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Coronavirus: The Thread

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Coronavirus: The Thread

Old 23rd Apr 2020, 18:53
  #5501 (permalink)  
 
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Originally Posted by Mr Optimistic View Post
I am curious as to how you would test the efficacy of a vaccine. Would you have to do a double blind affair, give 50% a placebo and then somehow expose them all to the virus? Anyone know?
Pretty much. In this trial they are using two vaccines, one is a proven meningitis vaccine, the other the trial vaccine. 50% get one and 50% get the other. No one involved in administering the vaccines knows who has been given which. The aim of this first trial is to establish whether the vaccine has any adverse side effects, and comparing it with a vaccine that is well understood gives a good indication as to which side effects might be real, and which may just be random effects unconnected with the vaccine.
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Old 23rd Apr 2020, 18:57
  #5502 (permalink)  
 
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Originally Posted by KelvinD View Post
I have zero idea when it comes to medicines (I do know about aspirin but I can't remember how many years since I last saw one of them!) so I thought I would look up these drugs.
Ii discovered this: ARB stands for Angiotensin Receptor Blocker and ACE Inhibitor stands for Angiotensin-converting-enzyme inhibitors. I can see one point of commonality there so how does one differentiate from the other?
You may find some illumination in:
https://www.nature.com/articles/s41581-020-0279-4
Controversies of renin–angiotensin system inhibition during the COVID-19 pandemic

... but it seems to be "a good question" at the moment.
The picture in the paper is perhaps as clear as we're going to get for now.




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Old 23rd Apr 2020, 19:12
  #5503 (permalink)  
 
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Good post ChrisVJ. The masks are a pain the backside, uncomfortable, make your glasses steam up but nothing compared to how I feel when I go to the trouble of wearing one and see others not doing so and putting everyone else at risk. Right now until someone comes up with a better idea I think everyone wearing masks is the way to go.
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Old 23rd Apr 2020, 19:17
  #5504 (permalink)  
 
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Originally Posted by Peter H View Post
You may find some illumination in:
https://www.nature.com/articles/s41581-020-0279-4
Controversies of renin–angiotensin system inhibition during the COVID-19 pandemic

... but it seems to be "a good question" at the moment.
The picture in the paper is perhaps as clear as we're going to get for now.

Thank you very much for posting this, Peter H. This explains why the medication question was asked on the Covid19 symptom tracker app. Clearly, the scientists are trying to see if there’s a connection between vulnerability/reported symptoms/recovery and certain hypertension prescriptions.

Fascinating stuff and makes perfect sense.
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Old 23rd Apr 2020, 20:00
  #5505 (permalink)  
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Originally Posted by BehindBlueEyes View Post
Did my daily login to the C19 Sympton app and have noticed occasionally I’m asked whether I am taking medication for high blood pressure and if so, does that prescription end in ‘sartan’ as in Losartan, Valsartan, Candesartan but not Amlodipine - which a family member currently takes?

I’m curious why the type of drug is more relevant that the underlying health condition.
Mrs PN has just joined with my account. She ticks all the boxes. She rang her GP he said at the beginning it was thought to be a problem but not now. The tracker people are probably just covering bases.
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Old 23rd Apr 2020, 20:05
  #5506 (permalink)  
 
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Originally Posted by VP959 View Post
The snag is that 50% isn't the infection risk reduction figure for the wearer, that's an unknown,
Agreed. But a 50% reduction in the material getting past the mask is a 50% reduction of the input to a process which we know very little about - but which we apparently believe to be quantitative because that was one of the first things the Chinese noticed.
Depending on the way the infection works the reduction in the number of people infected in such a case seems likely to be somewhere between zero and 50%, but technically could be more than 50%.
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Old 23rd Apr 2020, 20:09
  #5507 (permalink)  
 
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Masks are only useful if worn correctly and taken off correctly. I'm a Consultant surgeon in a hospital and going out into the waiting area atrium, I saw a patient wearing a surgical mask covering his mouth but not his nose and as I walked past, he was fiddling with the outside of the lower part - worse than useless to protect me and if there had been virus on the outside, he would have been infecting himself! Went to the local butchers recently. He had a surgical mask on but couldn't understand why it kept falling down his face. It was on upset down with the metal strip you bend to fit your nose under his chin. Again he was taking it down and up between customers using his hands on the outside - again useless mask. Quite a few non medics wear masks correctly let alone remove them properly. In theatre settings, it is suggested that masks are only useful for up to an hour max. The only way masks will work if everyone wears them, covers both mouth and nose, changes them hourly or so and doesn't fiddle or touch the outside - take them off by only using the straps. They also give a false sense of security - I'm wearing one so maybe I don't need to wash my hands so much. My PPE is gloves (washed between patients) a mask worn over both nose and mouth for a whole session (morning or afternoon clinic) and an apron to cover my clothes again for the complete session. Mask on patient if symptoms of covid or being close to their mouth or nose. Short consultations.
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Old 23rd Apr 2020, 20:20
  #5508 (permalink)  
 
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Originally Posted by VP959 View Post
This latter message was repeated, again, this afternoon by CSA, and has also been mentioned by CMO, and the published UK advice is in line with the research findings, that mask wearing probably offers little protection to the wearer from infection, and may increase the risk for some. The BBC News site carries this message, and has done for some time now
When I read the BBC message it simply reminds me of the Iraq dossiers. You look for the supposed background material and it is simply not there.
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Old 23rd Apr 2020, 20:40
  #5509 (permalink)  
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And the second drug fails to meet the hoped results. And this one was the one with the highest expectations behind it.......

https://www.theguardian.com/world/20...-in-full-trial

First trial for potential Covid-19 drug shows it has no effect

Remdesivir, a drug thought to be one of the best prospects for treating Covid-19, failed to have any effect in the first full trial, it has been revealed.

The drug is in short supply globally because of the excitement it has generated. It is one of the drugs Donald Trump claimed was “promising”.

In a “gold standard” trial of 237 patients, some of whom received remdesivir while others did not, the drug did not work. The trial was also stopped early because of side-effects.

News of the failure was posted on a World Health Organization clinical trials database, but later removed. A WHO spokesman said it had been uploaded too soon by accident.

“A draft document was provided by the authors to WHO and inadvertently posted on the website and taken down as soon as the mistake was noticed. The manuscript is undergoing peer review and we are waiting for a final version before WHO comments,” said Tarik Jasarevic, a WHO spokesperson.......
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Old 23rd Apr 2020, 20:41
  #5510 (permalink)  
 
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Originally Posted by occasional View Post
When I read the BBC message it simply reminds me of the Iraq dossiers. You look for the supposed background material and it is simply not there.
In some respects you're right, the issue is partly that there is an absence of any good evidence that masks provide the wearer with any significant protection from infection. It's also true that an absence of evidence is never proof that something has no useful effect, it's just that no one has yet been able to measure that effect, if it does exist.

The question is really how much work needs to be done in order to reach a sensible conclusion. There have been lots of tests, and some infection studies (which probably wouldn't be considered ethically acceptable now) and none have shown that surgical-type masks offer a clear benefit. The precautionary principle applies in environments where mask wearing has been traditional, like surgery, despite evidence showing that masks may possibly not offer a benefit, just because people are so used to them now that not wearing one would be interpreted as being unsafe, even if it isn't.

If people want to wear something that makes them "feel" safer, then that may be a benefit, but there is always the risk compensation problem, where we tend to take greater risks in other areas if they feel that something is making them feel safer. Really hard to quantify the balance of the various risk elements, the best we can do is try to make as much information available as possible, so that people can try to form their own view of the balance of the various risks.
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Old 23rd Apr 2020, 20:48
  #5511 (permalink)  
 
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Originally Posted by occasional View Post
Agreed. But a 50% reduction in the material getting past the mask is a 50% reduction of the input to a process which we know very little about - but which we apparently believe to be quantitative because that was one of the first things the Chinese noticed.
Depending on the way the infection works the reduction in the number of people infected in such a case seems likely to be somewhere between zero and 50%, but technically could be more than 50%.
That's not borne out by the infection control studies at all, though. They seem to show that there is no measurable benefit from wearing a surgical type mask at all, and some studies showed that infection rates were actually slightly higher when this type of mask was used.
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Old 23rd Apr 2020, 21:29
  #5512 (permalink)  
 
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I've been trying to dig out more papers that may shed some light on ways that may mitigate transmission of infection. This paper seems to be the closest I can find to something relatively recent and probably applicable to this pandemic, as it looked at ways to mitigate transmission of disease during an influenza pandemic: https://link.springer.com/content/pd...2458-7-208.pdf

This is the section summing up the case for using face masks from this article, but the rest of the paper is well worth reading, as it looks at the totality of non-pharmaceutical interventions for controlling pandemic infection of disease caused by a respiratory virus:

Provider and patient use of masks and other personal protective equipment
Uncertainty about the mode of influenza transmission has influenced debate about when and whether to use masks or N95 respirators for pandemic influenza. Droplet transmission is thought to be the primary mode of transmission, and provides the basis for CDC guidelines that health-care personnel wear masks for close patient contact (i.e., within 3 feet) to control influenza transmission during the influenza season [41]. But experience from seasonal influenza also provides evidence of contact, droplet and aerosol transmission of influenza that lend support for N95 respirators, which are designed to stop up to 95% of small airborne particles [42]. A recent Institute of Medicine (IOM) study found that empirical evidence about the efficacy or effectiveness of inexpensive, disposable masks and respirators against influenza is limited [43-46].
Our experts recognized this as an area of significant controversy and complexity, but they generally recommended reserving surgical masks, N95 respirators and other personal protective equipment for hospital and ambulatory patients and providers when a community outbreak begins or when the pandemic was widespread. Moreover, surgical masks and N95 respirators were recognized as a
non-invasive technology that would induce no antiviral drug resistance. The experts qualified their recommendation, noting that poor training, improper use and, for N95 respirators, the need for fit-testing may compromise the overall effectiveness of these measures.
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Old 23rd Apr 2020, 22:05
  #5513 (permalink)  
 
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Originally Posted by occasional View Post
When I read the BBC message it simply reminds me of the Iraq dossiers. You look for the supposed background material and it is simply not there.
Oddly enough a current theme on another thread:
https://assets.publishing.service.go...ve_Summary.pdf

Lest we forget having our chains royally yanked.
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Old 23rd Apr 2020, 23:43
  #5514 (permalink)  
 
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Originally Posted by VP959 View Post
Pretty much. In this trial they are using two vaccines, one is a proven meningitis vaccine, the other the trial vaccine. 50% get one and 50% get the other. No one involved in administering the vaccines knows who has been given which. The aim of this first trial is to establish whether the vaccine has any adverse side effects, and comparing it with a vaccine that is well understood gives a good indication as to which side effects might be real, and which may just be random effects unconnected with the vaccine.
Thank you.
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Old 24th Apr 2020, 01:25
  #5515 (permalink)  
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Originally Posted by VP959 View Post
The flip side is that respirators, and properly fitted FFP3/N95 masks, can provide some protection, although the level of that protection isn't easy to quantify, as again it's been extrapolated from measurements, rather than real world testing on people (for the same ethical reasons as surgical masks can't be evaluated this way).
A point of detail: N95 masks are equivalent to FFP2 masks, not FFP3. FFP1 is 80%, FFP2 is 94%, and FFP3 is 99%.
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Old 24th Apr 2020, 04:11
  #5516 (permalink)  
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Originally Posted by VP959 View Post
Pretty much. In this trial they are using two vaccines, one is a proven meningitis vaccine, the other the trial vaccine. 50% get one and 50% get the other. No one involved in administering the vaccines knows who has been given which. The aim of this first trial is to establish whether the vaccine has any adverse side effects, and comparing it with a vaccine that is well understood gives a good indication as to which side effects might be real, and which may just be random effects unconnected with the vaccine.
Can you provide a link please to confirm the above and how are you aware of the nature of the trials

This is all I can find from the site of those involved.

https://www.ovg.ox.ac.uk/news/covid-...ne-development
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Old 24th Apr 2020, 04:32
  #5517 (permalink)  
 
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I had this forwarded to me on social media, any idea if it's correct ?
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Old 24th Apr 2020, 04:37
  #5518 (permalink)  
 
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April 22 2020
Researchers at MIT; the Ragon Institute of MGH, MIT, and Harvard; and the Broad Institute of MIT and Harvard; along with colleagues from around the world have identified specific types of cells that appear to be targets of the coronavirus that is causing the Covid-19 pandemic.

https://www.sciencedaily.com/release...0422132556.htm

Apologies again if this has been posted before. If anything it shows the complicated web of possibilities with which these people are struggling.
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Old 24th Apr 2020, 05:08
  #5519 (permalink)  
 
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Originally Posted by krismiler View Post

I had this forwarded to me on social media, any idea if it's correct ?
I have no idea if this is correct.

Any type of face mask? That is obviously wrong.

2 things missing

1 the distance, which is critical
2 two mask free subjects

I will stick to the avoid relating if possible and 6ft/2m minimum distance (more if I can) when I have to. This looks too good to be true and could lead to overconfident complacency and very high risk.

If only face masks made it that easy.

I believe VP959 has more detailed information on masks. If this info is found to be wrong can it be removed?
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Old 24th Apr 2020, 05:21
  #5520 (permalink)  
 
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Originally Posted by Krystal n chips View Post
Can you provide a link please to confirm the above and how are you aware of the nature of the trials

This is all I can find from the site of those involved.

I have removed the link because the Web page does not look like the OVG pages


The Oxford team is lead by Prof Sarah Gilbert, at the Jenner Institute. Google and YouTube are your friends here. Loads of info. BBC Andrew Marr interview with Prof Gilbert is particularly interesting.

Info from Wiki.

The Jenner Institute is a research institute on the Old Road Campus in Headington, east Oxford, England. It was formed in November 2005 through a partnership between the University of Oxford and the UK Institute for Animal Health. It is associated with the Nuffield Department of Medicine, in the Medical Sciences Division of Oxford University.


The link information looks very out of date. I am alerted to the request for funding aid! It may be ligitimate but the UK Gomernment has already allocated £20 million pounds to this project. They are not short of funds today.

DONATE WITH CAUTION! if you are tempted to.

Last edited by Islandlad; 24th Apr 2020 at 05:56.
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