COVID COVID-19 Coronavirus Containment Efforts

[kyphysics]

https://www.theguardian.com/world/2020/mar/27/coronavirus-vaccine-when-will-it-be-ready

So the Covid-19 vaccine candidates have to be treated as brand new vaccines, and as Gellin says: “While there is a push to do things as fast as possible, it’s really important not to take shortcuts.”

An illustration of that is a vaccine that was produced in the 1960s against respiratory syncytial virus, a common virus that causes cold-like symptoms in children. In clinical trials, this vaccine was found to aggravate those symptoms in infants who went on to catch the virus. A similar effect was observed in animals given an early experimental Sars vaccine. It was later modified to eliminate that problem but, now that it has been repurposed for Sars-CoV-2, it will need to be put through especially stringent safety testing to rule out the risk of enhanced disease.

It’s for these reasons that taking a vaccine candidate all the way to regulatory approval typically takes a decade or more, and why President Trump sowed confusion when, at a meeting at the White House on 2 March, he pressed for a vaccine to be ready by the US elections in November – an impossible deadline. “Like most vaccinologists, I don’t think this vaccine will be ready before 18 months,” says Annelies Wilder-Smith, professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine. That’s already extremely fast, and it assumes there will be no hitches.

Question: In this March 27 Guardian piece reporting on how long it would take to get a COVID19 vaccine, it says at one point that vaccine candidates usually take a decade or more to get to regulatory approval. But, later, it quotes a professor from the London School of Hygiene and Tropical Medicine implying we could have one after 18 months.

Am I missing something? So, 18 months would be super fast. But, the typical length of time is 10+ years. How are people coming up with these numbers for when we can expect a vaccine? And, why is the COVID one talked about being potentially much faster than average?

edited to add: Or, am I confusing the vaccine time with a treatment/cure time? When people talk about a successful treatment/cure, are they talking about a vaccine? Or, is that different? If different, can treatments and cures come sooner usually than a vaccine?

 

[collinsmark]

I'll echo the previous poster who quoted you in that a person qualified in the relevant fields should give you a much better answer.

However, would it not be logical that the virus can survive in the summertime, due to summertime not being universal simultaneously for everyone? In other words, the entire globe does not experience summer at the same time. The U.S., for example, is in winter. But, countries like Australia are in the middle of summer. Or, they were: Dec. thru February. They are in fall right now technically.

Allow me to elaborate on that since I was the previous poster in question.

Although places like Australia and South America (i.e., places in the Southern hemisphere) did see the initial stages of the epidemic in their summertime, it was their late summer. Right now, as the pandemic is really picking up, the whole world is near an equinox. So there's really not a whole lot of data regarding of how well the virus spreads in a given hemisphere's summer.

I do think it's worth taking a look at the tropics though -- regions where summertime and wintertime don't really mean much.

Looking at a map,
https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
the virus appears to be spreading fairly readily in warm climates too, as far as I can tell.

 

[peanut]

If I'm not mistaken, the Spanish flu had a second wave that involved a mutated new strain, which was much more virulent than the first strain, no? What I am not sure of is whether those immune to the Spanish flu's first strain were still immune to the next wave.

Ages/areas not initially infected likely vulnerable in the second or third waves. In 1918, virus mutated into more virulent form. In 1957, schoolchildren spread initial wave, elderly died in second wave.

 

[peanut]

GOOD NEWS: 101-year old man in the coastal Italian town of Rimini has recently recovered from covdid-19. He was born in 1919 after his mother had survived the 1918 flu pandemic which had claimed the lives of over 600,000 Italians.

https://edition.cnn.com/2020/03/27/...rypBtnaC9rp9rTRlFP03dNjnbQ2g2rn3XWKZZh4Y4Y12c

 

[mfb]

Am I missing something? So, 18 months would be super fast. But, the typical length of time is 10+ years. How are people coming up with these numbers for when we can expect a vaccine? And, why is the COVID one talked about being potentially much faster than average?

Some things can be sped up when taking larger risks and spending more money. Ideally you want to do each test in sequence, if one test indicates a problem you can stop immediately without further harm, change the vaccine or in the worst case start from scratch. If you do multiple and larger tests in parallel you get results faster, but you have larger risk that the vaccine turns out to harm, and you might spend more money on something that doesn't work out.
A SARS-CoV-2 vaccine is urgently needed, so people will take some risks they wouldn't take for some low priority disease.

 

[DennisN]

That's a very interesting comparison (numbers/population ratio plotted against time) I've been thinking of doing myself for different countries. @mfb , do you mind telling where you got the numbers (with respect to time) from?

I just did two charts for a couple of countries.
I plan to add a bunch of other countries later (e.g. China).
The charts only show cases, not deaths, which I plan to add later.

Corona cases¹ (normal chart):
(Italy, Germany, Sweden, US, Spain, South Korea)

Corona cases¹ (logarithmic chart):
(Italy, Germany, Sweden, US, Spain, South Korea)

¹ The number of cases have been divided by the population of each country and then multiplied by one million to get a ppm value (parts per million).

Data sources used:

• http://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy
• http://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Germany
• http://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Sweden
• http://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_United_States
• and http://en.wikipedia.org/wiki/Template:2019–20_coronavirus_pandemic_data/United_States_medical_cases
• http://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Spain
• http://en.wikipedia.org/wiki/Template:2019–20_coronavirus_pandemic_data/South_Korea_medical_cases

Please also note that the numbers reflect only reported cases and that different countries have done different numbers of tests.

EDIT 1: I've added the US numbers.
EDIT 2: I've added the Spain numbers (I wanted to add Spain because I've read reports that the development in Spain was troubling, and the data and graphs seem to reflect that.)
EDIT 3: I've added the South Korea numbers.

 

[Vanadium 50]

Some things can be sped up when taking larger risks

Those risks need to be balanced. Consider the case of BIA 10-2474. Caused brain damage in 4% of the subjects in human trials, and killed 1% outright. Likely would have been far worse had the trial not been stopped. At the time of the trials, there appeared to be no issues in the animal trials.

Rushing out a cure or preventative without tests - you know, science - has its own dangers that could conceivably be worse than the disease.

 

[dlgoff]

However, would it not be logical that the virus can survive in the summertime, due to summertime not being universal simultaneously for everyone?

Of course. I must have a brain virus of some sort. :(
Thanks

 

[peanut]

Rushing out a cure or preventative without tests - you know, science - has its own dangers that could conceivably be worse than the disease.

Exactly! We don't want an unsafe answer to the problem!

 

[Astronuc]

That article looks like a meaningless, innumerate journalistic piece. Saying that "half of patients were between 20 and 64 years old" reveals typical journalistic innumeracy. . . .

Statistics wasn't the point of the article, but rather "Young people appear to be at greater risk of serious illness from the Coronavirus than initially realized in the U.S." Early in this epidemic/pandemic, there was commentary in social media and the media that 'young' people would not be seriously affected. If one looked at the mortality statistics, very few deaths were reported in folks younger than 40. I have seen stories of individual cases involving juveniles, teenagers and young adults who have been hospitalized or in some cases deceased. The virus doesn't discriminate by age, race, ethnicity, . . . .

See Post #1,716 (page 69) - https://www.physicsforums.com/threads/covid-19-coronavirus-containment-efforts.983707/post-6315715

From Michigan - https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html
[CODE highlight="1"] Age %
0 to 19 years 1%
20 to 29 years 8%
30 to 39 years 13%
40 to 49 years 17%
50 to 59 years 19%
60 to 69 years 20%
70 to 79 years 14%
80+ years 8%[/CODE]

The Michigan numbers by age group are similar to those of Washington, while NY seems a slightly higher proportion of younger folks affected, but then NY reports different age groups. Certainly it seems that mortality is skewed to the older population > 60 years.

Michigan deceased statistics (not much detail)

Age Data of Overall Deceased
Average Age 68.4 years
Median Age 70 years
Age Range 36-92 years

I wouldn't rely on a newspaper or magazine for statistics.

 

[PeroK]

The virus doesn't discriminate by age, race, ethnicity, . . . .

Illnesses and viruses do discriminate. They are not bound by notions of political correctness!

 

[peanut]

PCR tests are designed to target specific segments of viral genome, that do not necessarily mutate. For Covid-19, there's an added complexity as this is RNA- virus. Primers are attached to the target RNA, converting to DNA, replication and comparison to negative and positive controls. Hence, PCR takes time.

My question: Is there any report about change in strain of Covid-19?

 

[TeethWhitener]

Young people appear to be at greater risk of serious illness from the Coronavirus than initially realized in the U.S.

Realized by whom? I’m with @PeroK here. It just seems like a fluff piece that adds on to fluff pieces that were shared by social media about the virus being more dangerous to old people.

But the thing is, all the available statistics do point to the virus having a much higher mortality rate in old people. That’s not saying young people can’t get sick and die; it’s just saying that if I had to wager who had a better prognosis—a 30 year old or a 70 year old, all other things equal—I’d put my money on the 30 year old and I’d be right the vast majority of the time.

The Michigan numbers by age group are similar to those of Washington, while NY seems a slightly higher proportion of younger folks affected, but then NY reports different age groups. Certainly it seems that mortality is skewed to the older population > 60 years.

This still doesn’t mean much without a knowledge of Michigan age demographics. Is 20% of Michigan’s population between the ages of 60-69?

Edit: answering my own question, here’s Michigan demographics:
https://worldpopulationreview.com/states/michigan-population/
Only about 10% of Michigan’s population is 60-69, meaning someone in that age range is far more likely to be diagnosed with Covid-19 than if the illness were distributed randomly across the population. Of course, the only ones being diagnosed are the ones who are getting sick enough to actually warrant a test.

 

[mfb]

Rushing out a cure or preventative without tests - you know, science - has its own dangers that could conceivably be worse than the disease.

That's why it takes 18 months and not 6.
The more dangerous the disease is the better the case for faster tests.
Without a vaccine we need to eradicate it by other means (looks nearly impossible), keep social distancing and similar measures up forever (doesn't sound good), find a miracle cure to reduce case fatality rate (sounds good, but ...) or accept tens of millions of deaths over time (this doesn't sound good either).

 

[Ygggdrasil]

A follow-up for you or anyone else is whether we can still, in theory, get a mutated new strain in the future that would make survivors with immunity to the current strain once again susceptible to getting sick from that new strain?

If I'm not mistaken, the Spanish flu had a second wave that involved a mutated new strain, which was much more virulent than the first strain, no? What I am not sure of is whether those immune to the Spanish flu's first strain were still immune to the next wave.

Mutation of the 1918 pandemic flu to a more virulent strain seems specific to the circumstances of WWI:

This increased severity has been attributed to the circumstances of the First World War.[91] In civilian life, natural selection favors a mild strain. Those who get very ill stay home, and those mildly ill continue with their lives, preferentially spreading the mild strain. In the trenches, natural selection was reversed. Soldiers with a mild strain stayed where they were, while the severely ill were sent on crowded trains to crowded field hospitals, spreading the deadlier virus. The second wave began, and the flu quickly spread around the world again. Consequently, during modern pandemics, health officials pay attention when the virus reaches places with social upheaval (looking for deadlier strains of the virus).[92]

https://en.wikipedia.org/wiki/Spanish_flu#Deadly_second_wave
See also: https://www.newyorker.com/magazine/1997/09/29/the-dead-zone

Wikipedia suggests that exposure to the first wave produced immunity to the second wave:

The fact that most of those who recovered from first-wave infections had become immune showed that it must have been the same strain of flu. This was most dramatically illustrated in Copenhagen, which escaped with a combined mortality rate of just 0.29% (0.02% in the first wave and 0.27% in the second wave) because of exposure to the less-lethal first wave.[93]

https://en.wikipedia.org/wiki/Spanish_flu#Deadly_second_wave

It is possible that the Coronavirus could mutate to evade immunity, but current estimates of the mutation rate of the virus suggest that this possibility would be rare. Furthermore, the virus would not have selective pressure to evade immunity until a large percentage of the population has immunity (either though getting the disease or through vaccination). When we get to that point, however, it will be very important to monitor the virus for mutations in the spike protein that could indicate evolution to evade immunity.

Allow me to elaborate on that since I was the previous poster in question.

Although places like Australia and South America (i.e., places in the Southern hemisphere) did see the initial stages of the epidemic in their summertime, it was their late summer. Right now, as the pandemic is really picking up, the whole world is near an equinox. So there's really not a whole lot of data regarding of how well the virus spreads in a given hemisphere's summer.

I do think it's worth taking a look at the tropics though -- regions where summertime and wintertime don't really mean much.

Looking at a map,
https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
the virus appears to be spreading fairly readily in warm climates too, as far as I can tell.

There is some evidence that the virus shows lower transmissibility in warmer climates than colder climates, but this evidence is still preliminary. There are certainly reasons to think transmissiblity could be reduced by warmer weather (respiratory droplets do not travel as far at higher humidity and the viruses lose viability faster outside of the body at warmer temperatures). However, I don't think we can count on summer weather to completely eliminate virus transmission in the Northern hemisphere (though it may mean that we can get by with fewer restrictive measures).

At the same time, I worry that as the Southern hemisphere moves into winter, many developing nations that do not have the resources to fight the disease will be very hard hit by the virus.

 

[kyphysics]

Repost of Possibly Missed Question:

I previously asked if vaccine and "treatment/cure" are used interchangeably when talking about the virus?

Or, are they separate? E.g., Would a vaccine simply train the body to recognize the virus and destroy it, while a cure/treatment doesn't necessarily train the body to do so but does it for the body? Or, am I just bumbling these terms?

Thanks!

 

[kyphysics]

GOOD NEWS: 101-year old man in the coastal Italian town of Rimini has recently recovered from covdid-19. He was born in 1919 after his mother had survived the 1918 flu pandemic which had claimed the lives of over 600,000 Italians.

https://edition.cnn.com/2020/03/27/...rypBtnaC9rp9rTRlFP03dNjnbQ2g2rn3XWKZZh4Y4Y12c

This is interesting. I'd read an article about a very old Chinese male survivor in the past as well. I believe he was over 100 too.

Is there an implication that having survive the 1918 Spanish flu helps with fighting off COVID-19? Or, was that just an "interesting fact" and not a medically relevant correlation?

 

[TeethWhitener]

Usually a vaccine is prophylactic (preventative), whereas a cure tends to imply that a patient is already infected. I’m not sure whether there’s a technical definition for “cure” in the medical community.

A vaccine can be administered as a therapeutic. The most prominent example in my mind is the rabies vaccine, which is generally administered in response to a possible rabies exposure but before the onset of symptoms.

 

[kyphysics]

With that in mind - the distinction between vaccine and "treatment/cure" - is the time-frame to a treatment/cure faster than the highly optimistic timeline for a vaccine, which is 18 months?

I.e., could we get a cure, before we get a vaccine?

 

[Ygggdrasil]

With that in mind - the distinction between vaccine and "treatment/cure" - is the time-frame to a treatment/cure faster than the highly optimistic timeline for a vaccine, which is 18 months?

I.e., could we get a cure, before we get a vaccine?

It's possible that we could get a treatment before a vaccine. Most of the efforts at finding a treatment are based on re-purposing existing drugs to see if they have any effect on the virus. For drugs that are already FDA approved (e.g. the hydroxychloroquine/azithromycin combination discussed here), doctors already have the authority to prescribe the drugs off label to treat the virus, though most would hopefully want to wait for definitive evidence as to whether they are helpful before doing so. There is also a drug currently in Phase III clinical trials (remdesivir), where we could get data in a few months as to whether it will be effective (though experts are pessimistic about whether the data from ongoing trials would give a clear picture of its effectiveness).

I don't really expect any of the treatments, however, to be "cures" to the disease. The treatments may help lower death rates from the disease or reduce hospitalization times, but they are unlikely to make the disease go away. As our experience with influenza has shown, developing antiviral drugs is difficult:

Consider, for example, the limitations of Tamiflu (oseltamivir), a common treatment for another virus, influenza. To have any effect, the drug must be taken within 48 hours of symptoms appearing. And even then, “the overall impact on clinical outcomes is not very dramatic,” Lane says. “We don’t have a lot of success in treating RNA viruses.”

https://cen.acs.org/biological-chemistry/infectious-disease/initial-remdesivir-data-tell-us/98/i13

Here's a link to a site that's tracking the development of vaccines and treatments for COVID-19: https://milkeninstitute.org/covid-19-tracker

 

[Astronuc]

EDISON, N.J. — Jack Allard, a 25-year-old New Jersey man put on a ventilator at a local hospital after a delayed COVID-19 diagnosis (original test results were lost), will be airlifted Tuesday to the University of Pennsylvania.

He's one of more than 500 people on a waiting list there for a clinical trial that uses the novel antiviral drug remdesivir.

Remdesivir was studied as a treatment for Ebola patients in 2014.

https://www.pix11.com/news/coronavi...of-pennsylvania-for-clinical-trial-remdesivir

He was placed in a medically induced coma pending treatment for COVID-19.
https://www.nydailynews.com/coronav...0200325-z2xsr4xjkrb6jd5ub2vr6goneu-story.html
https://abc7ny.com/6047354/

 

[mfb]

A discussion why Germany's deaths/cases is so low
- half a million tests per week.
- large number of hospital beds and in particular ICU beds, the inclusion of military hospitals, and tens of thousands of ventilators, so Germany is still far away from capacity limits
- average age of infected people is 46. Many of the early cases were from ski trips, so initially it spread more among younger people

 

[atyy]

Or, are they separate? E.g., Would a vaccine simply train the body to recognize the virus and destroy it, while a cure/treatment doesn't necessarily train the body to do so but does it for the body? Or, am I just bumbling these terms?

Yes, that's the right idea about the distinction between a vaccine and a cure/treatment (not sure what the right language is, since vaccine is obviously a sort of treatment).

Just as having gotten the infection itself (if one survives) trains the body to fight off the infection (at least for some time after having recovered, so that a second infection is not likely), a vaccine mimics parts of the virus that train the body the fight the virus. Although it mimics the virus enough to train the body, a vaccine does not contain complete enough virus to enable viral replication etc.

 

[kyphysics]

@ Ygggdrasil

Thank you for the helpful/informative answer as usual. And thank you for the link, especially, as that will be something I'll want to follow. I have family members who are very vulnerable to the virus, so like a lot of people, I've been digging and learning as much as I can.

Yes, that's the right idea about the distinction between a vaccine and a cure/treatment (not sure what the right language is, since vaccine is obviously a sort of treatment).

Just as having gotten the infection itself (if one survives) trains the body to fight off the infection (at least for some time after having recovered, so that a second infection is not likely), a vaccine mimics parts of the virus that train the body the fight the virus. Although it mimics the virus enough to train the body, a vaccine does not contain complete enough virus to enable viral replication etc.

Good to know my distinction is correct. Thanks, atyy. I also agree the language is a bit "weird," as vaccine is also a treatment too - lol.

I couldn't help but also wonder: if a vaccine trains the body to fight off the virus, why wouldn't our own bodies just do the same? Is it because the vaccine utilizes a "weak" enough version such that the virus does not entirely overwhelm us as quickly (possibly making it harder for our bodies to fight it off at that point)?

 

[Ygggdrasil]

@ Ygggdrasil

Thank you for the helpful/informative answer as usual. And thank you for the link, especially, as that will be something I'll want to follow. I have family members who are very vulnerable to the virus, so like a lot of people, I've been digging and learning as much as I can.
Good to know my distinction is correct. Thanks, atyy. I also agree the language is a bit "weird," as vaccine is also a treatment too - lol.

I couldn't help but also wonder: if a vaccine trains the body to fight off the virus, why wouldn't our own bodies just do the same? Is it because the vaccine utilizes a "weak" enough version such that the virus does not entirely overwhelm us as quickly (possibly making it harder for our bodies to fight it off at that point)?

When infected, your immune system is racing against the virus to develop immunity before the virus can do too much damage to the body. A vaccine gives your body a large head start on that race, so the immune system can mount a powerful response to the virus the minute it shows up. This also helps eliminate the contagious period between when a person gets infected and when the immune system can control the virus, further lowering transmission of the virus.

 

[atyy]

I couldn't help but also wonder: if a vaccine trains the body to fight off the virus, why wouldn't our own bodies just do the same? Is it because the vaccine utilizes a "weak" enough version such that the virus does not entirely overwhelm us as quickly (possibly making it harder for our bodies to fight it off at that point)?

The vaccine is basically a "disabled" virus. A real virus also trains the body, just like a vaccine, but you may not survive the training.

Also, as @Ygggdrasil said, the vaccine trains you ahead of time, so that when the real thing comes you can fight it immediately before it starts having too many bad effects.

In the case of the rabies virus vaccine that @TeethWhitener mentioned above, the virus has such a long incubation period that it is ok to give the vaccine shortly after infection, so the body can be trained by the vaccine to fight the virus while the virus is still only incubating.

 

[Rive]

With that in mind - the distinction between vaccine and "treatment/cure" - is the time-frame to a treatment/cure faster than the highly optimistic timeline for a vaccine, which is 18 months?

I.e., could we get a cure, before we get a vaccine?

To find a 'cure' would require quite a luck (by my opinion cure is something what fights the virus itself, so it is a kind of targeted medicine): but the treatment (treatment, as something what helps and keeps the patient alive during an infection) will likely improve fast as known safe medicines will be tested and approved.

To develop (and test!) an entirely new medicine faster than the vaccine - that is not likely.

 

[peanut]

Taken from the news article.

In both tests, Delos Reyes said conclusions showed inhibition in viral replication, significant reduction of virus quantity, even the ability to selectively kill infected cells. Both drugs are approved by the Food and Drug Administration (FDA) in the Philippines and in the U.S. They have different mechanisms of action, but when combined, according to Dr. Ethan Taylor, it produces a synergistic effect with a natural alcohol antagonistic to the virus.

https://manilastandard.net/mobile/a...TwjliZwTe34otV_N0K_imko#.Xn7jfexqUlU.facebook

 

[phinds]

There have been news reports that some people are becoming frustrated in quarantine.

 

[DennisN]

I just wanted to say I found an error in one of my charts I posted before in post #1866, and I can't edit the post anymore. The date axis on chart 2 (the logarithmic) had the wrong dates. I blame it on Excel!

Here is the corrected chart:

(for data sources and additional info please see my original post)