ADVERTISEMENT

COVID-19 Pandemic: Transmissions, Deaths, Treatments, Vaccines, Interventions and More...

Status
Not open for further replies.
Much more data in today in a paper by Joyner et al (preprint), evaluating the use of convalescent plasma in 5000 severely ill COVID-19 patients participating in the large observational trial (no control arm - essentially an emergency use "expanded access program") being run by the Mayo Clinic. Bottom line is it appears to be safe and "promising" with respect to lowering morality rates, although the study wasn't designed to evaluate that.

https://www.medrxiv.org/content/10.1101/2020.05.12.20099879v1.full.pdf

First off they concluded that CP is generally "safe" in the context of not adding additional risk to patients - all 5000 patients had "severe or life-threatening" cases of COVID-19. With regard to effectiveness, the analysis wasn't designed to evaluate that specifically, but they shared some data on 7-day mortality and to me the most striking data was that of the 3,316 patients admitted to the ICU, 456 mortalities were observed (16.7% after adjustments) vs. the typical mortality rate for ICU patients of 57% - that's a 71% reduction in morality rate for patients in the ICU and this wasn't a 10-person study or even a 46-person study (with 60% mortality reduction with CP), like the one above. However, it was only a 7-day analysis and perhaps those mortality numbers will increase significantly over time - would be nice to know what percentage of deaths occur beyond 7 days for such severely ill patients.

Of the 1682 hospitalized patients not admitted to the ICU the 7-day mortality rate was 11.2% vs. 15-20% typical for hospitalized patients, more like a 25-45% reduction; again, this was a 7-day mortality rate. However, NYC hospitalization mortality rates are about 33%, so the overall hospitalization mortality rate for this study, so far at 7 days (so not complete data yet) of 14.9% would be a 55% reduction. As an aside, I was a bit confused here, though - I would have thought patients sick enough to eventually die would go into the ICU first.

EX-3vSaVcAo0ivW


Anyway, it's not time to go out and celebrate yet, as this was not a placebo (plasma without antibodies)/standard of care controlled randomized double blind clinical study (that is ongoing), meaning the study was not designed to evaluate efficacy of CP per se, as per the excerpt below. However, the data above, especially the ICU data, are still pretty impressive, IMO, although it's only 7-day mortality data, so it's not complete yet. It's also a little bit odd that they didn't include the 57% typical ICU mortality rate comment together with the 13.7% ICU mortality rate data in this study - it's almost as if they don't want people hyping the potentially positive result (which I'm trying not to do; just sharing the data).

Over the first seven days after the convalescent plasma transfusion, a total of 602 mortalities were observed. The overall seven-day mortality rate was estimated to be 14.9% (95% CI: 13.8%, 16.0%) using the product limit estimator; an estimate that was numerically higher than the crude estimate of 12.0% at day 7. Of the 3,316 patients admitted to the ICU, 456 mortalities were observed (16.7%, 95% CI: 15.3%, 18.1%). Of the 1,682 hospitalized patients not-admitted to the ICU, 146 mortalities were observed (11.2%, 95% CI: 9.5%, 12.9%)...

...Although this study was not designed to evaluate efficacy of convalescent plasma we note with optimism the relatively low mortality in treated patients. The case fatality rate of COVID-19 has been reported to be ~4% among all persons diagnosed with COVID-19 (2); however, the case fatality rate among hospitalized patients is much higher ~15-20% (3, 5) and even more so among patients admitted to the ICU (57%) (4). Thus, the seven-day mortality rate was 14.9% reported here is not alarming, particularly because some of these plasma transfusions may be characterized as attempts at rescue or salvage therapy in patients admitted to the ICU with multi-organ failure, sepsis and significant comorbidities.


In addition, it's also noteworthy that the study did not find any obvious evidence of "antibody dependent enhancement" (ADE), which is a theoretical concern of the use of convalescent plasma, which could lead to "deteriorated clinical condition after plasma transfusion secondary to antibody-dependent enhancement (ADE) of infection or antibody-mediated proinflammatory effects." Limited evidence of this was seen with antibody therapies for other coronaviruses.

The absence of a toxicity signature with the use of convalescent plasma in individuals with COVID-19 implies that this phenomenon may be clinically inconsequential. COVID-19 is known to elicit high neutralizing antibody titers in individuals who have recently recovered from infection and three case series of convalescent plasma administration also describe no deleterious ADE effects after infusion (27-29).

The Mayo Clinic folks updated their paper on convalescent plasma; the one above had results from 5000 patients, while the update has results from 20,000 patients (across a large network of hospitals giving plasma under the FDA's "expanded access program). The primary objective of this study has been to assess patient safety and CP continues to be very safe.
Of course, everyone's waiting for results on efficacy, but that's still not available, as this is not a randomized, controlled study (those are ongoing), but we received more "hints of efficacy," as per the excerpt below from the WaPo article (the paper is the 2nd link).

Also, I actually communicated with one of the lead authors, asking when we might have efficacy data and also asking if they can do something similar to what was done with the Mt. Sinai study that retrospectively looked at "matched controls" i.e., very similar patients that weren't treated with CP (and found significant mortality reduction in severely ill, non-intubated patients). He said that's ongoing, but gave no date for when we'd have data. It's a little frustrating, but I'd rather get definitive data, later, than misleading data now. I would have to at least hope, though, with all the positive anecdotal information, that there's at least some efficacy or else we wouldn't have treated 20,000 patients.

https://www.washingtonpost.com/heal...vid-19-treatment-study-says/#comments-wrapper

The results are encouraging, showing severe adverse events were rare, in less than 1 percent of patients. But they also highlight the difficulty of conducting conclusive studies in the midst of a global pandemic — and add to a body of inconclusive and sometimes conflicting evidence about the approach.

“The actionable message here is that this is safe, inexpensive, and the mortality rates in sick patients are quite low,” said Michael Joyner, an anesthesiologist at the Mayo Clinic who led the study.


https://els-jbs-prod-cdn.jbs.elsevi...urnals/jmcp/jmcp_ft95_6_8.pdf?linkId=91181747
 
This will never go away. It goes away when peeps decide to live their lives without masks, social distancing etc. We have an immune system. Let it work. We can't have another shutdown come October.
We also have a brain. Try using yours. Masks and social distancing is the only path forward. It’s been the only path from the get go, unless you preferred millions dead.
 
Millions are going to die of this anyway, but over several years, unless we magically break the o-fer streak of creating an effective vaccine for a coronavirus. And then a few months later when it mutates and the vaccines have to be reformatted for 7 billion people more will die in the interim. As much as I dislike the NYTimes they already ran the article that explains pandemics end when society learns to live with the illness becoming endemic and everyone goes back to living their life.
 
  • Like
Reactions: Knight177lb
This will never go away. It goes away when peeps decide to live their lives without masks, social distancing etc. We have an immune system. Let it work. We can't have another shutdown come October.

There's a good argument about letting the immune system do its thing and bolster itself to combat some of the more common/less virulent viruses and bacteria. CV-19 is a different beast and had NJ/NY healthcare facilities on their heels for weeks..very close to catastrophe. NJ has squashed the curve and needs to be careful and avoid what we saw in April and May in the hospitals and nursing homes.
 
  • Like
Reactions: Greg2020
Just made plans for a Maine vacation and we found out well need a COVID test 72 hrs before arrival. Has anyone gotten tested and do you know how long it takes to get results?

Can you get results in under 3 days?
 
Millions are going to die of this anyway, but over several years, unless we magically break the o-fer streak of creating an effective vaccine for a coronavirus. And then a few months later when it mutates and the vaccines have to be reformatted for 7 billion people more will die in the interim. As much as I dislike the NYTimes they already ran the article that explains pandemics end when society learns to live with the illness becoming endemic and everyone goes back to living their life.

We will have a vaccine for this within a year.
 
We will have a vaccine for this within a year.

Dr. Dennis Carroll who serves as the Chair of the Global Virome Project Leadership Board. He previously served as the Director of the U.S. Agency for International Development's (USAID's) Pandemic Influenza and other Emerging Threats Unit.

He was asked if we will have a vaccine by the end of the year. His exact words were "It's spin. It's political spin. Look, we've never developed a vaccine that fast, period." He also added that we have never developed a vaccine for a Corona virus.
 
Dr. Dennis Carroll who serves as the Chair of the Global Virome Project Leadership Board. He previously served as the Director of the U.S. Agency for International Development's (USAID's) Pandemic Influenza and other Emerging Threats Unit.

He was asked if we will have a vaccine by the end of the year. His exact words were "It's spin. It's political spin. Look, we've never developed a vaccine that fast, period." He also added that we have never developed a vaccine for a Corona virus.
And how many other times have we tried to develop a vaccine for a coronavirus, and how many times with the amazing technology we have have we spent billions and had all this man power working to make a vaccine?
 
And how many other times have we tried to develop a vaccine for a coronavirus, and how many times with the amazing technology we have have we spent billions and had all this man power working to make a vaccine?

I have yet to hear from a credible doctor or scientist, someone who doesn't work for a pharmaceutical company who's trying to make the stock go up, state that they're sure a vaccine will be developed in the next year. If you really believe one will be developed, I'll be more than happy to make a wager.
 
I have yet to hear from a credible doctor or scientist, someone who doesn't work for a pharmaceutical company who's trying to make the stock go up, state that they're sure a vaccine will be developed in the next year. If you really believe one will be developed, I'll be more than happy to make a wager.
I would take that bet.
 
I would take that bet.

What makes you so sure? Is there a reliable expert that is sure a vaccine will be developed? And I'm not going to listen to any representative from a pharmaceutical company. Dr. Dennis Carrol is about as good as you get when it comes to pandemics and he is sure one won't be developed soon.
 
What makes you so sure? Is there a reliable expert that is sure a vaccine will be developed? And I'm not going to listen to any representative from a pharmaceutical company. Dr. Dennis Carrol is about as good as you get when it comes to pandemics and he is sure one won't be developed soon.
Yes. I’ll predict by next spring. So within a year.
 
I have yet to hear from a credible doctor or scientist, someone who doesn't work for a pharmaceutical company who's trying to make the stock go up, state that they're sure a vaccine will be developed in the next year. If you really believe one will be developed, I'll be more than happy to make a wager.
I mean I am not 100 percent sure, but that doesn't answer my questions which are when has the entire world tried to make a coronavirus vaccine (pretty sure the USA never tried for SARS or MERS) and when has the whole world spent this much money or manpower on any vaccine program before? Additionally, we have better technology than ever before.
 
I have yet to hear from a credible doctor or scientist, someone who doesn't work for a pharmaceutical company who's trying to make the stock go up, state that they're sure a vaccine will be developed in the next year. If you really believe one will be developed, I'll be more than happy to make a wager.

You haven't been reading very much then. Here's what Fauci had to say in the interview I posted earlier today. He thinks end of the year is possible, which is what I've been saying for a few months. And he's not alone. Doesn't mean Dr. Carroll is wrong, as quite a few folks feel next spring or summer are more realistic. But there has never been amassed so much scientific firepower as there is now working on vaccines, so I have some confidence we'll have one by the end of the year. By the way, do you have a link to his statement you quoted? He's a fascinating guy. For those who don't know him, here's a link to a really good interview with him.

https://www.washingtonpost.com/opinions/2020/04/08/we-made-this-disaster-ourselves/

Fauci: Well I think the challenge for getting a vaccine against SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] is more of a time element. We feel fairly confident, given the fact that the body makes a pretty good immune response against natural infection, that you can get a vaccine to induce a similar response that could protect—you never guarantee that; there’s never a guarantee with vaccinology. But we feel fairly confident that we’ll get a vaccine. We’d like to get one.

And the projections are that’s at least aspirationally possible by the end of the year and the beginning of 2021. Whereas with HIV, we’ve been working on a vaccine for 30-plus years. It is very difficult to get a vaccine because it’s very difficult to induce the body to do something that even natural infection doesn’t successfully allow it to do, [which] is to develop an adequate immune response to clear the virus. So the challenges are very, very different. I’m more confident that we’ll get a vaccine for SARS-CoV-2 than I am that we’ll get one against HIV, although I have cautious optimism that we’ll get it for both. But I think it’s going to be much easier to get it against the coronavirus.
 
Just made plans for a Maine vacation and we found out well need a COVID test 72 hrs before arrival. Has anyone gotten tested and do you know how long it takes to get results?

Can you get results in under 3 days?

Be sure to find out if they require the nasal swab test or if the antibody test results will do. I'm having an elective medical procedure next week and they require the nasal swab test taken within 96 hours of my procedure.
 
Just made plans for a Maine vacation and we found out well need a COVID test 72 hrs before arrival. Has anyone gotten tested and do you know how long it takes to get results?

Can you get results in under 3 days?
I was thinking I may ride to Maine in August. Maybe this is a stupid question but who is asking for the results exactly? Your hotel?
 
Be sure to find out if they require the nasal swab test or if the antibody test results will do. I'm having an elective medical procedure next week and they require the nasal swab test taken within 96 hours of my procedure.
I'm having the same but it is the spit test...Why would they be making you take the nasal test?
 
I had booked Aruba for late September. Aruba just opened up for tourists, but the procedure they are using to admit people is too cumbersome and I decided to put the trip off till everything gets back to normal

If it ever does
 
I had a nasal swab test done at the Beginning of this mess and it took 13 days to get a negative result back. I know of other tests/sites that are now getting results in less than 24 hours (some even within 15 minutes). I think the timing all depends on the type of test and the site doing the test.
 
I had a nasal swab test done at the Beginning of this mess and it took 13 days to get a negative result back. I know of other tests/sites that are now getting results in less than 24 hours (some even within 15 minutes). I think the timing all depends on the type of test and the site doing the test.
Did you have symptoms or were you just getting tested?
 
Just made plans for a Maine vacation and we found out well need a COVID test 72 hrs before arrival. Has anyone gotten tested and do you know how long it takes to get results?

Can you get results in under 3 days?

My wife got it a couple of weeks ago. Only took 3 days to get results and that was over a weekend.
 
Less than a week. Again symptoms were minor shortness of breath. Slight coughing when taking a deep breath. I was more worried about spreading something at work (pharmacy).

at the time I figured it would take a day or three for results. Had no idea the turnaround would be almost 2 full weeks.
 
I saw a lot of pushback on that study. Saying that there were still levels longer than that.
A couple of question for the experts re: antibodies;

1) As the Coronavirus antibodies diminsh over time, can the body quickly begin re-producing them if exposed to the same virus or does it take another 2 weeks before specific antibodies can be produced? 2) Will the existence of a low level of titers reduce the severity of re-infection?
 
Dr. Dennis Carroll who serves as the Chair of the Global Virome Project Leadership Board. He previously served as the Director of the U.S. Agency for International Development's (USAID's) Pandemic Influenza and other Emerging Threats Unit.

He was asked if we will have a vaccine by the end of the year. His exact words were "It's spin. It's political spin. Look, we've never developed a vaccine that fast, period." He also added that we have never developed a vaccine for a Corona virus.
This! × 1000. I've said many times before, there is no guarantee there will ever be one. And if there is one will it work against the next mutated strand?
People who constantly say we must stay in lockdown mode, social distancing until one is available are just completely ignorant.
 
This! × 1000. I've said many times before, there is no guarantee there will ever be one. And if there is one will it work against the next mutated strand?
People who constantly say we must stay in lockdown mode, social distancing until one is available are just completely ignorant.
Social distancing yes, lockdown mode (whatever that means?) no. Point me to someone in this thread who said we must remain in “lockdown mode” until a vaccine. Otherwise you’re just whining/exaggerating. If you can point me to even one person I’ll apologize no questions asked.
 
Social distancing yes, lockdown mode (whatever that means?) no. Point me to someone in this thread who said we must remain in “lockdown mode” until a vaccine. Otherwise you’re just whining/exaggerating. If you can point me to even one person I’ll apologize no questions asked.
If it is so important to you than you look through all 187 pages and if you don't find any than I'll apologize. Jeeze talk about missing the point!!
 
This! × 1000. I've said many times before, there is no guarantee there will ever be one. And if there is one will it work against the next mutated strand?
People who constantly say we must stay in lockdown mode, social distancing until one is available are just completely ignorant.
When posts are negative towards the scientific community , those posters are criticized for being negative , not as educated or refusing to understand the hundreds of reports and articles they post daily. Why in this day and age would people not be suspect, knowing very well , a vaccine at minimum would take 18-24 months if not longer. This we add to the daily media messages of doom and gloom... the contradicting messages from State and Federal guidelines. Since day one nobody has made an effort ( above the public) to say” we need to work together .Until they do that we may never get a working vaccine.
 
You haven't been reading very much then. Here's what Fauci had to say in the interview I posted earlier today. He thinks end of the year is possible, which is what I've been saying for a few months. And he's not alone. Doesn't mean Dr. Carroll is wrong, as quite a few folks feel next spring or summer are more realistic. But there has never been amassed so much scientific firepower as there is now working on vaccines, so I have some confidence we'll have one by the end of the year. By the way, do you have a link to his statement you quoted? He's a fascinating guy. For those who don't know him, here's a link to a really good interview with him.

https://www.washingtonpost.com/opinions/2020/04/08/we-made-this-disaster-ourselves/

Fauci: Well I think the challenge for getting a vaccine against SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] is more of a time element. We feel fairly confident, given the fact that the body makes a pretty good immune response against natural infection, that you can get a vaccine to induce a similar response that could protect—you never guarantee that; there’s never a guarantee with vaccinology. But we feel fairly confident that we’ll get a vaccine. We’d like to get one.

And the projections are that’s at least aspirationally possible by the end of the year and the beginning of 2021. Whereas with HIV, we’ve been working on a vaccine for 30-plus years. It is very difficult to get a vaccine because it’s very difficult to induce the body to do something that even natural infection doesn’t successfully allow it to do, [which] is to develop an adequate immune response to clear the virus. So the challenges are very, very different. I’m more confident that we’ll get a vaccine for SARS-CoV-2 than I am that we’ll get one against HIV, although I have cautious optimism that we’ll get it for both. But I think it’s going to be much easier to get it against the coronavirus.

I don't have a link because Dr. Carroll said this during an interview on the show Vice which airs on Showtime. This episode aired on 6/14/20 and you can watch it on demand. He has a pretty strong argument as to why we're not going to have a vaccine anytime soon, but that was actually not what he talked about the most. His main concern was the thousands of viruses that exist today that have yet to be spread. But that's a topic for another thread.
 
Status
Not open for further replies.
ADVERTISEMENT
ADVERTISEMENT