Coronavirus treatment options and the impact on public policy

DIY-HP-LED

Well-Known Member
New MIT Study Shows The Cost Of The Patchwork Response To Coronavirus In The U.S.
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MIT Study Shows Devastating Cost of Failure to Coordinate Economic Reopenings
ON MAY 21, 2020
A new study released by the Social Analytics Lab at the MIT Initiative on the Digital Economy shows the devastating cost of the current chaotic and uncoordinated reopening of states and cities across the US and the globe. The study, which used data from mobile phones, network connections through social media and census data, estimates that total welfare is reduced dramatically when reopening is not coordinated among states and regions.

The study showed, for example, that the contact patterns of people in a given region are significantly influenced by the policies and behaviors of people in other, sometimes distant regions. In one finding, it showed that when just one third of a state’s social and geographic peer states adopt shelter in place policies, it creates a reduction in mobility equal to the state’s own policy decisions. When states fail to coordinate in the presence of spillovers as large as those detected in the analyses, total welfare is reduced by almost 70%t.

As federal, state and local governments begin opening businesses and relaxing shelter-in-place orders worldwide, policymakers are doing so without quantitative evidence on how policies in one region affect mobility and social distancing in other regions. And while some states are coordinating on COVID policy at the level of “mega regions,” most, unfortunately are not. This lack of coordination will have devastating effects on efforts to control COVID-19, according to the study.

“There have been many calls for a coordinated national pandemic response in the U.S. and around the world, but little hard evidence has quantified this need,” said Sinan Aral, director of the MIT Initiative on the Digital Economy and a corresponding author of the study. “When we analyzed the data, we were shocked by the degree to which state policies affected outcomes in other states, sometimes at great distances. Travel and social influence over digital media make this pandemic much more interdependent than we originally thought.” “Our results suggest an immediate need for a nationally coordinated policy across states, regions and nations around the world,” he added.

The research not only assesses the impact of an uncoordinated reopening, but also gives governors a map with which to coordinate in the absence of national guidance. The research shows for all fifty states, which states affect each other the most and thus maps the states that should be coordinating. These maps are sometimes surprising because, as a result of digital social media, each state’s success with social distancing is impacted by the policy decisions not just of geographically proximate states, but also of socially connected, but geographically distant states. For instance, Florida’s social distancing was most affected by New York implementing a shelter-in-place policy due to social media influence and travel between the states, despite their physical distance. New Hampshire had a strong influence on adjacent Massachusetts, despite being a small state.

This research highlights the need for states across the country to coordinate, even if they are not near one another and the results suggest which states should be coordinating with which other states based on the strength of the spillovers between them.
 

Fogdog

Well-Known Member

CEBM
The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare.

N-acetylcysteine: A rapid review of the evidence for effectiveness in treating COVID-19

An old drug repurposed?

N-acetylcysteine (NAC) was introduced in the 1960s as a mucolytic drug for chronic respiratory diseases. It has a well-established safety profile and is still commonly used orally at doses of 600mg/day as a mucolytic. In hospital settings, it is also used as an antidote for paracetamol overdose (IV formulation at doses of up to 150mg/kg) and in nebulized format in patients with acute bronchopulmonary disease (pneumonia, bronchitis, tracheobronchitis). Acetylcysteine makes bronchial mucous less viscous. In vitro, cysteine derivatives act by breaking disulphide bridges between macromolecules, which leads to a reduction in mucus viscosity.(1)

However, at higher doses (≥1200mg), acetylcysteine also acts as an antioxidant through complex mechanisms which can combat conditions of oxidative stress. Acetylcysteine is a derivative of the natural amino acid cysteine, which serves as a substrate for the synthesis of glutathione (GSH) in the body which an antioxidant effect. This reduces the formation of proinflammatory cytokines, such as IL-9 and TNF-α and also has vasodilator properties by increasing cyclic GMP levels and by contributing to the regeneration of endothelial-derived relaxing factor. It is this potential antioxidant mechanism that has sparked interest with the current COVID-19 pandemic and whether this might be useful in community settings.

We therefore aimed to conduct a rapid review of NAC with specific emphasis on its potential for early administration in the community for patients at greater risk of severe COVID-19.
more...
The undoctor speaks.

And nobody listens.
 

DIY-HP-LED

Well-Known Member
The undoctor speaks.

And nobody listens.
Speaking of Doctors I see Donald is recruiting for GOP physician taking heads to go on TV and prescribe the snake oil of reopening. How do you think that will work out for them in a month? Think Donald will blame them when it goes badly? " I was just following the advice of doctors, you seen them on TV yourself, all the deaths are their fault..."
 

Fogdog

Well-Known Member
Speaking of Doctors I see Donald is recruiting for GOP physician taking heads to go on TV and prescribe the snake oil of reopening. How do you think that will work out for them in a month? Think Donald will blame them when it goes badly? " I was just following the advice of doctors, you seen them on TV yourself, all the deaths are their fault..."
Trump is the head anti-doctor. Those who listen will harm themselves by doing so. His legion of anti-doctors are poisonous.

The anti-doctors will "accept no responsibility whatsoever". The thing is, they don't get to decide. We will hold them responsible and accountable.
 

DIY-HP-LED

Well-Known Member
The more I read, the more I think development of a safe effective long lasting vaccine for a corona virus any time soon if ever is a pipe dream.


I'd strongly suspect anything before the new year and will await a consensus of independent expert scientific and medical opinion, and studies proving efficacy and especially safety. Independent review by places like Health Canada would be helpful too, the "official" CDC not so much as long as Donald is in charge. I wouldn't get one until Health Canada approved it anyway, we have a minority government in Canada and that means an honest government, no mater how much the prime minister would like it to be otherwise (which he doesn't), there will be an independent public health commision concerning the covid -19 response coming in the future and they know it.
 

Fogdog

Well-Known Member
I'd strongly suspect anything before the new year and will await a consensus of independent expert scientific and medical opinion, and studies proving efficacy and especially safety. Independent review by places like Health Canada would be helpful too, the "official" CDC not so much as long as Donald is in charge. I wouldn't get one until Health Canada approved it anyway, we have a minority government in Canada and that means an honest government, no mater how much the prime minister would like it to be otherwise (which he doesn't), there will be an independent public health commision concerning the covid -19 response coming in the future and they know it.
I think the vaccine being fast tracked in Canada is made using the same tech used to make the US vaccine. Same in other countries too. After this is all over, we might see a whole new way of making and testing vaccines. A new approach using new technology and new test methods really ARE the only way we can end this crisis without it dragging the world into a deep and long lasting recession. So, I'm all for funding the research. Like you, I'm skeptical about the product. But I'm listening. Not to Trump. Trump is a harbinger of death on this subject. People working to design and test this new tech not like him. Many are in it for profit but also are trying to do the right things. Regarding voices coming from the government, thus far, Fauci has been reliable.

 
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DIY-HP-LED

Well-Known Member
HCQ is taking a pounding and I wonder if some studies will be cut short for ethical reasons?
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Study links drug Trump touted to greater risk of death

Seriously ill Covid-19 patients treated with hydroxychloroquine and chloroquine were more likely to die or develop dangerous heart arrhythmias, according to a large observational study published Friday in the medical journal The Lancet.
Researchers looked at data from more than 96,000 Covid-19 patients from 671 hospitals. All were hospitalized from late December to mid-April and had died or been discharged by April 21. Just below 15,000 were treated with the antimalarial drugs hydroxychloroquine or chloroquine, or one of those drugs combined with an antibiotic.
 
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DIY-HP-LED

Well-Known Member
Regarding voices coming from the government, thus far, Fauci has been reliable.
He's one of the ones I would trust, but we don't need to, his peers would call him out if he lied or was mistaken and it would be a real stink in the news with everybody getting an education.
 

DIY-HP-LED

Well-Known Member
Speaking of vaccines on the fast track, here's a contender, but I figure we can do better.
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The Lancet: First human trial of COVID-19 vaccine finds it is safe and induces rapid immune response

The first COVID-19 vaccine to reach phase 1 clinical trial has been found to be safe, well-tolerated, and able to generate an immune response against SARS-CoV-2 in humans, according to new research published in The Lancet. The open-label trial in 108 healthy adults demonstrates promising results after 28 days--the final results will be evaluated in six months [1]. Further trials are needed to tell whether the immune response it elicits effectively protects against SARS-CoV-2 infection.

"These results represent an important milestone. The trial demonstrates that a single dose of the new adenovirus type 5 vectored COVID-19 (Ad5-nCoV) vaccine produces virus-specific antibodies and T cells in 14 days, making it a potential candidate for further investigation", says Professor Wei Chen from the Beijing Institute of Biotechnology in Beijing, China, who is responsible for the study. "However, these results should be interpreted cautiously. The challenges in the development of a COVD-19 vaccine are unprecedented, and the ability to trigger these immune responses does not necessarily indicate that the vaccine will protect humans from COVID-19. This result shows a promising vision for the development of COVID-19 vaccines, but we are still a long way from this vaccine being available to all." [2]

The creation of an effective vaccine is seen as the long-term solution to controlling the COVID-19 pandemic. Currently, there are more than 100 candidate COVID-19 vaccines in development worldwide.

The new Ad5 vectored COVID-19 vaccine evaluated in this trial is the first to be tested in humans. It uses a weakened common cold virus (adenovirus, which infects human cells readily but is incapable of causing disease) to deliver genetic material that codes for the SARS-CoV-2 spike protein to the cells. These cells then produce the spike protein, and travel to the lymph nodes where the immune system creates antibodies that will recognize that spike protein and fight off the coronavirus.

The trial assessed the safety and ability to generate an immune response of different dosages of the new Ad5-nCoV vaccine in 108 healthy adults between the ages of 18 and 60 years who did not have SARS-CoV-2 infection. Volunteers were enrolled from one site in Wuhan, China, and assigned to receive either a single intramuscular injection of the new Ad5 vaccine at a low dose (5 × 1010 viral particles/0·5ml, 36 adults), middle dose (1×1011 viral particles/1.0ml, 36 adults), or high dose (1.5 x 1011 viral particles/1.5ml, 36 adults).

The researchers tested the volunteers' blood at regular intervals following vaccination to see whether the vaccine stimulated both arms of the immune system: the body's 'humoral response' (the part of the immune system that produces neutralising antibodies which can fight infection and could offer a level of immunity), and the body's cell-mediated arm (which depends on a group of T cells, rather than antibodies, to fight the virus). The ideal vaccine might generate both antibody and T cell responses to defend against SARS-CoV-2.

The vaccine candidate was well tolerated at all doses with no serious adverse events reported within 28 days of vaccination. Most adverse events were mild or moderate, with 83% (30/36) of those receiving low and middle doses of the vaccine and 75% (27/36) in the high dose group reporting at least one adverse reaction within 7 days of vaccination.

The most common adverse reactions were mild pain at the injection site reported in over half (54%, 58/108) of vaccine recipients, fever (46%, 50/108), fatigue (44%, 47/108), headache (39%, 42/108), and muscle pain (17%, 18/108). One participant given the higher dose vaccine reported severe fever along with severe symptoms of fatigue, shortness of breath, and muscle pain--however these adverse reactions persisted for less than 48 hours.

Within two weeks of vaccination, all dose levels of the vaccine triggered some level of immune response in the form of binding antibodies (that can bind to the coronavirus but do not necessarily attack it - low-dose group 16/36, 44%; medium dose 18/36, 50%; high dose 22/36, 61%), and some participants had detectable neutralising antibodies against SARS-CoV-2 (low-dose group 10/36, 28%; medium dose 11/36, 31%; high dose 15/36, 42%).

After 28 days, most participants had a four-fold increase in binding antibodies (35/36, 97% low-dose group; 34/36 (94%) middle-dose group, and 36/36, 100% in high-dose group), and half (18/36) of participants in the low- and middle-dose groups and three-quarters (27/36) of those in the high-dose group showed neutralising antibodies against SARS-CoV-2.

Importantly, the Ad5-nCoV vaccine also stimulated a rapid T cell response in the majority of volunteers, which was greater in those given the higher and middle doses of vaccine, with levels peaking at 14 days after vaccination (low-dose group (30/36; 83.3%), medium (35/36, 97.2%), and high-dose group (35/36, 97.2%) at 14 days).

Further analyses showed that 28 days after vaccination, the majority of recipients showed either a positive T cell response or had detectable neutralising antibodies against SARS-CoV-2 (low-dose group 28/36, 78%; medium-dose group 33/36, 92%; high-dose group 36/36, 100%).

However, the authors note that both the antibody and T-cell response could be reduced by high pre-existing immunity to adenovirus type 5 (the common cold virus vector/carrier)--in the study, 44%-56% of participants in the trial had high pre-existing immunity to adenovirus type 5, and had a less positive antibody and T-cell response to the vaccine.

"Our study found that pre-existing Ad5 immunity could slow down the rapid immune responses to SARS-CoV-2 and also lower the peaking level of the responses. Moreover, high pre-existing Ad5 immunity may also have a negative impact on the persistence of the vaccine-elicited immune responses", say Professor Feng-Cai Zhu from Jiangsu Provincial Center for Disease Control and Prevention in China who led the study.

The authors note that the main limitations of the trial are its small sample size, relatively short duration, and lack of randomised control group, which limits the ability to pick up rarer adverse reactions to the vaccine or provide robust evidence for its ability to generate an immune reaction. Further research will be needed before this trial vaccine becomes available to all.

A randomised, double-blinded, placebo-controlled phase 2 trial of the Ad5-nCoV vaccine has been initiated in Wuhan to determine whether the results can be replicated, and if there are any adverse events up to 6 months after vaccination, in 500 healthy adults--250 volunteers given a middle dose, 125 given a low dose, and 125 given a placebo as a control. For the first time, this will include participants over 60 years old, an important target population for the vaccine.
 

Fogdog

Well-Known Member
Speaking of vaccines on the fast track, here's a contender, but I figure we can do better.
-------------------------------------------------------------------------------------------------------------------

The Lancet: First human trial of COVID-19 vaccine finds it is safe and induces rapid immune response

The first COVID-19 vaccine to reach phase 1 clinical trial has been found to be safe, well-tolerated, and able to generate an immune response against SARS-CoV-2 in humans, according to new research published in The Lancet. The open-label trial in 108 healthy adults demonstrates promising results after 28 days--the final results will be evaluated in six months [1]. Further trials are needed to tell whether the immune response it elicits effectively protects against SARS-CoV-2 infection.

"These results represent an important milestone. The trial demonstrates that a single dose of the new adenovirus type 5 vectored COVID-19 (Ad5-nCoV) vaccine produces virus-specific antibodies and T cells in 14 days, making it a potential candidate for further investigation", says Professor Wei Chen from the Beijing Institute of Biotechnology in Beijing, China, who is responsible for the study. "However, these results should be interpreted cautiously. The challenges in the development of a COVD-19 vaccine are unprecedented, and the ability to trigger these immune responses does not necessarily indicate that the vaccine will protect humans from COVID-19. This result shows a promising vision for the development of COVID-19 vaccines, but we are still a long way from this vaccine being available to all." [2]

The creation of an effective vaccine is seen as the long-term solution to controlling the COVID-19 pandemic. Currently, there are more than 100 candidate COVID-19 vaccines in development worldwide.

The new Ad5 vectored COVID-19 vaccine evaluated in this trial is the first to be tested in humans. It uses a weakened common cold virus (adenovirus, which infects human cells readily but is incapable of causing disease) to deliver genetic material that codes for the SARS-CoV-2 spike protein to the cells. These cells then produce the spike protein, and travel to the lymph nodes where the immune system creates antibodies that will recognize that spike protein and fight off the coronavirus.

The trial assessed the safety and ability to generate an immune response of different dosages of the new Ad5-nCoV vaccine in 108 healthy adults between the ages of 18 and 60 years who did not have SARS-CoV-2 infection. Volunteers were enrolled from one site in Wuhan, China, and assigned to receive either a single intramuscular injection of the new Ad5 vaccine at a low dose (5 × 1010 viral particles/0·5ml, 36 adults), middle dose (1×1011 viral particles/1.0ml, 36 adults), or high dose (1.5 x 1011 viral particles/1.5ml, 36 adults).

The researchers tested the volunteers' blood at regular intervals following vaccination to see whether the vaccine stimulated both arms of the immune system: the body's 'humoral response' (the part of the immune system that produces neutralising antibodies which can fight infection and could offer a level of immunity), and the body's cell-mediated arm (which depends on a group of T cells, rather than antibodies, to fight the virus). The ideal vaccine might generate both antibody and T cell responses to defend against SARS-CoV-2.

The vaccine candidate was well tolerated at all doses with no serious adverse events reported within 28 days of vaccination. Most adverse events were mild or moderate, with 83% (30/36) of those receiving low and middle doses of the vaccine and 75% (27/36) in the high dose group reporting at least one adverse reaction within 7 days of vaccination.

The most common adverse reactions were mild pain at the injection site reported in over half (54%, 58/108) of vaccine recipients, fever (46%, 50/108), fatigue (44%, 47/108), headache (39%, 42/108), and muscle pain (17%, 18/108). One participant given the higher dose vaccine reported severe fever along with severe symptoms of fatigue, shortness of breath, and muscle pain--however these adverse reactions persisted for less than 48 hours.

Within two weeks of vaccination, all dose levels of the vaccine triggered some level of immune response in the form of binding antibodies (that can bind to the coronavirus but do not necessarily attack it - low-dose group 16/36, 44%; medium dose 18/36, 50%; high dose 22/36, 61%), and some participants had detectable neutralising antibodies against SARS-CoV-2 (low-dose group 10/36, 28%; medium dose 11/36, 31%; high dose 15/36, 42%).

After 28 days, most participants had a four-fold increase in binding antibodies (35/36, 97% low-dose group; 34/36 (94%) middle-dose group, and 36/36, 100% in high-dose group), and half (18/36) of participants in the low- and middle-dose groups and three-quarters (27/36) of those in the high-dose group showed neutralising antibodies against SARS-CoV-2.

Importantly, the Ad5-nCoV vaccine also stimulated a rapid T cell response in the majority of volunteers, which was greater in those given the higher and middle doses of vaccine, with levels peaking at 14 days after vaccination (low-dose group (30/36; 83.3%), medium (35/36, 97.2%), and high-dose group (35/36, 97.2%) at 14 days).

Further analyses showed that 28 days after vaccination, the majority of recipients showed either a positive T cell response or had detectable neutralising antibodies against SARS-CoV-2 (low-dose group 28/36, 78%; medium-dose group 33/36, 92%; high-dose group 36/36, 100%).

However, the authors note that both the antibody and T-cell response could be reduced by high pre-existing immunity to adenovirus type 5 (the common cold virus vector/carrier)--in the study, 44%-56% of participants in the trial had high pre-existing immunity to adenovirus type 5, and had a less positive antibody and T-cell response to the vaccine.

"Our study found that pre-existing Ad5 immunity could slow down the rapid immune responses to SARS-CoV-2 and also lower the peaking level of the responses. Moreover, high pre-existing Ad5 immunity may also have a negative impact on the persistence of the vaccine-elicited immune responses", say Professor Feng-Cai Zhu from Jiangsu Provincial Center for Disease Control and Prevention in China who led the study.

The authors note that the main limitations of the trial are its small sample size, relatively short duration, and lack of randomised control group, which limits the ability to pick up rarer adverse reactions to the vaccine or provide robust evidence for its ability to generate an immune reaction. Further research will be needed before this trial vaccine becomes available to all.

A randomised, double-blinded, placebo-controlled phase 2 trial of the Ad5-nCoV vaccine has been initiated in Wuhan to determine whether the results can be replicated, and if there are any adverse events up to 6 months after vaccination, in 500 healthy adults--250 volunteers given a middle dose, 125 given a low dose, and 125 given a placebo as a control. For the first time, this will include participants over 60 years old, an important target population for the vaccine.
Translation: It's not a deadly poison and confirmed theory behind developing the test. It's still in the early phases of testing. Odds are still very good that it will fail.

DIY, you pushed the same kind of bullshit when HCQ became the darling of Republicans. You are the un-doctor. Purveyor of unfiltered sciency bullshit. There is no way that I would have posted that article. It is misleading in its optimism. And annoying.
 

DIY-HP-LED

Well-Known Member
Translation: It's not a deadly poison and confirmed theory behind developing the test. It's still in the early phases of testing. Odds are still very good that it will fail.

DIY, you pushed the same kind of bullshit when HCQ became the darling of Republicans. You are the un-doctor. Purveyor of unfiltered sciency bullshit. There is no way that I would have posted that article. It is misleading in its optimism. And annoying.
I could have posted the link to the Lancet article, but I figured this was a reliable summary from a good source. The fact that this thing appears not to work with some people because they've had colds? in the past would be one concern that I would have, and the fact the Canadian government might consider this is another! The source is a good one foggy, the vaccine not so much IMHO. We are a long way from a vaccine and this one is making the news and therefore policy discussion, even at this early stage.
 

Fogdog

Well-Known Member
I could have posted the link to the Lancet article, but I figured this was a reliable summary from a good source. The fact that this thing appears not to work with some people because they've had colds? in the past would be one concern that I would have, and the fact the Canadian government might consider this is another! The source is a good one foggy, the vaccine not so much IMHO. We are a long way from a vaccine and this one is making the news and therefore policy discussion, even at this early stage.
Same as when you cluttered this site with misleading information about HCQ. Republicans love idiots like you.
 

Fogdog

Well-Known Member
You mean like my most recent two posts? One from CNN and the other from Lancet.
A link would have sufficed. You posted the whole misleading article as if it were worth reading.

It was not. The entire article could be summed up as: It's not poisonous. Theory behind the experimental vaccine was validated. More than likely this vaccine will fail in later testing because that's what usually happens.
 

DIY-HP-LED

Well-Known Member
A link would have sufficed. You posted the whole misleading article as if it were worth reading.

It was not. The entire article could be summed up as: It's not poisonous. Theory behind the experimental vaccine was validated. More than likely this vaccine will fail in later testing because that's what usually happens.
So the lancet is misleading now? Your opinion on the subject matter is welcome though, questioning the source I take issue with or the fact that the article was misleading, I stand by my source.

The vaccine has many shortcomings and they were explained. I want to go as close to the original source as is appropriate for these things and the summary was good enough for here.
 

Fogdog

Well-Known Member
So the lancet is misleading now? Your opinion on the subject matter is welcome though, questioning the source I take issue with or the fact that the article was misleading, I stand by my source.

The vaccine has many shortcomings and they were explained. I want to go as close to the original source as is appropriate for these things and the summary was good enough for here.
The article by itself isn't bad. But why post the whole damn thing here? Just like those dumb posts about HCQ from a site that was the darling of Republicans when they wanted to distract us from their fuck up that's already killed 90,000 people.

A quick summary and a link was all it deserved. It wasn't all that informative. Here is the gist of what you copied and pasted that occupied a whole page:

The vaccine under test is not a deadly poison. The test validated the theory. Tons more testing remains and the likelihood of it succeeding is tiny.

I could write a whole page with mathematical models about "why it might rain next year in the Mojave Desert in August but it probably won't". That's about how significant the article is. So, I'm guessing you didn't really understand what you posted. It was more like, "gee whiz, I don't understand this but if I copy and paste it, you guys will think I'm a genius".
 
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