OT: COVID Science - Pfizer/Moderna vaccines >90% effective; Regeneron antibody cocktail looks very promising in phase II/III trial and more

[RU848789]

I am much more bullish on moderna. better study overall without the nightmare of storage, distribution in a practical sense.
efficacy does not equal effectiveness. the media loves to use these terms interchangeably. you can have an extremely efficacious vaccine in animal and human early trials but effectiveness in my world is measured by keeping vulnerable out of the hospital and ultimately dying on the vent, clotting and bleeding, children getting inflammatory syndromes. I'm still not entirely convinced that the side effect profile, short or long term, in expecting crabby old people or young people (no offense to anyone here) to come back for a second shot after feeling shitty, their arm hurting etc is going to be all that easy of a sell. some scream on like Tarzan with a flu shot or a blood draw. I've already borrowed the prep of telling patients that the more your arm hurts the better the vax is working. with all the young docs dropping like flies from getting infected from their small gatherings, we are probably going to have to hand out white coats to the Scarlet Nation bulletin board peeps. I'm not in danger since I threw my kids out of the house and I have no friends anyway. thank God for the real heroes which are the nurses and other ancillary staff and respiratory therapists. doctors are wusses compared to them.
early use of convalescent serum was always a shot in the dark-too many variables - timing and the variable unmeasurable titers in the donation and the variable unmeasurable titers in the recipient. worth a shot since desperation was in full force and history of its use in it's covid, flu like relatives. the full spectrum of this disease is still a mystery and much work needs to be done. this is a really immunologically driven disease, more autoimmune like,more in some than others, and it's unlike other diseases that you can follow a logical sequence of innoculation, innate and adaptive defenses kick in and effectuate a positive predictable clinical response.

Since we were discussing this on Pfizer's vaccine, the Moderna trial was quite broad with respect to patient populations, as per the excerpt below from their press release. Pfizer hasn't shared patient population data as far as I've seen - it's possible they had similar breakdowns, but we just don't know. Perhaps Moderna sharing theirs will inspire Pfizer to. Either way, we'll absolutely get that data when they complete the trials and file for approval. I still have my lab coat from Merck, lol.

The Phase 3 COVE study was designed in collaboration with the FDA and NIH to evaluate Americans at risk of severe COVID-19 disease and completed enrollment of 30,000 participants ages 18 and older in the U.S. on October 22, including those at high risk of the severe complications of COVID-19 disease. The COVE study includes more than 7,000 Americans over the age of 65. It also includes more than 5,000 Americans who are under the age of 65 but have high-risk chronic diseases that put them at increased risk of severe COVID-19, such as diabetes, severe obesity and cardiac disease. These medically high-risk groups represent 42% of the total participants in the Phase 3 COVE study. The study also included communities that have historically been under-represented in clinical research and have been disproportionately impacted by COVID-19. The study includes more than 11,000 participants from communities of color, representing 37% of the study population, which is similar to the diversity of the U.S. at large. This includes more than 6,000 participants who identify as Hispanic or LatinX, and more than 3,000 participants who identify as Black or African American.

 

[ScarletNut]

When high risk participants are categorized, are hypertensive patients that are on meds and their blood pressure is well controlled, still considered high risk? Same for diabetics whose sugar is well under control?

 

[RUfubar]

When high risk participants are categorized, are hypertensive patients that are on meds and their blood pressure is well controlled, still considered high risk? Same for diabetics whose sugar is well under control?

hypertension turns out not so bad in isolation
well controlled premorbid diabetes verdict out still but I haven't lost anybody with well controlled diabetes type 1 or type 2
but unfortunately all too many with uncontrolled DM

 

[RUfubar]

Since we were discussing this on Pfizer's vaccine, the Moderna trial was quite broad with respect to patient populations, as per the excerpt below from their press release. Pfizer hasn't shared patient population data as far as I've seen - it's possible they had similar breakdowns, but we just don't know. Perhaps Moderna sharing theirs will inspire Pfizer to. Either way, we'll absolutely get that data when they complete the trials and file for approval. I still have my lab coat from Merck, lol.

The Phase 3 COVE study was designed in collaboration with the FDA and NIH to evaluate Americans at risk of severe COVID-19 disease and completed enrollment of 30,000 participants ages 18 and older in the U.S. on October 22, including those at high risk of the severe complications of COVID-19 disease. The COVE study includes more than 7,000 Americans over the age of 65. It also includes more than 5,000 Americans who are under the age of 65 but have high-risk chronic diseases that put them at increased risk of severe COVID-19, such as diabetes, severe obesity and cardiac disease. These medically high-risk groups represent 42% of the total participants in the Phase 3 COVE study. The study also included communities that have historically been under-represented in clinical research and have been disproportionately impacted by COVID-19. The study includes more than 11,000 participants from communities of color, representing 37% of the study population, which is similar to the diversity of the U.S. at large. This includes more than 6,000 participants who identify as Hispanic or LatinX, and more than 3,000 participants who identify as Black or African American.

now correct me if I'm wrong.
the moderna vaccine design seemsto have been more akin to let's vaccinate this diverse group and use a benign placebo in this other group and just let em rip and go out and live their life ..
disease come what may.
the Pfizer vaccine design seem to follow their less diverse groups more proactively and define a case by the merest wisp of a sniffle along with a positive covid test and nobody was allowed ,sort of speak,to get very ill. so to me I could see efficacy without definite effectiveness in my mind. And their placebo was antigenic whose side effects could make any vaccination group look better comparitively.

 

[RU848789]

Interesting article (1st link; abstract below) on the D614G "variant" of the SARS-CoV-2 virus, which has been discussed here before (2nd link). The article provides stronger evidence that this mutation on the spike protein, wherein a a glycine amino acid is substituted for an aspartic acid, leads to a more infectious virus (it's the one that has become dominant in most of the world) than the original strain from Wuhan, but there is no indication that it's any more dangerous/lethal. One would expect evolutionary pressure to lead to more infectious viruses, but not more lethal ones (infecting more hosts is the goal, not killing them, per se).

https://science.sciencemag.org/content/early/2020/11/11/science.abe8499.full

https://rutgers.forums.rivals.com/t...es-interventions-and-more.198855/post-4624725

The spike D614G substitution is prevalent in global SARS-CoV-2 strains, but its effects on viral pathogenesis and transmissibility remain unclear. We engineered a SARS-CoV-2 variant containing this substitution. The variant exhibits more efficient infection, replication, and competitive fitness in primary human airway epithelial cells, but maintains similar morphology and in vitro neutralization properties, compared with the ancestral wild-type virus. Infection of human angiotensin-converting enzyme 2 (ACE2) transgenic mice and Syrian hamsters with both viruses resulted in similar viral titers in respiratory tissues and pulmonary disease. However, the D614G variant transmits significantly faster and displayed increased competitive fitness than the wild-type virus in hamsters. These data show that the D614G substitution enhances SARS-CoV-2 infectivity, competitive fitness, and transmission in primary human cells and animal models.

 

[RUfubar]

Interesting article (1st link; abstract below) on the D614G "variant" of the SARS-CoV-2 virus, which has been discussed here before (2nd link). The article provides stronger evidence that this mutation on the spike protein, wherein a a glycine amino acid is substituted for an aspartic acid, leads to a more infectious virus (it's the one that has become dominant in most of the world) than the original strain from Wuhan, but there is no indication that it's any more dangerous/lethal. One would expect evolutionary pressure to lead to more infectious viruses, but not more lethal ones (infecting more hosts is the goal, not killing them, per se).

https://science.sciencemag.org/content/early/2020/11/11/science.abe8499.full

https://rutgers.forums.rivals.com/t...es-interventions-and-more.198855/post-4624725

The spike D614G substitution is prevalent in global SARS-CoV-2 strains, but its effects on viral pathogenesis and transmissibility remain unclear. We engineered a SARS-CoV-2 variant containing this substitution. The variant exhibits more efficient infection, replication, and competitive fitness in primary human airway epithelial cells, but maintains similar morphology and in vitro neutralization properties, compared with the ancestral wild-type virus. Infection of human angiotensin-converting enzyme 2 (ACE2) transgenic mice and Syrian hamsters with both viruses resulted in similar viral titers in respiratory tissues and pulmonary disease. However, the D614G variant transmits significantly faster and displayed increased competitive fitness than the wild-type virus in hamsters. These data show that the D614G substitution enhances SARS-CoV-2 infectivity, competitive fitness, and transmission in primary human cells and animal models.

antigenic drift is common and what you refer to in coronaviruses as a whole are not usually associated with lots of major surface protein variations , aka, mutation.
on the other hand antigenic shift involves genomic mixing of a Coronavirus with let's say a skanky herpes virus from a Tibetan yak which would be ominous to say the least.

 

[RU848789]

now correct me if I'm wrong.
the moderna vaccine design seemsto have been more akin to let's vaccinate this diverse group and use a benign placebo in this other group and just let em rip and go out and live their life ..
disease come what may.
the Pfizer vaccine design seem to follow their less diverse groups more proactively and define a case by the merest wisp of a sniffle along with a positive covid test and nobody was allowed ,sort of speak,to get very ill. so to me I could see efficacy without definite effectiveness in my mind. And their placebo was antigenic whose side effects could make any vaccination group look better comparitively.

You have your vaccines mixed up. Both Pfizer and Moderna used saline placebos, so no difference there (Astra Zeneca/Oxford is the one using the meningococcal vaccine as a control vs. their adenovirus vector vaccine). And unless you've seen something I haven't, we don't yet know the breakdown of populations injected from Pfizer to know that they injected less diverse groups - they said that "up to 45 percent of all the participants are between 56 and 85 years old." I also haven't seen anything saying the companies defined positive COVID patient results any differently or that participants behaved any differently - presumably both trials didn't control/restrict participants in any way.

 

[greenknight]

There will be a vaccine by spring for all the common folk. 1st responders. Drs and Nurses get 1st doses.

 

[RUBOB72]

I am much more bullish on moderna. better study overall without the nightmare of storage, distribution in a practical sense.
efficacy does not equal effectiveness. the media loves to use these terms interchangeably. you can have an extremely efficacious vaccine in animal and human early trials but effectiveness in my world is measured by keeping vulnerable out of the hospital and ultimately dying on the vent, clotting and bleeding, children getting inflammatory syndromes. I'm still not entirely convinced that the side effect profile, short or long term, in expecting crabby old people or young people (no offense to anyone here) to come back for a second shot after feeling shitty, their arm hurting etc is going to be all that easy of a sell. some scream on like Tarzan with a flu shot or a blood draw. I've already borrowed the prep of telling patients that the more your arm hurts the better the vax is working. with all the young docs dropping like flies from getting infected from their small gatherings, we are probably going to have to hand out white coats to the Scarlet Nation bulletin board peeps. I'm not in danger since I threw my kids out of the house and I have no friends anyway. thank God for the real heroes which are the nurses and other ancillary staff and respiratory therapists. doctors are wusses compared to them.
early use of convalescent serum was always a shot in the dark-too many variables - timing and the variable unmeasurable titers in the donation and the variable unmeasurable titers in the recipient. worth a shot since desperation was in full force and history of its use in it's covid, flu like relatives. the full spectrum of this disease is still a mystery and much work needs to be done. this is a really immunologically driven disease, more autoimmune like,more in some than others, and it's unlike other diseases that you can follow a logical sequence of innoculation, innate and adaptive defenses kick in and effectuate a positive predictable clinical response.

And yet 99.8% of those infected survive and return to the living . Some take longer to recover depending upon the severity of their illness especially with comorbidities .

 

[RUfubar]

You have your vaccines mixed up. Both Pfizer and Moderna used saline placebos, so no difference there (Astra Zeneca/Oxford is the one using the meningococcal vaccine as a control vs. their adenovirus vector vaccine). And unless you've seen something I haven't, we don't yet know the breakdown of populations injected from Pfizer to know that they injected less diverse groups - they said that "up to 45 percent of all the participants are between 56 and 85 years old." I also haven't seen anything saying the companies defined positive COVID patient results any differently or that participants behaved any differently - presumably both trials didn't control/restrict participants in any way.

you are correct..mixed up the two...i should not post while sleep deprived.

And yet 99.8% of those infected survive and return to the living . Some take longer to recover depending upon the severity of their illness especially with comorbidities .

agree but we are talking lots of nonsymptomatic healthy infected included in your numbers who don't know they're infected and then give it to the vulnerable who end up in the hospital (without necessarily dying) all at once and the ICUs which throughout the nation has been overrun with covid patients, and healthcare personel get ill, and the whole healthcare system gets backed up and overrun. See how that works ? so once again it's not necessarily about overall mortality but about how many people get sick enough who require hospitalization all at one time and the whole health Care system getting overrun, and the secondary effects and that's where the notion of flattening the curve comes in. it's like one auto body shop where there's a chain reaction of a car collision and The body shop gets overrun and backed up. it's not such a hard concept to grasp. everything gets backed up and that's not good when it comes to cancer and heart disease which gets pushed to the back of the line.

 

[King of S]

We see NJ’s leader Murphy was just quoted earlier in NJ.com saying getting the vaccine out will be an issue and it will be months until we can approach some type of normal. Oh and some of us are batshit crazy. We are 8-10 months from inoculating half the population in the US. He also noted that areas in NJ where the virus impacts more ( assuming inner cities ) will be some of the first . So you old senior age farts , in your wealthy towns , better prepare to shelter in place. Seems like sides have. Wrong - vaccine will be available to anyone who wants it by April. Why are you such a pessimistic? Did you short the market and got caught?

 

[King of S]

We see NJ’s leader Murphy was just quoted earlier in NJ.com saying getting the vaccine out will be an issue and it will be months until we can approach some type of normal. Oh and some of us are batshit crazy. We are 8-10 months from inoculating half the population in the US. He also noted that areas in NJ where the virus impacts more ( assuming inner cities ) will be some of the first . So you old senior age farts , in your wealthy towns , better prepare to shelter in place. Seems like sides have already been drawn and you’ll be expendable .

Wrong- such a pessimistic!

 

[greenknight]

Vaccine for the masses will be available in the spring. Anything prior is going to 1st responders, Drs and Nurses anybody in medical. It was mid summer in May now it is spring it is not going to be available to the masses any sooner.

 

[RUfubar]

You have your vaccines mixed up. Both Pfizer and Moderna used saline placebos, so no difference there (Astra Zeneca/Oxford is the one using the meningococcal vaccine as a control vs. their adenovirus vector vaccine). And unless you've seen something I haven't, we don't yet know the breakdown of populations injected from Pfizer to know that they injected less diverse groups - they said that "up to 45 percent of all the participants are between 56 and 85 years old." I also haven't seen anything saying the companies defined positive COVID patient results any differently or that participants behaved any differently - presumably both trials didn't control/restrict participants in any way.

maybe I'm not totally nuts here. reading between the lines you get subtle feeling that pfizer was a little less restrictive than Moderna in case definition and skewed towards a younger client. obviously I was mixing up the antigen part w AZ.
The Moderna and Pfizer studies were conducted using slightly different protocols. To be counted as a COVID-19 case, participants in the Moderna study had to have at least two symptoms of disease in addition to a positive test for the virus. The Pfizer study required only one symptom. Also, Moderna waited 14 days following the second injection to begin counting cases; Pfizer's study started counting at seven days.
Table 1
Characteristics of ongoing phase III covid-19 vaccine trials

​	Moderna​	Pfizer​	AstraZeneca (US)​	AstraZeneca (UK)​	Janssen​	Sinopharm*​	Sinovac​
Vaccine name​	mRNA-1273​	BNT162​	AZD1222​	AZD1222​	Ad26.COV2.S​	Sinopharm vaccine​	Sinovac CoronaVac​
Registration No​	NCT04470427​	NCT04368728​	NCT04516746​	NCT04400838 (UK), NCT04536051 (Brazil), NCT04444674 (South Africa)​	NCT04505722​	NCT04510207​	NCT04456595​
Target enrolment​	30 000​	43 998​	30 000​	19 330​	60 000​	45 000​	8870​
Ages eligible​	18+​	12+​	18+​	5-12, 18+​	18+​	18+​	18+​
Protocol publicly available​	Y​	Y​	Y​	N†​	Y​	N​	N​
Notable excluded populations:​
Children and adolescents​	Excluded​	Many excluded​	Excluded​	13-17 excluded​	Excluded​	Excluded​	Excluded​
Immunocompromised patients​	Excluded​	Excluded​	Excluded​	Excluded​	Excluded​	Excluded​	Excluded​
Pregnant or breastfeeding women​	Excluded​	Excluded​	Excluded​	Excluded​	Excluded​	Excluded​	Excluded​
Endpoints undergoing formal study‡:​
Prevention of symptomatic disease in vaccine recipient​	Y​	Y​	Y​	Y​	Y​	Presumably§​	Y​
Reduction in severe covid-19 (hospital admission, ICU, or death)​	N​	N​	N​	N¶​	N​	N​	N​
Interruption of transmission (person to person spread)​	N​	N​

 

[RUBOB72]

Wrong- such a pessimistic!

Lol... Don’t call me pessimistic... suggest you tell your govenor whose mouth that came out of just yesterday. I wish it was coming out and being distributed in a few weeks but realize one thing this is still political from both sides. People such as you can’t understand that fact.

 

[gef21]

My sister in law works at a major tri state area hospital. They were told to be prepared for getting, and distributing a vaccine by the end of December or early January.

 

[MulletCork]

Wife works in a large hospital in NJ in pharmacy. They have been getting their ducks in order for the vaccines for a while now and recruiting among the department those folks willing to administer it. Also of course a committee including who the chief points of contact will be for the state and lots of other things that are way over my head, not working in healthcare personally.

 

[RUBOB72]

My sister in law works at a major tri state area hospital. They were told to be prepared for getting, and distributing a vaccine by the end of December or early January.

When it gets there let us know . I’m certain everyone will be interested to see how it gets distributed to groups and what areas in the state of NJ. Question: Will elected politicians and their families , those who want the vaccine , be moved to the front of the pecking order?

 

[RUBOB72]

This disjointed information about the vaccine and it’s anticipated time of arrival in hospitals leads to confusion . No different than the mask vs no mask back in the spring. It will change 100 times between now and then.

 

[gef21]

When it gets there let us know . I’m certain everyone will be interested to see how it gets distributed to groups and what areas in the state of NJ. Question: Will elected politicians and their families , those who want the vaccine , be moved to the front of the pecking order?

I am assuming high risk, and medical/law enforcement will get it....and connected/wealthy individuals.

 

[RU848789]

When it gets there let us know . I’m certain everyone will be interested to see how it gets distributed to groups and what areas in the state of NJ. Question: Will elected politicians and their families , those who want the vaccine , be moved to the front of the pecking order?

Bob - we're trying to keep this thread focused on COVID science only. Your posts on politics, governors, masking behaviors and vaccine distribution rumors would be fine in any of the CE board threads, but they're kind of derailing this thread. Please try to keep to the science. Thanks.

 

[gef21]

Bob - we're trying to keep this thread focused on COVID science only. Your posts on politics, governors, masking behaviors and vaccine distribution rumors would be fine in any of the CE board threads, but they're kind of derailing this thread. Please try to keep to the science. Thanks.

That was my bad. I sort of brought it up. Sorry.

 

[RUBOB72]

I am assuming high risk, and medical/law enforcement will get it....and connected/wealthy individuals.

You would hope so but this isn’t when the “ polio” sugar cubes were distributed back in the 60’s. We will know by the end of December -January 😎 ... It will be very telling.

 

[RUBOB72]

Bob - we're trying to keep this thread focused on COVID science only. Your posts on politics, governors, masking behaviors and vaccine distribution rumors would be fine in any of the CE board threads, but they're kind of derailing this thread. Please try to keep to the science. Thanks.

Ok Numbers because I actually do respect you contrary to some others. Time will tell...

 

[Yeah Baby]

I have been searching for a couple of hours now the Redfield interview on Fox News. Has anyone else seen it?

I just looked at the death rate curves for the Top 20 states and they are started to flatten or drop everywhere except TX which is a huge state. Good signs. Illinois is also up but now concentrated down near St Louis so it will turn around there as well.

The vaccine coupled with all of the herd immunity we are starting to unfortunately get right now should drive this into submission. I think it will linger for years just like everything else but we can mitigate it with the vaccines and the treatments are also working well now. We had no clue back in March and April. We put people on vents then that we would not and will not today and they are surviving.

 

[pmvon]

you are correct..mixed up the two...i should not post while sleep deprived.


agree but we are talking lots of nonsymptomatic healthy infected included in your numbers who don't know they're infected and then give it to the vulnerable who end up in the hospital (without necessarily dying) all at once and the ICUs which throughout the nation has been overrun with covid patients, and healthcare personel get ill, and the whole healthcare system gets backed up and overrun. See how that works ? so once again it's not necessarily about overall mortality but about how many people get sick enough who require hospitalization all at one time and the whole health Care system getting overrun, and the secondary effects and that's where the notion of flattening the curve comes in. it's like one auto body shop where there's a chain reaction of a car collision and The body shop gets overrun and backed up. it's not such a hard concept to grasp. everything gets backed up and that's not good when it comes to cancer and heart disease which gets pushed to the back of the line.

What is the current view of the mortality rate and transmissibility?

Some folks cite the similar mortality rate to the flu. I think about it simply by looking at the number of deaths. We will likely have 400k people die within a year and this is with extreme changes in behavior and restrictions on movement etc vs the flu where 40k may die in a given year and we don’t change our behavior at all. So the death rate when adjusting for transmission is 10 times the flu. Not to mention what appears to be much more prevalent longer term issues with COVID vs the flu and taxing the healthcare system that could simply not manage an uncontrolled transmission of the virus. Am I wrong?

Many thanks to the healthcare workers and doctors around the country. It feels like these folks are completely forgotten in the mask/movement discussion.

 

[RUBOB72]

What is the current view of the mortality rate and transmissibility?

Some folks cite the similar mortality rate to the flu. I think about it simply by looking at the number of deaths. We will likely have 400k people die within a year and this is with extreme changes in behavior and restrictions on movement etc vs the flu where 40k may die in a given year and we don’t change our behavior at all. So the death rate when adjusting for transmission is 10 times the flu. Not to mention what appears to be much more prevalent longer term issues with COVID vs the flu and taxing the healthcare system that could simply not manage an uncontrolled transmission of the virus. Am I wrong?

Many thanks to the healthcare workers and doctors around the country. It feels like these folks are completely forgotten in the mask/movement discussion.

Keep it to the Science... masks are not part of the covid19 thread... the B1G guy who leads this has asked to keep it separate. So please listen to the man.😜

 

[Yeah Baby]

What is the current view of the mortality rate and transmissibility?

Some folks cite the similar mortality rate to the flu. I think about it simply by looking at the number of deaths. We will likely have 400k people die within a year and this is with extreme changes in behavior and restrictions on movement etc vs the flu where 40k may die in a given year and we don’t change our behavior at all. So the death rate when adjusting for transmission is 10 times the flu. Not to mention what appears to be much more prevalent longer term issues with COVID vs the flu and taxing the healthcare system that could simply not manage an uncontrolled transmission of the virus. Am I wrong?

Many thanks to the healthcare workers and doctors around the country. It feels like these folks are completely forgotten in the mask/movement discussion.

There have not been 400k deaths by or from covid. Not even with Covid. So that is incorrect for starters.

I think it has been worse than the flu overall. Way worse in the spring. Just keep in mind if a cancer patient dies and at one point in his life had the flu it does not count as a flu death. We have been doing that for covid to get more money into the hospitals. I am all for that and protecting the workers there. Due to dying from
Covid vs with covid issue, it is pretty tough to compare the rates but I do think covid was far more deadly early on, is slightly more deadly today and likely will end up being the same going forward with vaccines and better care for patients happening as I said a few posts above. No more vents for borderline patients is resulting in a lower death rate today. Better therapeutics as well. Night and day now vs the Spring.

 

[RU848789]

I have been searching for a couple of hours now the Redfield interview on Fox News. Has anyone else seen it?

I just looked at the death rate curves for the Top 20 states and they are started to flatten or drop everywhere except TX which is a huge state. Good signs. Illinois is also up but now concentrated down near St Louis so it will turn around there as well.

The vaccine coupled with all of the herd immunity we are starting to unfortunately get right now should drive this into submission. I think it will linger for years just like everything else but we can mitigate it with the vaccines and the treatments are also working well now. We had no clue back in March and April. We put people on vents then that we would not and will not today and they are surviving.

I'm going to have to break my own rule about not talking about deaths, just to set the record straight. It is unequivocal that death rates in the US are rising rapidly (the 7-day avg went from about 700 to 1200 over the past 2-3 weeks) and will continue to rise rapidly until they're very likely at least in the 2000-2500 per day rate we saw in April, given that cases continue to skyrocket and as always, hospitalizations are starting to skyrocket and deaths lag cases by 2-4 weeks and hospitalizations by 1-2 weeks.

We're in for horrific pain from now through at least January, when hopefully we'll start seeing the effects of vaccines and antibody treatments. We should expect to have close to 400K COVID deaths by the end of January if we average ~2000/day until then - only much more effective masking/distancing (and possible targeted shutdowns) will reduce this somewhat. Note that many European countries, right now, have death rates that are equivalent to 2500-3000 per day on a US per capita basis. I hope I'm wrong, but for what it's worth, I was pretty accurate on my predictions for deaths from this summer's wave 2 in the US.

 

[NickRU714]

Will there have to be a choice between Pfizer and Moderna?

For example, have two kids in daycare.
At the doctor, will we have to pick between the 2 Pfizer vs. Moderna?
Or will our/their doctor only have 1 in stock and we have to take that?

 

[fsg2]

Hey @Yeah Baby , do me a favor and just add that to the list of things you were horribly wrong about. I'm having trouble keeping track, and I figure it'd be easier just to track at the source.

Thanks!

 

[ScarletNut]

There have not been 400k deaths by or from covid. Not even with Covid. So that is incorrect for starters.

I think it has been worse than the flu overall. Way worse in the spring. Just keep in mind if a cancer patient dies and at one point in his life had the flu it does not count as a flu death. We have been doing that for covid to get more money into the hospitals. I am all for that and protecting the workers there. Due to dying from
Covid vs with covid issue, it is pretty tough to compare the rates but I do think covid was far more deadly early on, is slightly more deadly today and likely will end up being the same going forward with vaccines and better care for patients happening as I said a few posts above. No more vents for borderline patients is resulting in a lower death rate today. Better therapeutics as well. Night and day now vs the Spring.

So let me ask you a question. What happens when a physician has a patient either in the office or calling from home with signs of an acute myocardial infarction (heart attack) and can't get into an ER or hospital for lifesaving treatment because the hospital is overrun with COVID-19 patients? That patient ends up dying. Despite not having COVID-19 himself, his preventable death (most heart attacks do not end up in death) was indirectly caused because of COVID-19. Is it fair to be complacent because the COVID-19 deaths are down without seeing the ripple effect on non-COVID patients' dying because of inability to treat them?
I had a patient with Stage 1 cancer of the larynx in February, almost 100% curable with localized treatment or radiation therapy. Our office got shut down due to an outbreak of COVID-19 for about 10 weeks and subsequently were limited in our procedures due to the high risk of examining the nasal and throat areas. The patient returned in May and now had a Stage 3 cancer that required surgery and RT with probable cure (though nowhere near 100%) and significant decrease in his quality of life.

 

[Yeah Baby]

So let me ask you a question. What happens when a physician has a patient either in the office or calling from home with signs of an acute myocardial infarction (heart attack) and can't get into an ER or hospital for lifesaving treatment because the hospital is overrun with COVID-19 patients? That patient ends up dying. Despite not having COVID-19 himself, his preventable death (most heart attacks do not end up in death) was indirectly caused because of COVID-19. Is it fair to be complacent because the COVID-19 deaths are down without seeing the ripple effect on non-COVID patients' dying because of inability to treat them?
I had a patient with Stage 1 cancer of the larynx in February, almost 100% curable with localized treatment or radiation therapy. Our office got shut down due to an outbreak of COVID-19 for about 10 weeks and subsequently were limited in our procedures due to the high risk of examining the nasal and throat areas. The patient returned in May and now had a Stage 3 cancer that required surgery and RT with probable cure (though nowhere near 100%) and significant decrease in his quality of life.

Not sure how your question applies to my comments at all but I’ll offer my opinion. I would rather hear your opinions since you’re in the field but since you asked:

I think shutting down your office for 10 weeks was a big mistake. I assume this was back in the March-May time frame when we had no clue how to treat covid, we put too many people on vents, we didn’t have the therapeutics and we had no vaccines in the pipeline. We probably should have used the Javitz and the 1000 bed US Navy Hospital Ship that arrived on 4/3 to treat covid patients and allow our hospitals to function properly. Hindsight is always 20/20 and I realize we were in a state of chaos but we had the beds and didn’t use them. Whoever made the decision not to use those assets made a mistake. Same with the huge push for ventilators that were not used or needed even though we used them more than we should have.

Your specific field is one I know well unfortunately. We need your team at full capacity. I know that did not happen in the Spring and is heading in that direction agaln today. It’s not the right thing to do.

 

[ScarletNut]

Not sure how your question applies to my comments at all but I’ll offer my opinion. I would rather hear your opinions since you’re in the field but since you asked:

I think shutting down your office for 10 weeks was a big mistake. I assume this was back in the March-May time frame when we had no clue how to treat covid, we put too many people on vents, we didn’t have the therapeutics and we had no vaccines in the pipeline. We probably should have used the Javitz and the 1000 bed US Navy Hospital Ship that arrived on 4/3 to treat covid patients and allow our hospitals to function properly. Hindsight is always 20/20 and I realize we were in a state of chaos but we had the beds and didn’t use them. Whoever made the decision not to use those assets made a mistake. Same with the huge push for ventilators that were not used or needed even though we used them more than we should have.

Your specific field is one I know well unfortunately. We need your team at full capacity. I know that did not happen in the Spring and is heading in that direction agaln today. It’s not the right thing to do.

At the time, ENT and dentists were at the highest risk. In England, a number of their ENT docs passed away in that timeframe, many were young and healthy. We also didn't have the PPE's needed for safety reasons. Our staff also were petrified and didn't want to come to the workplace. The local health dept had recommended we quarantine all who were exposed to positive patients (at that time, test results took over a week). Once a couple of staff members took ill, that was the ballgame.

 

[ScarletNut]

Not sure how your question applies to my comments at all but I’ll offer my opinion. I would rather hear your opinions since you’re in the field but since you asked:

I think shutting down your office for 10 weeks was a big mistake. I assume this was back in the March-May time frame when we had no clue how to treat covid, we put too many people on vents, we didn’t have the therapeutics and we had no vaccines in the pipeline. We probably should have used the Javitz and the 1000 bed US Navy Hospital Ship that arrived on 4/3 to treat covid patients and allow our hospitals to function properly. Hindsight is always 20/20 and I realize we were in a state of chaos but we had the beds and didn’t use them. Whoever made the decision not to use those assets made a mistake. Same with the huge push for ventilators that were not used or needed even though we used them more than we should have.

Your specific field is one I know well unfortunately. We need your team at full capacity. I know that did not happen in the Spring and is heading in that direction agaln today. It’s not the right thing to do.

The point I was trying to make was directed to your comment about a cancer pt dying with COVID being categorized as a COVID pt. and not cancer as the cause of death. My counterpoint was the non-COVID pt dying due to lack of medical access DUE to the COVID population filling hospitals and ER's.

 

[richthedentist]

Question for you numbers during the height of the pandemic in Jersey they were only doing 4000 tests per day now we are doing upwards of 50-55,000 per day so and also many people who had symptoms were told not even to get tested so in your opinion do you think we had this many if not more cases per day back then since our testing was so limited and people weren't even getting tested?

 

[Yeah Baby]

The point I was trying to make was directed to your comment about a cancer pt dying with COVID being categorized as a COVID pt. and not cancer as the cause of death. My counterpoint was the non-COVID pt dying due to lack of medical access DUE to the COVID population filling hospitals and ER's.

Gotcha but my point was compared to the flu death count. We don’t test for flu so we can’t really compare the two is all I’m saying.

 

[ScarletNut]

Gotcha but my point was compared to the flu death count. We don’t test for flu so we can’t really compare the two is all I’m saying.

We actually do test for flu, in office, with results in a few minutes. Its just not tabulated with any health dept and just as often treated without a test. There is an anti viral for the flu, Tamiflu, which is effective in resolving or greatly diminishing the symptoms if started within 48 hours of getting symptoms.

 

[pmvon]

Gotcha but my point was compared to the flu death count. We don’t test for flu so we can’t really compare the two is all I’m saying.

But we know the death rates and we also don’t assign people who die with the flu to some other underlying cause.

Are the 240k people who would have died at that moment? If not, they died of covid.

I am just trying to understand the numbers.

 

[RUfubar]

Results of the retrospective surveillance study of more than 10,000 plasma samples taken from the beginning of February to July will be published in Nature on Tuesday, November 3 at 5AM ET.
exerpt
The virus that causes COVID-19 was present in New York City long before the city’s first case of the disease was confirmed on March 1, researchers at the Icahn School of Medicine at Mount Sinai report. Their study found that more than 1.7 million New Yorkers—about 20 percent of the city’s population—have already been infected with the virus, known as SARS-CoV-2, and that the infection fatality rate of the virus is close to 1 percent, ten times deadlier than the flu.