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  1. #1
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    Default Potential Good News On the COVID Front

    So, this is a country agnostic comment. I can't stop anyone from going off track but can't promise I won't respond if someone does.

    The point is more from my view as a kind of country agnostic person (I feel like I could live anywhere other than countries where you are not allowed to speak freely) is understanding how all of us get past covid. That's not just countries with infection, but letting countries with low rates out of the cage. If you're in a country anywhere that exposure has been low, then until or unless there's a useful long term vaccine or treatment, this hasn't gone away.

    Lead time between small problem and big problem is only a couple of months.

    There was an article in the news here lately that explains a lot of mysteries here in the states where infection rates have been pretty high:
    * why isn't antibody testing more accurate or reliable (I don't know how accurate the antibody tests are, there may be two aspects to this)
    * stories coming out that antibodies fade fairly quickly
    * negative tests for people with covid that come back to positive later (I think this is a testing issue and not that people are "re-getting" the same thing). I don't have HIV but when I was younger, I read about it out of curiosity. I remember seeing that you can have low viral loads (can be undetectable) in some parts of the body and the virus can reside elsewhere (gones, especially) and then recur if you drop your guard. Actually, I don't know that I've ever known anyone who has HIV or had it, but for some reason, I found the information fascinating. If someone is swabbing your nose and you have covid virus in concentration elsewhere bobbing up and down above detectable levels, then by all means.

    So, here's the point. fading antibodies is bad because if you're going to provide people with antibodies and they don't last, what good are they? If someone gets the virus and their antibodies fade, then they're going to get it again at some point. Figure the news will always make it sound worse than it is, so if they can find someone who loses their antibodies to any detectable amount in 3 months, then they'll just love a story like that. People seem to love to click on scary stories. Pro wrestling psychology - show someone something they really like or they really hate. Anything in the middle will be forgotten.

    It turns out that there may be some immunity from T cells for two reasons (in the absence of antibodies or after loss of antibodies)
    1) some people have T cells that are reactive to covid that exist much longer than antibodies (17 years so far for SARS patients)
    2) a separate story suggested that when lab samples were checked from prior to the COVID outbreak, some samples have T cells that are reactive to COVID even though it's suspected that those cells weren't exposed to the current COVID round

    Why is that? I don't know. Was there a virus strain in the past that wasn't recognized or maybe as severe, but was similar?

    Whatever the case may be, it means immunity may last longer, and another cohort may never be easily infected in the first place.

    That's good news.

    Apparently, immunizations can be tailored to elicit T cell response, and if vaccines intended to make antibodies aren't long lasting, then a different type of vaccine may be.

    And we may be as a population (especially in places who have weathered it, US, western europe, Sweden) further ahead of it than we think.

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  3. #2
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    Just what the forum needed, Another COVID thread. They haven't been divisive at all.

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    Quote Originally Posted by bueller View Post
    Just what the forum needed, Another COVID thread. They haven't been divisive at all.
    Perhaps one where people are dedicated to talking about nothing other than solving the issue (and not what other people should do to solving other issues, or telling anyone else what to do in general) would be good.

    I've noticed here, and probably in much of the US, when I'd come into work (which we are allowed to do on a limited basis), I was here by myself the first day. There was no traffic, etc. That was after the first outbreak was over and the entire county of 1.2MM had only 8 people serious enough to be hospitalized.

    I came to work today and had to pay attention to other drivers, because people are just going back to work, anyway. In this county of 1.2MM, the total deaths are only 210. I asked my PCP and he said that they have had 3 deaths in their clinic, but none were a surprise, and in most cases, he wasn't aware of any. We have twice as many cases as we did the first time around, but the death count increases by about 1 per day or a little bit less. People under lockdown will eventually get tired of waiting as they have here.

    the idea that things may be bad, but not as bad as we thought (or we're told in most news outlets "the antibodies go away within months!!!!") seems like good news. We're a canary in the mine here, so to speak. What appears to be the case is that most of the places that were not much exposed early on decided they'd not be affected, and they're heavily affected now and locking down. The places that were heavily affected don't seem to be as highly impacted as one would expect on the second go-around here.

    That's good news, because from a problem solving standpoint, I suspect we'll be living with this thing for quite some time. Maybe forever.

  5. #4
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    responding in the spirit of the post ...
    Quote Originally Posted by D.W. View Post
    So, this is a country agnostic comment. I can't stop anyone from going off track but can't promise I won't respond if someone does.

    Lead time between small problem and big problem is only a couple of months.
    based on the "moral panic" currently influencing Covid responses in Victoria and Australia more generally, the lead time between "not an issue" and "big problem" is more likely measured in weeks, not months.

    Quote Originally Posted by D.W. View Post
    There was an article in the news here lately that explains a lot of mysteries here in the states where infection rates have been pretty high:
    * why isn't antibody testing more accurate or reliable (I don't know how accurate the antibody tests are, there may be two aspects to this)
    my understanding, based a lot on Canadian media reporting of scientific research, is that the "false negative" testing rate can be as high as 30%.
    i.e. 30% of people who are positive to Covid-19 test negative via the molecular test.
    What I don't know is whether the "false negative" result is independent (i.e. the chance of two "false negative" tests on the same person have a probability of 0.09) or if the testing is related -- if your first test result is a "false negative" subsequent test results are also likely to be "false negatives".
    Quote Originally Posted by D.W. View Post
    * stories coming out that antibodies fade fairly quickly
    that is my understanding. A "successful antiviral will likely require annual boosters much like the flu vaccine.
    Quote Originally Posted by D.W. View Post
    * negative tests for people with covid that come back to positive later (I think this is a testing issue and not that people are "re-getting" the same thing).
    I think -- i.e. I don't have access to the relevant research, or the research is not yet available -- that the problem is related to the "false negative" results I mentioned above and might provide evidence that each Covid test is independent.

    Quote Originally Posted by D.W. View Post
    So, here's the point. fading antibodies is bad because if you're going to provide people with antibodies and they don't last, what good are they? If someone gets the virus and their antibodies fade, then they're going to get it again at some point.
    this is the outcome I figure is most likely, annual or even bi annual booster anto virus injections.
    Quote Originally Posted by D.W. View Post
    It turns out that there may be some immunity from T cells for two reasons (in the absence of antibodies or after loss of antibodies)
    1) some people have T cells that are reactive to covid that exist much longer than antibodies (17 years so far for SARS patients)
    2) a separate story suggested that when lab samples were checked from prior to the COVID outbreak, some samples have T cells that are reactive to COVID even though it's suspected that those cells weren't exposed to the current COVID round

    Why is that? I don't know. Was there a virus strain in the past that wasn't recognized or maybe as severe, but was similar?
    I also don't know.

    Quote Originally Posted by D.W. View Post
    Whatever the case may be, it means immunity may last longer, and another cohort may never be easily infected in the first place.

    That's good news.
    I agree. That would be good news

    Though I accept that annual flu shots are a wise idea
    regards from Alberta, Canada

    ian

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    We do the annual flu shot here. It's free. I'm pretty much country agnostic as an individual and politically uninterested in any political organization of any type (politics uses problems, I prefer people who solve problems and get fulfillment out of the goodness of doing that, not using things and people).

    At any rate, there's some misunderstanding, probably in most places, that getting the flu shot is to keep you from getting the flu. Many here rely on anecdotes (the "it gives you autism" cohort is small despite the amount of blog posts they make). Based on how I view things (in my day job, more spatial), I've never read the point, but would suspect it's outbreak control. Reduce the likelihood of a carrier for certain types, reduce the concentration of it and greatly slow the spread.

    It's uncommon for me to get the flu either way, so I don't care for myself. It's more a matter of not contributing to a problem. which now is a lot more understandable for people given how easy it is to observe the spread of covid.

    Yes on the news. As soon as an outbreak starts and testing numbers go up, the news will seize on it. As lockdown progresses and the new diagnoses go down but death numbers go up, it won't be "the trailing indicator of reported covid deaths are up, but we would've expected this and new cases are down, so the increased deaths should be temporary".

    We get this instead:
    * RECORD NUMBER OF DAILY DEATHS AGAIN, 5 DAYS IN A ROW. WHEN WILL IT END ?!?!?!
    * DEATHS UP, MYSTERY OF DELIRIUM IN INDIVIDUALS WITH NO OTHER SYMPTOMS, COVID CAUSING PERMANENT BRAIN DAMAGE!!!

    It becomes a 1950s horror story and the "what can you do to help" message is lost.

    The upside is we're in our second outbreak here - diagnosed cases are up, deaths are way down vs. the first. We opened bars and restaurants and expected we'd see a bump up in cases (at least I did), but not that many deaths because most folks with vulnerable relatives are a lot more cautious.

    I expect that the outbreaks will occur more and more slowly here as it's likely that about 50 million people in the states have had the virus by now.


    Still extremely dangerous for the vulnerable, but we're getting to see the effect a second time now that transmission occurs inside. Second wave diagnosis numbers are trending downward again after only two weeks of the second shutdown. It's controllable, except this time, dining is still allowed outside (it's summer here) and outdoor recreation continues in great volume than it did previously (our club pool stayed open this time - about 500 members, no cases).

    Flu shot and avoidance of getting colds is a good thing for the upcoming fall and winter season here if for no other reason than to not have to guess that with cold or flu (about 93% of symptomatic folks here have something other than covid according to the test results) that you might have to quarantine due to having covid.

  7. #6
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    Quote Originally Posted by D.W. View Post
    At any rate, there's some misunderstanding, probably in most places, that getting the flu shot is to keep you from getting the flu. Many here rely on anecdotes (the "it gives you autism" cohort is small despite the amount of blog posts they make). Based on how I view things (in my day job, more spatial), I've never read the point, but would suspect it's outbreak control. Reduce the likelihood of a carrier for certain types, reduce the concentration of it and greatly slow the spread.
    my understanding is that annual flu shots are about REDUCING the severity of the annual flu strain.
    The Australian Broadcasting Corporation reported yesterday that so far this year 39 people have died from influenza compared with an expected 430 deaths from the flu. The cause is most likely related to improved hand hygiene. Total Covid-19 deaths in Australia are currently 133, so after adding in the 39 due to "the flu", the total deaths are well under half the expected number.

    Not sure at this time what that means for deaths due to other causes.


    It becomes a 1950s horror story
    minus the "duck and cover" to survive the 1950s expected nuclear fall out
    regards from Alberta, Canada

    ian

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    It sounds like flu is more easily spread by hand/touch than covid. As time goes on here, we are finally dealing with the fact that most transmission is respiratory in enclosed spaces. Early large groups of transmission made this pretty obvious. My wife bleached all of our food and mail, but I was skeptical at first after reading some chinese study information and said "let's watch the letter carriers. they're carrying a thousand times as much as we're touching - they can't walk around without touching their faces, etc forever".

    None of ours got sick. I'm sure some did, but would suspect they did from delivering mail into apartment buildings and working together. They gradually stopped wearing gloves and masks (our carriers drive their van to the center of the neighborhood and then walk on foot).

    That was a REAL concern early on. We all lock down, everyone increases the amount of food they're getting by mail, etc. If the letter carriers go down, we're going to be in real trouble.

    Fortunately, it didn't happen. I have asthma (though not severe). Information about my risk level is ambiguous at best. I've avoided enclosed spaces (stopped riding public trans - not surprisingly, we did end up with a bunch of bus drivers getting covid - they're sitting in an enclosed tube and a lot of the ridership is nutty folks who may not grasp the whole covid thing. public trans in the US generally is only concentrated in cities, so the nutty types will end up living here because transit is free for them. You can spot them pretty quickly, or figure it out when they talk, but who is going to do anything about them rubbing their faces and touching seats and coughing without a mask.

    I would imagine the data about influenza and respiratory infections other than covid will be very enlightening - as in, if we stop going indoors with each other, all of that stuff is going to drop drastically. Nursing homes don't allow guests on the premises indoors. They've been hit hard by covid, but that's better controlled now, too. I'd bet their seasonal flu and other respiratory infections will be down. In order to slow down covid, those avenues are greatly reduced.

    Yes on the reduction in severity of the flu, I've heard that, too and forgot. The people who won't do the flu shot because they believe it gets everyone sick with the flu remind me of an aunt of mine. For those folks, nothing ever happens that's just routine. This aunt went to McDonalds once in the 1980s here, ate a big mac and felt ill later that day. She probably was already sick and didn't know it. Since then, nobody in her family has ever gone to mcdonalds. She's got them all convinced that "the food is bad".

    One of my coworkers won't get the flu shot "i once got a flu shot and got the flu two weeks later. You can't tell me that the shot didn't cause the flu". (OK, that tells me enough to know not to try...but jeez, ever get the flu in a year you didn't get the flu shot? what caused it).

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    Don’t want to derail your thread but I agree with your Aunt.
    H.
    Jimcracks for the rich and/or wealthy. (aka GKB '88)

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    Quote Originally Posted by D.W. View Post
    One of my coworkers won't get the flu shot "i once got a flu shot and got the flu two weeks later. You can't tell me that the shot didn't cause the flu".
    As far as I know no one who has had influenza will knock back the chance to get a shot of anti-flu vaccine.
    Sounds like your coworker just had a common cold.
    regards from Alberta, Canada

    ian

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    Quote Originally Posted by ian View Post
    As far as I know no one who has had influenza will knock back the chance to get a shot of anti-flu vaccine.
    Sounds like your coworker just had a common cold.
    Well said. I had influenza once as a youngster (diagnosed by a test). For three days I didn't know where I was, hallucinations, sweating etc. and had to be spoon-fed and bed bathed. I often wonder how many cases of influenza which are reported and go to make up the annual statistics are the real deal.

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    Quote Originally Posted by woodhutt View Post
    Well said. I had influenza once as a youngster (diagnosed by a test). For three days I didn't know where I was, hallucinations, sweating etc. and had to be spoon-fed and bed bathed. I often wonder how many cases of influenza which are reported and go to make up the annual statistics are the real deal.
    I suspect all of the cases reported and making up the annual stats are the real deal.

    Unless your test result is positive for influenza, by definition you don't have it.
    regards from Alberta, Canada

    ian

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    Quote Originally Posted by ian View Post
    I suspect all of the cases reported and making up the annual stats are the real deal.

    Unless your test result is positive for influenza, by definition you don't have it.
    I'm not so sure, Ian. I know many people who have been given a GP certificate for their employer claiming they have 'flu but without having been given a test. In fact, I am the only person I know to have had such a test. If the stats are based on sickness certificates issued then this would be misleading.
    A GP I know socially said the furthest he would go is to write a cert stating the patient was 'displaying 'flu-like symptoms'. He said that, if a patient had influenza they would not be able to make it to his surgery. I can vouch for that!
    Pete

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    Quote Originally Posted by woodhutt View Post
    I'm not so sure, Ian. I know many people who have been given a GP certificate for their employer claiming they have 'flu but without having been given a test. In fact, I am the only person I know to have had such a test. If the stats are based on sickness certificates issued then this would be misleading.
    Hi Pete

    It's sometimes surprising what's available on the internet from: Department of Health | Australian Influenza Surveillance Report - No 08 - week ending 26 July 2020


    • Activity – Following a high start to the 2020 interseasonal period, currently, influenza and influenza-like illness (ILI) activity are lower than average across all systems for this time of year. At the national level, notifications of laboratory-confirmed influenza have substantially decreased since mid-March and remain low.
    • Severity – There is no indication of the potential severity of the 2020 season at this time. In the year to date, of the 20,934 notifications of laboratory confirmed influenza, 36 (0.17%) laboratory-confirmed influenza-associated deaths have been notified to the National Notifiable Diseases Surveillance System (NNDSS).
    • Virology – In the year to date, the majority of nationally reported laboratory-confirmed influenza cases were influenza A (87.3%). Of cases in the last fortnight, the proportion of cases attributed to influenza B has increased (29.2%), compared to the previous fortnight (26.6%; 29 June to 12 July 2020).
    • Vaccine match and effectiveness – It is too early in the season to assess vaccine match and effectiveness.

    Based on the above I think it safe to conclude that "flu like symptoms" are not counted in the annual stats.
    regards from Alberta, Canada

    ian

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    influenza tests are underdone here, too. I guess the PCPs (our term for general doc) usually assume that unless you're not resolving by the time a subsequent visit is needed, there's no great need to test for influenza.

    If there are complications from it at a nursing home or hospital for elderly, same.

    No clue if overall, reported deaths are overstated or understated - pneumonia is often reported as a cause of death here.

    Fellow in my office had influenza in February, and was slow to resolve. He got tested for it several times and actually had confirmed positive results, first test and second, and only tested negative after resolving at a third visit.

    Much of what people refer to as "having the flu" for 24 hours or whatever else it may be is probably something else, like mild food poisoning. There's just no economic incentive for the health systems to really narrow down what an illness is with an assay unless they're doing a data survey or someone isn't resolving. Many nursing homes here are for profit and probably have no incentive to spend unneeded money. The not-for-profit versions probably don't have the money to spend.


    Second round of covid is thoroughly around here now, though. It's in a local nursing home that's not a county home of abandonment (as in, well run), and I see reports that it's on the upswing in parts of western europe.

    At the same time, the initial testing of vaccines sounds like it's being done less than objectively. For example, the vaccines can cause complications or increases in other infections (Some flu vaccines increase the frequency of respiratory viruses, at least in some past tests - and with statistical confidence). Listening to a debate between Alan Dershowitz and Robert Kennedy's son (can't remember his name, he's a nephew of JFK), about how well a mandatory vaccine will go here, RFK's son mentioned that when vaccine trials go poorly with complications, the next test generally gets done against the meningitis vaccine as placebo (which often leads to other illness not related to meningitis, sometimes paralysis and more deaths when given widely than meningitis generally causes itself).

    It's apparently not yet clear whether it's better for most to avoid a vaccine if their death rates for a cohort are 1 in 1000 or less. This leaves the people in at risk cohorts stuck.

    I didn't believe the commentary about respiratory viruses, but I have asthma and respiratory viruses lead to bronchitis for me about 2/3rds of the time. That sucks. It turns into a three week ordeal of lost sleep unless addressed with steroids (not a fan). I located the study that RFK referred to, and it was legitimate. I also located conflicting studies and others that said there was an increased risk but less than 4 times higher for respiratory viruses.

    I probably won't get the flu vaccine next year if it matches one of the types mentioned in the increased risk studies, but my kids and spouse don't have asthma, so they will.

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    Quote Originally Posted by D.W. View Post
    influenza tests are underdone here, too. I guess the PCPs (our term for general doc) usually assume that unless you're not resolving by the time a subsequent visit is needed, there's no great need to test for influenza.

    If there are complications from it at a nursing home or hospital for elderly, same.

    No clue if overall, reported deaths are overstated or understated - pneumonia is often reported as a cause of death here.
    David,
    I think the big difference between the US and Aus is that between Australian version of Medicare and the eight State funded public Hospital systems there is little to no cost incentive (positive or negative incentives) to under-test for the influenza infection. If anything, the "free" health care as provided in Australia leads to more tests for influenza being conducted than might strictly be necessary.

    If you have influenza and thus will be off work for more than 2 days, you will almost always be tested for the virus.


    What will be interesting is if the greater availability of the "annual flu shot" in March and April 2020 has a bearing on the incidence of influenza this current flu season.
    regards from Alberta, Canada

    ian

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