COVID-19 Thread [V2.0]

[Fear The Chorizo]

Info coming out of Japan on a small antibody study started in Tokyo right after their 1st initial spike in the spring and continued testing through Japan's 2nd "wave" in July/August was quite interesting...

 

After Japan's 1st COVID wave went through in the spring, roughly 6% of the asymptomatic case group (anyone showing symptoms at all was removed from the study) had COVID antibodies in May. That same grouping had up to a 47% positive seroprevalence during the midst of Japan's July/August summer spike (which came and went without any additional mitigation measures/lockdowns). The really interesting part is a good chunk of the initial 8% no longer tested positive for COVID antibodies in the midst of that second wave, and over 80% of the test group who tested positive for antibodies at some point during the study tested negative for them about 1 month later. This suggests COVID antibodies in true asymptomatic cases don't stick around long at all, and also suggests the potential of former asymptomatic cases to become immune to future COVID infection. It's both good and bad news, particularly for the US.

 

Much of the conventional thought revolving around Japan and how well they did addressing COVID was they did a great job of isolating early and targeted testing/contact tracing. Yet an asymptomatic study group of roughly 615 people over a wide range of adult ages across Tokyo had basically 50% seroprevalence in July. Japan's actual infection rate was probably huge in mid-summer, similar to when we saw the sunbelt spike here...they just had hardly anyone get really sick from it or even cared to aggressively test for it. This data points to hopes of reaching 70-80% of people to have antibodies at any given time in order to reach "herd immunity" isn't possible for a virus that such a large percentage of the healthy population can process asymptomatically - many to the point of having hardly any immune system response that results in antibodies even being generated. Japan, which had some of the earliest confirmed COVID cases outside of China and had a COVID-laden cruise ship to deal with in February (~120M population crammed onto islands roughly the size of california) has tested roughly the same amount as the state of Minnesota (~6 million people scattered quite a bit apart outside the twin cities metro area). Japan did great at limiting COVID infections that led to severe medical traumas because they have an incredibly healthy population - frequently they are viewed as the healthiest in the world. They never had significant health issues across any large portions of their population, so they lost interest in worrying about it. Unfortunately, our current state of public health prevents the US from doing the same thing - frankly we all knew that back in March and hoped for a silver bullet or lucky bounce that wouldn't prolong how much a pain in the ass COVID would be here. Unfortunately, a huge country with huge numbers of people whose health is artificially propped up by other medicines and medical advancements doesn't do well when faced with a novel virus that is hardest on people with those same comorbidities. At this point we're stuck waiting on a vaccine that will hopefully provide temporary immunity to the most vulnerable, and it'll get added to the laundry list of shots and medications we need to lean on to keep our society going - there really isn't a way to sugarcoat that.

 

Replace Japan with Sweden and remove Sweden's initial bumbled response in protecting long term care facilities and there are alot of similarities - general public health pre-COVID also helps explain why Germany has done so much better than other populous western european countries dealing with the severity of COVID outbreaks. Different countries do different things and take different measures, but at the end of the day how each developed country fares has much more to do with its public health conditions before it even had to worry about a novel virus.

 

In short, and it sucks to say it because I've had more than my share myself, all those Big Macs have come back to bite our country in the ass in 2020.

[tmwiese55]

Move on my man. You already dug the hole, don't make it worse. Sometimes it's best to step away from the interwebs for a day.

 

Fair enough. I don't believe I have, as I said I stand by the whole overall point. I appreciate his pointing out a mistake (especially appreciate his take as he comes from this background), and how to improve on writing and discussing in a better more inclusive way.

 

Go crew, need this one tonight.

 

ETA: Good post FTC

[HiAndTight]

 

It's hard to pinpoint what the actual mortality rate is, as as soon as a number is released, the people who don't like seeing that high of a number call it "fake news" or say that it doesn't count because some of those people had underlying health conditions.

 

That's another idea that bothers me, though, too. I've been a Type 1 Diabetic for 27 years. Because of that, I am at a higher risk of complications should I contract COVID. However, my diabetes is highly controlled, and does not stop me from living a normal life. It's a minor inconvenience more than anything.

 

If I were to contract COVID and succumb to it, there would be a large group of people arguing that I should not be counted as a COVID death because I'm a diabetic, when in reality, diabetes wasn't going to kill me anytime soon. What a mess.

 

 

Kinda goes back to that "one death is a tragedy," line of thinking.

 

This has become so political that people have become pretty callous when discussing the topic....unless it impacts them.

The good news it is SEEMS as though Doctors are doing a better job of treating this, reacting more quickly, they're lowering the mortality rate(according to some studies) when compared with cases from March and April.

[igor67]

I'll throw-in a few thoughts again:

 

In regards to school openings and models- On the ground it is super complicated. I know of multiple schools for example that rushed into hybrid or in person expecting it to be unsustainable, but motivated to do so by a number of factors. The variations in what hybrid or in person looks like is wildly different for different schools. So I would urge anyone to be extremely cautious in judging, what I will do is guarantee that for whatever issues you can think of there are 10 more that the school boards and administrators have also thought about.

 

While there have been moments I think it is worth recognizing that compared to the internet at large we have managed to have discussions about political topics in a productive manner. I frequent some other places frankly that are overpopulated with otherwise intelligent people that can't actually have anywhere near the level of discussion we have a sports based site. Being able to have real discussion is important, I'll even say it is way more important than anything Covid related.

 

In regards to politicization of science. First, politics absolutely should be involved in science. How it is involved however is a very important question. It is well recognized in science ethics that the widespread funding from the government after WWII creates a significant obligation for the scientist to report and communicate their results (https://www.nap.edu/catalog/12192/on-being-a-scientist-a-guide-to-responsible-conduct-in). As I try to teach my students however that creates a reciprocal responsibility for citizens in a democracy to listen and learn enough to participate in that discussion.

 

What should never happen is political concerns altering scientific conclusions/interpretations. Every scientist is of course subject to their own bias, but that is a big reason why public communication is so critical it allows others to test and check for the real (if any) impact of that bias. A good example of politics solving and causing problems can be found in https://www.penguinrandomhouse.com/books/547559/pandoras-lab-by-paul-a-offit-md/

Those old enough may remember that selling margarine in Wisconsin was illegal for many years. In the long run this purely economically driven decision proved to be a health benefit. But the original political problem was creating policy on poorly developed links between cholesterol and heart disease. Ultimately there is clearly an important role for people to be involved in making policy decisions from scientific conclusions. What I would label as very concerning about the top level CDC communications is how out of character and modified it has become. It usually referred to as 'guidance' for a reason. It historically has been the agency's best attempt to synthesize existing data and conclusions into a useable format for policy makers. There certainly seem to have been a number of instances where that guidance has been adjusted significantly from what non-agency experts would have produced.

[homer]

Those old enough may remember that selling margarine in Wisconsin was illegal for many years.

 

I come from a long line of Canadian margarine smugglers.

[Ron Robinsons Beard]

Probably best not to make statements like ""So far the evidence seems it to be the case with this one as well" and then spend a page back-peddling from it. This has been going on since March, not very helpful, or responsible.

 

I personally don't believe that attempting to float the idea of herd immunity as a viable option (sans a viable and effective vaccine) is helpful or responsible either, but perhaps that's just me.

[igor67]

Probably best not to make statements like ""So far the evidence seems it to be the case with this one as well" and then spend a page back-peddling from it. This has been going on since March, not very helpful, or responsible.

 

I personally don't believe that attempting to float the idea of herd immunity as a viable option (sans a viable and effective vaccine) is helpful or responsible either, but perhaps that's just me.

 

It's worth recognizing that relatively early-on based on the very limited information a case could have been made for it. Based on how most countries reacted it was not a compelling case, but not a Flat-Earth situation either.

 

From a news story today

https://www.yahoo.com/news/parents-knowingly-sent-kids-coronavirus-170052665.html

 

“The human behavior aspect of sending sick and positive children to school is not something we can control, and we never accounted for people completely disregarding basic health guidance,” Johnson said. “We have no tools left, and we just want everyone to be safe.”

 

As much as I suggested caution above, any plan that didn't account for parents sending sick kids to school wasn't developed by anyone with normal school experience. There are any number of reasons it should have been easy to imagine parents sending kids anyway. A little cynicism about human behavior and rule breaking is useful when trying to make plans.

[Machu Peach]

Probably best not to make statements like ""So far the evidence seems it to be the case with this one as well" and then spend a page back-peddling from it. This has been going on since March, not very helpful, or responsible.

 

I personally don't believe that attempting to float the idea of herd immunity as a viable option (sans a viable and effective vaccine) is helpful or responsible either, but perhaps that's just me.

 

Humanity has survived many many epidemics/pandemics throughout history. Most ended via some level of herd immunity. You can argue that it's not the best option, but it absolutely is a 'viable option'. It's been the default option fo millennia.

[Ron Robinsons Beard]

Probably best not to make statements like ""So far the evidence seems it to be the case with this one as well" and then spend a page back-peddling from it. This has been going on since March, not very helpful, or responsible.

 

I personally don't believe that attempting to float the idea of herd immunity as a viable option (sans a viable and effective vaccine) is helpful or responsible either, but perhaps that's just me.

 

It's worth recognizing that relatively early-on based on the very limited information a case could have been made for it. Based on how most countries reacted it was not a compelling case, but not a Flat-Earth situation either.

 

From a news story today

https://www.yahoo.com/news/parents-knowingly-sent-kids-coronavirus-170052665.html

 

“The human behavior aspect of sending sick and positive children to school is not something we can control, and we never accounted for people completely disregarding basic health guidance,” Johnson said. “We have no tools left, and we just want everyone to be safe.”

 

As much as I suggested caution above, any plan that didn't account for parents sending sick kids to school wasn't developed by anyone with normal school experience. There are any number of reasons it should have been easy to imagine parents sending kids anyway. A little cynicism about human behavior and rule breaking is useful when trying to make plans.

 

At some point the power is simply out of your hands, though, and you are in the situation then of depending on others to take the similar precautions you have chosen to take. But due to selfishness, resistance to change, a sense of entitlement, or what many would call "freedom", that hasn't happened in the U.S. You are correct in saying that the people making the plans should very well have planned on a number of people not following the guidelines. But I totally get what Mr. Johnson is saying above, though. Like the old worn-out cliche says, you can lead a horse to water, but you can't make him drink.

 

What scares me about the majority of the herd immunity truthers, though, is that they seem to be advocating that society take no safety precautions whatsoever, basically taking the "whatever happens, happens" philosophy many are preaching and injecting it with steroids. I'm sure there are plenty of people out there who have no problem with the idea of becoming infected with COVID, and possibly infecting and killing others, as that is simply "nature running its course." I am never going to believe in that line of thinking, though.

[Ron Robinsons Beard]

Probably best not to make statements like ""So far the evidence seems it to be the case with this one as well" and then spend a page back-peddling from it. This has been going on since March, not very helpful, or responsible.

 

I personally don't believe that attempting to float the idea of herd immunity as a viable option (sans a viable and effective vaccine) is helpful or responsible either, but perhaps that's just me.

 

Humanity has survived many many epidemics/pandemics throughout history. Most ended via some level of herd immunity. You can argue that it's not the best option, but it absolutely is a 'viable option'. It's been the default option fo millennia.

 

If that's the case, why even invest in medical research? While we're at it, why invest in roads, sewers, and plants that provide safe water to drink? We could go back to the Middle Ages, when people threw their raw sewage out the window into the street below, and epidemics ran rampant.

 

I realize that what I'm saying above is very hyperbolic, but I guess the point is that if we have the technology and know-how to keep people alive though an epidemic, why choose not to?

[FVBrewerFan]

What scares me about the majority of the herd immunity truthers, though, is that they seem to be advocating that society take no safety precautions whatsoever, basically taking the "whatever happens, happens" philosophy many are preaching and injecting it with steroids. I'm sure there are plenty of people out there who have no problem with the idea of becoming infected with COVID, and possibly infecting and killing others, as that is simply "nature running its course." I am never going to believe in that line of thinking, though.

 

This is the type of hyperbole that is all over the internet, and is dividing us. This is not helpful in any way. "Herd immunity truthers" is both dismissive, and really makes no sense. Claiming that anyone who believes herd immunity is part of the solution have no problem with infecting and killing others is, well, a disgusting comment to make.

[Ron Robinsons Beard]

What scares me about the majority of the herd immunity truthers, though, is that they seem to be advocating that society take no safety precautions whatsoever, basically taking the "whatever happens, happens" philosophy many are preaching and injecting it with steroids. I'm sure there are plenty of people out there who have no problem with the idea of becoming infected with COVID, and possibly infecting and killing others, as that is simply "nature running its course." I am never going to believe in that line of thinking, though.

 

This is the type of hyperbole that is all over the internet, and is dividing us. This is not helpful in any way. "Herd immunity truthers" is both dismissive, and really makes no sense. Claiming that anyone who believes herd immunity is part of the solution have no problem with infecting and killing others is, well, a disgusting comment to make.

 

OK, so let me get this straight. My comment is the type of hyperbole that is dividing us and isn't helpful, but you throwing around phrases such as "we can't hide in the corner for two years, for a whole lot of reasons" isn't? I mean, to me, that reads as a direct insult to those who have chosen to take precautions. I'm not a big fan of being called a coward.

 

There is certainly some basis to the idea that herd immunity is part of the solution, along with taking safety precautions and an effective vaccine. It is those who are propping up herd immunity, and advocating a "business as usual" approach as the only viable solution, who I believe are missing the mark here.

[Machu Peach]

Info coming out of Japan on a small antibody study started in Tokyo right after their 1st initial spike in the spring and continued testing through Japan's 2nd "wave" in July/August was quite interesting...

 

After Japan's 1st COVID wave went through in the spring, roughly 6% of the asymptomatic case group (anyone showing symptoms at all was removed from the study) had COVID antibodies in May. That same grouping had up to a 47% positive seroprevalence during the midst of Japan's July/August summer spike (which came and went without any additional mitigation measures/lockdowns). The really interesting part is a good chunk of the initial 8% no longer tested positive for COVID antibodies in the midst of that second wave, and over 80% of the test group who tested positive for antibodies at some point during the study tested negative for them about 1 month later. This suggests COVID antibodies in true asymptomatic cases don't stick around long at all, and also suggests the potential of former asymptomatic cases to become immune to future COVID infection. It's both good and bad news, particularly for the US.

 

Could you please provide a link to this study?

 

On important thing to note that most of the public is confused about is that just because someone tests 'negative' for anti-COVID antibody does not that they do not have anti-COVID antibody. All ELISAs (the gold-standard test used to detect the presence of serum-antibody) have a little-of-detection below which, the ELISA is not sensitive enough to reliably detect specific antibody above background. The smallpox vaccine, for example, is protective for decades after anti-smallpox serum antibody titers fall below the limit-of-detection.

 

It's also unknown what the correlate(s) of protection are for COVID. For most infectious disease it's non-neutralizing or neutralizing antibody titers, but not all.

[Machu Peach]

I personally don't believe that attempting to float the idea of herd immunity as a viable option (sans a viable and effective vaccine) is helpful or responsible either, but perhaps that's just me.

 

Humanity has survived many many epidemics/pandemics throughout history. Most ended via some level of herd immunity. You can argue that it's not the best option, but it absolutely is a 'viable option'. It's been the default option fo millennia.

 

If that's the case, why even invest in medical research? While we're at it, why invest in roads, sewers, and plants that provide safe water to drink? We could go back to the Middle Ages, when people threw their raw sewage out the window into the street below, and epidemics ran rampant.

 

I realize that what I'm saying above is very hyperbolic, but I guess the point is that if we have the technology and know-how to keep people alive though an epidemic, why choose not to?

 

I'm not going to respond to a straw-man argument. I'm not making any of the claims you're ascribing to me.

[Machu Peach]

herd immunity truthers

 

I don't understand this. The concept of herd immunity is extremely well established, well documented, and well accepted. Do you think it's some sort of conspiracy?

[Ron Robinsons Beard]

 

I'm not going to respond to a straw-man argument. I'm not making any of the claims you're ascribing to me.

 

You sorta did, though ... which is why I was surprised you responded the way you did, saying that herd immunity is a viable option based on historic context. I do realize that is technically correct, but it also defies the advancements in medical science and in civilization in general.

[homer]

What scares me about the majority of the herd immunity truthers, though, is that they seem to be advocating that society take no safety precautions whatsoever, basically taking the "whatever happens, happens" philosophy many are preaching and injecting it with steroids. I'm sure there are plenty of people out there who have no problem with the idea of becoming infected with COVID, and possibly infecting and killing others, as that is simply "nature running its course." I am never going to believe in that line of thinking, though.

 

This is the type of hyperbole that is all over the internet, and is dividing us. This is not helpful in any way. "Herd immunity truthers" is both dismissive, and really makes no sense. Claiming that anyone who believes herd immunity is part of the solution have no problem with infecting and killing others is, well, a disgusting comment to make.

 

OK, so let me get this straight. My comment is the type of hyperbole that is dividing us and isn't helpful, but you throwing around phrases such as "we can't hide in the corner for two years, for a whole lot of reasons" isn't? I mean, to me, that reads as a direct insult to those who have chosen to take precautions. I'm not a big fan of being called a coward.

 

There is certainly some basis to the idea that herd immunity is part of the solution, along with taking safety precautions and an effective vaccine. It is those who are propping up herd immunity, and advocating a "business as usual" approach as the only viable solution, who I believe are missing the mark here.

 

The other thing I've noticed about people that are pro herd immunity is that they offer up "We will protect the vulnerable" as a solution but haven't really given any details as to how that would happen. The "vulnerable" are not just elderly and retired. There are a ton of them in the workforce (as you know given your diabetes diagnosis). It may be that we get to herd immunity in the long run but to strive for that without precautions (e.g. mask mandates, social distancing, etc.) will put a massive strain on the healthcare system as we've seen in places like Houston, Miami, New York, New Orleans, etc.

[Ron Robinsons Beard]

herd immunity truthers

 

I don't understand this. The concept of herd immunity is extremely well established, well documented, and well accepted. Do you think it's some sort of conspiracy?

 

Of course I do not. My phrasing is a criticism of those using the idea of herd immunity as a political argument, or as a societal argument in advocating for a "business as usual, throw caution to the wind" approach.

[Machu Peach]

 

I'm not going to respond to a straw-man argument. I'm not making any of the claims you're ascribing to me.

 

You sorta did, though ... which is why I was surprised you responded the way you did, saying that herd immunity is a viable option based on historic context. I do realize that is technically correct, but it also defies the advancements in medical science and in civilization in general.

 

I'm a literal medical scientist. Your argument is that a medical scientist does not believe in medical science.

 

This is a ridiculous position and as a result I don't wish to discuss it with you further.

[Ron Robinsons Beard]

 

I'm not going to respond to a straw-man argument. I'm not making any of the claims you're ascribing to me.

 

You sorta did, though ... which is why I was surprised you responded the way you did, saying that herd immunity is a viable option based on historic context. I do realize that is technically correct, but it also defies the advancements in medical science and in civilization in general.

 

I'm a literal medical scientist. Your argument is that a medical scientist does not believe in medical science.

 

This is a ridiculous position and as a result I don't wish to discuss it with you further.

 

That's fine. Given that you are a medical scientist, I simply ask that you expand on your above idea that herd immunity, taken as a sole precaution against COVID-19, is viable in the present. I believe that something has been lost in translation, and it very well may be on my end. If that is the case, I apologize.

 

As noted above, as a high-risk individual, this is a hot-button issue for me, and I tend to react emotionally rather than scientifically, probably much more often than I should.

[Machu Peach]

That's fine. Given that you are a medical scientist, I simply ask that you expand on your above idea that herd immunity, taken as a sole precaution against COVID-19, is viable in the present. I believe that something has been lost in translation, and it very well may be on my end. If that is the case, I apologize.

 

As noted above, as a high-risk individual, this is a hot-button issue for me, and I tend to react emotionally rather than scientifically, probably much more often than I should.

 

I said I was done discussing this, but you're greatly misstating my position(s) so I feel I need to respond one final time. I have NEVER said anything advocating herd immunity as "a SOLE precaution against COVID-19". I even state "You can argue that it's not the best option". If you honestly think that I'm advocating herd immunity as "a SOLE precaution against COVID-19" you need to go reread what I wrote.

 

I spent 15 years of my life making vaccines. I've been an extremely strong vaccine advocate throughout this thread. Do you honestly believe that I don't think vaccines are, in all likelihood, going to be a fantastic, highly efficacious, safe, low-cost option?

 

I'm sorry to hear that you are a high-risk individual and I truly understand why that would make this a hot button issue. However you must stop incorrectly restating my positions. It is unfair to me and detrimental to productive discussion. Use quotes in the future if you want to respond to something I said instead of using straw-mans.

[SoCalBrewfan]

Herd immunity can be achieved by widespread vaccination. That's obviously a desirable endgame.

 

What most people who use the term (in this thread and in national conversation) seem to be advocating is herd immunity by infection and subsequent immunity. That requires that people get infected and then some of them will die. Is that a viable strategy?

 

I don't know that it's well known what percentage of a population needs to develop antibodies to COVID to reach that threshold. For some diseases that percentage is very high, over 90% for measles. A number I've seen frequently is 65-70% for COVID; I hadn't seen this before, but this mentions an outbreak on the French aircraft carrier that hit 70% before the outbreak stopped:

 

https://www.nature.com/articles/s41577-020-00451-5

 

From that article:

 

Taking these considerations into account, there is little evidence to suggest that the spread of SARS-CoV-2 might stop naturally before at least 50% of the population has become immune. Another question is what it would take to achieve 50% population immunity, given that we currently do not know how long naturally acquired immunity to SARS-CoV-2 lasts (immunity to seasonal coronaviruses is usually relatively short lived), particularly among those who had mild forms of disease, and whether it might take several rounds of re-infection before robust immunity is attained.

[LouisEly]

That's fine. Given that you are a medical scientist, I simply ask that you expand on your above idea that herd immunity, taken as a sole precaution against COVID-19, is viable in the present.

There is a difference between "viable" and "best option".

 

Herd immunity is certainly viable, and in today's world is probably not the best option. Both of these can exist at the same time.

[SoCalBrewfan]

[edited] I think it's better to assume good faith and try to clarify rather than getting angry.

 

FOLLOWUP EDIT: This should really be what guides us all, in my opinion, and it's unfair of me to single out any one poster. We try very hard on brewerfan to keep the heat low even when we disagree.

[Ron Robinsons Beard]

That's fine. Given that you are a medical scientist, I simply ask that you expand on your above idea that herd immunity, taken as a sole precaution against COVID-19, is viable in the present. I believe that something has been lost in translation, and it very well may be on my end. If that is the case, I apologize.

 

As noted above, as a high-risk individual, this is a hot-button issue for me, and I tend to react emotionally rather than scientifically, probably much more often than I should.

 

I said I was done discussing this, but you're greatly misstating my position(s) so I feel I need to respond one final time. I have NEVER said anything advocating herd immunity as "a SOLE precaution against COVID-19". I even state "You can argue that it's not the best option". If you honestly think that I'm advocating herd immunity as " a SOLE precaution against COVID-19"you need to go reread what I wrote.

 

I spent 15 years of my life making vaccines. I've been an extremely strong vaccine advocate throughout this thread. Do you honestly believe that I don't think vaccines are, in all likelihood, going to be a fantastic highly efficacious, safe, cheap, low-cost option?

 

I'm sorry to hear that you are a high-risk individual and I truly understand why that would make this a hot button issue. However you must stop incorrectly restating my positions. It is unfair to me and detrimental to productive discussion. Use quotes in the future if you want to respond to something I said instead of using straw-mans.

 

Thank you for your response. It is much appreciated, and once again, I apologize for obviously taking what you said out of context. It is obvious that the argument was somewhat lost in translation in this case, as my argument has never been anti-herd immunity as a portion of the solution, but rather using it as the sole solution. I believe we are on the same page on that idea, and perhaps I didn't lay out my argument clearly enough above. I believe that the crux of the disagreement is in our varied interpretations of the word "viable". To me, a solution that potentially kills millions is not a viable option, especially when the science and intelligence (along with responsibility) is available to avoid a large number of those deaths. The simple definition of "viable" is "capable of working successfully; feasible." In this case, determining success and feasibility is subjective.