Coronavirus prep

Our little old state which used to be a forerunner in getting vaccinated, least infected, less deaths due to Covid, etc., etc., is now rising in Covid infections and deaths, etc.

People are not masking or staying home anymore, all those plastic thingies separating customers from cashiers are now gone. Disinfecting shopping carts? Pbbst. Keeping 6 ft. apart? Pbbst. People are assuming, just because they're vaccinated, the virus won't touch them. OR the people they touch.
People have either become too complacent or are assuming too much.

kimny72 wrote: »

SModa61 wrote: »

ythannah wrote: »

kimny72 wrote: »

It's viruses that can hide in your body (like the chicken pox) and reemerge in a couple of decades to do more damage.

Or just hang out in your body forever, like the herpes simplex virus, and reappear periodically to be annoying. Says the woman who currently has a cold sore.

My imagined concern is another comparative. In cats, there is a feline coronavirus that is commonly caught. It manifests in the cat like a cold or the like. The cat recovers, but the virus lays dormant in the cat for life. What I recall is that stressors to the animal (aging, rehoming, other illnesses, etc) promote mutations in the virus. Certain mutations do not impact the animal a go undetected, but other mutations manifest as FIP which is essentially a fatal condition for the animal. I am sure there are much better explanations out there, but you can get the general idea. I am hoping that this COVID-19 virus does not share this trait.

I think there's good news and bad news. There are lots of coronaviruses and it sounds to this layperson like they don't all behave the same, so it's just as likely 19 will be like the common cold, or not like any of them at all, as that.

BUT, they've mentioned on TWIV that there are a lot of animal species that seem able to get infected with covid-19 and this does "possibly" mean that it can hide in other species and re-emerge in the future. It's why they don't think we'll be able to eradicate it, I guess all the viruses we've eradicated were only ever found in humans.

If it helps, I've noticed the TWIV podcasts seem to be assuming that we are on the tail end of this thing. They were just poking fun at a NYT article that quoted a cardiologist who said we'll be masking for the rest of our lives. They wondered why anyone would ask a cardiologist about a pandemic and said it was a ridiculous thing to say. Obviously they are not perfect, but listening to experts who have seen other virus outbreaks and who work with viruses all the time, who are confident in our progress, is reassuring for me!

I am a member of a professional medical organization. My day job is as a controller (head of accounting/finance), but I hold a niche professional-level medical certification. This is a niche organization and includes medical professionals from various areas. I was with a group with that organization this past weekend and the discussion of masks and how long they will be a thing came up. It was general consensus that they will be required in medical settings forever in the future. This group included a flight paramedic, ER doctor, radiologist, and several other medical backgrounds.

Perhaps the cardiologist was thinking about the use of masks in clinical settings?

Theo166 wrote: »

WHY NATURAL IMMUNITY DOESN'T COUNT IN THE USA
https://www.youtube.com/watch?v=Lz7fZOfPf8M

My Summary:

1. CDC recommends vaccination even if you've had COVID due to the lack of data
2. Israel study supports Natural Immunity alone is effective for relatively young and healthy people, but not those with comorbidities.
3. Natural Immunity has higher variability in protection vs vaccination
4. Combining past infection with vaccination appears to supercharge your immunity but it also increases the risk of side effects.
5. Immunity from infection appears to be under recognized by public health officials

For discussion:

• I support everyone getting vaccinated, but I would personally agree to allowing a exception to the vaxx mandate for people with natural immunity, if they so desired.
• I believe most with natural immunity will still choose to get vaccinated and forgoe requesting an exception.
• I think allowing an exception for people with some degree of natural immunity is a reasonable compromise in our drive for herd immunity.

#1 explains away #2. There is a lack of data, meaning that one study is not enough. There is also some data (though again not enough) that suggests people can get symptomatic covid multiple times.

#3 doesn't count for much if the period of immunity after infection is not long lasting, which is still a question that needs answering.

Immunity from infection is "under recognized" by public health officials because there is not enough data yet to prove it's reliable.

FWIW the TWIV team says that based on the data they're seeing, they think immunity from infection provides strong protection for about 3 months, but that is their best determination so far, not a conclusion they've reached.

Another issue with allowing those who've had covid to remain unvaxxed is, how do you determine whose had it? If someone tests positive but has no symptoms, is that definitely an infection that is conferring immunity? A false positive? What about people who had symptoms but it was too inconvenient to get tested? Home tests aren't catalogued or confirmed by any agency. Do we ask people to carry around their positive test and trust it is actually there's?

What I hear over and over from virologists is that this pandemic will be ended by vaccinations, and strongly recommending everyone whose already had covid to get at least one shot. I can't imagine why we wouldn't listen to the vast majority of folks who have been studying viruses their entire lives unless or until they get conclusive data that changes their minds. Just my two cents, obviously.


ETA: Crap, I didn't realize another YT video was embedded in that post. Dr. Hong is a pharmacist. I'm sure he's well intentioned, but I don't have time to keep watching this stuff, and I prefer to get as much info as I can about viruses from professionals who actually work with viruses. My response is just to the post.

neanderthin wrote: »

There is a world where natural immunity is taken more seriously. The beautiful thing is that everything comes out in the wash when it's on a global stage......I'm getting my popcorn ready when we find out that the new oral drugs from the manufacturers are the same as ivermectin in how they work by blocking the 3CL protease. Which begs the question why hasn't ivermectin been studied and is that reason justified considering it could have been implemented in a home defense kit along with vit d for pennies and potentially saved thousands of lives. The plot thickens.

There is currently a controlled study going on with ivermectin, but it will be a while before we know the the results. The problem was that in the beginning we were desperate for treatments, and sometimes anecdotal evidence was given too much weight. So studies were done without adequate controls. We have to correct that now. I don't know how it will turn out, but there is no strong evidence for ivermectin now.

neanderthin wrote: »

Dnarules wrote: »

neanderthin wrote: »

There is a world where natural immunity is taken more seriously. The beautiful thing is that everything comes out in the wash when it's on a global stage......I'm getting my popcorn ready when we find out that the new oral drugs from the manufacturers are the same as ivermectin in how they work by blocking the 3CL protease. Which begs the question why hasn't ivermectin been studied and is that reason justified considering it could have been implemented in a home defense kit along with vit d for pennies and potentially saved thousands of lives. The plot thickens.

There is currently a controlled study going on with ivermectin, but it will be a while before we know the the results. The problem was that in the beginning we were desperate for treatments, and sometimes anecdotal evidence was given too much weight. So studies were done without adequate controls. We have to correct that now. I don't know how it will turn out, but there is no strong evidence for ivermectin now.

Except when there is strong evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/

Conclusions:
Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.


This was published on the 5th of October 2021

https://pubs.rsc.org/en/content/articlehtml/2021/cp/d1cp02967c

Microscopic interactions between ivermectin and key human and viral proteins involved in SARS-CoV-2 infection†

“In silico”
Which is a computer model. Not in vivo.
It’s interesting. But it’s not “strong evidence”

neanderthin wrote: »

MargaretYakoda wrote: »

neanderthin wrote: »

Dnarules wrote: »

neanderthin wrote: »

There is a world where natural immunity is taken more seriously. The beautiful thing is that everything comes out in the wash when it's on a global stage......I'm getting my popcorn ready when we find out that the new oral drugs from the manufacturers are the same as ivermectin in how they work by blocking the 3CL protease. Which begs the question why hasn't ivermectin been studied and is that reason justified considering it could have been implemented in a home defense kit along with vit d for pennies and potentially saved thousands of lives. The plot thickens.

There is currently a controlled study going on with ivermectin, but it will be a while before we know the the results. The problem was that in the beginning we were desperate for treatments, and sometimes anecdotal evidence was given too much weight. So studies were done without adequate controls. We have to correct that now. I don't know how it will turn out, but there is no strong evidence for ivermectin now.

Except when there is strong evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/

Conclusions:
Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.


This was published on the 5th of October 2021

https://pubs.rsc.org/en/content/articlehtml/2021/cp/d1cp02967c

Microscopic interactions between ivermectin and key human and viral proteins involved in SARS-CoV-2 infection†

“In silico”
Which is a computer model. Not in vivo.
It’s interesting. But it’s not “strong evidence”

Of course they're different and really shouldn't need to be said. Using more than 1 methodology/strategy is just being thorough, can you imagine. Calling insilico not strong evidence is not understanding science in general. I would call your assessment confirmation bias which is very strong in this thread by some it appears.

I understand science just fine thanks much.

A computer model is interesting.
But it isn’t in vivo. Which is what I would call strong evidence.

neanderthin wrote: »

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/

Conclusions:
Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.


This was published on the 5th of October 2021

https://pubs.rsc.org/en/content/articlehtml/2021/cp/d1cp02967c

Microscopic interactions between ivermectin and key human and viral proteins involved in SARS-CoV-2 infection†

Just for clarity: that meta-analysis includes the now-infamous Elgazzar study which was shown to include falsified data, and the primary author has had a recent article regarding the MATH+ protocol for COVID retracted as outcome data was falsified. see here. And has generally worked unscientifically during the pandemic to propose treatments for covid without adequate clinical evidence, including vitamin C and hydroxychloroquine, and now ivermectin. The shame is that the unscientific use of methylprednisolone (which he and other members of his group promulgated) was effective and has been borne out in later scientific trials.

Further, it includes a bunch of observational studies which are weak evidence of efficacy. More contemporary and well controlled trials have not shown the same effect (see here and here.)

Further: the article quotes a the rates of covid and mortality in large cities with and without distribution of ivermectin without adequately controlling for other factors which affect the nature of outbreaks in that area, or the reporting of covid incidence or mortality in the area. This is not evidence of clinical efficacy.

In general, the published trials into ivermectin efficacy (certainly those in the meta-analysis here, and the ones by Hill and Bryant (who directly thanks Kory in the acknowledgements, and rated the Elgazzar as reliable in their analysis)) are not of good quality and have relatively small numbers and heterogenous inclusion criteria and outcome assessments compared to those that are ongoing, or other trials which have shown good evidence of efficacy of other treatments or prophylaxis.

As for the modelling that suggests that ivermectin can bind various proteins of SARS-CoV2/human proteins involved in infection: this is weak evidence of an interaction on a structural level and no evidence of clinical efficacy at all. It is very straightforward to model an interaction like this, but evidence of a true physical interaction (a crystal structure by X-ray, or cryo-EM, evidence of interaction by SPR or even calorimetry) would be at least practical evidence, rather than purely modelled. But even then it would be essentially no evidence of either physiological effect in humans (which would require distribution of the drug into an appropriate body compartment to have an effect in sufficient quantities to actually affect the pathophysiology of the virus and under conditions that mimic that compartment).

There is a huge issue at the moment with preprints and small journals publishing material that would never have been accepted prior to the pandemic: trying to publish a purely computational model of a small molecule binding a protein would have very little traction without real-world data to back it up, and certainly would get mostly ignored in the structural biology community (in the absence of a clear reason why that interaction was relevant).

N.B. I am not ruling out that ivermectin has a significant effect in clinical use in the treatment of covid. This remains to be seen and will come out in due course with several large trials ongoing - although the together trial have stopped the ivermectin arm due to inefficacy, so it's not looking good. But there is nothing at the moment to support the widespread use that we have seen in some parts of the world.

SModa61 wrote: »

kimny72 wrote: »

SModa61 wrote: »

ythannah wrote: »

kimny72 wrote: »

It's viruses that can hide in your body (like the chicken pox) and reemerge in a couple of decades to do more damage.

Or just hang out in your body forever, like the herpes simplex virus, and reappear periodically to be annoying. Says the woman who currently has a cold sore.

My imagined concern is another comparative. In cats, there is a feline coronavirus that is commonly caught. It manifests in the cat like a cold or the like. The cat recovers, but the virus lays dormant in the cat for life. What I recall is that stressors to the animal (aging, rehoming, other illnesses, etc) promote mutations in the virus. Certain mutations do not impact the animal a go undetected, but other mutations manifest as FIP which is essentially a fatal condition for the animal. I am sure there are much better explanations out there, but you can get the general idea. I am hoping that this COVID-19 virus does not share this trait.

I think there's good news and bad news. There are lots of coronaviruses and it sounds to this layperson like they don't all behave the same, so it's just as likely 19 will be like the common cold, or not like any of them at all, as that.

BUT, they've mentioned on TWIV that there are a lot of animal species that seem able to get infected with covid-19 and this does "possibly" mean that it can hide in other species and re-emerge in the future. It's why they don't think we'll be able to eradicate it, I guess all the viruses we've eradicated were only ever found in humans.

If it helps, I've noticed the TWIV podcasts seem to be assuming that we are on the tail end of this thing. They were just poking fun at a NYT article that quoted a cardiologist who said we'll be masking for the rest of our lives. They wondered why anyone would ask a cardiologist about a pandemic and said it was a ridiculous thing to say. Obviously they are not perfect, but listening to experts who have seen other virus outbreaks and who work with viruses all the time, who are confident in our progress, is reassuring for me!

slow response on my part. life is causing me to be hit or miss here atm.

i do certainly hope that that CV19 behaves like the majority of CVs, and like the common cold does not return in another form. with the scenario of chicken pox/shingles brought up already, I thought bringing up feline CV/FIP was pertinent to future possible concerns for CV19.

Yes, I wasn't trying to disagree with you, sorry if that's the way it sounded! The primary reason I'm trying to not get infected for as long as I possibly can is the possibility of long term effects of even mild or asymptomatic infections that aren't clear yet.

neanderthin wrote: »

Thanks for the detailed assessment. I have no doubt it won't be used in NA anytime soon even though many Dr.s are prescribing it. Apparently the CDC is gathering at speed more data on ivermectin, which is encouraging. Ivermectin is known to block 3CL main protease, which as you know is how the virus replicated itself. Pfizer's new molecule does the same but it's patented which will be a big money maker for the next 20 yrs....as opposed to ivermectin where the patent has expired and can be reproduced by anybody for pennies and it's not in the best interests to study a drug for a specific purpose because of the literal cost to performed such a study to then not make any money. Remdesivir for example made by Gilead is approved and has a low efficacy rating and costs I believe around 700.00 usd for a 5 day supply. Many countries have and are using it now. It cost pennies, has virtually no side effects and can be administered at home, it's just mind boggling it hasn't been done from the very outset of the pandemic, that's pretty much just basic medical science prevention along with vit d. it's not rocket surgery. imo

Both remdesivir and paxlovid (Pfizer's new drug) have their own issues, but are not relevant to the discussion about ivermectin.

(For one I can't wait to see the resistance data after exposure to paxlovid given the nature of rapid resistance to oral antiviral medications, but the outcome of EPIC-HR is very interesting, and I'm excited to see it in a form other than a press-release.)

In terms of study costs: lots of these costs have been funded by national health bodies and governments rather than pharma. Many countries and doctors would jump at the chance to provide an effective treatment that isn't a novel antiviral (hence the utilisation of dexamethasone after evidence was found in a large, government funded clinical trial). And this is the issue: some doctors and countries have been so desperate to find a cure.

The problem with ivermectin is that there is no evidence that it works. It's the same nonsense that went on with hydroxychloroquine: in vitro inhibition of a virus means nothing in real clinical terms. It is wildly unethical to recommend a treatment that hasn't been shown to work, even if it is cheap and has few side effects.