International COVID-19 Updates & Discussion 2

[MiW]

Interesting, but there is no reported information about how many patients would have recovered if they had not received treatment. The followup double-blind randomised study should provide more certainty, but at present it seems a hopeful but untested strategy.

Nearly all the countries I've seen talking about 'treatment' , mentioned using plasma very successfully, but they didn't bother doing trials.If it works, it works ...

 

[Geoff.D]

This is like someone knocking in a nail with a rock instead of a customised hammer NOW instead of waiting until next year when someone designs and develops and makes the customised hammer. The outcome is the same except for the wasted time.

 

[Gordon_R]

There is another option.
Protect the high risk cohort, while the broad population builds herd immunity.

I am convinced the stark difference in death rates between countries like Japan and Germany vs countries like Italy and the UK is explained by the effectiveness of strategies employed to isolate the high risk group.

True. The problem in SA is that most of the care worker and essential staff live and commute in circumstances where they are likely to be exposed and transmit the virus, and it is impossible to isolate the vulnerable.

Herd immunity is a statistical concept, and natural epidemics do not prevent secondary waves when previously isolated groups mix. Over a period of years there are always new susceptible populations.

Vaccinations achieve true herd immunity by 'overkill', inoculating multiple times the population fraction needed to sustain any transmission. Only by pushing R0 below a few percent (not just less than 1.0) can outbreaks be stopped. No country has come close to this level for Covid.

 

[Gordon_R]

Typical response. Who cares? The patients that got better certainly don't. They went into critical care, a doctor treated them, they got better. No fancy drugs required, just a bog standard plasme transfusion.
Let the epi-whatisnames number crunch and screw around as long as they like. Meanwhile sick patients are recovering and walking out of the doors.

That's a pretty dumb statement!? Most cases have mild symptoms, many recover naturally. Your assertion makes no sense.

Nearly all the countries I've seen talking about 'treatment' , mentioned using plasma very successfully, but they didn't bother doing trials.If it works, it works ...

I'm not saying I doesn't work, but in the absence of facts, this is like the apocryphal advice: If you do nothing the symptoms last about a week, but this new treatment should clear you up in 7 days.

Many medical 'treatments' have persisted for generations, based on this vague idea that they work. Dr Beetroot and NDZ should take note...

This is like someone knocking in a nail with a rock instead of a customised hammer NOW instead of waiting until next year when someone designs and develops and makes the customised hammer. The outcome is the same except for the wasted time.

Blood transfusions and serum are never cheap nor risk free. Obviously in the case of acute illness they may be justified, but should not be rolled out globally without further study. The use of HIV infected plasma to treat haemophiliacs should be a strong reminder of what can go wrong.

 

[Geoff.D]

And no country will in this season if this virus behaves the same as all the other corona viruses already out there.
At best, there will be an apparent or temporary point reached where it looks like herd immunity has been reached in the short term.
You can't mess around with definitions to suit your beliefs.
The same with this R0 crap.
R0 has a very specific meaning. It is the effective R (Re, or Rt) that changes NOT R0. R0 is a fixed value which is almost impossible to determine before some time has lapsed in an epidemic and the derived by working backwards, UNLESS past experience with similar viruses is used to provide a best guess at what that value is. Hence why the figure used is 3 until otherwise determined as the infection develops.

 

[Brian_G]

If we look at the even bigger picture, planning for the future, LD is not a solution. Except in some politicians' minds, lovely tool for them.

Vaccinations are at best only going to give a partial solution (would like to know how they think they already know that with certainty, but that's another topic...), and those refusing their exaggerated poisons will be blamed but there's actually then no way to stop this. Never really has been with some disease, man just thinks he can.

EDIT: At this stage, re existing certainty the herd immunity concept is all that's left. Unfortunately it does mean isolating unhealthy older citizens (must be both factors) to protect health services, although in S.A. that's a waste of time for many hospitals anyway IMO.

Lastly, it's endlessly forgotten that we're dealing with a low mortality rate. The panic should stop. These never ending debates about how to micromanage it seem increasingly pointless to me.

 

[Geoff.D]

That's a pretty dumb statement!? Most cases have mild symptoms, many recover naturally. Your assertion makes no sense.

I'm not saying I doesn't work, but in the absence of facts, this is like the apocryphal advice: If you do nothing the symptoms last about a week, but this new treatment should clear you up in 7 days.

Many medical 'treatments' have persisted for generations, based on this vague idea that they work. Dr Beetroot and NDZ should take note...

Blood transfusions and serum are never cheap nor risk free. Obviously in the case of acute illness they may be justified, but should not be rolled out globally without further study. The use of HIV infected plasma to treat haemophiliacs should be a strong reminder of what can go wrong.

That is a given. The profession has surely learnt that lesson and knows by now what sources of blood products can be used relatively safely. That is why some of us have never been able to become blood donors.
And, relatively speaking plasma transfusions are a cheaper option than weeks in ICU on a death machine.
BTW, the "trial" was carried out on patients in ICU, so your 7 day/week argument is not applicable.
Obviously, after the triple blind twice removed trial it may be found that all patients can be treated like this to speed up immune process. Right now it is not about reducing those that get sick but preventing the really sick from becoming a statistic.

 

[Gordon_R]

That is a given. The profession has surely learnt that lesson and knows by now what sources of blood products can be used relatively safely. That is why some of us have never been able to become blood donators.
And, relatively speaking plasma transfusions are a cheaper option than weeks in ICU on a death machine.

Good points, and that's one limitation with using plasma as a treatment: Its rare, hard to collect, and cannot keep up with demand during the exponential phase of the epidemic. It has to be collected from patients who were infected, and have fully recovered from the virus. Given the pressure on testing, identifying potential donors is a challenge. Anyway, far off topic, and unlikely to make the slightest difference in SA...

 

[pixel_ninja]

So you think that is a good thing ? .

I can go to the movies with my wife, the park with my son, mountainbiking with my mates.

That country is effectively closed to the rest of the world now .

We have a travel bubble with Aus from 1 July, and Japan too shortly, besides, when last have you been overseas?

When do you think first world countries will open their borders to Saffas with the skyrocketing infection rates?

This virus is not going to go away , we are going to have to live with it until a vaccine comes along .

Literally, it has gone away in NZ? Life back to normal, save for international travel excluding Aus, Pacifika and parts of Asia. Until then, seems the better alternative no?

 

[Brian_G]

My last post edited to also accommodate unfolding medical treatments.

Good points, and that's one limitation with using plasma as a treatment: Its rare, hard to collect, and cannot keep up with demand during the exponential phase of the epidemic. It has to be collected from patients who were infected, and have fully recovered from the virus. Given the pressure on testing, identifying potential donors is a challenge. Anyway, far off topic, and unlikely to make the slightest difference in SA...

What about using recovered patients' antibodies to try create a synthetic cure. Surely also possible.

 

[Geoff.D]

Good points, and that's one limitation with using plasma as a treatment: Its rare, hard to collect, and cannot keep up with demand during the exponential phase of the epidemic. It has to be collected from patients who were infected, and have fully recovered from the virus. Given the pressure on testing, identifying potential donors is a challenge. Anyway, far off topic, and unlikely to make the slightest difference in SA...

Except last night a researcher did mention that SA will be starting its own plasma derived antibody trials as soon as the required protocols and antibody tests are approved by SAHPRA.
Early days for us as the wheels are turning backwards at the moment.

 

[Geoff.D]

I can go to the movies with my wife, the park with my son, mountainbiking with my mates.

We have a travel bubble with Aus from 1 July, and Japan too shortly, besides, when last have you been overseas?

When do you think first world countries will open their borders to Saffas with the skyrocketing infection rates?

Literally, it has gone away in NZ? Life back to normal, save for international travel excluding Aus, Pacifika and parts of Asia. Until then, seems the better alternative no?

When to let in saffas? Not for a long time would be my reaction if I was in charge, and then with a 28-day quarantine to boot.

 

[Brian_G]

When do you think first world countries will open their borders to Saffas with the skyrocketing infection rates?

Infection rates are easy to manipulate and are confused locally by many factors, been a main debate in the SA thread.
It's been many months, the LD could not have been effective enough locally (also discussed in detail), there is no wide risk. Only the WC is a (strange) change, not yet understood.

I think the next 1 to 3 weeks will be the last we need to wait, on level 3 that's enough time to see what has changed if anything, and to also give the doubters of the widely believed non-winter-effect theory enough time to test their concerns.

At least we should have the earliest opportunity to emigrate, given half a chance I'm gone from this laregely politically and economically ruined sub-continent.

 

[pinball wizard]

I think the next 1 to 3 weeks will be the last we need to wait,

Wait till it gets into the townships, then you'll see.
I think the next month will be crucial.

 

[Brian_G]

Wait till it gets into the townships, then you'll see.
I think the next month will be crucial.

Not sure if you're joking, been there for months.
Alright then - on 8 July if all is still equivalently stable, forum optimists and pessimists alike jointly call for the LD to completely end?

 

[pinball wizard]

Alright then - on 8 July if all is still equivalently stable, forum optimists and pessimists alike jointly call for the LD to completely end?

I don't think I fit into either camp. I've been vehemently anti-crackdown since March.

 

[flippakitten]

Fergus Walsh: Was coronavirus here earlier than we thought?

Could Covid-19 have been here earlier than we thought? The BBC’s medical correspondent investigates.

www.bbc.co.uk

I was talking to my wife about this before seeing the article.

In December I had all the symptoms over Christmas, the loss of taste is an extremely vivid memory because I've never had anything like it before and I couldn't taste Christmas lunch.

 

[C4Cat]

we are going to have to live with it until a vaccine comes along .

6 months till vaccine (looking in my crystal ball)

 

[Geoff.D]

Wait till it gets into the townships, then you'll see.
I think the next month will be crucial.

Its there already, everywhere. We just don't know it. How severe the outbreak? Without testing we won't know until the bodies start dropping.

 

[pinball wizard]

Its there already, everywhere. We just don't know it. How severe the outbreak? Without testing we won't know until the bodies start dropping.

Wait for the next week.