Capitol Hill Blue Forums Thread Like Summary - Coronavirus: The Plague of The 21st Century?

When the Black Death hit the world in the 14th Century it was incredibly deadly. In some regions the death toll exceeded 50% of the population. It literally changed the history of Europe. What made it so deadly was the profound ignorance of the population, and governments, about what caused and spread it. Modern medicine generally fares much better, but the Spanish flu epidemic of 1918 was still one of the deadliest in history, though the mortality rate was "only" about 10%.

The Coronavirus (COVID-19) has created a worldwide concern, affected the markets, and sown panic in certain areas. Yet, the mortality rate is much lower (so far) than the annual flu, which clocks in at around 14 per 100,000. Why the panic?

There seem to be two reasons: it is unique, and it is unknown. Unique, because, while the virus is known (even common), this strain is behaving differently. Similarly, the Spanish flu virus was believed to have been a strain of the H1N1 virus, but was particularly deadly. (Swine flu was another H1N1 strain.) Unknown, because its spread and mechanisms of infection and morbidity are not fully understood. Nor, is there yet a "cure". The unknown is scary.

The question is: is this outbreak more like the annual flu, or more like the Spanish flu? Until we know that answer, the concern seems warranted.

"Pandemic is over" is the latest big lie. People are tired of the pandemic, so they WISH it was over. There are still a lot of infections, and a lot of people dying. Some places in the country are on the downslope. Others are not. Millions of people are still suffering from Long Covid. As I predicted about a month ago, the immunologically naive are almost depleted, so there are fewer opportunities for the virus to wreck havok. But there are still a ton of the immunosuppressed, older folks with co-morbidities, babies who were not passively immunized via breast milk, etc. Immunized people are going to continue to get mostly mild infections, but some will have a more difficult time. Some will die, since vaccination response is not uniform.

The latest news is we are starting to get more Paxlovid. It is reserved for patients with indications they will progress to serious illness, but I think that will change. Even asymptomatic cases can end up with Long Covid! So there is no such thing as "a case that won't progress". Just cases that probably won't progress. The percentage of people who get infected that end up with Long Covid is shocking.

So sorry, Jeff. Yes, it really sucks. I hope they can figure out some good therapies, but prevention looks like the best thing so far. Some Long Covid victims find that getting vaccinated again helps, but that's under 50% of them that try it. Saying it's over and going back to normal condemns lots of people who will get it and have bad outcomes to an early death or poor health for who knows how long.

Many wild animals have contracted it and spread it throughout their populations. (Pigs seem to be the exception, so our valuable barbeque resource remains unthreatened. But they have their own deadly corona viruses.) There is some evidence Omicron spent a long time evolving in mice before spilling back into humans. We have no idea when or where the next spillover event could occur. We (humans) are really doing a piss-poor job of sampling wild animals and keeping an eye on these things. Note I did NOT saw "if": It's a sure thing

Interesting: The South African doctor who first announced the new Omicron variant of concern, said she and other South African doctors are seeing increases in the infection rate which indicates Omicron may be better at transmitting. BUT those cases tend to be milder than usual, with fatigue and headache the main symptoms. So there is the possibility this variant is "the end" of the pandemic: A variant that infects most of the immunologically naive, but causes few hospitalizations or deaths. A "natural vaccination" variant, so to speak.

When viruses mutate, this is always a possibility. Increased fitness, but decreased virulence, because the former has selective advantage, while the latter does not.

The doubling rate for Omicron appears to be 2-3 days. That is incredibly fast - 70% faster than Delta. It will be the dominant strain within the month. Let us hope that it proves to be less deadly, because the inoculation rater to reach herd immunity will be >95%. What's worse, is that the level of reinfection is so high.

"The new study from Discovery Health shows that two shots of the Pfizer-BioNTech vaccine, which provided more than 90% protection against the original virus, is only 33% protective against omicron infection.

Full vaccination continues to provide 70% protection against severe disease, which seemed to hold up across high-risk groups, though it declined somewhat in people over 60 and even more in those over 70.
....
"Seventy percent is definitely a dropdown. It isn't great," he said. "It was 95% effective severe disease when it was delta variant and then about 85% after six months of waning," he said. ... Other research from Pfizer-BioNTech suggests that a third, booster dose can restore the original levels of protection at least for some period of time.
....
People infected in South Africa's first wave early last year, have a 73% chance of reinfection, while those infected with the beta variant have a 60% chance of reinfection and those infected in its most recent delta wave face a 40% risk of reinfection with omicron, the new study showed.

That fits with findings from a preliminary briefing released by the United Kingdom on Friday showing an approximately three- to eight-fold increased risk of reinfection with the omicron variant". 'Spreading at a rate we have not seen' - Omicron more resistant to COVID-19 vaccines (USA Today)

That blows the "natural immunity" claim out of the water.

I think getting your Vitamin D levels up has been a pretty good prophylactic right from the beginning. MABs as theraputics have been around for a very long time, but they do tend to be extremely variant-specific. That's why the original "bam-bam" one from Regeneron was stopped soon after other variants appeared, and replaced by MAB "cocktails". They are generally a single (monoclonal) antibody against one specific part of the virus spike protein. There are three locations on the spike protein receptor binding site they can bind with, and Delta had changes in two of those. Omicron has changes in all three. That's why MABS tend to be much less effective as variants emerge. But if you get the right MAB for your variant, they work pretty well.

Still not as well as the mRNA vaccines. Keep in mind that we only have ONE sterilizing vaccine: HPV. Every other vaccine on Earth is not. They prevent serious illness and death, mostly. The fact that some SARS-COV2 vaccines do prevent almost all symptomatic disease before natural antibody contraction was just gravy. Nobody expected that. Remember, CDC said a 70% effective vaccine would be great. And that's 70% effective at preventing serious illness or death. Instead we got MUCH better vaccines by lucky accident. Antibody level contraction is exactly how the immune system works. It's not a "vaccine problem". It's a natural immune system function. Keeping high levels of circulating antibodies against everything you ever encounter would be lethal.

That's why we have memory T and B cells. Those are another layer of the immune system that remembers antigens, and quickly make new antibodies if they see it. Much quicker than the initial exposure. And they do that for years. People who recovered from SARS1 more than a decade ago still have memory T and B cells for it, and because of a natural evolution of antibody genes they respond to SARS-COV2 as well! The mRNA vaccines elicit a very good T and B cell response, and T cells use a much larger number of epitopes than antibodies, so they are much better at handling variants. Omicron infections in South Africa seem to be very mild, because most everybody already had Delta and their T-cells respond very well to Omicron. If you are triple-vaxxed, you get the same response.

I watched a YouTube video from Laura Walker the other day about making much broader MABs. They started with frozen serum sample from SARS1 patients, isolated antibodies, and ran the evolution in their lab. What they got was antibodies that work against SARS1, SARS-COV2, MERS, and any possible variant. And they are much much stronger than any of the current MABs. They are in clinical 2/3 trials right now. They also modified the antibody stem so it lasts about 6 months. Near the end of her talk, she also mentioned making vaccines against the invariant portion of these viruses that their antibody binds with. Those vaccines would work against every variant, and even against future corona virus spillovers.

I agree 100% with chunkstyle about labor shortages: It's an indictment against our economic system, because we are so far up conservative bungholes, employers can't understand that when people resist doing certain obnoxious jobs, you have to pay them more. That's a heretical concept after decades of wage stagnation. Long Beach port is jammed because no truck drivers? Nursing shortages? "Pay them more? Are you insane? If we pay nurses a living wage, we will have to raise our CEO compensation to a billion dollars a year!"

As one of my sources, Dr. Daniel Griffon says: "Multiple anecdotes are not data." Reporters like anecdotes because they can be attributed to individuals their readers can relate to. Dr. Griffon personally takes care of Covid patients. He is also in touch with hundreds of other doctors who take care of Covid patients. (He is currently accepting new patients in New York!) So he is in an excellent position to collect anecdotes. Much more so than any average nurse or doctor who is much less connected. But he also has a PhD and understands the difference between reporting anecdotes and real data from real research, with real peer-reviewed papers, published in real scientific journals.

If you want to learn some real stuff about Covid, again I would urge you to watch TWIV on YouTube, The virologists and immunologists on it have many decades of experience, they feel free to call BS on untrue or misleading media reports, and even on physicians who have no experience with either of their life-long specialties making such misleading or untrue statements. They will point out the many times their ideas have been taken up months (or years) later by authorities like the CDC.

I have just a BS in Biology, worked in medical research for 11 years, and have my name on a single journal paper. So I would not presume to present any of my original ideas as anything but an amateur hypothesis. All that stuff in my "raw fish" paragraph you quoted is from those virologists, immunologists, and Dr, Griffin.

A fairly straightforward open letter appearing in the BMJ from over a hundred public health professionals, scientists etc outlining the current problem with ongoing covid strategies and a list of 5 recommendations.

It’s first recommendation:

“ Unequivocally declare SARS-CoV-2 an airborne pathogen and stress the implications for preventing transmission.18 A clear message from the World Health Organisation will help to remove confusion that has been used to justify outdated policies”

A fairly straightforward and reasonable list of recommendations but na gunna happen. An open letter by a group of public health experts, clinicians, scientists

If aerosols were the main route of infection, then countries where everybody wears masks would not have lower infection rates. Because aerosols go right through even N95 masks completely unimpeded. Contact tracers analyzed 75,000 cases of transmission in China, and found zero cases where aerosol transmission occurred. I've read papers where they talk about finding viral RNA floating in the air of hospital rooms, or rooms where workers remove PPE, but they found zero cultural virus! You have to be careful reading such papers because being outside of a droplet and exposed to air denatures competent viruses into RNA fragments that are detected by PCR, but are not infectious. PCR is a lot easier than culturing viruses and running plaque assays, but quite often is not the right assay for what they are investigating.

Certainly aerosol transmission does occur, when superspreaders are inside with poor ventilation and in crowds without masks. I remember one paper talking about an indoor wedding reception where everybody at tables adjacent to a spreader got infected, hardly anybody two tables away, and nobody at the other tables. They were all in there talking, dancing, eating, etc. for hours and if aerosol transmission was significant, more people far away from that spreader would have gotten infected. But the infected were within droplet range.


Yes, if one completely ignored exponential spread, the politicization of anti-vax and anti-mask efforts, governors proclaiming public health efforts illegal, people deciding they are tired of being careful, etc. But one would have to be a troll to do that. The one good thing Trump did regarding SARS-COV2 was to see that vaccine development had enough money to remove the risk of doing all required steps in parallel, and that resulted in the vaccines you seem to despise.

You also seem to have a fixation on aerosol virus and N95 masks, as if wearing an N95 would protect you from aerosols. They won't. Aerosol virus goes right through N95 masks. This is why researchers experimenting on competent SARS-COV2 virus have to work in BSL-4 labs. The ones where they have to wear pressurized plastic suits and helmets with an external air supply. Masks block your droplets from escaping and infecting others. They do a pretty good job of that. Not perfect, like most reasonable public health measures, but pretty good.

The US already is "vaccination+". It makes sense to stress the things that make the biggest differences, and the things we can do easily. Yes, there have been some major screw-ups. But most of those were from Trump fighting public health messages coming from the CDC. Sometimes those messages have changed as new data emerges, but that's how science and medicine work. Yes, it would be much nicer and a lot cheaper if we all had single-payer, but the government's response all along has been mostly single-payer! Including the approved vaccines, approved MABs, and approved anti-viral drugs.

The biggest impediment has been politicians: Fighting vaccination mandates. Promoting anti-vax and anti-mask claims for political gain. Promoting "snake-oil" cures. And as a result, one third of the US population sees all efforts to stop the spread of the virus as some sort of Liberal plot to curtail their freedom. Nothing in that open letter addresses this elephant in the room.

I know, "profit" is a dirty word. But the people promoting public health policies have very little connection with vaccine makers profits. I think vaxvaxvax because vaccination is the most successful thing we have. In the last two years, people have spent all of maybe 6 hours to get vaccinated two or three times, and it keeps almost all of them from getting seriously ill, from dying, or from getting Long Covid. Nothing else takes less time and is so successful, by far. On the other hand, people get tired of isolating after several thousand hours. They get tired of wearing masks every time they are out of the house, some for hours a day being essential workers. They get tired of staying six feet apart. They get tired of never getting together with family. So they take calculated risks, and sometimes that doesn't work out the way they wanted.

People who are vaccinated can't get tired of that protection and take a risk to do without it. Antibody levels contract naturally, but T and B-cell memory remains.

As for the aerosol vrs droplet question: If smaller aerosol particles travel deep into the lungs, and aerosol is the major route of SARS-COV2 infection, then why are so many infections asymptomatic or occurring in the nose? Simple: Most infections are through droplets, that primarily stop in your nose. Deep lung infections are present in about 1% of SARS-COV2 infections.

CORRECTION: We are doubling every 10 days, according the US CDC data. So my prediction for the US is off. Same result, but unless people's behavior changes dramatically (like locking down voluntarily) it will take about two months instead of one. California has doubled in the last six days, so in about 5 weeks it will be mostly over here. My prediction for the UK was based on their Rt values, so it still stands.

Went to get my teeth cleaned today, and got a smog test so I can still drive my car. The dentists office is fully vaccinated and boosted, and I was impressed by their precautions. For example, how many dentists keep their office door wide open with fans running in January? Smog test was essentially outdoors, so that was probably okay too. But my wife is isolating from me for 5 days to see if I show signs of infection. That means sleeping in another room, wearing masks in common areas, etc.

BTW: Everybody getting infected does not mean everybody gets sick. It's bad news for the unvaccinated who were never infected, but for the majority of vaccinated folks it's asymptomatic.

I think you are ignoring the fact that all of these prophylactics and Covid treatments, from Paxlovid to MABs, are covered by the federal government. In fact, vaccinations and treatments are a perfect example of single-payer health care. I'm confused: If you don't like the US government paying for this stuff, who do you think should pay for it?

If the US government had sent out billions of ivermectin doses instead, would you be complaining about them sending placebos to keep everybody dumb and happy? Most of the deaths right now are among people who denied the virus existed, then claimed it was just a cold, then refused to get vaccinated, and ignore their Covid symptoms until the antiviral treatment window is closed. They don't take their horse paste prophylactically, and they dismiss their Covid as "just the flu" until they are getting hypoxic. These folks would have thrown their ivermectin kits away, and claimed the government was trying to poison them.

I would not be surprised if Mikaela Shiffrin's poor performance at the Olympics was Covid-related. I think a lot of athletes are going to find their performance is not up to their pre-pandemic level. Mostly it's from the heart damage even asymptomatic infections can cause. Early in the pandemic, researchers at Ohio State University used MRI to find evidence of recent or active cardiomyopathy in around 40% of student athletes who had mild or asymptomatic infections. This could be unknown by the victims, until they tried to compete in their sport. Then their maximum cardiac output could be just a bit impaired.

Sorry, off-topic: TWIV on YouTube just reviewed two new papers that show the relationship between Epstein-Barr virus and Multiple Sclerosis right down to the molecular level! Pretty simple: People have different HLA types (What they match for transplants). These are the molecules that stick out of cells and "present" foreign antigens (like virus epitopes) to the T-cells. T-cells talk to B-cells and convince them to make a bunch of antibodies against the foreign epitopes.

Humans with normal immune systems start out with B-cells that make antibodies against every possible epitope (a series of amino acids the immune system can react against) . They even make antibodies against everything you could possibly be allergic to. These antibodies go through a testing phase, so every antibody against "self" is knocked out. This is why we don't all die as infants of autoimmune diseases.

But when people with the right HLA types get Epstein-Barr virus (which 90% of us have) it can turn on production of a certain antibody. That keeps the EBV in check. But the new antibodies also undergo something called "somatic hypermutation" in which the antibody genes get varied enough to protect us from virus variants we may encounter in the future. One (or a few) of those mutated antibodies cross reacts with a protein used by oligodendrocyctes, the cells that make myelin. They stop or are impaired in making new myelin (nerve cell insulation) and voila: You have MS.

You can go back and read through that again. This will be on the test.

So the interesting question is would an Epsein-Barr vaccine give a bunch of people MS? I think it could, if you used the wrong virus epitope to make the vaccine. The first Pasteur rabies vaccine used rabbit spinal cord to grow the virus before killing the "live" virus, and it did tend to give people autoimmune paralysis when they cross-reacted to the nerve cells..

DeathSantis is at it again: His death toll is not high enough yet. He's set up many MAB sites, so they can treat people who could have gotten vaccinated, but didn't. Problem is they are using MABs for anybody, instead of just for the immunocompromised who really need them, and the supply has always been limited. Now to top that off, his suppliers, Lilly and Regeneron have announced their initial MABs are not effective against Omicron (Almost all cases in Florida). A peer-reviewed and published study just recently said Regeneron's MAB is 1000 times less effective and Lilly's 3000 times less effective. Between that and the manufacturer's announcements, the FDA is cancelling their EUAs.

He's blaming Biden for that. He insists it's people's right to get ineffective treatments, which the FDA is specifically tasked with controlling. I suppose he'll want snake-oil and bleeding next. How about "laying on of hands" (or Reiki, it's modern equivalent), or The Power of Positive Thinking, Ron?

MABs are a good idea, but monoclonal antibodies are only effective for variants they match. A few mutations from immune-evasion evolution, and they don't interact with the new variant very well. But I suppose "evolution" is something he denies, as well! Months after vaccination or a suitable natural infection, our germinal centers do something called somatic hypermutation, where thousands of different but closely related mutations occur during antibody maturation, and the results are tested against the viral antigen. This natural process can produce antibodies that are thousands of times better at binding to the antigen! Those "better antibodies" are available for mass production when needed in the event of reinfection. This process can never happen with MABs. Which is one reason why vaccination is so effective against new variants.

Ron's Folly

NPR said the quick development of the Corona virus vaxx has its genesis in 20 years of HIV vaxx research. THAT may be another reason why Rightwingers don't want the vaxx.

The HIV vaccine is being tested currently in human beings. PrEP has pretty much eliminated sexually active men of a certain marginalized group from getting HIV and/or reduced the viral load so far that it's undetectable now.

Hey, that's your strawman, not mine. I never said any of that. I said what we need to do is a lot more monitoring of wild animals so we have some advance warning when a spillover is coming. We should also be working on a general purpose polymerase blocker. Like the very successful protease blocker Paxlovid and the HIV proteases, but for a different enzyme that is highly conserved by all corona viruses. (That means it doesn't change much, if ever.) These are things that need government funding, because there is no immediate return on investment for a corporation. The way corporate duties are defined in America, it would actually be illegal for them to do these things! We could have started on that drug back when SARS1 showed up, but everybody just ignored it when standard public health methods contained it. For that matter, we in America need to bring back public health's powers to contain outbreaks early.

Yeah, agree wholeheartedly.
We cannot go through a repeat of the Putin-fueled Republican funded anti-vax hysteria.

I.
just.
can't.

It got so bad here for a little while that I actually considered concealed carry to protect my wife.
Thankfully I decided I wasn't cut out to be some hyper-vigilant cranked up guy always on alert and trying to
take matters into my own hands, but it got so bad that instead we just hunkered down for about a month watching
the hysteria.

Public health directives have the force of law, but the problem is, law ENFORCEMENT is decidedly on the side of the anti-vaxxers, so there's no teeth.
We cannot afford to go through this crap again...when public health says do something, people better damn well do it.
It's like that Army tee shirt:

"Saving your dumb ass whether you like it or not"

Some particularly bad news in the form of new papers about how Covid affects the brain: Researchers looked at MRIs of people who had brain scans both before and after Covid. They actually saw shrinkage, and not just in the seriously ill. Another paper said researchers found the onset of dementia is a very common result of serious Covid. Several researchers have found the virus is NOT neuro-invasive: It does not invade neurons in the body, the spine, or the brain. Nobody has found competent virions in nerve tissue. But they have found viral RNA fragments, which indicates they were floating around in the bloodstream after the virus was all "killed" by the immune system. The brain damage is probably a result of the cytokines and other agents that take part in the immune system over-reaction.

SARS-CoV-2 is associated with changes in brain structure

New Onset Dementia

These are from TWIV 874 on YouTube. The main presenter, Dr. Griffon, also said a neurologist personally told him loss of smell and taste that has persisted for more than three months will probably never come back.

On the lighter side concerning the booster shot.

This happened yesterday and is important information for our age group. especially those of us over 70.

A friend had his 3rd dose of the vaccine - the "booster" at a Pharmacy, after which he began to have blurred vision on the way home. When he did get home, he immediately called the pharmacy for advice about seeing a doctor, or to be hospitalized.

He was told NOT to go to a doctor or a hospital, but to immediately return to the pharmacy and pick up his glasses.

Sad news: WHO estimates over 200 million people worldwide have suffered from Long Covid symptoms, the most common being exhaustion and cognitive difficulties. Early on, some victims seemed to benefit from vaccination. Pretty soon some studies of monoclonal antibodies for Long Covid may start, but the problem is which monoclonal? We have a battlefield littered with useless monoclonals as they are quite variant-specific.

Active immunity following vaccinations or multiple infections promote some great things like somatic hypermutation and affinity maturation, which make antibodies against every variant possible and antibodies that are 1000s of times better at neutralizing virus respectfully. Passive immunity (monoclonals) do not. Antivirals and monoclonals are wonderful, but they might actually prevent a robust immune response that can give you T and B-cell immunity that can last for many years. (17 years so far for SARS victims who survived.)

I've had 4. If you are over 50 you can get another booster. CDC Guidelines

I've continued to mask up in public places, and that seems prudent as it is spiking again in my area.

We just got our bivalent boosters, which will be shot #6.
Yeah, we're that serious because in Feb 2020 when I caught it the first time I came very close to winding up as 215 pounds of fertilizer. The second time I caught it three months ago it was three days of the sniffles and some fatigue and that's all.

I hope I don't ever catch it again even if it is just the sniffles.
My sense of smell is juuuuuuuuuust now beginning to come back a little bit, about 35% of what it used to be pre-COVID.