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Discussion thread IV - COVID-19 (new coronavirus)

Then if antibiotics are helping a greater percentage of cases, (or could if they were used), there would be another mechanism. Tetano posted an article about macroglides being thought to have anti-inflammatory and anti-viral properties. Azithromycin is one.
 
Here are two pieces of interesting (but concerning) data. Seems to me that there must be either a second point of entry & receptor / antibody mechanism involved here, or some other immune mechanism is at work here that we do not yet fully understand - either way a substantial proportion of individuals do not generate an antibody response to the S protein via ACE2. This raises concerns of potential ADE mechanisms, and its certainly going to present challenges to vaccine development and may explain ELISA failures.. they may not be failing at all. It may also explain potential for rapid re-infections.

Wu F et al. Neutralizing antibody responses to SARS-CoV-2 in a COVID-19 recovered patient cohort and their implications. medRxiv 2020.03.30.20047365; doi: https://doi.org/10.1101/2020.03.30.20047365 and

Zhao J et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019, Clinical Infectious Diseases, , ciaa344, https://doi.org/10.1093/cid/ciaa344
 
Blow to Britain's hopes for coronavirus antibody testing as study finds a THIRD of recovered patients have barely-detectable evidence they have had the virus already
  • Nearly third of patients have very low levels of antibodies, Chinese study found
  • Antibodies not detected at all in 10 people, raising fears they could be reinfected
  • Explains why UK Government repeatedly delayed rolling them out to the public
By CONNOR BOYD HEALTH REPORTER FOR MAILONLINE

PUBLISHED: 06:49 EDT, 9 April 2020 | UPDATED: 07:00 EDT, 9 April 2020
;) https://www.dailymail.co.uk/news/art...survivors.html
 
The lower neutralizing anti-body count in younger patients could possibly leave them open to reinfection but I think the second infection would be a lot milder. The NAbs may not be at a high enough level but the memory T and B cells should rapidly up production. I do not expect protection to be life long for anybody, much like flu. Pooled serum should give adequate titers for short term protection, how often you would need top-ups I have no idea. It would not be surprising if SAR-2 could use a secondary binding site should the spike RBD be blocked by a NAb, but I doubt it would be a very effective method of entry so the immune system would have plenty of time to get on top of the infection.
 
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"Chilling" or good news?


Only 6% of coronavirus cases actually being detected, claims chilling study


If German researchers are correct that worldwide cases have been "dramatically understated" due to insufficient testing, as many as 25 million people could have Covid-19

A chilling new study claims just 6% of all coronavirus cases are actually being detected.

If true, this means up to 25 million people around the world could have Covid-19, far more than official estimations.

Researchers from G?ttingen University in Germany claim a huge proportion of infected people are flying under the radar.

Dr Christian Bommer and Professor Sebastian Vollmer used estimates of virus mortality and time until death from a recent study published in The Lancet Infectious Diseases in an attempt to verify the accuracy of official case records.

Their findings indicate countries have discovered, on average, only about 6% of their coronavirus infections.

Insufficient and delayed testing is responsible for this enormous underreporting of cases, they say.

This could explain why countries like Italy and Spain have experienced a much higher mortality rate than Germany – because far fewer cases are being recorded, it skews the data and creates the illusion that a higher proportion of Covid-19 patients are dying than they really are.
 
More good news?

Massachusetts sewage suggests more than 100K coronavirus cases in state: MIT lab

Just one section of Massachusetts could have more than 100,000 coronavirus cases — many times more than the entire state has identified at this point, according to an MIT-associated study of local sewage.

Biobot Analytics, which is a lab associated with the Massachusetts Institute of Technology, published research this week that an analysis of sewage from a treatment facility in “a large metropolitan area in the state of Massachusetts” suggested that many more people potentially have the highly contagious disease than tests have confirmed.

“On March 25, the area represented by the sample had approximately 446 confirmed cases of Covid-19,” Biobot researchers wrote Wednesday in a post about their research. “Based on our sewage analysis, we estimate that up to 115,000 people are infected and shedding the SARS-CoV-2 virus.”
 
What if we are wrong about Covid-19?

What if Covid-19 doesn't cause a "normal" pneumonia? But something else? Italian top doctor Gattinoni writes: Covid-19 Does Not Lead to a "Typical" Acute Respiratory Distress Syndrome

Edit: see also this interview with NY doctor: Do COVID-19 Vent Protocols Need a Second Look?

What if Covid-19 chops off the iron of hemoglobin, so your red blood cells can't carry oxygen anymore: COVID-19: Attacks the 1-BetaChain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism

If the previous hypothesis is true, ventilation is futile, it can buy some time perhaps (see article above by Gattinoni c.s.).

Now what? Perhaps this: Effectiveness of convalescent plasma therapy in severe COVID-19 patients
 
they are not telling us, how many people died in Gangelt or Heinsberg or Tirschenreuth from all causes
during COVID period.
It will probably come out later ... but the world needs to know it now in order to determine their measures.
We had reports from Italy,France,Spain,NY about increased mortality from all causes. >5times increased
during the wave in Bergamo,Brescia, , >2fold in Milan and presumably NYC so far (they stopped the increase ?!)
This is rarely being talked about. They just only talk about the official COVID-confirmed deaths.
We had been following influenza here since 2006 and we know, that the official flu-deaths are only
~10% of the total deaths caused by a H3-wave.
 
I have been worried about Sickle cell anemia as a comorbidity factor in West Africa for a while. Selective pressure has reduced prevalence over time in the US but it is the decedents of slaves from Malarial areas who are likely to effected. This selection pressure has not reduced incidence in West Africa and I fear for the populations in these areas but doubt we will get very good data from lower income countries.
For those not familiar with sickle cell disease it is a recessive allele that gives some protection to malaria but at a cost. If the normal allele is N and sickle is S then
NN leaves you at risk of a poor outcome if you contract malaria
SS causes a malformation of the red blood cells and you struggle to breath
NS is a half way house giving some protection against malaria but at a small loss in the bloods ability to carry oxygen.
Under most normal conditions this is not a big problem but it is that last few % of oxygen saturation that makes all the difference for severe COVID cases.
 
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#158 #159

"Stefansson said Iceland's randomized tests revealed that between 0.3%-0.8% of Iceland's population is infected with the respiratory illness, that about 50% of those who test positive for the virus are asymptomatic when they are tested, and that since mid-March the frequency of the virus among Iceland's general population who are not at the greatest risk – those who do not have underlying health conditions or signs and symptoms of COVID-19 – has either stayed stable or been decreasing."

https://eu.usatoday.com/story/news/w...ta/2959797001/
 
All cause mortality would be useful numbers for the areas where the special studies are occurring. gsgs are there figures available from Iceland yet?
 
Gert van der Hoek said:
From Germany: Preliminary results and conclusions of the COVID-19 case cluster study (Gangelt municipality)

A case study of the community of Gangelt,one of the strongest COVID19 affected places in Germany.

Some highlights:

- approx. 14% of the population had antibodies

- mortality rate 0.06%, much lower than we were thinking?
Click to expand...

That does sound low but it is just one community. Germany has apparently had a low mortality rate in general, and maybe this community doesn't have a lot of older or otherwise high risk residents. (No nursing homes?) Something I read about Germany is that they don't promote flu vaccination of the older/vulnerable population like a lot of other countries do. I posted a military study that showed the flu vaccination was associated with viral interference with coronavirus infections. It didn't say that morbidity was increased as Tetano pointed out, but the study was of a young, healthy military population. They did not study viral interferene in the population most susceptible to the sars-cov-2 virus.
 
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A representatieve sample of aprox 500 people, from a population of aprox 12,000

So the question seems to be, is this village representative for Germany or the World?
 
Japan's sudden spike in coronavirus cases after Tokyo Olympics postponement raises eyebrows

Japan reported more than 500 new positive cases for the first time Thursday.


9 April 2020

............................

Before the Games were pushed back, Japan appeared to have its outbreak largely under control. Despite the global pandemic, organizers maintained they were forging ahead with preparations for the 2020 Summer Olympics to kick off in Tokyo on July 24, and they encouraged athletes to do the same.

Then on March 24, amid mounting calls to delay or cancel the Olympics, Japanese Prime Minister Shinzo Abe and the International Olympic Committee announced that the upcoming Games would be held a year later due to the worldwide health crisis.

On that day, Japan had reported just 1,140 diagnosed cases of COVID-19, the disease caused by the new respiratory virus, according to data compiled at the time by Johns Hopkins University. As of Thursday night, that tally was up to around 5,500, not including the 712 cases linked to the Diamond Princess cruise ship that docked in Tokyo earlier this year, according to figures published by Japan's national broadcaster NHK. By prefecture, Tokyo tops the list of infections with over 1,500.

Over 100 people in Japan have died from the disease so far, including 11 from the cruise ship, according to NHK. There has been a threefold increase in deaths since the Tokyo Games were postponed.
 
Gert van der Hoek said:
What if we are wrong about Covid-19?

What if Covid-19 doesn't cause a "normal" pneumonia? But something else? Italian top doctor Gattinoni writes: Covid-19 Does Not Lead to a "Typical" Acute Respiratory Distress Syndrome

Edit: see also this interview with NY doctor: Do COVID-19 Vent Protocols Need a Second Look?

What if Covid-19 chops off the iron of hemoglobin, so your red blood cells can't carry oxygen anymore: COVID-19: Attacks the 1-BetaChain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism

If the previous hypothesis is true, ventilation is futile, it can buy some time perhaps (see article above by Gattinoni c.s.).

Now what? Perhaps this: Effectiveness of convalescent plasma therapy in severe COVID-19 patients
Click to expand...

The discussion is not over yet:


Covid-19: Debunking the Hemoglobin Story


I hope it has been sufficient to make clear that the blog post, and even the scientific article that likely inspired it, should not be viewed as a source of any meaningful insight into SARS-CoV-2, how it affects patients, or how the virus might be treated.

https://medium.com/@amdahl/covid-19-...y-ce27773d1096
 
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