The biology of coronavirus COVID-19 - including research and treatments

Arnie Pye said:
If this article is true then having a covid vaccine is unlikely to prevent people getting the disease, it will allegedly, at best, just reduce the severity of symptoms. So, Covid-19 has brought in an entirely new definition of what a vaccine is intended to achieve.
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It looks to me as if the author has lost it in terms of understanding of what vaccines do. Vaccines have no ability to stop you getting infected. That happens when you breath in or swallow a virus. The point of the vaccine is to stop the virus then producing symptoms and signs - i.e. being ill - by preventing the virus from replicating. Which is the same as 'preventing people getting disease'. He seems to be just muddling up words to make some clever point.

There seems to something a bit preachy about this doctor - his autobiography is entitled something like 'My lifelong fight against illness'. Sure we all did that, but don't necessarily want to bore people with it.
 
Mij said:
@Jonathan Edwards

So wearing a mask is much better at preventing us from contracting the virus in the first place. Not as practical as getting a vaccine, but something I would prefer.
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That relies on others to wear masks and continued social distancing. I will gladly take any vaccine offered me that has been through testing and approval. I'd prefer to take the risk with that than be permanently isolated.
 
Mij said:
@Jonathan Edwards

So wearing a mask is much better at preventing us from contracting the virus in the first place. Not as practical as getting a vaccine, but something I would prefer.
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A mask is better at stopping the virus getting in to one particular person who has met virus but that does not mean that a mask is better than a vaccine. It does a different job. In the long run a vaccine is likely to be much better at stopping most people getting infected because masks are not that good at stopping virus getting in every time. If a mask stops the virus on Monday and Tuesday it may still not stop the virus on Wednesday. And for the next person the same applies and so the virus spreads.

Or put another way, vaccines stop other people getting infected after any one person has been infected. And everyone who is infected is an other person in relation to someone infected. So for a population vaccines are better at stopping infection than masks.
 
Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

https://www.medrxiv.org/content/10.1101/2020.10.15.20205054v1

Findings At 2-3 months from disease-onset, 64% of patients experienced persistent breathlessness and 55% complained of significant fatigue. On MRI, tissue signal abnormalities were seen in the lungs (60%), heart (26%), liver (10%) and kidneys (29%) of patients. COVID-19 patients also exhibited tissue changes in the thalamus, posterior thalamic radiations and sagittal stratum on brain MRI and demonstrated impaired cognitive performance, specifically in the executive and visuospatial domain relative to controls. Exercise tolerance (maximal oxygen consumption and ventilatory efficiency on CPET) and six-minute walk distance (405±118m vs 517±106m in controls, p<0.0001) were significantly reduced in patients. The extent of extra-pulmonary MRI abnormalities and exercise tolerance correlated with serum markers of ongoing inflammation and severity of acute illness. Patients were more likely to report symptoms of moderate to severe anxiety (35% versus 10%, p=0.012) and depression (39% versus 17%, p=0.036) and significant impairment in all domains of quality of life compared to controls. Interpretation A significant proportion of COVID-19 patients discharged from hospital experience ongoing symptoms of breathlessness, fatigue, anxiety, depression and exercise limitation at 2-3 months from disease-onset. Persistent lung and extra-pulmonary organ MRI findings are common. In COVID-19 survivors, chronic inflammation may underlie multiorgan abnormalities and contribute to impaired quality of life.
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The 6-minute walking test is rather high in this cohort. Although it's a low-intensity test so it has a very low ceiling. Looking at the SF-36, there is a wide range of functioning, from 45 to 90.

There doesn't appear to have been any questions about neurological or autonomic symptoms. Very unfortunate that people miss out on things just because they don't know what questions to ask.
 
I don't feel compfortable with a fast track vaccine.

I'm not anti vaxx but I don't know what it - or any vaccine - might be doing to my immune system.

I haven't had any ever since coming down with ME.

I'm not sure vaccinating can be made mandatory directly. But indirectly maybe by denying/granting access to certain institutions/jobs etc.
 
@Leila

I'm not anti-vaxx either. But, during my sudden ME viral onset I was vaccinated x4 (!) within a 2 month period. It was terrible timing and I'll never know if that triggered ME. I have not had a vaccine since (28 years).

My immune system feels like it has been over active for the last 15+ years. I'm a little concerned about receiving a vaccine and becoming worse.
 
Here is the link to Professor Sir Stephen Holgate’s lecture on COVID19. Definitely worth a watch.



The current ME Association poll is on the flu vaccine, who has it and the aftereffects on people with ME. It looks like there is a 50/50 chance of either no ill effects or a deterioration in ME if you have the vaccine. I am in favour of vaccination but hesitant to have one myself. My immune system is very over-reactive. The risk of deteriorating is fearful.
 
Jonathan Edwards said:
Vaccines have no ability to stop you getting infected. That happens when you breath in or swallow a virus. The point of the vaccine is to stop the virus then producing symptoms and signs - i.e. being ill - by preventing the virus from replicating. Which is the same as 'preventing people getting disease'.
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Exactly. People seem to lose sight of the fact that SARS-Cov-2 and Covid-19 are separate things. The former being a virus and the latter being the disease it can cause. We don't need a vaccine that prevents SARS-Cov-2 infection we need one that prevents Covid-19.

Perhaps later down the road one may be developed that blocks infection?

Reading further on the issue I see concern that a vaccine that only prevents symptoms development (Covid-19) would maybe leave the elderly vulnerable due to a possibly less robust reaction to the vaccine and that we would also need to meet a certain threshold in terms of % of population vaccinated in order to protect those them to the fullest.

Does any of that pass the smell test?
 
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Arnie Pye said:
I use as my yardstick the vaccinations I got as a child or young adult. I don't hear of outbreaks of (for example) diphtheria and whooping cough in the UK, and I was vaccinated against those.
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I was vaccinated against mumps and still got mumps. Pertussis (whooping cough) seems to lead to a mild infection even in those who have been vaccinated and so on...

So the yardstick for (efficacy) of the SARS-CoV-2 vaccine is much the same as existing vaccines.

As for your other concerns, I agree. One key point that many people seem to miss is the viral vector (lentivirus or adenovirus) and RNA/DNA vaccines need higher doses than subunit vaccines since they need to "infect" the cell before the antigen protein is actually produced. Whereas subunit vaccines induce immunity directly. The higher doses increase the risk of autoimmune consequences by a magnitude of order or more (autoimmune cytopenia, Transverse myelitis, Guillain-Barre syndrome etc.)

The discussion of mucosal immunity arises from the claims about preventing infection (and has been discussed in other media articles on this topic). A key point to note is that only the live (recombinant viral-vectored) vaccines are suitable for oral/nasal administration. Hence some of the discussion about administration methods is from the people who are pushing for this class of vaccine over the others (including AstraZeneca). Yet I have concerns (due to mechanistic reasons) that this vaccine type will have the worst symptom reduction versus side effect profile.
 
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Just seen this about 'active challenge' trials:

BBC said:
UK plan to be first to run human challenge Covid trials

By Michelle Roberts
Health editor, BBC News online

The UK is pushing ahead to be the first nation to carry out "human challenge" studies where up to 90 healthy people will be deliberately exposed to Covid.

The trials, which could begin in January, aim to speed up the race to get a Covid-19 vaccine.

The government is putting £33.6m towards the groundbreaking work.

Safety will be a number one priority, experts insist. The plans will need ethical approval and sign-off from regulators before they can go ahead.

Human challenge studies provide a faster way to test vaccines because you don't have to wait for people to be exposed to an illness naturally.

Researchers would first use controlled doses of the pandemic virus to discover what is the smallest amount that can cause Covid infection in volunteers aged 18 to 30.

These human guinea pigs, who will be infected with the virus through the nose and monitored around the clock, have the lowest risk of harm due to their young age and good health.

Next, scientists could test if a Covid vaccine prevents infection...
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https://www.bbc.co.uk/news/health-54612293
 
I am a great believer in vaccines and can understand why they need to develop one to get covid-19 under control. I get the flu vaccine every year and have never had a problem but I am wary about being among the first to get this one when it is available.

It is a completely new entity and we will not know what the side effects are until it has been used widely. It would make sense to give it too healthy key workers first as they could withstand any side effects better than the likes of us.

That sounds cold, but they are the ones most likely to get infected with all the risks attached to that and the economic impact of not being able to work is worse for them than people who cannot work already.

Basically, we can lower our risk of disease by isolation so the virus should go to those who cannot or do not want to take other preventative measures.

I say this assuming the vaccine is effect in the vast majority of those vaccinated.

Every disease has its own risk profile. Diseases like diphtheria attacked children and killed them quickly so there was no doubt a vaccine should be used even if there were side effects. They demanded that school teachers should no longer be vaccinated against TB because case numbers had dropped so low the risk of side effects was greater than the risk of disease for instance.
 
I haven't read the article, but there was an article in De Volkskrant about a Dutch breath-test that could tell about 75% of people with symptoms immediately that they didn't have covid. The others would still have to be tested. Apparently a Finnish firm is working on the same.
 
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