Wading through info that conflicts... COVID related..

[Bootsie]

1 hour ago, Where's Toto? said:

 

Yep, this.  People are demanding information immediately.  But immediate information isn't always the best information and it changes constantly.   Then people yell because the information wasn't accurate.   Honestly I feel like the researchers and media sharing information can't win.  

There is a great advantage to researchers sharing their information with each other quickly.  The researchers know that what is being shared has not been peer reviewed and the realize the limitations of the studies.  What I have seen as a problem is that a blogger or someone in the media takes some of the information from that research out of context without understanding these limitations in a report and then people begin citing that blogger's article as if were established fact. 

I have even seen instances of where things such as an author having in the conclusion of a paper a statement like, "further research needs to be done to see if more X results in more Y"  (a statement that is common in much academic research indicating areas for further study) has been reported as Author A concluded that she thinks X results in more Y.  

[Wheres Toto]

18 minutes ago, Bootsie said:

There is a great advantage to researchers sharing their information with each other quickly.  The researchers know that what is being shared has not been peer reviewed and the realize the limitations of the studies.  What I have seen as a problem is that a blogger or someone in the media takes some of the information from that research out of context without understanding these limitations in a report and then people begin citing that blogger's article as if were established fact. 

I have even seen instances of where things such as an author having in the conclusion of a paper a statement like, "further research needs to be done to see if more X results in more Y"  (a statement that is common in much academic research indicating areas for further study) has been reported as Author A concluded that she thinks X results in more Y.  

I agree.   Researchers sharing information is very beneficial.   It's the general, not-science-educated public screaming for immediate information then using the fact that it changes to scream conspiracy theories, that causes the problem. 

[Pen]

12 hours ago, SKL said:

Well I'm talking about how I would approach it if I knew for sure I'd had the virus and developed antibodies and got over it.  I would act differently than if I thought I might be walking around with an unsymptomatic but contagious case.  That does not mean I'd go cough on my parents - I am always reasonably careful around fragile people regardless.  But I wouldn't have the high level of vigilance that applies to "I might be contagious with Covid19 right now."

 

But you might use low vigilance and cough on someone you did not know was fragile?

[Clemsondana]

21 minutes ago, square_25 said:

 

How could people be immune without antibodies? I thought antibodies were literally the way your immune system fights off a virus... 

I agree that we have to act on what we know and what is reasonable to believe. Therefore, I personally believe that antibodies are protective, even if it's not settled. But I see no reason to assume that people without antibodies to COVID-19 are immune and don't see how acting on this belief would be reasonable. 

Immunology is not my specialty, so I don't want to say too much about this.  But, antibodies are one way that your body avoids infection.  But, the immune system is complicated and I could imagine other responses that get rid of something before you develop too much antibody response - I can't speak to how that fits with viruses, or specifically this virus, though. 

But, at the base level, skin, mucus membranes, etc are part of what helps us avoid infection - they are our first line of defense and are often mentioned in the non-specific immunity section of textbooks.  Some people may not get infected because they have particularly robust responses in some other way - this isn't based on any data, just thinking through ideas like if something infects cells in the respiratory tract, then possibly having more/less mucus, or a more/less dry or inflamed tract, or an inordinate/unusually low amount of degradative enzymes in saliva, might affect rates of infection such that some people don't get sick despite repeated exposures and others get sick with a small exposure.  It's nothing specific to this virus, but I'd imagine that many of us know folks who get every bug that circulates while others never get sick.  We don't know why that is and it is the sort of thing that would be really hard to research. 

I read a really fascinating article this week (actually, a review - I didn't dig into the primary data) that said that the error-prone reverse transcriptase only causes 2% of the variation in HIV - the rest comes from a deaminase protein in the host cell.  The idea seemed to be that the cell modifies the daylights out of the virus in an attempt to make it dead/less virulent (I wasn't sure about which).  If it works, great - no virus.  If it doesn't, then you've got a variable population of virus, making it harder to treat.  So, folks with less deaminase were more likely to get sick because they didn't kill it.  I had never heard of this, but these sorts of things are ways that I could imagine somebody being 'immune' to a virus but not having antibodies.  They're not truly immune, but they might not get it while everybody around them does. 

I think that most people don't understand that there is this level of human variation - ultimately, there is an explanation for the results that we see, but it could be years before we figure out what it is.  I remember hearing about how quickly HIV mutates when I was in college, and probably earlier.  The deaminase paper was published in 2015.  We can't see what we don't know to look for.  It's what makes biology fun, but, in cases where people are waiting for something to be done, it's frustrating.  

[Clemsondana]

1 minute ago, square_25 said:

 

Yes, of course, that makes sense :-). But is there any reason to assume that some people will just NEVER get it, as opposed to have had good luck to be exposed to a lower viral load or having had other protective responses? 

I agree that it might turn out that only some people are susceptible. But I don't think it'd be reasonable to act as if we know that the people who've been exposed but haven't been infected can't get infected. 

Of course not.  But, there might be, just like there are people who don't get AIDS (a guy in the UK was cured after a bone marrow transplant -  fascinating stuff!).  And, even if it were true, there's no way to predict who they would be without a lot more information.  Similarly, even with antibodies, we don't know how long they'll last - most likely for months, but beyond that...who knows.  It seems to be specific to different infections.  We already know that we get booster shots for some things but not others...personally, I was unlucky enough to have mono, test negative after a period of time, and then test positive again years later despite being told that 'you can't get it twice'.  

I've got my own opinions about what we ought to be doing based on the likelihood of finding a lasting vaccine, improved treatments, etc, but I don't really want to get involved in a discussion about it - I just saw a biology question and thought I'd jump in with an answer.  

[vonfirmath]

On 5/5/2020 at 9:37 PM, CuriousMomof3 said:

 

None of the Chick Fil A's or Dairy Queens around here have drive thrus.  It wasn't until recently that I posted something about Chick Fil A and realized that that is uncommon.  

 

They recently rebuilt our Chick-fil-A and now it is drive through ONLY. No dining room space at all.

 

[Pen]

18 minutes ago, ClemsonDana said:

Immunology is not my specialty, so I don't want to say too much about this.  But, antibodies are one way that your body avoids infection.  But, the immune system is complicated and I could imagine other responses that get rid of something before you develop too much antibody response - I can't speak to how that fits with viruses, or specifically this virus, though. 

But, at the base level, skin, mucus membranes, etc are part of what helps us avoid infection - they are our first line of defense and are often mentioned in the non-specific immunity section of textbooks.  Some people may not get infected because they have particularly robust responses in some other way - this isn't based on any data, just thinking through ideas like if something infects cells in the respiratory tract, then possibly having more/less mucus, or a more/less dry or inflamed tract, or an inordinate/unusually low amount of degradative enzymes in saliva, might affect rates of infection such that some people don't get sick despite repeated exposures and others get sick with a small exposure.  It's nothing specific to this virus, but I'd imagine that many of us know folks who get every bug that circulates while others never get sick.  We don't know why that is and it is the sort of thing that would be really hard to research. 

I read a really fascinating article this week (actually, a review - I didn't dig into the primary data) that said that the error-prone reverse transcriptase only causes 2% of the variation in HIV - the rest comes from a deaminase protein in the host cell.  The idea seemed to be that the cell modifies the daylights out of the virus in an attempt to make it dead/less virulent (I wasn't sure about which).  If it works, great - no virus.  If it doesn't, then you've got a variable population of virus, making it harder to treat.  So, folks with less deaminase were more likely to get sick because they didn't kill it.  I had never heard of this, but these sorts of things are ways that I could imagine somebody being 'immune' to a virus but not having antibodies.  They're not truly immune, but they might not get it while everybody around them does. 

I think that most people don't understand that there is this level of human variation - ultimately, there is an explanation for the results that we see, but it could be years before we figure out what it is.  I remember hearing about how quickly HIV mutates when I was in college, and probably earlier.  The deaminase paper was published in 2015.  We can't see what we don't know to look for.  It's what makes biology fun, but, in cases where people are waiting for something to be done, it's frustrating.  

 

My grandfather was a professor of immunology.  Much has developed since his time.  Including some of the interesting bits in your post.

As a basic though, yes, immunology and immunity can encompass far more than just antigen-antibody mediated immunity. 

 

 

[ktgrok]

14 hours ago, SKL said:

You assumed way more than what I was saying.  I was responding to someone commenting that we need to protect the essential workers.  I was saying that for the past 2 months, a lot of the essential workers have been exposed all along (and the only people acting concerned about that were some family members of those workers).  In areas with any significant number of cases, some of them most likely had the virus and didn't even know it; others probably didn't.  I feel that the exposure of all these people to the virus was an obvious, predictable outcome of the way the policies were implemented back in March.  And that is not all bad, because a high % of those workers could get the virus without serious repercussions and contribute to herd immunity.  I did not say herd immunity is already accomplished, though I still think it may be close in places like NYC/New Jersey.

I think a whole lot of us were acting concerned about the essential workers - we recognized that the best way to prevent them getting sick is to minimize spread in the general population, and to stay home as much as possible. Contactless delivery, and doing what I can to keep from getting sick myself helps protect them. 

to me, those who have been advocating for the more open the better, lets get herd immunity, are the ones not showing concern for the essential workers. 

14 hours ago, SKL said:

I still think there is enough info to suggest you don't get it over and over again in a short period of time.  Waiting until we know the long-term immunity doesn't sound like a workable plan (whether one is targeting herd immunity or vaccines).

Do you have links to that? I have seen all sorts of speculation, but nothing even close to a good idea of how long it would be, other than probably not within the same month. But beyond that, there are coronaviruses that have little to no lasting immunity I thought?

4 hours ago, square_25 said:

 

 

Also, I disagree that people haven't been worried about essential workers. My best attempt not to affect essential workers is not to leave the house and not to interact with essential workers, and that's what I've been doing. Anything we do to prevent spread protects essential workers. 

yes

1 hour ago, SKL said:

But again, there might be other reasons why people have immunity but not specific-to-Covid19 antibodies.

Yeah we don't have settled research on any of this yet.  We won't until a very long time has passed.  We have to act on what we know and what is reasonable to believe.

Right, innate immune system vs learned immune system. And yes, we don't know. The disagreements are on what to do based on that lack of knowledge in the meantime. 

[Pen]

13 minutes ago, StellaM said:

 

A lot of people can't be visually identified by others as 'fragile', anyway. 

 

 

Yes.  I know.  

That’s why I asked.  People may presume they are going to be careful if someone looks old, or has some obvious outward sign of disability.  

But many people have invisible higher risk factors.  

For example, us. Or for example, 2 teenage kids in my son ‘s class are type 1 diabetic, and only one has anything outwardly obvious. 

 

[SKL]

11 hours ago, square_25 said:

 

How could people be immune without antibodies? I thought antibodies were literally the way your immune system fights off a virus... 

I agree that we have to act on what we know and what is reasonable to believe. Therefore, I personally believe that antibodies are protective, even if it's not settled. But I see no reason to assume that people without antibodies to COVID-19 are immune and don't see how acting on this belief would be reasonable. 

I didn't say I assume they are immune.  I'm saying the antibodies test alone does not seem to be an accurate measure of how many people are immune.

[SKL]

11 hours ago, Pen said:

 

But you might use low vigilance and cough on someone you did not know was fragile?

Um I thought it was obvious that I was using "cough on" as tongue in cheek.  But in case anyone is unsure, let me clarify.  I do not cough on people ever.  I'm not sure why you are picking at straws here.  I think people can picture how differently we act when we have a bug (or think we might) and when we don't.  Last December, were you walking around with a mask and staying 6' away from everyone?  Probably not, because you didn't have any reason to believe you might be carrying an unusually dangerous disease.  Of course you could have been carrying something without knowing it - you always could - but reasonable hygiene normally balances that out.  So that December level of reasonable care is the goal vs. the current fear of visiting my folks at all.

[mathnerd]

12 hours ago, ClemsonDana said:

Of course not.  But, there might be, just like there are people who don't get AIDS (a guy in the UK was cured after a bone marrow transplant -  fascinating stuff!).  And, even if it were true, there's no way to predict who they would be without a lot more information.  Similarly, even with antibodies, we don't know how long they'll last - most likely for months, but beyond that...who knows.  It seems to be specific to different infections.  We already know that we get booster shots for some things but not others...personally, I was unlucky enough to have mono, test negative after a period of time, and then test positive again years later despite being told that 'you can't get it twice'.  

I've got my own opinions about what we ought to be doing based on the likelihood of finding a lasting vaccine, improved treatments, etc, but I don't really want to get involved in a discussion about it - I just saw a biology question and thought I'd jump in with an answer.  

To add to this, I remember reading some interesting facts about the antibody test for CV19: the tests may turn out negative if a person had the virus for a short time (similar theory to what you said about robust responses of some individuals to the virus), it is possible to get exposed and not develop antibodies, it is possible to get a False Positive because of antibodies from a different kind of coronavirus. Club these facts along with the fact that nobody knows if a person who got it in Dec or Jan would test positive for antibodies in June or July and that the FDA is not really sure if most of the tests in the market are effective, I think that antibody testing at this point is not a smart move. We need more reliable tests before we can pull out numbers and plot charts.

It might help if China did some testing on its people who were infected in November and December and helpfully shared the data with the world, but I know that such things would mean that the Communist party needs to become more transparent and admit to the actual number of cases and most people would never believe their data, anyway.

Edited May 8, 2020 by mathnerd

[kbutton]

On 5/8/2020 at 1:30 AM, SKL said:

Of course you could have been carrying something without knowing it - you always could - but reasonable hygiene normally balances that out.  So that December level of reasonable care is the goal vs. the current fear of visiting my folks at all.

But we aren't always carrying a virus that is novel to the entire human population. Reasonable care is not enough to keep deaths down, or we wouldn't be where we are now. 

On 5/7/2020 at 6:32 PM, square_25 said:

Just posted this in the big thread, but since we were talking about how many people are already immune... I'm watching Cuomo's update today, and apparently, the percent of healthcare workers who have antibodies for COVID in NYC is lower than the percentage of the general population that has antibodies for COVID! Fascinating, and I guess evidence that PPE works? The percentage of police that were positive was less than the overage rate, too.

Early on when they went from droplet protocols to airborne protocols before going back to droplet protocols for all but the most invasive procedures, a hospital ER in Chicago found that healthcare workers who had been quarantined because they had used only the droplet protocols but using them thoroughly while treating COVID patients, did not end up developing the virus. TeamHealth put out a podcast about that a couple of months ago. I don't think they were rationing PPE heavily at that point, but keeping an eye on levels.

For high-risk procedures, most places that have the supplies are using the airborne procedures, COVID cubes, etc. 

Still, frontline healthcare workers in our state are 16% of our cases. I think that is largely due to nursing home staff not having enough PPE and having so much close patient contact though.