The COVID-19 Science and Medicine Question Thread

In case you were wondering why the EU has banned Americans from coming in, a picture is worth 1,000 words. This is a direct result of Nation-wide pandemic controls like implementing things social distancing, stay at home orders, wearing masks, etc. quickly and beginning openings very slow and controlled manner. Obviously Europe has weathered the first wave while the US stopped the initial rise, but never really extinguished it enough to prevent the resurgence we're seeing now.

Angela Merkel of Germany had a great quote recently,

As we are experiencing firsthand, you cannot fight the pandemic with lies and disinformation any more than you can fight it with hate or incitement to hatred. The limits of populism and denial of basic truths are being laid bare.

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Looks like Sweden decided to just get it over with...


By all accounts, Sweden's high rate of coronavirus deaths was evidence that the country had made a horrendous error. Sweden — which did not impose a strict lockdown — suffered 543 deaths per million of its population, compared to just 105 in neighboring Denmark.
The Swedish death toll has been roughly 11 times worse than Norway's, on a per capita basis.Yet coronavirus deaths in Sweden have fallen dramatically in recent days, and are now approaching zero. Between June 30 and July 6, Sweden recorded fewer than five deaths per day on all days but one.
The decline in newly diagnosed cases has been even more dramatic. In late June, Sweden diagnosed more than 1,800 people per day as COVID-19 positive. Today, just two weeks later, only one-sixth of that number are testing positive on a daily basis.

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jpd said:
Looks like Sweden decided to just get it over with...


By all accounts, Sweden's high rate of coronavirus deaths was evidence that the country had made a horrendous error. Sweden — which did not impose a strict lockdown — suffered 543 deaths per million of its population, compared to just 105 in neighboring Denmark.
The Swedish death toll has been roughly 11 times worse than Norway's, on a per capita basis.Yet coronavirus deaths in Sweden have fallen dramatically in recent days, and are now approaching zero. Between June 30 and July 6, Sweden recorded fewer than five deaths per day on all days but one.
The decline in newly diagnosed cases has been even more dramatic. In late June, Sweden diagnosed more than 1,800 people per day as COVID-19 positive. Today, just two weeks later, only one-sixth of that number are testing positive on a daily basis.

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Posted this 1 page back from here, a bleak summary of the Sweden Experiement, an epic fail:

Ever since the coronavirus emerged in Europe, Sweden has captured international attention by conducting an unorthodox, open-air experiment. It has allowed the world to examine what happens in a pandemic when a government allows life to carry on largely unhindered.

This is what has happened: Not only have thousands more people died than in neighboring countries that imposed lockdowns, but Sweden’s economy has fared little better.

“They literally gained nothing,” said Jacob F. Kirkegaard, a senior fellow at the Peterson Institute for International Economics in Washington. “It’s a self-inflicted wound, and they have no economic gains.”
 
Some scary chit here. Albeit these data are from in vitro studies in cell culture, but it's rare that isn't translated in situ.

Coronavirus-Infected Cells Grow Filopodia
SARS-CoV-2 causes cells to put out projections that spread the virus, a study finds


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Filopodia protrusions extend from the surface of a cultured monkey cell to enable budding of viral particles (circular spheres) and infection of nearby cells.

When SARS-CoV-2 infects cultured monkey cells, it co-opts numerous host proteins, changing their function through chemical tags known as phosphate groups, a study finds. Among the effects, the study authors report this week (June 28) in Cell, is that a cell protein called CK2 spurs the growth of tentacle-like protrusions known as filopodia. These filopodia contain viral particles and are likely used to poke holes in nearby cells, spreading SARS-CoV-2 to them, according to a university press release.
 
Today's topic: What is Pooled COVID-19 Testing??

OK, you've probably heard that FDA has given Emergency Use Authorization to pooled testing for COVID-19 which increases testing capacity. What exactly is that?

It's pretty simple, in pooled testing, samples from a given number of folks, let's say 10, are all mixed together and tested for COVID-19, with accurate records kept from who is in the pool. If the test result comes back negative, then everyone is negative. If the test is positive, then there is at least one person in the pool who is positive and follow-up testing is necessary for everyone in the pool.

It's a great tool in the following instances:
  • Test availability is limited, i.e. there is a shortage of tests or high demand. ✔
  • The is a low incidence of disease. The expected positive rate helps determine the number of people in a pool. If you expect a 10% positivity rate, you would want less than 10 people in a testing pool. ✔ depending on the location and/or group testing
  • Testing capacity is limited, e.g. the test needs expense equipment and turnaround time is high. ✔
This HAS been used before. In the late 90s, blood testing for donations was shifted from serological tests to nucleic acid testing. At that point the test needed expensive equipment and took a long time. Since donated blood had low positivity rates, < 1% for AIDS, Hepatitis B, Hepatitis C, etc., it fit the pattern. IIRC, the initial pool size was 25 folks. Now the tests are less expensive and have been automated with high-throughput machines so they now longer pool.
 
I've been upset with the media in that they're not reporting the vaccine progress with accuracy. Not through malice, but by aping comments from the companies/scientists regarding the vaccines' progress, there are critical bits of info that are missing and not put into proper context.

For example, here's a headline from today's Portland, ME newspaper:

UK coronavirus vaccine prompts immune response in early test - The report in the British medical journal The Lancet suggested that so far the vaccine appeared safe and was able to conjure a promising immune response.

Sounds great, and it is, BUT...

What is missing is whether or not the immune response seen in trial patients effective in preventing a COVID-19 infection. Right now, nobody knows which antibodies, and in what quantities, are necessary for a person to resolve a COVID-19 infection. It's not until the large, Phase III trials that we'll know whether or not any of the candidate vaccines are effective.

Please, don't misconstrue what I'm saying as bad news, this is great news!! They got both antibody production, and more importantly, a robust T-Cell activtion. However, it needs to be recognized that we've still have a long way to go. Many vaccine trials can go off the rails at this stage.

Here are the phases in a nutshell:

  • Phase I - Injecting the candidate vaccine in a limited amount of people to make sure it doesn't have any dangerous side effects.

  • Phase II - Injecting the candidate vaccine in a larger cohort and seeing if there is an immune response, along with measuring the amount of antibody production in relation to dosages and boosting schedules.

  • Phase III - Injecting the candidate vaccine in a very large cohort from an endemic area to see if the incidence of infection is lower in folks getting the vaccine vs. the placebo. This is where the rubber meets the road.
Fingers crossed, as there are 2 vaccines about to enter Phase III. Hope that all continues to help an effective vaccine at this warp speed timeline.
 
NY Times did a better job with the headline this AM:


Three Coronavirus Vaccine Developers Report Promising Initial Results

Early trials showed a good immune response in vaccinated subjects, but one researcher sounded a note of caution: “There is still a long way to go.”
 
And for those of you Waiting for Godot, I mean Herd Immunity...


The results also indicate that in vast swaths of the country, the virus has touched only a small fraction of the population. In Utah, for example, just over 1 percent of people had been exposed to the virus by early June. The rate was 2.2 percent for Minneapolis-St. Paul as of June 5, 3.6 percent for the Philadelphia metropolitan region as of May 30. It was 1 percent for the San Francisco Bay Area as of April 30.

In New York City, 23.3 percent of people in the study had antibodies as of May 6. That number is almost identical to the 22.7 percent found by a state survey in late April, and much lower than the 60 or 70 percent that researchers estimate is needed for herd immunity, when the virus would stop spreading through a community.

“These figures suggest that the U.S. is nowhere near herd immunity,” said Carl Bergstrom, an infectious diseases expert at the University of Washington in Seattle.
 
No, with so many distancing and wearing masks, I am just hoping for a vaccine, sometime before my Med. cruise in Sep. 2021.
 
As the amount of testing has dramatically increased, there was an expectation of increased diagnosed cases, that's why some folks would rather see the Percent Positives Results.

This number should decrease in that when tests were in short supply early in the pandemic, testing was focused on symptomatic people. Now many states have loosened that requirements and folks can get tested without showing symptoms.

Well, this isn't the case. After the initial highs of April, the Percent Positive Results are on an upswing, giving further credence to the realization that this new upward trend in diagnosed cases is not solely an artifact of increased testing. Graphs from NY Times from CDC and State CDC data...

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Unfortunately, they only show the graphs state by state in this map-like representation and I can't blow up representative states more. Once again, look at the hot spots like FL, TX & AZ. Their gap between expected positive and actual positives is alarmingly high.

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At least it seems that there is some coming around by all that short of a vaccine, the best we got is the practice of social distancing, wearing a mask and washing one's hands until they're raw...
 
Roccus7 said:
As the amount of testing has dramatically increased, there was an expectation of increased diagnosed cases, that's why some folks would rather see the Percent Positives Results.
Click to expand...

I'm one of those folks that's more concerned with the mortality rate. Initially when they were only testing those exhibiting symptoms, you would think that Percent Positives Result would have been fairly high. Look at Wyoming in the graph, 33 more cases than expected which puts their graph out of sight - seriously? Each state has on its own scale? The expected cases were flat - does that mean they expected none? That's not very realistic.

An enduring coronavirus mystery: Why do only some get sick?


Wyo.png
 
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jpd said:
I'm one of those folks that's more concerned with the mortality rate. Initially when they were only testing those exhibiting symptoms, you would think that Percent Positives Result would have been fairly high. Look at Wyoming in the graph, 33 more cases than expected which puts their graph out of sight - seriously? Each state has on its own scale? The expected cases were flat - does that mean they expected none? That's not very realistic.

An enduring coronavirus mystery: Why do only some get sick?


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True enough, the variability of most diseases' virulence from patient is nothing new, including cancer.
 
A chart where every state has the same scale

Death rates from coronavirus (COVID-19) in the United States as of July 24, 2020, by state (per 100,000 people)




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Rouccus, question for you. I just saw on the news that an airline is using UV light to sanitize the planes. They showed a guy walking slowly behind the device and they said it does the job in 10 min. We used to use UV light to sanitize a 14x14 BMTU room when one pt left but we would leave it on for 30 min at least.

My question is just how long would the uv light have to be on to kill the virus? I'm thinking the maybe 10 seconds on each surface that the airlines are doing would not be enough to kill. What is your opinion?
 
Dx life Rx fishing said:
Rouccus, question for you. I just saw on the news that an airline is using UV light to sanitize the planes. They showed a guy walking slowly behind the device and they said it does the job in 10 min. We used to use UV light to sanitize a 14x14 BMTU room when one pt left but we would leave it on for 30 min at least.

My question is just how long would the uv light have to be on to kill the virus? I'm thinking the maybe 10 seconds on each surface that the airlines are doing would not be enough to kill. What is your opinion?
Click to expand...

Can't comment with any authority here. It's all a matter of UV wavelength and doseage. If they're using an FDA registered device to do this, then it must be delivering enough UV in the process.

That being said, from what you wrote I too am skeptical. Whenever I encountered UV sterilization, the "zapping" was so strong that you couldn't be in the room. The person walking behind the UV source doesn't make sense. I know that the NY Subways are decontaminating with UV and the cars are empty when this occurs.
 
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