same as above IF the test was done with a nose swab sample. HOWEVER when and if there are Antigen Blood Tests made and used, they would become positive post-vaccination because the vaccines either cause you body to make, or inject the virus' spike protein to stimulate your immune system.

Antibody Blood Test: YES, but depends on the timing. This test looks for antibodies against COVID-19 in your blood, which is exactly what the vaccine has your body making. It takes some time for antibodies to get produced, so this test may be negative for up to a few days after your first vaccine dose, but suffice it too say, one week post-vaccination, you should become positive for this test.
 
Is it true the vaccination works up to six months? If so does everyone have to get the shots again?

We just don't have enough time to figure out how long these immune responses last for these vaccines,” Smith said. The New England Journal of Medicine published a report on Tuesday about Moderna's vaccine, saying it should offer protection from COVID-19 for at least six months
 
Is it true the vaccination works up to six months? If so does everyone have to get the shots again?

We just don't have enough time to figure out how long these immune responses last for these vaccines,” Smith said. The New England Journal of Medicine published a report on Tuesday about Moderna's vaccine, saying it should offer protection from COVID-19 for at least
Unfortunately, a work in progress; to be determined. The jabs are the best alternative.
 
Is it true the vaccination works up to six months? If so does everyone have to get the shots again?

We just don't have enough time to figure out how long these immune responses last for these vaccines,” Smith said. The New England Journal of Medicine published a report on Tuesday about Moderna's vaccine, saying it should offer protection from COVID-19 for at least six months
This is an example of what those of us in the business call, "Real time studies", it just takes time. If you think about it, the Clinical Trials for Moderna and Pfizer ended around 6 months ago, and at this point, there hasn't been any noticeable drop in efficacy, ergo the "at least 6 months" effectivity comment. Next month it will be 7 months, and so and so forth until a drop in efficacy is noted.

When will that occur? Damned if anyone knows. I have a gut feeling that the primary drive for a booster anytime in 2021 will be more likely to address aggressive variants, as opposed to the original vaccine losing it's oomph.

The misunderstanding of "real time studies" is very common. I had an exchange with a corporate VP once, "So we only have 6 months dating on that product?"

"Yes sir, 6 months, but we're continuing our studies and should get the desired 12 month stability data in 6 months."

"How many people are working on that study?"

"One"

"So if I let you hire another person, we'll have that study completed in 3 months instead of 6?"

"No, to get 6 months more dating, we need 6 months to pass."

Wanted to add, but didn't for the sake of my career, "...unless we can hire someone that can alter the space/time continuum."
 
Wanted to add, but didn't for the sake of my career, "...unless we can hire someone that can alter the space/time continuum."
You should have found Mr. Tripton from My Cousin Vinny. Water soaks into a grit faster in his kitchen than any place on the face of the earth!
 
Interesting, the noise of convalescent plasma has disappeared as of late. I assumed it was because of the vaccine, but it turned out to be pretty much of a dud. Don't get me wrong, IMO it was money well-spent, as it furthered what we know about COVID-19, especially at the beginning when we didn't know squat!!

The Covid-19 Plasma Boom Is Over. What Did We Learn From It?​

The U.S. government invested $800 million in plasma when the country was desperate for Covid-19 treatments. A year later, the program has fizzled.

Scott Cohen was on a ventilator struggling for his life with Covid-19 last April when his brothers pleaded with Plainview Hospital on Long Island to infuse him with the blood plasma of a recovered patient.

The experimental treatment was hard to get but was gaining attention at a time when doctors had little else. After an online petition drew 18,000 signatures, the hospital gave Mr. Cohen, a retired Nassau County medic, an infusion of the pale yellow stuff that some called “liquid gold.”

In those terrifying early months of the pandemic, the idea that antibody-rich plasma could save lives took on a life of its own before there was evidence that it worked. The Trump administration, buoyed by proponents at elite medical institutions, seized on plasma as a good-news story at a time when there weren’t many others. It awarded more than $800 million to entities involved in its collection and administration, and put Dr. Anthony S. Fauci’s face on billboards promoting the treatment.

A coalition of companies and nonprofit groups, including the Mayo Clinic, Red Cross and Microsoft, mobilized to urge donations from people who had recovered from Covid-19, enlisting celebrities like Samuel L. Jackson and Dwayne Johnson, the actor known as the Rock. Volunteers, some dressed in superhero capes, showed up to blood banks in droves.

Mr. Cohen, who later recovered, was one of them. He went on to donate his own plasma 11 times.

But by the end of the year, good evidence for convalescent plasma had not materialized, prompting many prestigious medical centers to quietly abandon it. By February, with cases and hospitalizations dropping, demand dipped below what blood banks had stockpiled. In March, the New York Blood Center called Mr. Cohen to cancel his 12th appointment. It didn’t need any more plasma.

A year ago, when Americans were dying of Covid at an alarming rate, the federal government made a big bet on plasma. No one knew if the treatment would work, but it seemed biologically plausible and safe, and there wasn’t much else to try. All told, more than 722,000 units of plasma were distributed to hospitals thanks to the federal program, which ends this month.

The government’s bet did not result in a blockbuster treatment for Covid-19, or even a decent one. But it did give the country a real-time education in the pitfalls of testing a medical treatment in the middle of an emergency. Medical science is messy and slow. And when a treatment fails, which is often, it can be difficult for its strongest proponents to let it go.

Because the government gave plasma to so many patients outside of a controlled clinical trial, it took a long time to measure its effectiveness. Eventually, studies did emerge to suggest that under the right conditions, plasma might help. But enough evidence has now accumulated to show that the country’s broad, costly plasma campaign had little effect, especially in people whose disease was advanced enough to land them in the hospital.

In interviews, three federal health officials — Dr. Stephen M. Hahn, the former commissioner of the Food and Drug Administration; Dr. Peter Marks, a top F.D.A. regulator; and Dr. H. Clifford Lane, a clinical director at the National Institutes of Health — acknowledged that the evidence for plasma was limited.

“The data are just not that strong, and it makes it makes it hard, I think, to be enthusiastic about seeing it continue to be used,” Dr. Lane said. The N.I.H. recently halted an outpatient trial of plasma because of a lack of benefit.

Plasma promotions​

Doctors have used the antibodies of recovered patients as treatments for more than a century, for diseases including diphtheria, the 1918 flu and Ebola.

So when patients began falling ill with the new coronavirus last year, doctors around the world turned to the old standby.

In the United States, two hospitals — Mount Sinai in New York City and Houston Methodist in Texas — administered the first plasma units to Covid-19 patients within hours of each other on March 28.
Dr. Nicole M. Bouvier, an infectious-disease doctor who helped set up Mount Sinai’s plasma program, said the hospital had tried the experimental treatment because blood transfusions carry a relatively low risk of harm. With a new virus spreading quickly, and no approved treatments, “nature is a much better manufacturer than we are,” she said.

That investment turned out to be significant. According to contract records, the U.S. government has paid $647 million to the American Red Cross and America’s Blood Centers since last April.

“The convalescent plasma program was intended to meet an urgent need for a potential therapy early in the pandemic,” a health department spokeswoman said in a statement. “When these contracts began, treatments weren’t available for hospitalized Covid-19 patients.”



Lack of evidence​

In August, the F.D.A. authorized plasma for emergency use under pressure from President Donald J. Trump, who had chastised federal scientists for moving too slowly.

At a news conference, Dr. Hahn, the agency’s commissioner, substantially exaggerated the data, although he later corrected his remarks following criticism from the scientific community.

In a recent interview, he said that Mr. Trump’s involvement in the plasma authorization had made the topic polarizing.

“Any discussion one could have about the science and medicine behind it didn’t happen, because it became a political issue as opposed to a medical and scientific one,” Dr. Hahn said.

The authorization did away with the Mayo Clinic system and opened access to even more hospitals. As Covid-19 cases, hospitalizations and deaths skyrocketed in the fall and winter, use of plasma did, too, according to national usage data provided by the Blood Centers of America. By January of this year, when the United States was averaging more than 130,000 hospitalizations a day, hospitals were administering 25,000 units of plasma per week.

Many community hospitals serving lower-income patients, with few other options and plasma readily available, embraced the treatment. At the Integris Health system in Oklahoma, giving patients two units of plasma became standard practice between November and January.

Dr. David Chansolme, the system’s medical director of infection prevention, acknowledged that studies of plasma had showed it was “more miss than hit,” but he said his hospitals last year lacked the resources of bigger institutions, including access to the antiviral drug remdesivir. Doctors with a flood of patients — many of them Hispanic and from rural communities — were desperate to treat them with anything they could that was safe, Dr. Chansolme said.

By the fall, accumulating evidence was showing that plasma was not the miracle that some early boosters had believed it to be. In September, the Infectious Diseases Society of America recommended that plasma not be used in hospitalized patients outside of a clinical trial. (On Wednesday, the society restricted its advice further, saying plasma should not be used at all in hospitalized patients.) In January, a highly anticipated trial in Britain was halted early because there was not strong evidence of a benefit in hospitalized patients.

In February, the F.D.A. narrowed the authorization for plasma so that it applied only to people who were early in the course of their disease or who couldn’t make their own antibodies.

Dr. Marks, the F.D.A. regulator, said that in retrospect, scientists had been too slow to adapt to those recommendations. They had known from previous disease outbreaks that plasma treatment is likely to work best when given early, and when it contained high levels of antibodies, he said.

“Somehow we didn’t really take that as seriously as perhaps we should have,” he said. “If there was a lesson in this, it’s that history actually can teach you something.”

Today, several medical centers have largely stopped giving plasma to patients. At Rush University Medical Center in Chicago, researchers found that many hospitalized patients were already producing their own antibodies, so plasma treatments would be superfluous. The Cleveland Clinic no longer routinely administers plasma because of a “lack of convincing evidence of efficacy,” according to Dr. Simon Mucha, a critical care physician.

And earlier this year, Mount Sinai stopped giving plasma to patients outside of a clinical trial. Dr. Bouvier said that she had tracked the scientific literature and that there had been a “sort of piling on” of studies that showed no benefit.

“That’s what science is — it’s a process of abandoning your old hypotheses in favor of a better hypothesis,” she said. Many initially promising drugs fail in clinical trials. “That’s just the way the cookie crumbles.”

A clinical trial in Argentina found that giving plasma early to older people reduced the progression of Covid-19. And an analysis of the Mayo Clinic program found that patients who were given plasma with a high concentration of antibodies fared better than those who did not receive the treatment. Still, in March, the N.I.H. halted a trial of plasma in people who were not yet severely ill with Covid-19 because the agency said it was unlikely to help.

With most of the medical community acknowledging plasma’s limited benefit, even the Fight Is In Us has begun to shift its focus. For months, a “clinical research” page about convalescent plasma was dominated by favorable studies and news releases, omitting major articles concluding that plasma showed little benefit.

Now, the website has been redesigned to more broadly promote not only plasma, but also testing, vaccines and other treatments like monoclonal antibodies, which are synthesized in a lab and thought to be a more potent version of plasma. Its clinical research page also includes more negative studies about plasma.

Nevertheless, the Fight Is In Us is still running Facebook ads, paid for by the federal government, telling Covid-19 survivors that “There’s a hero inside you” and “Keep up the fight.” The ads urge them to donate their plasma, even though most blood banks have stopped collecting it.

Two of plasma’s early boosters, Mr. Lebovits and Ms. Berrent, have also turned their attention to monoclonal antibodies. As he had done with plasma last spring, Mr. Lebovits helped increase acceptance of monoclonals in the Orthodox Jewish community, setting up an informational hotline, running ads in Orthodox newspapers, and creating rapid testing sites that doubled as infusion centers. Coordinating with federal officials, Mr. Lebovits has since shared his strategies with leaders in the Hispanic community in El Paso and San Diego.

And Ms. Berrent has been working with a division of the insurer UnitedHealth to match the right patients — people with underlying health conditions or who are over 65 — to that treatment.

“I’m a believer in plasma for a lot of substantive reasons, but if word came back tomorrow that jelly beans worked better, we’d be promoting jelly beans,” she said. “We are here to save lives.”
 
This is a little disturbing.

How does the vaccine not use the same protein, and if not how does our immune system recognize it?

 
This is a little disturbing.

How does the vaccine not use the same protein, and if not how does our immune system recognize it?

Great question, but something we need not worry about.

The vaccine-generated "spike protein" isn't there "real deal. That's what the line in the article that says (which are very different from those safely encoded by vaccines) means. The vaccine encodes only the portion of the spike protein that has the maximum antibody-generating properties, not the entire, biologically active spike protein.
 
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