COVID-19 Thread [V2.0]

[LouisEly]

Why do airplanes always do this "It's too late" routine when there's any kind of issue and insist people get off the plane even when they're willing to adhere to the rules? It's always so annoying to watch.

It's usually not the airlines (or their airplanes), it's usually a couple of poorly-trained employees who don't know the rules and/or are afraid of getting in trouble if they ask someone what they should do. Differences in employees' knowledge or interpretation of rules is usually what leads to people getting on to planes before these things happen.

 

Also, the first time many people encounter an employee of the airline is at the gate when they're getting on the plane. Prior to that, they are running into TSA, airport employees, security, etc., who don't work for the airline and is not their job to enforce the airlines' policies.

[LouisEly]

According to this, Pfizer/BioNTech SE's COVID-19 vaccine could be submitted for regulatory review as early as October:

 

https://www.bloomberg.com/news/articles/2020-08-21/pfizer-virus-vaccine-on-track-for-regulatory-review-in-october

 

The companies said the vaccine was "well tolerated", with mild to moderate fever in less than 20% of participants. You can bet that it will get FDA priority review the day it is submitted (but will take several days for review of all of the trial data).

 

I've had a flu vaccine once in my life, and I had a mild fever/sweats about an hour after receiving it. If that's the extent of the side effects, that is good news.

 

Pfizer has a $2B deal to supply an initial 100M doses to the US.

 

There will likely be multiple vaccines as there is no way any one manufacturer can produce the supply that is needed globally.

[CheezWizHed]

I've had the flu vaccine a few times without a fever. 20% seems really high...

[nate82]

In high school I worked at a hospital and got the flu shot every year after high school and I went to college I never got the flu shot again. About 5-years ago I got the flu shot at work and got so sick it was worse than the flu couldn't keep liquids or food down for about a week. Never had a flu shot since and haven't been sick since there is probably something in the flu shot that my body doesn't like so I just don't get them.

 

I am hesitant on the COVID shot or whatever you want to call it. I will wait and see if it actually works and if the side effects that do come with it are more of a hassle than the actual disease.

[reillymcshane]

I have gotten the flu shot most years for as long as I can remember (I'm 56). I don't recall when I started, and I'm sure I've missed a year here and there, but I have never gotten the seasonal flu, and I've never had any side effects (at least that I remember).

 

My 20-year old son has had the shot every year since he could get it. He got the flu this past year for the first time.

[CheezWizHed]

I think I've had the flu shot 2-3 times in my life, but I've only had the flu twice. Last year, work paid us $75 dollars into our HSA to get the flu shot, so I did. I was the only one in my family that didn't get the flu last fall.

[reillymcshane]

One thing about the flu shot is it does not cause the flu. Reactions, if any, are generally mild (headaches, nausea, swelling). But nothing is long term or severe. LouisEly's comment about getting a mild fever and sweats is an example of this.

 

All that said, in very rare cases there can be an allergic reaction - which can cause all sorts of issues. But this is really rare.

 

One big issue people have about the flu shot is understand what it does and doesn't do. It only protects you from 3-4 strains of influenza. That's it (and it's never 100% effective). There's lots more strains that can be out and about. It's not protecting you from - or causing - stomach flu, or bacterial infections, or the common cold, or a host of other things. And a flu shot doesn't become fully effective right away. It takes 2 weeks or so for the antibodies to build up in your body once you get the shot (which is important, because often times people go get the shot once they find out others they know have the flu - co-workers, kids, etc. Well, the protection you get from the shot won't kick in for a week or two, which doesn't help them if the flu is running rampant through your home or workplace.)

 

In the end, we have to be sure we are not associating the flu shot with something else that occurs (meaning, I got a flu shot, and the the next day I got horrible diarrhea - so the flu shot must have cause that). I'm not saying it didn't cause it - but the odds are very, very low.

 

If I have made any errors, people can update/correct.

[PeaveyFury]

I think that's correct, reilly. I think what often happens is that a person is fighting something else off, and the flu shot causes their immune system to become a bit overwhelmed, causing them to feel really sick. That's why you're not supposed to get one if you have any symptoms.

 

I didn't get a flu shot ever until we had kids, then I have had one every year since. Other than the sniffles I got as a result of the germs brought home from daycare and such, I generally have felt better in the winters since getting the shot than I did before.

[FVBrewerFan]

How certain are we there will be no long-term side effects, problems, etc. with the vaccine? Because if it's only a matter of 20% chance of slight fever, there's no reason for anyone NOT to get immunized. The effectiveness shouldn't even be a question. If it's, let's say, 70% effective it's still worth it. Then you just get immunized again when there's a better vaccine.

 

I would think better therapeutics will be available around the same time the vaccine is approved. So with that combination, we really should be able to get back to normal, finally. Once everyone has had a chance to be vaccinated. If you take a pass, you're on your own.

[Storm]

In 1992 I got a flu shot. Before the nurse emptied a quarter of the syringe, the injection sight turned as hard as a rock, turned red, got hot and swelled up a good inch. She stopped the injection and I was kept in the Dr's. office for several hours for observation before I could go back to work. Have not had a flu shot since. I also haven't had the flu or a cold since I started doing a shot of fire cider every morning for close to four years.

[igor67]

The extent of mild to moderate side effects is probably the biggest wild card in going this fast. It is not unreasonable to think that more people than typical would experience reactions. The vast majority of those reactions would be like getting sick (since many disease symptoms are caused by your immune system working). Normally they want to minimize those reactions because it creates possibility for people to not want to get other vaccines for example. I would hope the testing that is being done is still rigorous enough combined with years of experience that they avoid anything with an unusual chance of severe reactions. It is a tough set of ideas to communicate because I think at this point most people are willing to have a chance of feeling sick to not actually get sick so we can all move on, but there are a very vocal group of people waiting to pounce on any vaccine symptoms to fuel their decades long propaganda machine. All medical treatments carry risk. If you can't imagine what the risk is for a treatment that doesn't mean its not there. Antibiotics for example increase your chances of infection, including some very unfortunate otherwise hard to catch infections.

[tmwiese55]

I've had it most years of my adult life as my company brings someone in to give it for free. Never have any side affects and never get the flu. Granted, I'm a fairly "never get sick" type person to begin with though.

 

Well the side effects, longer term ones and such is a legit worry. But that's also why you have to let the experts work the process correctly to do the best they can. Not forcing them to rush and approve stuff early for political reasons. I think I've also read the guess right now is that due to such concerns they'll probably be cautious on the first one approved, which might lead to effectiveness being only in the 50% ballpark. But, it's something you can get out there to curb the exponential growth issue while they continue to work on better ones and can test more long term. It's been at least several weeks since I read on it though so take a bit with a grain of salt of memory.

 

But an issue will be that if it's only ballpark 50% effective. You also will have 25% of the population that won't take it because it's part of a conspiracy, in their minds. Then you'll have a totally legit group like we're discussing here concerned on kind of being the first ones up, who won't take it right away. Either way, it should put a dent in it and reduce the exponential growth problem.

[FVBrewerFan]

Yea, the problem is this time around it's not just the anti-vaccine crowd, There will be a percentage of people who will think it's rushed and unsafe/ ineffective. So if/when the vaccine does get approved, they're going to need to have Trump, Biden, Pelosi, Fauci...a bunch of them come together and all take the vaccine united together.

[tmwiese55]

I'd say it's more the pro Trump crowd that thinks it's all BS that I'd be concerned about. They don't think this is real, so why would they get a vaccine. And the anti vacc crown is a strong overlap with the Trumpers already.

 

If there is nobody in the medical side of it saying they're being pressured (like what just happened on that treatment this week) the people who have been saying the whole time they believe in science should have no reason not to trust science. Like I said, that's why he has to stay out of it and not muddy it up with politics, let them do it the way they're supposed to. But of course, if he doesn't stick his nose in then he can't try to take credit combined with painting someone else as at fault

[CheezWizHed]

No more politics please.

 

Any more political posts will be removed.

[Fear The Chorizo]

But an issue will be that if it's only ballpark 50% effective.

 

Honestly, for a virus that maybe only leads to symptomatic responses to 50% of the people who come in contact with it, if the 1st round of this coronavirus vaccine is 50% effective it would be a fabulous (an probably unrealistic) result. My concern with relying too heavily on a vaccine is for society to assume that everyone getting it will suddenly make COVID-19 magically go away, and then have a followup overreaction to new cases continuing to crop up. A vaccine for this virus should be viewed as a tool to curtail COVID-19 outbreaks and keep them manageable even after allowing public life to resume closer to what it looked like a year ago.

[CheezWizHed]

On the COVID isn't the Flu front, i'm wondering how the vaccines compare.

 

As Reilly said, you don't get the flu (or other sickness) from the flu shot. Allergic reactions and such can happen, but not the actual flu.

 

So if 20% of people get a fever from this shot, what is the source of that? Seems very high for an allergic reaction.

[PeaveyFury]

Seems very high for an allergic reaction.

 

I'll let one of our microbiology folks correct me if I'm wrong, but fever is more indicative of your immune system fighting off an 'infection', which in this case could be somewhat expected. Allergic reaction is more the swelling and other symptoms, I believe.

[FVBrewerFan]

But an issue will be that if it's only ballpark 50% effective.

 

Honestly, for a virus that maybe only leads to symptomatic responses to 50% of the people who come in contact with it, if the 1st round of this coronavirus vaccine is 50% effective it would be a fabulous (an probably unrealistic) result. My concern with relying too heavily on a vaccine is for society to assume that everyone getting it will suddenly make COVID-19 magically go away, and then have a followup overreaction to new cases continuing to crop up. A vaccine for this virus should be viewed as a tool to curtail COVID-19 outbreaks and keep them manageable even after allowing public life to resume closer to what it looked like a year ago.

 

That's why testing and better therapeutics will be the trifecta, and hopefully we'll have all 3 in place within the next couple months. There are really good therapeutics now for specific application such as antibodies, hydroxychloroquine, etc, but what we really need are better therapeutics for patients that are in more critical condition.

[igor67]

Peavey has the correct general description, a fever is possible with any infection or perceived infection by the immune system but it a different part of the immune response from an allergic reaction. If it helps think about how long it takes to develop a fever (usually at least a full day after exposure to a disease often longer) while the allergic reactions happen in minutes to a few hours depending on amount of allergen.

 

A high sustained fever is a risk for just about any infection. It's kind of a remote (read on par with winning the lottery) possibility with a vaccine, but from when I've perused the subject the numbers or so low that it is possible the numbers attributed to those type of reactions are caused in whole or in part by other super rare infections. The way to think about it is that children today receive enough vaccinations that from about 6 months to a 3 or 4 years old it is true that they will have gotten a vaccine not that long ago. So demonstrating true cause and effect become really hard. The US actually set-up a vaccine court back in the 1980's to specifically handle any claims and damages that might result from wide spread immunization. The court does hand out awards to this day for documentable adverse vaccine reactions. They have done all the work to investigate what types of rare events actually happen and merit awards.

[LouisEly]

How certain are we there will be no long-term side effects, problems, etc. with the vaccine?

I've spent over 15 years in the pharmaceutical industry. Typically clinical trials that I have seen are between 500 and 2000 patients. Some of the clinical trials for the COVID-19 vaccines have had up to 30,000 patients enrolled.

 

There is always a chance that things that don't show up in clinical trials manifest themselves when the drug is issued to tens of thousands of people over the course of years instead of the 1,000 or so in the clinical trial. But when you have 30K people in a vaccine trial, the chances of things showing up that don't show up in the clinical trial are going to be very low. But each vaccine will literally be given to hundreds of millions of people.

 

Generally, the way vaccines work is that they take inactive/"dead" virus particles and inject them to simulate the virus infection which in turn stimulates the body to develop a response to it. It teaches the body to develop a response, kind of like a fire drill - it's so that the body knows what to do when it happens for real. Because the virus particles are inactive/"dead", it is extremely unlikely that it will cause an actual infection. It could easily cause a mild/moderate fever that lasts an hour to a day, but that is the body developing an immune response and not an actual infection.

 

You have to consider the alternative. What is the risk of not getting a vaccine? Both have risks; it's a matter of which risk people are more tolerant of. One of the human behavioral heuristics is that people prefer the known to the unknown. For a majority of people, the known is that they don't know anyone personally who has died or been hospitalized from COVID-19. So their default "known" is that they are and have been fine and the scary unknown is the vaccine. But for those who personally know someone who has died or been hospitalized, that's the "known" and not getting the vaccine is the scary unknown. (I don't know anyone personally but my parents' next door neighbors knew the people from Fond du Lac who went on the Nile River cruise.)

 

I'd be willing to bet that the willingness/unwillingness to get a vaccine is as much if not more correlated with personally knowing someone who has died/been hospitalized than it is with politics.

[reillymcshane]

For a majority of people, the known is that they don't know anyone personally who has died or been hospitalized from COVID-19. So their default "known" is that they are and have been fine and the scary unknown is the vaccine. But for those who personally know someone who has died or been hospitalized, that's the "known" and not getting the vaccine is the scary unknown. (I don't know anyone personally but my parents' next door neighbors knew the people from Fond du Lac who went on the Nile River cruise.)

I know eight people who have gotten COVID. Six of the people I know well - had dinner with, gone out for drinks - that sort of thing. So it's not like it's a 'I know someone who knows someone who knows someone' type of thing. Two others are people I've met a few times. One of those actually died from it.

[TURBO]

I know some people personally who have had the virus, none who died. My daughter had it in mid March. She did get pretty sick, and it knocked her down for about 3 weeks, but she didn't need hospitalization. Thankfully she is a healthy 22 year old, so even though it effected her a lot, she recovered.

 

My school district has one teacher who tested positive, and one on quarantine currently. One other teacher in my district tested positive a couple weeks before we started school.

 

We have one student that tested positive last week, and several on quarantine based on the time they spent with that student.

 

We have 2 days in with kids, and what the staff is basically doing now is waiting for the sh*t storm that is soon to follow once more positive cases are discovered.

 

I'm betting 2 weeks before we close, but hope I am wrong, and we buck the odds and make this work out. I'm not holding my breath.

[CheezWizHed]

Seems very high for an allergic reaction.

 

I'll let one of our microbiology folks correct me if I'm wrong, but fever is more indicative of your immune system fighting off an 'infection', which in this case could be somewhat expected. Allergic reaction is more the swelling and other symptoms, I believe.

 

I was avoiding "infection" based on the "not-sick" distinction, but allergy was the wrong term too. Still, 20% is high for a fever reaction.

[Machu Peach]

There's a ton of misinformation and disinformation out there regarding the seasonal flu vaccine. I'm certain that'll be 10x worse with any COVID vaccine. Most people in vaccine research pretty much accept that compliance will always be very suboptimal. C'est la vie.