SARS-CoV-2 is a new virus in the human ecosystem. Humans didn’t pay much attention to it when it was only in bats. It’s of great interest to humans now. Because it’s new to our bodies and societies, we know nothing about it. We are picking up empirical observations quickly, but it’s hard to put them together in real time, motivated by sickness and death.
Research is proceeding, particularly for testing methods for both the virus and human immunity to it, for a vaccine, and for treatments. Many questions are still open. We will hear bits and pieces from the research, but the bigger questions won’t be answered for some time.
Here are the open questions I can easily think of. Answers to any of them would help us manage the pandemic.
Please don’t send me the latest preprints on these topics. I know they’re out there. Every day brings a new one that someone thinks is THE ANSWER to all this. None of them is by itself. Some have been out-and-out wrong. The best are small pieces in a much bigger puzzle. Science, is never fully certain. As we learn on the fly, it’s more uncertain than usual. We have to live with that.
What is the course of the disease? It is extremely variable, with relatively mild cases approximating a bad flu, running through a disabling illness that involves severe muscle pains and difficulty in breathing, to hospitalization and intubation to provide oxygen. What variables determine that course? Are there long-lasting effects?
There seems to be an incubation period in which people are asymptomatic but can spread the virus. How long is that period? How much virus do they shed? By what means? Is the virus detectable in them?
We know almost nothing about immunity to the virus. Are all recovered people immune? How immune are they? How long does immunity last? Do recovered people shed virus? Are some people immune without ever having had the virus? There are also technical questions about what part of the immune system might be most effective in fighting the virus.
A number of reports of varying quality suggest that some cases of COVID-19 show no symptoms but result in immunity. Do those people shed the virus? For how long? Or do they have some previous condition that gives them immunity without being infected? When did infections begin in the United States?
Children seem to catch the virus at much lower rates than adults do. Are they asymptomatic carriers? Under what conditions?
Death rates are often reported as the deaths for which SARS-CoV-2 infection has been verified by test. But deaths at home and in hospital, without tests, may be due to COVID-19. Additionally, people are probably dying of other conditions but don’t go to the doctor or hospital because they are afraid of being infected. We don’t know, and probably won’t know for some time, how many deaths are occurring as a result of the pandemic.
Kevin Drum: We have no idea which interventions work against COVID-19.
Is the virus less virulent in hotter weather? So far the evidence appears to be negative; countries near the equator are affected as much as cooler countries. But it’s not definitive.
We are buying time with social distancing. Scientists are collecting data and doing experiments to find answers to these questions and more. Any answers will help.
Brachiator
Or is it more that the illness in children is much less severe, and rarely fatal, than when compared with adults?
This is a biggie. There have been reports of survivors having serious issues later. And obviously, the course of the virus is still recent, so we don’t have much in the way of long term follow-ups.
Another question: are there treatments which might make the later course of the illness less severe or less likely to be fatal?
I have not read a lot of the reports (so as to not scare myself) about the “typical course” of the disease. In the more severe cases, does the illness always ramp up from discomfort to severe attack on the body’s systems and defenses?
Is there any way to quantify the risk of a recurrence of the virus this coming winter?
Van Buren
Are there any other viruses that trigger such a wide variety of symptoms and reactions? I can’t think of any but I’m not medical.
Cheryl Rofer
Good questions.
The course of the illness, and symptoms, are all over the map. I am thinking of doing a post on that, but I’m not fond of contemplating the symptoms for as long as it takes to write a post.
No. We don’t know what its seasonal behavior is, and people’s behavior in “opening up” the various states will have a lot to do with it.
Enhanced Voting Techniques
Medlife Crises on the ventilators and how the medical view of them is changing (Medlife is heart specialist doctor in England)
youtu.be/Fz2gyhto-iI
Sandia Blanca
Hi Cheryl, great post, thank you! I work for a large healthcare system, and we’ve been holding weekly informational meetings on Covid19.
One of our physician executives mentioned last week that there are as many as 50 different strains that have been identified, with some originating directly in Asia, and others coming through Europe. The European strain that entered New York has been much more dangerous than some of the others coming from other entry points. For example, the strain that is more prevalent here in Texas is a bit milder, which may account for our lower rate of deaths (although our testing is abysmal).
I’m hoping that as scientists learn more, they may be able to pinpoint whether certain strains are associated with some of the non-respiratory damage to the body that’s been discussed recently (e.g. blood clotting, heart damage, other organs, etc.) Would be interested in anything you’ve heard along these lines. Thank you.
HarryBee
Are there people who are truly naturally immune? If so, is there a genetic mutation that confers absolute immunity? Could having two copies of such a mutation afford complete immunity and one copy provide a limited immunity and mild symptoms? I guess the question is, “Why do some people not get sick despite exposure to the virus?”
Cheryl Rofer
@Sandia Blanca: I am wary of reports of different “strains” of the virus. I am following Trevor Bedford, of the Fred Hutchison Center in Seattle, on this. He’s an expert in analyzing the virus genomes.
My understanding so far is that the “strains” have small differences that serve to mark them as coming from one place or another but don’t affect the virus functionally. Do you have a reference for what your physician executive said?
JaySinWA
@Cheryl Rofer: I wonder if this virus will really have seasons other than the distancing and isolation “seasons” that will last only as long as people can stand it. Would seasonality depend on the answers to the questions about acquired immunity?
Isn’t much of the winter season worry that this will be mixed with much of seasonal flu? While that could be true, if we manage to change our behavior about public gatherings and working while sick, I would think seasonal flu would be less of an issue. Of course that kind of change is not assured, especially if the perception remains that “only” some groups are at risk, and large parts of the population doesn’t see them as important enough to care for.
Cheryl Rofer
@JaySinWA: The common cold coronaviruses and influenza viruses are less active during the summer months. We don’t know if that’s the case for SARS-CoV-19.
Adding influenza to COVID-19 next fall and winter could be a real hospital-breaker.
Lord Fartdaddy (Formerly, Mumphrey, Smedley Darlington Mingobat, et al.)
I don’t know if you heard about this, but a very stable genius knows more about the corona virus than even the doctors do, and he says that mainlining bleach is a good thing to try.
There are all kinds of things we know about this. You just have to go to the right sources is all.
jackmac
There are reports today of COVID-19 treatments using famotidine — the active ingredient in Pepcid-AC and also sold in an OTC generic version. If you are like me and have heartburn issues and use the brand name or generic version, finding a supply has suddenly become difficult. We checked at a local Walmart and found a few 100-count bottles of the generic version remained and rushed to snap up two. Within two hours, Walmart and most Targets in the region were sold out. Online sales appear to have dried up.
prufrock
@jackmac: This mentality is as viral as Covid-19 itself. Over at Slacktivist, Fred Clark describes an experiment he ran by putting a “take only 2” sign that they use for things like paper towels at the Home Depot where he works on a display of laundry detergent. Now, this display had been mostly untouched for days. A couple of hours after he put the sign there, that detergent was gone.
Madness.
zhena gogolia
@jackmac:
Oh, God, that’s my problem too.
Draco7
The non-respiratory symptoms are what’s really drawing my focus. We are used to a number of respiratory consequences from familiar causes such as the flu, colds, bronchitis, etc. We don’t understand the behavior of the coronavirus, but at least the respiratory consequences seem familiar – only more severe.
The microclotting as described in reporting apparently causes strokes and sudden death in younger subjects who are otherwise healthy. They get some of the more common symptoms, seem to be recovered, and go home. A number of these individuals then are victims of a stroke or sudden death – now that’s creepy. The reporting is that the doctors addressing the initial clot in the brain are seeing clots actively form while they’re still operating.
What mechanism of the virus is responsible for that? That’s kind of off the map, as are the other non-respiratory symptoms. There’s another question mark.
Cheryl Rofer
Here’s a description of how one group is going about investigating one question.
Another Scott
Thanks for this, Cheryl.
Even with their early hickups/obfuscation, China seems to be the gold standard on understanding and fighting this disease. What are they doing right? Is it mostly/all just locking people down until they’re demonstrated to be free of the virus? Do they have better testing technology? Do they have better tracking/tracing? Do they have better treatments?
How can a country of 1.44B people have less than 10% of the deaths of the USA when the outbreak started there??!
The US and the UK are doing especially badly, but so did Italy and Spain (and several other European countries aren’t doing especially well). We need to learn and apply the sensible lessons from China and make sure those methods are used in South America and Africa and the rest of Asia before millions die. :-(
Thanks.
Cheers,
Scott.
PeakVT
@Cheryl Rofer: there is a pre-print floating around from a researcher in China that claims to have tested the lethality of several strains, found a difference, and then used a more detailed genetic decoding method to find differences in the strains that would explain the variations in lethality. The South China Morning Post had an article. I have not seen follow-ups.
Matt McIrvin
@Cheryl Rofer: I think some of the talk of “different strains” is people trying to rationalize real or perceived inconsistencies in what they’ve heard about COVID in different countries.
For instance, there was a lot of early emphasis on young people being at less risk, then they heard about younger adults filling up ICU beds in Italy and France, so they conclude that this is a functionally different strain at work (though these two facts could easily not be inconsistent with one another at all).
Another Scott
Al Jazeera:
Don’t do that!! :-(
Cheers,
Scott.
Barbara
@Another Scott: I am not saying that China has nothing to teach us, but I suspect that the efforts in Korea and Germany are more compatible with what a democratically elected government should be able to do. Korea was prepared because unlike us, it suffered a lot more under the first go round with SARS. In addition, in both Germany and Korea, developing a viable test was given paramount importance. CDC really, really screwed up and in many ways, we will never recover from that bit of misfeasance.
Barbara
@Matt McIrvin: From what I understand, scientists are using the viral DNA to track the disease source in specific areas, and have noted mutations along the way, but have considered these mutations to be sufficiently minor as not to change the essential nature of what happens when the virus invades your body. They could be wrong about that, but that is what they have noted so far.
John Revolta
So, latest stats show US with a million diagnosed cases, out of 3 million worldwide. Yay.
Laura Too
@jackmac: It does make me wonder if drug companys are trying the “buy only two” trick with their product? I’m a cynic but there is a lot of money to be made off people’s fear.
John Revolta
Is all this stuff that we don’t know, stuff that nobody knows, or just us in the US? Because sadly, I no longer assume that we’re in the forefront of researching anything.
JaySinWA
@Another Scott: It is important to note that they are talking about methanol as mentioned in the last paragraph you quote (industrial, automotive, heating) not ethanol (drinking). Alcohol poisoning is bad but some is more lethal than others. I understood that Isopropyl (rubbing) alcohol was part of the disinfectants Trump was touting, also deadly or damaging to ingest.
IIRC methanol was added to ethanol by less than scrupulous dealers during prohibition, and shows up occasionally today in bootlegging.
Gbbalto
@Another Scott: I expect that this is from poorly made moonshine rather than deliberately drinking methanol
Cheryl Rofer
@PeakVT: Yes, the South China Morning Post is where I saw it was being said.
As I said in the OP, one preprint doesn’t mean much. It’s something to be aware of, but not a gamechanger
@Matt McIrvin: I think there’s a lot to this.
piratedan
testing is still somewhat problematic, just sayin’…
we have the original WHO test kits out there using naso-pharyngeal swabs (or in a testing-media crunch, oral-pharyngeal swabs), we have home-grown facility testing using similar testing methodology, and now there’s sputum testing being generated (a container to spit in is a lot easier to come by than a sterile swab). Plus there are now also blood seriology testing being developed in addition to that, antibody testing is under way.
and I won’t harp much on the POC from Abbott, but the thing is, I’m still not reading that we’re seeing a significant effort in expanding the testing to track the asymptomatic carriers to try and prevent a second wave or even try and get a better handle on this in flyover country. I suspect that there are some issues there but the mechanism on reporting crappy numbers in Trump Country is problematic, is it by design or is it because most of these places do not have the reporting mechanisms to provide a proper accounting or some of both?
glc
@John Revolta: It’s the stuff that nobody knows.
We also don’t know how many cases there are in the U.S. (or most other countries) and how many people have died from the disease.
In the old days, of course, we would also have had to wait years for answers to most of the fundamental questions. Now we are actually able to address this in something like real time.
Which means that we don’t actually have a peer review process in place that operates at a comparable rate, so we now get to see the normal research process unfold, and we get to see it interact directly with journalism, which is unnerving and sometimes dangerous. And sometimes inspiring.
Cheryl Rofer
@John Revolta:
Stuff that nobody knows. I’m watching pretty closely, but I could have missed something.
The scientific community is working very much internationally, posting preprints on the internet and talking to each other. China had genome sequences up within days of the first case.
Lapassionara
@piratedan: Supposedly our very stable genius will be discussing testing at this afternoon’s press conference.
seriously, this is an important question. I don’t see how we “open” up without more testing.
MattF
It’s all quite frustrating. The vocabulary characterizing immunity states after infection seems confused. Is there a difference between immunity and resistance? And immunological mechanisms are famously complex— antigen, antibody, B-cells, T-cells, whatever. I’m sure actual experts understand, but I think a lot of amateur epidemiologists are becoming amateur immunologists as well…
WV Blondie
Thanks for this!
One question I’ve been wondering about is just how contagious it is. Do you need exposure to millions of droplets? Thousands? Hundreds? Or does it only take one …?
John Revolta
@glc: @Cheryl Rofer: Well, so at least there’s that. Frustrating though!
cain
@prufrock:
I wonder if that will work for pets?
Cheryl Rofer
@MattF: There are something like 160 different approaches to vaccines being tried. That gives you some idea of the complexity.
Cheryl Rofer
@WV Blondie: That is a great question! I should have included it.
We don’t know.
Uncle Cosmo
It most assuredly is not madness:
No limits? No hurry to buy the item; buy only when you need another one. Limits? Buy it & stash it, because you might not be able to find another when you need it.
Crap, that’s just common sense. Only someone totally bereft of common sense would call it “madness” – but that includes a fair hunk of the patronage here.
debbie
@Cheryl Rofer:
I will link to nothing, but that April 2020 Science Magazine article, “How does coronavirus kill?” makes makes me think this will be a very, very hard-fought battle.
Subsole
A sober and informative thread.
Meanwhile the party of hard-headed, unsentimental and totally rational realists are freebasing toilet cleaner and giving themselves tanning lamp suppositories…
cain
@Cheryl Rofer – what is your opinion about Sweden saying that they would have herd immunity by May. I don’t really know what that means since:
The person who declared that said that many elderly have died. But it seems people pointing to Sweden because they didnt shut down the country down.
Dan B
A friend’s mother just died of Covid-19. She was in her 90’s so it seemed nearly inevitable. It turned on my old brain cells. I’m 70 so my risk is high. I’m in Seattle which has plateaued with 100 new cases per day. This is not reassuring since Boeing has reopened and other businesses are being vetted for restarting. If the number of cases goes up a bit, say a doubling but not a huge increase that doubles my chance of being infected and may lead to a very long tail of infection. There are reports that SarsCoV-2 may be with us forever. Does that mean I and other high risk people must shelter in place until there is (if) a vaccine or effective treatments? Is that 18 months or three years?
The longer it takes for widespread reliable testing, plus tracking and isolating, the longer we’ll have vulnerable people in lockdown.
cain
@WV Blondie:
I’m not sure how many are in a single droplet, but I suppose it is a function of your immune system? But I dont know if that question has ever been answered even for the common cold?
Omnes Omnibus
@Uncle Cosmo: Aside from your anger issues, your view of common sense is somewhat lacking. If I don’t need something and don’t anticipate needing it, I don’t buy it as a general rule. Artificial indications of scarcity be damned.
There is a reason it is known as panic buying.
cckids
Grocery store cashier here in Seattle. This reminds me of the day, back in mid February, when our great TP panic started. I was working, and noticed the amounts of TP coming through the lines, asked a customer “why?” She told me she’d heard on FB that the local Costco was sold out of TP. People behind her in line heard it & went to grab some of their own, texted friends, etc. And it snowballed from there. By that night, and the next few days, we heard over and over “Costco is sold out of TP!!”
I know it isn’t the only cause, but I do believe that quite a bit of the panic buying is generated by this urban legend type of crap.
Subsole
@Lapassionara:
I think the plan is we open up like the Russians in Stalingrad:
“The patriot-customer with the rifle advances until infected. When he dies, the patriot-customer behind him picks up the rifle and shoots the virus.
Or the mailman.
Or a Black.
Or a Jew.
Or some livestock.
Or a cloud.
Or a bystander.
Y’know. Whatever. Point is, he shoots the gun.”
cain
@Dan B:
We need aggressive testing – sane contact tracing, and ways to monitor temperatures of people so then we can isolate them as quickly as possible until we can find a vaccine.
Barbara
@Dan B: It’s really unsettling, I agree, not least because there are so many unknowns. However, I do think that even if this is with us forever, so to speak, doctors will get better at treating it and recognizing and managing potentially deadly symptoms, especially if the number of new cases is not overwhelming — even for people who might have higher risks.
Ohio Mom
Every time I read there are questions about immunity, such as, If recovered people do develop it, or How long immunity might last, and so forth, I think of HIV. No herd immunity for that.
No vaccine either, though an effective treatment protocol was eventually developed. I hope we are luckier with this virus.
Cheryl Rofer
@cain: If the R0 of SARS-CoV-2 is 3-5, which it seems to be, you need 60-70% immune population for herd immunity.
You are correct that we do not know those things about herd immunity. There are a lot of questions.
If some of the higher estimates of people who have had the virus in New York City are correct, they are 15-20%. That is still a long way from herd immunity. Many more people will die on the way up to 60-70%. And you don’t want to get there fast and overrun hospital capacity.
Cheryl Rofer
@Dan B: I am contemplating those questions and will eventually write a post about them. Thinking down those paths illuminates why it is necessary to have a vaccine or a treatment that can cut off the disease early.
BR
As I’ve posted here before, I am waiting to see studies of various natural remedies which probably won’t “cure” COVID-19 on their own but together may prevent progression of mild cases to severe. A number were found to help with SARS, and they have the mechanisms of action that recent studies have found are key to slowing COVID-19. These include Baikal skullcap, licorice root, turmeric, astragalus, ginger, rhodiola, boneset, and zinc.
PeakVT
Aerosols vs droplets vs contact as the primary transmission mechanism seems to still be an open question, or at least one I haven’t seen answered.
Do we know how exactly asymptomatic people are shedding the virus, and in what quantities vs someone who is symptomatic?
Barbara
@Ohio Mom: You don’t “get over” HIV. If it doesn’t kill you, you do get over COVID, meaning, you start testing negative for active virus.
Cheryl Rofer
@BR: It’s possible that natural remedies exist, but we won’t have studies on them for a long time.
Mary G
@Dan B: I have considered that I may be in a virtual lockdown for the rest of my life if it turns out that no useful vaccine can be found, or people can contract it more than once. If herd immunity is considered 70% who’ve had it, am I really comfortable going out when 3 of 10 people I meet could be carrying it in the asymptomatic but shedding virus phase?
Good science takes time. Even if a clear winning strategy is found, it needs to be confirmed. It’s frustrating, but we just have to wait. It’ll take as long as it takes.
I do worry about Big Pharma and/or hedge funds snagging patents and charging an arm and a leg for a cure/vaccine when one is found.
BR
@Cheryl Rofer:
I just wonder if it might be better for some of the hospital trials to focus on some of the more promising natural remedies since they are or can be widely available and can’t be patented so can be made cheaply.
raven
I just learned a friend died of the virus, the first person I knew personally. She was a artist and made the most incredible Cat in the Hat costume for Halloween and she’s go to every “costume contest” in Champaign Urbana and win them all.
The Moar You Know
@BR: One of the great failures of America is that people peddling absolute bullshit – like you are here – aren’t flogged down the street in front of all your neighbors.
BR
@The Moar You Know:
Sigh, calling for clinical research into herbal responses to a disease that has no medical responses gets that kind of response?
Edit: I don’t appreciate the violence implied in your comment. I thought that wasn’t allowed here, and I’ve been commenting here for 15 years…
Ruckus
@Cheryl Rofer:
I have a couple questions.
First we’ve heard that common cold and influenza viruses are less active during the summer. Could that be from in the winter we are far more likely to be indoors, with heat, so that might mean better transmission rather than higher seasonally activity?
With the worldwide increase in population it seems there would be more transmission possibilities, so that any new strain of virus/bacteria could be far more likely to strike a larger number of people. Would/could that create a concept of a more dangerous virus/bacteria?
Uncle Cosmo
@Another Scott: One of Dad’s stories from his WW2 service as a diesel mechanic in the Pacific involved alcohol – despite the fact he didn’t drink[1]:
[1]Never saw him drink more than half a bottle of beer – he didn’t like the way it made him feel.
[2] Anachronism – in 1945 “party” was exclusively a noun.
[3] In the Pacific, mostly pineapple juice produced in Hawaii. Dad loved the stuff – I think he got halfway addicted to it over there
[4] Per one Bugs Bunny. Equivalent to BJ’s “moran.” Maybe an anachronism; probably not.
/trivia
Cheryl Rofer
@BR: The plant-grown ones cannot compete with the manufactured ones for availability. Plus there is always an issue of strength in plant-based remedies.
And they can be patented, depending on a number of circumstances.
Too erratic for the amounts that will be needed as soon as possible.
raven
@Uncle Cosmo: My FIL was a SeaBee and he told the story on Saipan where there was a fenced compound with liquor in it and the Marines went up and just killed the guards to get it.
BR
@Cheryl Rofer:
I agree that it could be problem growing enough in a short timeframe, depending on which plants we’re talking about, though faster than drugs that may not even have gone through clinical trials yet.
My understanding with the patentability of natural compounds has to do with the preparation, right, not the plant itself? If they do find certain extracts are much better than others, I could see that being patented.
I doubt herbal remedies will solve the current problem, but it seems an “all of the above” approach is worth considering — herbal remedies, pharmaceuticals, medical interventions, etc. for people who do get sick.
Cheryl Rofer
@Ruckus:
Seasonal activity of any virus is poorly understood. Science magazine had an article on it a few issues back. Some are more active in the summer, and if the indoors hypothesis were significant, all of them should be more active in the winter. This one will be resolved over the next few years only by observation.
Passing through many bodies, and particularly back and forth between species, tends to increase mutations and other weird stuff that viruses and bacteria do. It can make them more or less dangerous.
Cheryl Rofer
@BR: I’ve been being gentle, but the bottom line, as I understand it, is that natural remedies aren’t ever going to be a real solution.
Ella in New Mexico
If I had a whole other life to live I would go into the fields of immunology, rheumatology and infectious disease. This virus, while heartbreaking, will give us critical breakthrough information about why our immune systems, so incredibly complex and doing a damn good job of keeping most of us alive, can literally be triggered to turn against us in so many diseases and conditions.
People are dying in COVID-19 disease not so much from the virus itself, but from the complex over-reaction or disruption of our “normal” immune responses. Some folks are more likely to have these types of reactions than others, which I’m betting is not only related to comorbidity and access to good health care, but what types of receptors and where they’re located in your body for the Corona spikes to attach to. It’ll be related to how your particular immune system genetics respond–does it send too many leukocytes and cytokines to your lungs and give you ARDS? Does it disrupt your blood clotting cascade and cause you have thromboses that plug up your kidneys, your lungs or cause strokes? Is your unique immune response to send out mediators that are very effective against this virus with less occurrence of bad immune effects? Why does the virus seem to be able to hide in some patient’s tissues only to reemerge with a second infection, and what aspects of our immune system keep that in check?
The loads of knowledge we’ll gain from studying the incredibly diverse presentations of COVID will help us understand autoimmune diseases, as well as how the inflammatory process destroys the body in so many chronic diseases like diabetes and heard disease. I would love to be a young researcher or doctor in those specialties over the next few decades watching our medical knowledge take a quantum leap forward.
bluefoot
@Dan B: Until we have an effective vaccine, and/or effective treatments, coupled with widespread testing and contact tracing, then yes, I think people in vulnerable populations will essentially be self-quarantined. It could be months to years. Which is one of the many reasons I am so angry at all the people who want to “re-open” right away or who won’t practice social distancing.
Uncle Cosmo
@Omnes Omnibus: Anyone with an IQ over 80 understands perfectly well what I’ve described & why it makes sense. What’s your problem?
As for “anger issues,” a couple of things that really piss me off – somewhat less than do Trumpolini & the GOP & vulture capitalism, but still – are arrogance attempting to camouflaging an inability to think, and intellectual snobbery, which includes the bigotry of slapping nasty names onto political opponents so they’re easier to despise & dismiss as not-quite-human. All of which is disturbingly common, if not endemic in this blog.
Anotherlurker
@JaySinWA: For a good run down of Methanol during Prohibition, watch Ken Burns’ documentary on that horrible era of our history. Another good source on Methanol poisoning is “The Poisoner’s Handbook” by Deborah Blum. It is a history of the NYC Medical Examiner’s Office and its founder Pathologist Dr. Charles Norris and Chemist Alexander Gettler. Fascinating reading .
bluefoot
@Mary G: Unfortunately, we don’t know enough about immunity to COVID-19 to know if herd immunity is possible ,or will be sustained. I know at least one person who is at-risk enough that her doctor has insisted that not only she, but her entire family, stay under self-quarantine until there’s widespread immunity (either through vaccine or otherwise). She doesn’t know if they’ll ever be able to leave home. Thankfully, for right now she can WFH since she’s a schoolteacher, as can her husband. What they will do about their 8 year old child long-term, I don’t know. Home school indefinitely? Send her to relatives so she can go to school and live a somewhat normal life (except the minor detail of being separated from her parents indefinitely)?
Ruckus
@raven:
Before this is all over I’d bet we all will know someone who dies from this. If another 150,000 people die, I’d bet the odds of being more than 2 steps away from them will be slim.
I do, a good friend of mine, her dad, 93, died of it 2 weeks ago. I’ve had holiday meals with him and my friend, his daughter. A vet, he died in the local VA hospital after the care facility he lived in got him there by ambulance.
I had to go to the VA today for lab work and the place was pretty empty. They took my temp before they’d let me park my car.
WaterGirl
@BR: I think that was over the top, also. Remember, it’s one person saying it, not the whole blog.
John doesn’t allow for violence or threats, but I believe hyperbola skates by.
Elizabelle
@raven: My sympathies, raven. Very sad. Sounds like a very creative woman.
Ruckus
@raven:
Told this here before but we had an E6 on board and on one cruise we stayed out to sea for almost 2 months. He sobered up about a month into it and became just about the biggest asshole I’ve ever met, which is saying something. People were looking for stashed away bottles, mouthwash, breaking into the medical office was discussed, (there was liquor in there, we once had a Dutch navy ship come out to us and send over a diver to see if they could find the cause of what someone thought was a vibration and the medic gave him airline bottles after his dive – I actually saw this happen.) anything to get him back to his normal state of not a bad guy.
Ruckus
@Cheryl Rofer:
Thank you!
Ruckus
@Ella in New Mexico:
And that’s how it’s always been.
Quantum leaps from new info, new abilities, better science. I look how far we’ve come in my short lifetime and am amazed.
My friend who died 3 yrs ago, she was an early pacemaker user, got her first in 1972. She had sickle cell and would basically allow herself to be in almost any reasonable scientific study because it gave her so much more than it took away. She lived far beyond most sickle cell patients because of that. She still had to be careful, most hospitals/doctors would think she was looking for drugs when she’d show up in an ER and wouldn’t trust her at all about having sickle cell.
J R in WV
@BR:
Non-Science fiction being posted here. Isn’t this one good way to be banned here? Absurd, as bad as Trump’s disinfectant/UV cures!
debbie
@BR:
I invite you to read this article and then explain which natural remedies could halt this kind of destruction.
I’ve gone the natural route a time or two in my time, so I’m not against them, but this is a beast too big for them to even touch.
debbie
Where did my damn post go? Help me, WG!
Ruckus
@Uncle Cosmo:
I am still going to call trump, shit for brains. Because he is. If he was some guy standing on a street corner yelling at passing cars it would be entirely different. But he is a moron who put himself in the hottest caldron in the world, expecting to be honored, respected and loved, as he fucked over millions of people. And as I shouldn’t, wouldn’t and can’t do anything physical about it, I’m going to call him names.
WaterGirl
@debbie: checking..
edit: not sure why the went into spam, but I fished it out.
debbie
@WaterGirl:
Thanks!
Gvg
@BR: Insisting on believing in woo like natural remedies being the answer has been the hallmark of multiple dangerous group tendencies that have gotten many people killed in my lifetime. I try to be tolerant but this is a real big crisis and it is being made worse repeatedly by anti science biases in powerful people in our government and in media. Anti vaxers for instance. Everyone is trying to remain calm and have patience for what must be endured, but foolishness gets on my nerves especially right now.
most real medicines started with natural sources, but we have moved away from nature as soon as we find a useful function because nature is too variable to be reliable and the goal is predictable life improvement. Natural plants can be too weak to be useful in one crop, then deadly over strong in the next, so now we synthesize precisely and it’s better that way. Using natural remedies is romantic but not the most effective and I am not in a romantic mood about my life or others.
there is also a big market for traditional medics that has no basis in science and is responsible for wiping out rare plants and animals or of just selling any old thing with lies about what it is, what it does and supporting that by running down respect for actual facts. This has been going on for decades, I have been angry about it long before this crisis and now we are here.
it is pretty unlikely that natural remedies will have any relevance in this crisis. If that unlikely chance occurs, real scientists will say so with evidence and studies. Until then, speculating stubbornly with no evidence just leaves you predisposed to being conned.
Ohio Mom
Barbara @54: Yes I know one doesn’t get cured of HIV, I wasn’t clear I guess. My worry is, what if in recovered patients, there is no long term immunity to the Corona Virus?
Absent a vaccine given on a regular basis, people could get sick over and over, and needless to say, there would be no herd immunity.
Thinking anout HIV reminds me there is no guarantee of a vaccine for any new virus.
Gvg
Mostly we don’t yet have the facts for this particular disease but as a non medical person i’d like some general info. I have the impression that immunity and resistance to catching a specific disease varies by person due to natural variations among humans. That is Fred may be highly resistant to measles before he ever comes near it and Jane may be highly susceptible. You have vaccines which are generally thought to make everyone “immune” but I have been wondering if this is wrong and say 7 out of 10 people are immune, another 2 have better resistance and 1person isn’t helped at all but this doesn’t get noticed bad cause of higher heard immunity. Which is it? Or something else?
i am also guessing that each disease and each vaccine have different ratios of improvement?
I already know some people can’t take vaccines due to overly sensitive or weak immune systems, or allergies to ingredients. Is what I already know correct? I am trying to be careful and not assume I know something, that is incorrect. I was just going through life, not worrying about things that weren’t my subjects, and now I need to know. Please and thank you.
Robert Sneddon
@Ohio Mom: HIV is a retrovirus, COVID-19 is a coronavirus. They are both viruses, they invade cells to replicate themselves but they function very differently otherwise. A coronavirus is more like an influenza virus which we can and do make vaccines for. Effective COVID-19 vaccines (probably several since everybody and their dog is pushing forward on multiple fronts on this) for this particular coronavirus will have some effect, at least in the short term. It will take years to determine just how good any vaccine is in providing immunity long-term.
Ohio Mom
Robert Sneddon@88: thank you for that clarification. It’s reassuring to this High-risk oldster.
Ella in New Mexico
@Ruckus: Wow, that’s an amazing story! And sadly, yes, I’ve known sickle cell patients who told me horror stories of not being believed in the ED. If we REALLY DID have electronic medical records that were accessible across hospitals (even within different departments in hospitals, as is our case with our ED having a totally different one than the outpatient clinic or our inpatient EMR) patients wouldn’t have to start from scratch every time they went in for a chronic condition.
Dan B
Oxford University has had preliminary good results in its vaccine. It was given to monkeys, about 26 I believe, in a lab in Montana. They were then exposed to high doses of the virus and none became ill. It would be mind boggling if the first vaccine worked. And there are months of testing to go. This is better news than the most hopeful drugs.
Bill Arnold
@Dan B:
Six, not twenty six. But enough to go to human trials. There is also a Chinese vaccine already in clinical trials.
In Race for a Coronavirus Vaccine, an Oxford Group Leaps Ahead – As scientists at the Jenner Institute prepare for mass clinical trials, new tests show their vaccine to be effective in monkeys. (NYTimes, David D. Kirkpatrick, April 27, 2020)
Combining phase II and phase III is aggressive.
Sandia Blanca
@Cheryl Rofer: Hi Cheryl, not sure–she had charts showing the different threads on the globe. I’ll look for the slides to see if she gave a source. Thanks.
Cheryl Rofer
@Gvg: I think that some of your understanding is a bit off. I’m not an expert either, so I’m not going to address the specifics of what you’ve said in this comment.
Vaccines and diseases are different from each other, so it’s hard to generalize. The CDC has quite a bit of information available. Google “CDC” with the topic you’re looking for, or you can start here. They also have information sheets for the various vaccines.
Sandia Blanca
@Sandia Blanca: Cheryl, following up on this comment from yesterday, the chart she used is from Nextstrain; here’s their site: nextstrain.org/ncov/global