Working From Home - Impacts of Coronavirus

[cdev]

There is no proof that getting it once conveys permanent immunity, some viruses just stick with you and come out when your immune system is weakened.

I have already heard that, and am asking one question. (Sorry if this is naive, I'm no virology expert!)

If the above happened to be true, how could a vaccine for it ever work?
Maybe the answer is obvious, and if so, I'm going to learn something about vaccines.

Some viruses don't act predictably, this new one being an example. Its obvious that its extremely unpredictable and thats why this particular epidemic is taking a deep toll on doctors and nurses.

I have been trying to figure out a good answer that expresses what I feel I know with accuracy, while not overreaching.

One area where there is a lot of activity is imune system adjuvants. There were discovered by looking at the way that some substances magnify the ability of the immune system to remember some things when they present themselves to the immune system the same time as something else.

These are substances that make the body remember a substance with an extra kick.. But from what little I know that can also be very problematic, its very complicated, the thing that seems to be killing people so frequently with covid 19 is an immune response thats delayed too long and then its too strong, the delayed, overstrong  immune response is part of what is killing people.
 

Some viruses basically just effect peoples immune systems they deplete certain kinds of cells in the immune system. Example: https://www.ncbi.nlm.nih.gov/pubmed/23087407

This is an interesting article about the virus vaccine industry which explains why lots of viruses still have no vaccines.

Why are vaccines against many human viral diseases still unavailable; an historic perspective?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7166819/

Here is another one on the situation in 2006. (Right around the time of SARS-CoV-1 )

New viral vaccines.
https://www.ncbi.nlm.nih.gov/pubmed/16364754

I'm not qualified to take much of a stab at this, as thats a subject I know very little on. What I know could be summarized in a few pragraphs. There are lots of reasons why a vaccine, even if it is available might not work in everybody or certain groups, even groups of the same age..

One thought - there are big moral and liability issues, a vaccine might be effective in some situations but not in others, if so, they likely dont want people to think they are protected when they are not. Also some vaccines seem (from what Ive read)  actually make things worse if you get some other similar illness, it seems this happened with HPV vaccines made a few years ago The vaccine many people got was adquate protection for some strains but it put people at higher risk for HPV and I think also some cancers if they got others, So now there is a debate about what they should do.

There is a lot of focus on vaccines because at least in the past that was the most common way of fighting viral diseases.

But the economics of vaccines may not be what they want, take for example Gilead's treatment for hepatitis C. It cured the very costly disease but it was itself insanely costly.

With coronaviruses, they mutate very quickly, many coronaviruses mutate so much there is a very real chance that they would mutate into something else enough for a vaccine you got now to no longer to be effective against a very similar virus a few years from now.


Here is a good unknown question, why do people on ships tend to get it in such high numbers? Is it just them being confined in fairly close quarters? Because it seems those cuise ships were pretty spacious and once the coronavirus became an issue on some ships everybody was confined to quarters. But they still continued to have more and more people test positive. Maybe there is some aspect of ships that they all share that makes them an ideal environment for coronavirus transmission?

You won't know until mass testing for immune globuline reveals the true spread and whether it was enough to build any kind of herd immunity. But when I look at the current mortality figures especially for England, boy, that's not looking good. Something has started eating into the 15-64 year age bracket worse than any influenza in the past years. I hope it's the lockdown working when the curve flattens.

[coppice]

There is no proof that getting it once conveys permanent immunity, some viruses just stick with you and come out when your immune system is weakened.

I have already heard that, and am asking one question. (Sorry if this is naive, I'm no virology expert!)

If the above happened to be true, how could a vaccine for it ever work?
Maybe the answer is obvious, and if so, I'm going to learn something about vaccines.

Nobody knows if a vaccine will be feasible, and if it's feasible whether it will be very effective. The development of vaccines has always been rather patchy. When they say 18 months to a vaccine you need to check carefully which end of their anatomy the statement came from.

[nctnico]

There is no proof that getting it once conveys permanent immunity, some viruses just stick with you and come out when your immune system is weakened.

I have already heard that, and am asking one question. (Sorry if this is naive, I'm no virology expert!)

If the above happened to be true, how could a vaccine for it ever work?

If I add up all the information I have read so far I think there are a couple things to be aware off:
1) The flu symptoms caused bij Covid-19 are not that bad.
2) It is the immune system going into overdrive what is causing the deaths.
3) The Covid-19 virus is probably going to become a seasonal recurring 'flu' for the next couple of years.

So in my opinion what is needed is a 2 pronged approach:
1) A vaccine which dampens the flu effects like a regular flu vaccine
2) Medicines to stop the immune system from damaging the healthy tissue.

And that is what is already happening. There is research going on to create a vaccine to combat the virus and doctors are experimenting with (existing) medicines to keep the immune system in check. Both still need a lot of research because how the virus works isn't fully understood yet.

[SiliconWizard]

There is no proof that getting it once conveys permanent immunity, some viruses just stick with you and come out when your immune system is weakened.

I have already heard that, and am asking one question. (Sorry if this is naive, I'm no virology expert!)

If the above happened to be true, how could a vaccine for it ever work?
Maybe the answer is obvious, and if so, I'm going to learn something about vaccines.

Nobody knows if a vaccine will be feasible, and if it's feasible whether it will be very effective. The development of vaccines has always been rather patchy. When they say 18 months to a vaccine you need to check carefully which end of their anatomy the statement came from.

Alright then - that's what I thought as well.

[SiliconWizard]

There is no proof that getting it once conveys permanent immunity, some viruses just stick with you and come out when your immune system is weakened.

I have already heard that, and am asking one question. (Sorry if this is naive, I'm no virology expert!)

If the above happened to be true, how could a vaccine for it ever work?

If I add up all the information I have read so far I think there are a couple things to be aware off:
1) The flu symptoms caused bij Covid-19 are not that bad.

Yeah. Well, according to some that have had it, it's no picnic either. No idea the percentage of people for whom it's light or bad, and if this % is similar to seasonal flu.

2) It is the immune system going into overdrive what is causing the deaths.

That's what I've understood too. Which would also explain why being slightly immunodepressed, as counter-intuitive as it looked, seems to actually help NOT getting into this state, and why some of the possible drugs that are currently being tested are immunomodulators.

3) The Covid-19 virus is probably going to become a seasonal recurring 'flu' for the next couple of years.

I don't think we have a clue about that. I don't think that happened with the previous SARS-CoV, for instance? (I may be wrong about this, I actually don't remember much of it.)

So in my opinion what is needed is a 2 pronged approach:
1) A vaccine which dampens the flu effects like a regular flu vaccine

Maybe, but I don't know how that works. That's maybe where my knowledge stops. If it ever happened that the immune system could not get immunity (as hypothesized by some), a vaccine is not likely to work, and I don't know if it could work to "dampen" things then. Of course that's the worst-case scenario.

2) Medicines to stop the immune system from damaging the healthy tissue.

Yeah, as far as treatment goes, that'll probably be either some antiviral that works against it, or some immunomodulator, or a combination of both.

[cdev]

At the same time, there are strategies that might prove to be useful against lots and lots of viruses,  (or maybe not!) (Example of how this might work)

More general overview

This might help a lot of people come through this alive

I do intend to keep on being paranoid until the number of sick people falls to a lot lower than it is now. People have died in my neighborhood. Not people I knew but people nontheless.

I'm avoiding contact as best as I can. When I get stuff in the mail, I just put it aside for a couple of days, then open it.

It sure would suck to go on like this forever.

Nobody knows if a vaccine will be feasible, and if it's feasible whether it will be very effective. The development of vaccines has always been rather patchy. When they say 18 months to a vaccine you need to check carefully which end of their anatomy the statement came from.

[james_s]

From what I've been seeing, the symptoms are mild to moderate for the vast majority of people who get it, with apparently a large but as of yet unknown percentage possibly as high as 50% who have no symptoms at all, or symptoms so mild they don't realize they're sick.

But for a not insignificant percentage of people the symptoms are severe and there's no way to know ahead of time what it will be like for any given person. If it was contracted by numbers similar to the seasonal flue it wouldn't be so bad, but this thing is being contracted by huge numbers of people.

[SiliconWizard]

Anyone knows why it spreads so easily compared to seasonal flu?

[cdev]

Youre right, it does seem to spread more.

Thats quite possibly just the normal exponential rate of increase. There is a number based on how many people its expected to be spread to which varies - its related to how well we are preventing transmission. In a city like New York without social distancing in normal times its virtually impossible to not spread a virus like this because people spend a lot of time indoors next to other people. many buildings dont have windows that open. If somebody sneezes elements of whatever virus they expel remain in the air for a significant amount of time if the building doesnt have powered ventilation that can exchange the air in the rooms several times an hour. Also, the optium temperature for corona virus is kind of cool. Hot weather reduces transmission a lot. The next cold winter people are going to have to find a balance between heating and ventilation and or getting sick. Not using the heat to save energy is going to make the likelihood of illness higher. As will constant use of AC.

The "Harald Wave" is the first season and then there may be one next winter-spring and sometimes even the one after that. https://www.ncbi.nlm.nih.gov/pubmed/?term=herald+wave

 

And government and businesses are slowly losing the ability to capitalise on people's fear, all this stuff isn't going to last too much longer, people's patience is already starting to wear thin.

Maybe. I mean, you're right that people are getting restless and if it all blew over right now we'd be back to where we were pretty soon. But that assumes it will blow over. Suppose we all start going back to work and it blows up again, like it's doing in Singapore

That's the 2nd time someone here has claimed it's flaring back up in places that have eased lockdowns. Do you have data for that? Because it looks like that's not the case, daily case totals have not increased.

Just saw this picture in the news:
(Attachment Link)

According to the article the lockdown was released on the 19th of March and 2 weeks later infections started to rise at a faster pace than before.

Just looking at a country as a whole is not a good idea. Even in small countries (like the Netherlands) the number of infections vary wildly between areas so the epidemic flaring up in one area can easely get lost in the noise of the country's total.

Generic disclaimer: you have to be very careful with trying to interpret Corona numbers yourself; it is easy to get to the wrong conclusions.

Once the free healthcare ends here in the US, (when the emergency ends and people can go back to work, getting sick with COVID disease will go back to being just like any disease, insanely expensive, really unaffordable for almst everybody, even those with health insurance. ) everything may change. Infection rate will rocket up again because they have not, in fact can not change anything. Both candidates are pretending they can but they cant  they signed away the right to do so decades ago.

there is a reason why the numbers are so bad here and its structural aspects of the system that are carved in stone forever in Geneva.

This web page is a useful resource. Its the John Hopkins COVID-19 dashboard.

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

But keep in mind that its quite possible that the lions share of the people dying from COVID-19 are not in those statistics because they die at home .

[DrG]

Anyone knows why it spreads so easily compared to seasonal flu?

There are some reasonable thoughts on that.

As has been stated, Covid-19 SARS-CoV-2 can produces almost no symptoms in some people and very mild symptoms in other people, which may not even show up for many days. The duration of the symptoms can last what, 14 days or more? In all of those situations, you may be contagious.

Those, it seems to me, are all differences from what we generally call the "seasonal flu" (of which there are several varieties or strains, as I understand).

When you know you have the flu, you are not going anywhere for the most part and you are extra careful about infecting others (most people are).

Nevertheless, a longer duration with symptoms offers more opportunities to spread the infection.

I think, however, (but don't know), that a big difference is that in all cases of infection (let's say after 1 day) that are asymptomatic, the individual is contagious and they don't even know they are infected.

Well, that is all you need to spread so easily, compared to the "seasonal flu".

I have not seen any real data that it has a greater airborne capability or that it can be absorbed more easily through skin and we know something about its short viability on surfaces, so I don't think any of those factors are major reasons.

That is my understanding anyways.

[coppice]

These are substances that make the body remember a substance with an extra kick.. But from what little I know that can also be very problematic, its very complicated, the thing that seems to be killing people so frequently with covid 19 is an immune response thats delayed too long and then its too strong, the delayed, overstrong  immune response is part of what is killing people.

This is the same behaviour as the original SARS in 2003. Maybe if they'd kept working on a vaccine for that they would have the ground work in place for tackling this virus, but I guess funding for the development of treatments and vaccines dried up with the infection suddenly went away. Well, you know, having got over it, it was obviously never going to come back in a modified form to bite us. Right?

[NiHaoMike]

Perhaps the regular/seasonal flu does spread as easily from person to person, but gets another "hop" far less often because a lot of people are immune to it.

[james_s]

Anyone knows why it spreads so easily compared to seasonal flu?

I think it's a combination of things that creates a perfect storm.

For one thing it's a novel virus, it has not been spreading around human populations until recently so none of us have any immunity.

The incubation period is exceptionally long, up to 2 weeks between infection and the onset of symptoms during which time a person can be quite contagious. They may feel perfectly find and have no idea they've been infected and spend anywhere up to 2 weeks infecting other people. There are only so many degrees of separation and most of us are connected to most others through a chain of only a handful of people.

Then there  are the asymptomatic carriers or those with very mild symptoms who go to work or out in public even though they know they're sick but don't realize they have something so dangerous to some.

On top of all that there may be other factors. Perhaps the virus is exceptionally adept at getting into the body and establishing an infection. Maybe it floats in the air unusually well, maybe it survives on surfaces longer than most viruses, a lot of this we really don't know yet.

I do hope that this pandemic results in more people staying home if they're sick. Here in the US at least we've long had a culture where people try to show how tough or hard working they are and come to work when they're clearly horribly ill. I've seen it happen so many times, someone hacking and coughing at their desk and in meetings and a week later a dozen people are out sick. It's like people worry that if they stay home sick someone will think they're faking it.

[cdev]

This story shows why infections are likely to spike way up in the US as soon as companies go back to work. 

https://theintercept.com/2020/04/30/coronavirus-warehouse-deaths-broadridge/

Just like many other countries now, the US has a multitiered labor system where poor people and legal guest workers increasingly staff companies for very low, hourly wages and they work with no benefits in dangerous conditions. We're told in the trade literature that this is the future.

Well this future treats workers like their lives dont matter one bit. the owners have said as much. They are very angry at Mexico for treating the workers like human beings whose lives matter.

US companies and officials have been threatening Mexico for closing many of the Maqiladora factories (the factories built under the NAFTA trade agreement) along the border because of high numbers of people getting sick in them. the US companies that assemble products with their sub assemblies (putting a Made in USA label on them) want them to go back to work. Some of these factories have lost lots of workers, one factory has had 18 workers die.  these buildings are cramped and crowded and not safe in any way as designed under the new conditions..

My guess is they may move the factories to Africa or South Asia  where wages are lower and safety conditions less restrictive, perhaps. But they may be surprised.

[cdev]

James, one time many many years ago I worked for a major US bank for just a few days, writing a web application. During the time I was there, somebody in my department literally died at their desk and the other workers didnt notice it until lunchtime when he didn't move and somebody a few desks away saw that something was not right. An ambulance came but he had been dead for so long that they didn't even try to revive him.

[bd139]

That happens surprisingly often. It was only a couple of months ago a friend of mine went 8 stops on a tube train next to a dead guy. It was only when he fell off the seat people knew something was up.

[cdev]

A lot of illness comes from work..But you can't live without it either. But soon we will have to figure out a way to.

I got into a discussion about the statistics yesterday with my Chinese friend, she told me that  "All the (deaths and hospitalization) figures from China are totally fake" She says that all Chinese people "just know that they all are totally fake" and she feels that I should just totally ignore all of them. I kind of am inclined to agree.

 and that the real death figures are much much higher. How could they not be. I doubt if its as bad here but still lots and lots and lots of people are dying and never diagnosed or counted as COVID-19 including a fair number of young people.

Also looking at the JHU dashboard, the figures in my little county (of which I live in the least urbanized part) are higher than all of Los Angeles. So they are doing much better out in California. IF the figures are to be trusted (certainly more than China's) I am close to NYC. Just a short ride away. (Yes, the busses and trains are still running!)

I think we are in the worst area in the world right now.

[EEVblog]

There is no proof that getting it once conveys permanent immunity, some viruses just stick with you and come out when your immune system is weakened.

I have already heard that, and am asking one question. (Sorry if this is naive, I'm no virology expert!)

If the above happened to be true, how could a vaccine for it ever work?

If I add up all the information I have read so far I think there are a couple things to be aware off:
1) The flu symptoms caused bij Covid-19 are not that bad.

Yeah. Well, according to some that have had it, it's no picnic either. No idea the percentage of people for whom it's light or bad, and if this % is similar to seasonal flu.

According to many reliable reports, the majority of people that get it will get it have no symptoms, or symptoms mild enough not to even seriously suspect they have it (i.e. so that's likely less serious symptoms than the flu)
If it's not the majority then it certainly seems to be a very high percentage.

[EEVblog]

Perhaps the regular/seasonal flu does spread as easily from person to person, but gets another "hop" far less often because a lot of people are immune to it.

The good thing about this whole affair is the awareness level of hygiene has reached hyper levels in practically all the population. This should help reduce the transmission of all sorts of stuff in the coming years.

[PlainName]

Also, the optium temperature for corona virus is kind of cool. Hot weather reduces transmission a lot.

Might we be jumping to erroneous conclusions there? Hot weather means people aren't cooped up in a small room trying to keep warm for so long, and probably spending a significant amount of time outside (which will 'social distance' you even if you're reasonably close to someone just because of the wind). I don't think it's safe to say that warmth is bad (for the virus) just on the basis of seasonal cases - as pointed out previously, your insides are warmer than most environments and it's there that this thing lasts longest.

[digsys]

The good thing about this whole affair is the awareness level of hygiene has reached hyper levels in practically all the population. This should help reduce the transmission of all sorts of stuff in the coming years.

LOL ... I wish you are right, but as a famous aussie once said ...

[langwadt]

Perhaps the regular/seasonal flu does spread as easily from person to person, but gets another "hop" far less often because a lot of people are immune to it.

The good thing about this whole affair is the awareness level of hygiene has reached hyper levels in practically all the population. This should help reduce the transmission of all sorts of stuff in the coming years.

and an explosion in https://en.wikipedia.org/wiki/Mysophobia

[DrG]

There is no proof that getting it once conveys permanent immunity, some viruses just stick with you and come out when your immune system is weakened.

I have already heard that, and am asking one question. (Sorry if this is naive, I'm no virology expert!)

If the above happened to be true, how could a vaccine for it ever work?

If I add up all the information I have read so far I think there are a couple things to be aware off:
1) The flu symptoms caused bij Covid-19 are not that bad.

Yeah. Well, according to some that have had it, it's no picnic either. No idea the percentage of people for whom it's light or bad, and if this % is similar to seasonal flu.

According to many reliable reports, the majority of people that get it will get it have no symptoms, or symptoms mild enough not to even seriously suspect they have it (i.e. so that's likely less serious symptoms than the flu)
If it's not the majority then it certainly seems to be a very high percentage.

Well, that is a big issue. The only reports that we have come from complete testing of "closed" populations. These are situations where everybody in a sample was tested. For example, everyone on a cruise ship or in a nursing home.

Look at the table in this article https://www.cebm.net/covid-19/covid-19-what-proportion-are-asymptomatic/ that reviews those situations. The proportions are all over the place. I believe that most are valid, but none of the numbers can be generalized to populations with much confidence.

Many folks, including myself, are in favor of some degree of random testing (both for evidence of infection and immunity as well as a self reporting of symptoms) in countries to specifically address the issue because it is integral to a response strategy.

[rsjsouza]

I just saw this today and it is the first time I see comorbidity numbers, reducing the number of deaths by ~40%.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm?fbclid=IwAR1xKt19EwyxwqGeRRMiaXCXdyyIBJ1FmLS6-m24EJapcW_JUrI8AtwwraQ

Given the text mentions the number of deaths may increase due to delays in reporting (it says one to eight weeks), how is the current 60k death toll really being counted?

This whole thing is terribly confusing and, with such data deviations, there is no right answer if one option is better than the other due to the criticality/lethality of this disease.

[nctnico]

Perhaps the regular/seasonal flu does spread as easily from person to person, but gets another "hop" far less often because a lot of people are immune to it.

The good thing about this whole affair is the awareness level of hygiene has reached hyper levels in practically all the population. This should help reduce the transmission of all sorts of stuff in the coming years.

No. What doesn't kill you makes you stronger; IOW: if you stay in a sterile environment your immune system doesn't get any training. Most vaccines work by training your immune system to a weaker variant of a virus so it is ready for when the real deal hits.

Many folks, including myself, are in favor of some degree of random testing (both for evidence of infection and immunity as well as a self reporting of symptoms) in countries to specifically address the issue because it is integral to a response strategy.

They are already doing that in several countries by testing donated blood for Covid-19 virus anti-bodies. This gives a statistically relevent sample (which can be split by ages groups). From the last numbers I've seen the percentage of people in the Netherlands and Belgium that have had the Covid-19 virus is about 4% on average.