Coronavirus Updates

Sovereignty

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(Also posted in Ferrets for Couldbe)
Now I know why the people on TWIV have been making snide comments about ferrets!

There may be a better virus-animal model now.

The last TWIV (microbe.tv and youtube) discussed the development of a strain of SARS-CoV2 in the lab that produces quite similar symptoms in a standard type of lab mice. The TWIVers were excited. No one could use mice before since the ACE2 receptor differs and SARS-CoV-2 did not cause disease in mice.

It was relatively easy to do. Spray human virus up their noses (mouse noses), wait a day or two, harvest the virus found in the lungs. Repeat nine more times. After ten iterations they had a virus with a limited number of mutations that has similar effects on these mice as found with COVID-19, e.g., increasing mortality/morbidity with age and lung damage. (The mutated virus no longer infects [or is it: causes disease in?] human cells. It is adapted to these mice.)

I thought the TWIVers were a little bit too excited, though Raccaniello did say, "Mice lie, and monkeys exaggerate."
 
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Innula Zenovka

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BGR isn't exactly something like The Lancet, is it?
According to their About page " At age 19, Geller spun off his column into a website devoted to bringing exclusive mobile and gadget news to the masses — and Boy Genius Report was born. "
 
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Innula Zenovka

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The poet Michael Rosen contracted Covid-19 at the age of 74 and spent seven weeks in intensive care, on a ventilator for six of them.

 
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Innula Zenovka

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But Mark Maslin, a professor at UCL and author of the book The Cradle of Humanity, cautioned that the work risked oversimplifying the causes and impact of the pandemic. “Covid-19 is a complex disease, the severity of which has been linked to age, gender, ethnicity, obesity, health, virus load among other things,” he said.

“This paper links genes inherited from Neanderthals with a higher risk of Covid-19 hospitalisation and severe complications. But as Covid-19 spreads around the world it is clear that lots of different populations are being severely affected, many of which do not have any Neanderthal genes.

“We must avoid simplifying the causes and impact of Covid-19, as ultimately a person’s response to the disease is about contact and then the body’s immunity response, which is influenced by many environmental, health and genetic factors.”
 

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Aribeth Zelin

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I'm just really confused on if I'm more at risk or less.

I do have neanderthal genes....
 

Kamilah Hauptmann

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Mask up more and wash your hands longer, my fellow white people.
 

Archer

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An excellent article on transmission clusters and more focused mitigation.

The Overlooked Variable Driving the Pandemic

The definition of k is a mouthful, but it’s simply a way of asking whether a virus spreads in a steady manner or in big bursts, whereby one person infects many, all at once. After nine months of collecting epidemiological data, we know that this is an overdispersed pathogen, meaning that it tends to spread in clusters, but this knowledge has not yet fully entered our way of thinking about the pandemic—or our preventive practices.
Once an infected person is identified, we try to find out with whom they interacted afterward so that we can warn, test, isolate, and quarantine these potential exposures. But that’s not the only way to trace contacts. And, because of overdispersion, it’s not necessarily where the most bang for the buck lies. Instead, in many cases, we should try to work backwards to see who first infected the subject.
It’s not always the restrictiveness of the rules, but whether they target the right dangers. As Morris put it, “Japan’s commitment to ‘cluster-busting’ allowed it to achieve impressive mitigation with judiciously chosen restrictions. Countries that have ignored super-spreading have risked getting the worst of both worlds: burdensome restrictions that fail to achieve substantial mitigation. The U.K.’s recent decision to limit outdoor gatherings to six people while allowing pubs and bars to remain open is just one of many such examples.”
 

Sovereignty

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An excellent article on transmission clusters and more focused mitigation.

The Overlooked Variable Driving the Pandemic
Once an infected person is identified, we try to find out with whom they interacted afterward so that we can warn, test, isolate, and quarantine these potential exposures. But that’s not the only way to trace contacts. And, because of overdispersion, it’s not necessarily where the most bang for the buck lies. Instead, in many cases, we should try to work backwards to see who first infected the subject.
They classify a case as community spread if they don't know how someone got the virus, so wouldn't they already be trying to work backwards to some degree?

I thought this part was interesting.

Meanwhile, researchers have shown that rapid tests that are very accurate for identifying people who do not have the disease, but not as good at identifying infected individuals, can help us contain this pandemic. As Dylan Morris, a doctoral candidate in ecology and evolutionary biology at Princeton, told me, cheap, low-sensitivity tests can help mitigate a pandemic even if it is not overdispersed, but they are particularly valuable for cluster identification during an overdispersed one.
That's Michael Mina territory.
 

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Brilliant article on how racist covid coverage is obscuring how we should be responding to covid in the 'developed' world.

I wonder how much of this is pure racism and how much is the 1%ers black listing ad buys on news from countries with a public health system. I guess that's all part of structural racism.

The real story is that places like Vietnam and Mongolia have completely kicked COVID-19’s ass. The real story is that places like Rwanda and Ghana have innovated and survived. There are countless stories like this — from Sri Lanka to Trinidad & Tobago, but you wouldn’t know because we’re not rich or white. But you should know. Because we’re right. This information could save your life.
 

Sovereignty

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The latest TWIV is TWiV 668: Mice, bats, and coronaviruses with Tony Schountz. My own thoughts are in (). The podcast is a couple hours long, so this summary might be helpful.

Strictly speaking the episode is not about mice but about deer mice. Deermouses separated from mice and rats about 18 million years ago and
are vulnerable to SARS-CoV-2. However, there is no long tradition of using them as animal models except with hanta virus. That creates problems in using them for research, like a shortage of lab deermouses. You can't just trap them in the wild and do experiments because it could introduce too much genetic variability which over time could invalidate research results. (I think that's part of the reason other researchers went the extra mile to create a new Coronavirus from SARS-CoV-2 that does infect at least one type of lab mouse as reported in the previous TWIV episode.)


The fact that deermice can be infected by SARS-CoV-2 may create a problem because deermice are quite happy living with people and the virus might spill over into deer mice from people. It would then be reservoir from which new COVID-19 outbreaks could arise in the future. (I'd think if people never develop sterilizing immunity either from being infected or a vaccine, then that's sort of a moot point, but if we do obtain sterilizing immunity, the deermice become a concern.)

Right now deer mice are a reservoir for hanta virus. People collecting them have to use BSL3 ppe whcih basically means space suits. SARS-CoV-2 is also handled according to BSL3 protocols. (My own thoughts-->In contrast, Ebola requires the highest safety level, BSL4. Hanta virus is at least as concerning as bubonic plague which is also BSL3. Link.)

Schountz suggests that rodents would be a good candidate for carrying SARS-CoV-2 or an ancestor from bats over to humans. He is surprised that idea does not get more attention.
 

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Innula Zenovka

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This is exactly why lockdowns, masks and social-distancing could have been a saving strategy. They would have bought us time until treatments were available.
Conducting proper double-blind tests rather than flinging everything at the patient and hoping something works would be a good idea, too.
UK researchers point out that both medicines – remdesivir and REGN-COV2 – have still to complete the large-scale, randomised trials needed to demonstrate fully their ability to counter Covid-19 in patients. And many have criticised US authorities for their failures to carry out such trials. This has undermined efforts to find effective medicines to treat people affected by the disease.

“If President Trump gets better, we will still not know if those drugs played a role in his recovery or not. They may have been critically important or played no part at all,” said Professor Martin Landray of Oxford University. “That means when we come to treat the next patient hospitalised with Covid, we will still be none the wiser about the usefulness of those drugs.”
 
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Sovereignty

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Interesting "TWiV 669: All the wrong COVID-19 moves". The podcast/video is three hours long. Some sort of summary may be helpful.

The TWIV panelists interviewed the authors of an editorial
"COVID-19: All the wrong moves in all the wrong places". A lot was covered. The parts I found most interesting were:
  • They suggest there is a disconnect between MD's specializing in infectious disease (ID) and those specializing in critical care and trauma (intensivists). ID gets the most attention in the news media (emphasizing the cytokine storm aspect, I think). The authors like the idea of having a national institue of critical care and trauma similar to the NIAID. The needs are different.
  • They remark that people generally don't die directly from the virus. (provocative sounding) Given support and time most people's immune systems will defeat the virus. (Long haulers wonder what the heck is going on, of course.) As they see it people are dying from organ failure. (The virus causes trauma, perhaps is one way of looking at it.) As intensivists, their job is to support patients during organ failure long enough that they are able to mount a defense against the virus and resume (more or less) normal organ function.
  • They see COVID-19 more in terms of being a disease of the endothelium. Link. They are interested in blood clots, micro-thrombi in particular. (Seheult posted a series of videos on MedCram starting in April on this issue. He also is an intensivist.)
(It is interesting to contrast what these intensivists say with what Daniel Griffin says. Griffin specializes in ID and during the pandemic has been leading off each TWIV episode with news from his practice.. Griffin and others like to divide the disease up into stages. I think in August [or September] he decided to add a blood clot stage to his spiel. Previously he was stopping with cytokine storm.)