Just curious, anyone have a plan, or preps for global pandemic?

[KHashmi316]

Here:

https://clinicaltrials.gov/ct2/show/NCT04377789

[Dean Pomerleau]

2 hours ago, Gordo said:

Was it though?  A quick search of pubmed seems to indicate otherwise:

https://pubmed.ncbi.nlm.nih.gov/?term=zinc+ionophore+covid

My impression was that it is probably helpful in early stages, but possibly useless in advanced stages when you really have to deal with the cytokine storm (at that point you aren't really fighting 'covid' per se).

Here is a newer published study:

20-Week Study of Clinical Outcomes of Over-the-Counter COVID-19 Prophylaxis and Treatment

https://pubmed.ncbi.nlm.nih.gov/34225463/

Design and participants.: We present results of a clinical study with a multi-component OTC "core formulation" regimen used in a multiply exposed adult population. Analysis of clinical outcome data from our sample of over 100 subjects - comprised of roughly equal sized regimen-compliant (test) and non-compliant (control) groups meeting equivalent inclusion criteria - demonstrates a strong statistical significance in favor of use of the core formulations.

Results.: While both groups were moderate in size, the difference between them in outcomes over the 20-week study period was large and stark: Just under 4% of the compliant test group presented flu-like symptoms, but none of the test group was COVID-positive; whereas 20% of the non-compliant control group presented flu-like symptoms, three-quarters of whom (15% overall of the control group) were COVID-positive.

Conclusions.: Offering a low cost, readily implemented anti-viral approach, the study regimen may serve, at the least, as a stopgap modality and, perhaps, as a useful tool in combatting the pandemic.

From the full text I see:

 

Interesting Gordo. But several things raise a red flag for me about this study.

The two groups (zinc+ionophores and "controls") weren't actually randomized. The so-called controls were simply patients at this small Ohio pain clinic which didn't comply with the recommendation to take the supplement combo. Here is how the authors describe it:

Since testing and the conventional medications were not readily available and access to personal protective equipment was limited, we suggested to participants to voluntarily use our over-the-counter formulations and methods for prevention and treatment. 54 participants (Group 1) implemented the over-the-counter regimen (mostly the core formulations and some or all the methods), while 60 (Group 2) chose to decline the regimen of formulations and methods out of concerns ranging from cost, education and socio-economic barriers or other reasons.

The authors point out the potential problem with this:

However, it is possible that some factor other than implementation of supplementation may be contributing to the outcomes. For instance, subjects interested and motivated to implement and maintain compliance with a multi-component supplement regimen, apparently being more health conscious than control group subjects, may indeed actually be healthier, with more robust immune systems more resistant to viral infection. Perhaps also or alternatively, health conscious subjects are more careful about minimizing their exposure to virus-carrying sources and/or about post-exposure disinfection.

In other words, the patients at this clinic who were diligent enough to comply with taking all these pills and drops for the full 20 weeks may also be more conscientious about taking care of their health and/or avoiding exposure to covid. Notice that in the full text the authors do not provide any comparison in the demographics or overall health of the test group vs. the control group.

Even those in the test group weren't all that compliant and the study sounds very informal:

Patients typically reported use of the recommended Vitamin C, Zinc and Vitamin E, as described above, over the observation time, with some use of Quercetin as above (based on the availability and cost) and of Quina.

In other words, they don't really know what their patients were taking, and only some unknown subset were taking quercetin. It sounds like they told there patients to go out and buy these supplements and take them, or perhaps more likely, buy them from the good doctor himself - see next point.

Second, the authors claim "no potential conflicts of interest with respect to the research, authorship, and/or publication of this article."  But then in the acknowledgement sections of they paper, it says "Formulations and Methods are US patent pending to Leon Margolin, with foreign filing license granted." First, it is pretty cheesy to file for a patent on the formulation of a bunch of commonly used supplements. Second, in what universe is filing for a patent on the supplement formula tested in the paper not a conflict of interest?

Finally, it appears this doctor has something in common with the guy who claims to have ran the bogus "low fat vs. low carb" study I reviewed previously - namely a penchance for fraudulent billing. From the US Justice Department complaint against him, which ironically was settled right around the time he was conducting this study:

Comprehensive Pain Management Institute and its owner, Leon Margolin, M.D., have agreed to pay the United States $650,000 to resolve False Claims Act allegations that they knowingly billed Medicare for nerve conduction studies and alcohol/substance abuse assessments and interventions (SBIRT) that were medically unnecessary or not provided as billed, the Justice Department announced today.  Margolin is a pain management physician in Columbus, Ohio.

I have no dog in this fight and would be happy to learn that zinc supplements helps prevent to covid, since I've been taking it for years. But I don't think this so-called study provides much if any reliable evidence.

--Dean

 

[KHashmi316]

Some of you founding fathers may recall Lester Packer and his “network antioxidant “ network…. 
http://www.thailand-guide.com/networkantioxidants/about.htm

Q+Z may be similar 

[Dean Pomerleau]

28 minutes ago, KHashmi316 said:

Here:

https://clinicaltrials.gov/ct2/show/NCT04377789

Thanks Khurram,

That clinical trial registration shows that a group in Turkey tested quercetin (alone) as a prophylactic for covid. There are plenty more as well either alone or in combination with zinc or other antioxidants. The question is results. The research effort you point to was completed over a year ago, and as far as I can tell has yet to report results, even in preprint form. If it actually worked you would think the authors would have made it known by now. After all, several million people have died from covid in the meantime.

Like I said to Gordo, it would be cool if quercetin either with or without zinc helped prevent covid. I even bought some last spring when we discussed it in this thread and when there wasn't anything else to prevent or treat covid. I ended up not taking it since the evidence was lacking. Even if they do have some effect, they will have miniscule benefit compared with the safe, effective and free vaccines currently available to you and I in the US...

--Dean

[KHashmi317]

2 hours ago, Dean Pomerleau said:

. The question is results. The research effort you point to was completed over a year ago, and as far as I can tell has yet to report results, even in preprint form. If it actually worked you would think the authors would have made it known by now. After all, several million people have died from covid in the meantime.

Many, many studies like that ... including treatments like Ivermectin, HCQ ... or even common-sense advice (my holy trinity: DIET-EXERCISE-SLEEP) being pushed by CDC or media .. as push notification ... headline news ... but all we get are crickets ... and/or studies DELIBERATELY kept "under investigation"  (like that Q study) ..  so the powers that be can continue rake in the pharma vax  $ ... and always fall back to vitamin D, Ivermectin ,etc... its CYA ... when the vax BS  major fails (Israel, etc) .. and becomes common knowledge... they'll say "we never covered up anything --  see this:" https://clinicaltrials.gov/ct2/show/NCT04377789 , etc, etc. CYA! Ivermectin, Vitamin D, etc all have had MINOR and RECORDED coverage by the MSM ... in the "back pages" ... so they can cover their rears. And cont. to have plenty of fresh squeezed content for their well-paid anchors.

About dying "WITH" covid??? And not FROM covid. The PCR cycle threshold being used (anything over 30 units) and the victims (> 70 years old, obese) . Who knows??

Now if this were a REAL emergency ... >10% of working-age population actually not able to report to work because they are REALLY sick ... there would be martial law, forced nutrition, banning booze, tobacco, etc.

[Mike41]

On 8/21/2021 at 3:47 PM, Gordo said:

All the recent talk (and controversy apparently) about "booster shots" had me wondering... since I got the J&J vax, which booster, if I decide I should get one, should/would I get?  This led me to some searches which turned up an interesting article published recently - I didn't hear anything about this until randomly stumbling upon it today:

https://news.yahoo.com/studies-show-j-j-vaccine-170757355.html

A recent study showed that the J&J vax is "highly effective against the delta variant", but maybe more importantly: “Current data for the eight months studied so far show that the single-shot Johnson & Johnson COVID-19 vaccine generates a strong neutralizing antibody response that does not wane,” said Mathai Mammen, the global head of Janssen Research & Development at Johnson & Johnson, in a press release. “Rather, we observe an improvement over time. In addition, we observe a persistent and particularly robust, durable cellular immune response.”  

There was possibly some hint of this from the clinical trials where they found that the J&J vaccine was 100% effective at preventing severe symptoms and hospitalizations starting four weeks after people got the shot (and it was not as effective UNTIL 4 weeks after).

Maybe all you mRNA people should be getting the J&J vax for your booster! 😉

And speaking of the mRNA vaccines... I finally ran in to an actual real person in my circle that suffered from a nasty complication from an mRNA vaccine - he is around 40 years old, and had myocarditis his docs said was caused by the vaccine.  This led me to do some more searching and I see the FDA actually updated their patient provider fact sheets to reflect this risk:

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-june-25-2021

Another possible reason to avoid the mRNA vaccines.

I don’t think it is at all “another reason to avoid the mRNA vaccines.” Not at all rationale!

The EMA analysis of cases found:

• Pfizer-BioNTech - 145 cases of myocarditis and 138 cases of pericarditis out of 177m doses given
• Moderna - 19 case of myocarditis and 19 cases of pericarditis out of 20 million doses given

Five people died. The review said they were all either elderly or had other health conditions. And the others basically got over it in a couple weeks and were mostly folks under 40. My hunch immune system overreactions. IAC DO THE MATH. THIS ISNT EVEN COMPARABLE TO GETTING STRUCK BY LIGHTNING. 
 

According to the National Weather Service, a person has a 1-in-15,300 chance of getting struck by lightning in their lifetime, defined as an 80-year span. 
 

again do the Math. Come on Gordo get serious! This is SO SILLY!

Edited August 22, 2021 by Mike41

[Dean Pomerleau]

Khurram,

More conspiracy theorizing without evidence. 

5 minutes ago, KHashmi317 said:

...studies DELIBERATELY kept "under investigation"  (like that Q study) .. 

So are the Turks in on the conspiracy too, since that was a clinical trial conducted at a Turkish hospital which happens to be registered at the FDA's clinical trial website? And are the Turkish authors in on it too? Or did the "powers that be" get to them, threatening to kill them if they tried to post a pre-print about their miracle covid prevention protocol? Or are the pre-print servers part of the conspiracy, filtering out papers that don't fit the official narrative?

You are sounding more and more like Alex Jones.

--Dean

[Gordo]

2 hours ago, Mike41 said:

• Pfizer-BioNTech - 145 cases of myocarditis and 138 cases of pericarditis out of 177m doses given
• Moderna - 19 case of myocarditis and 19 cases of pericarditis out of 20 million doses given

Touche Mike.  I figured if I ran into a person that suffered from this AND the FDA added it to their fact sheet as a risk, that it was more common than the stats you cite above but I must confess I never even tried to find the number of reports.  But regardless, the J&J strength against delta and lack of waning efficacy might be a reason to prefer it.

2 hours ago, KHashmi317 said:

when the vax BS  major fails (Israel, etc)

This comment made me look up Israel's latest stats:

I don't know if this is a vax fail or not, but things don't seem all that dire based on number of deaths.  And didn't we already previously establish that even in the Israel data it was the unvaxed at greatest risk?

[Saul]

Hi Gordo!

Yeah.  Israel has a problem with several untra-orthodox sets, where the "Rebi" speaks against vaxines.  I don't know which country has the highest percentage of anti-vaxxers -- Israel, France, US, UK?

antivaxxers have the "right to die" -- but the hurt the general populations by presenting their bodies to the virus, as a breeding ground.  That's bad for the rest of us.

  --  Saul

 

[Saul]

Happily, University of Rochester has required all faculty and students to be fully vaccinated.  Exception: those with anti-vax religious, or other verifiable personal objections.  Those few who choose this path are required to be PCR tested weekly, or more often.

And all faculty and students are required to teach in-person, no social distancing.

Happily, this Wednesday, I'll resume my in-person teaching.

  --  Saul

[KHashmi317]

2 hours ago, Gordo said:

 

This comment made me look up Israel's latest stats:

I don't know if this is a vax fail or not, but things don't seem all that dire based on number of deaths.  And didn't we already previously establish that even in the Israel data it was the unvaxed at greatest risk?

You're looking at DEATHS based on what ? ... dying WITH covid cooties vs FROM covid cooties ? ... or dying FROM some comorbidity or very old age  with a covid PCR > 30? So many ENTERTAINING ways to interpret this ;)

But if "official" CASE count -- hopefully  based on antibody tests ???????? --  is to be accepted, then as of 20 Aug., Israel breakthu's are at least 50%:

https://www.precisionvaccinations.com/2021/08/11/israels-covid-19-vaccine-breakthrough-cases-exceed-50

Maybe 60%:

https://www.beckershospitalreview.com/public-health/nearly-60-of-hospitalized-covid-19-patients-in-israel-fully-vaccinated-study-finds.html

Edited August 23, 2021 by KHashmi317

[Sibiriak]

5 hours ago, Gordo said:

... the J&J strength against delta and lack of waning efficacy might be a reason to prefer it. 

That may be true,  assuming  the J&J press report assertions can be taken  as definitive.  My only option was Sputnik V, which is similar to the J&J  vaccine [ it uses the same adenovirus as J&J for the first dose (adenovirus-26) and a different adenovirus (adenovirus-5) for the second dose. ]

A recent official statement:

Quote

MOSCOW, August 22. /TASS/. The researchers of the Gamaleya center have developed new structures for the Sputnik V vaccine based on emerging new strains of the coronavirus, but so far there is no need to update it, Alexander Gintsburg, head of the Gamaleya center, told TASS.

"We have created structures based on mutant strains. If the regulator decides that it is time to do this (to change the vaccine - TASS), we are ready for this. But now Sputnik V is protecting against all those strains that have emerged recently," he said.

 

[Dean Pomerleau]

23 hours ago, mccoy said:

So, I would like to hear some real facts about the booster shot. 

From this Reuters article:

Breaking down statistics from Israel's Gertner Institute and KI Institute, ministry officials said that among people aged 60 and over, the protection against infection provided from 10 days after a third dose was four times higher than after two doses.

A third jab for over 60-year-olds offered five to six times greater protection after 10 days with regard to serious illness and hospitalisation.

And from last week:

Israeli HMO Maccabi, which covers around a quarter of the country's 9.3 million population, compared results from 149,144 people aged over 60 who received their third dose at least a week ago against those from 675,630 more who had received only two doses, between January and February.

Some 37 people tested positive for coronavirus after their third jab, compared with 1,064 positive cases among those who had received only two doses, Maccabi said in a statement. The comparison groups had similar demographic profiles, it added.

37 cases / 149k = ~28 cases per 100k people vs. 1064 cases / 675k = ~157 cases per 100k people. A quite dramatic drop. 

--Dean 

[Todd Allen]

An open letter with rapidly growing support of UK doctors:

OUR GRAVE CONCERNS ABOUT THE HANDLING OF THE COVID PANDEMIC BY GOVERNMENTS OF THE NATIONS OF THE UK

I'm glad to see this as I believe the concerns raised are highly relevant here in the US.

[mccoy]

Dean, thanks for the lowdown,  the >60 individuals would be significantly more protected according to the Israeli data. I'm waiting for data from other parts of the world and possibly other age classes, although I'm in the >60 now. 

Personally, at this point, I would rely on my 2 shots plus allegedly efficient immune system, unless I'm compelled to take the 3rd one for practical reasons (government rules).

[Todd Allen]

https://www.sciencemag.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta

Quote

Aran’s message for the United States and other wealthier nations considering boosters is stark: “Do not think that the boosters are the solution.”

 

[Dean Pomerleau]

23 minutes ago, Todd Allen said:

https://www.sciencemag.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta

 

Todd,

You left out important context for that quote, which makes it clear the problem isn't that boosters won't help. It's largely that there are too many unvaccinated or partially vaccinated people for boosters to make that much of a different (i.e. prevent hospitals from getting overwhelmed). Here is the full context:

Yet boosters are unlikely to tame a Delta surge on their own, says Dvir Aran, a biomedical data scientist at Technion. In Israel, the current surge is so steep that “even if you get two-thirds of those 60-plus [boosted], it’s just gonna give us another week, maybe 2 weeks until our hospitals are flooded.” He says it’s also critical to vaccinate those who still haven’t received their first or second doses, and to return to the masking and social distancing Israel thought it had left behind—but has begun to reinstate.

Aran’s message for the United States and other wealthier nations considering boosters is stark: “Do not think that the boosters are the solution.”

Perhaps the best analysis I've seen of the data from Israel is this article.

Despite what on the surface appears to be waning efficacy against Delta at preventing severe disease among the vaccinated in Israel ("look at the large fraction of hospitalized patients who are vaccinated!"), this careful analysis shows the vaccine remains highly effective in this regard, once you are careful and stratify by age.

This is due to several factors clearly explained in the article. By far the most important one is the fact that older people are both much more highly vaccinated and also much more prone to serious negative outcomes from covid. This makes it look like the vaccines aren't working when you simply pool all vaccinated people and compare them to all unvaccinated people. Here is the upshot, showing that when you strategy by age, the vaccine (two doses) remains highly (81-100%) effective at preventing severe disease across all age groups in Israel:

The fact that two doses (of Pfizer) remains so effective against severe diseases seems like the real reason to focus on boosters for only the most vulnerable and instead redouble efforts to convince the unvaccinated that to get the jab is in their own best interest.

--Dean

[Todd Allen]

1 hour ago, Dean Pomerleau said:

Todd,

You left out important context for that quote, which makes it clear the problem isn't that boosters won't help.

Yes, I had fun with that quote.  I was curious to see who might read the full article.

But now that you have read it here are some other interesting tidbits:

Quote

To try to tame the surge, Israel has turned to booster shots, starting on 30 July with people 60 and older and, last Friday, expanding to people 50 and older. As of Monday, nearly 1 million Israelis had received a third dose, according to the Ministry of Health.

The population of Israel is around 9 million suggesting that most of the vaccinated elderly are now triple vaccinated.  And yet:

Quote

What is clear is that “breakthrough” cases are not the rare events the term implies. As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older. “There are so many breakthrough infections that they dominate and most of the hospitalized patients are actually vaccinated,”

I would like to have seen statistics for the percent of hospitalizations triple vaccinated.  This data is 10 days old and things are changing fast so if the booster program is truly effective we should see a dramatic improvement soon in their hospitalizations.  But

Quote

The Israeli government’s decision to start boosting those 50 and older was driven by preliminary Ministry of Health data indicating people over age 60 who have received a third dose were half as likely as their twice-vaccinated peers to be hospitalized in recent days, Mevorach says.

If the 3rd dose is only reducing hospitalizations by half it would suggest there are still a significant number of breakthrough infections in the triple vaccinated.  Expanding the pool of triple vaccinated with increased selective pressure ought to speed the rate we produce vaccine resistant variants.   I'm hopeful that the increased infectiousness of current strains in circulation means we are rapidly approaching herd immunity but it will be interesting to see if we can defeat that process with even more vaccinations.

[Dean Pomerleau]

10 hours ago, Todd Allen said:

I would like to have seen statistics for the percent of hospitalizations triple vaccinated. 

Umm... Did you miss this part of what I quoted from Monday's report from Israel? 

The third jab for over 60-year-olds offered five to six times greater protection after 10 days with regard to serious illness and hospitalisation. 

 

10 hours ago, Todd Allen said:

If the 3rd dose is only reducing hospitalizations by half it would suggest there are still a significant number of breakthrough infections in the triple vaccinated. 

I think it is pretty well established now that the delta variant reproduces so rapidly in the nose and throat that even a vaccine-bolstered immune system can't stop all covid infections from initiating, so breakthrough infections are inevitable.

But see my most recent post for the compelling evidence that even the standard two doses of the Pfizer vaccine is 80-100% effective at preventing hospitalizations and how simply looking at the percentage of hospitalized patients who are vaccinated can be very misleading.

Whether a new, more virulent variant of the virus will arise due to selection pressure remains to be seen. 

One thing I'm curious about Todd. Given how transmissible Delta is, without a vaccine it seems almost inevitable that nearly everyone would eventually be exposed to the virus and thereby achieve some degree of immunity via infection (or die), leaving few people susceptible to the circulating variant. Wouldn't the selection pressure on the virus to mutate to reinfect people be just as great in that scenario as in a scenario where a large fraction of the population is unsusceptble as a result of vaccination? The vaccine route has the advantage that along the way many fewer people would get seriously sick, hospitalized and die due to the protection the vaccine affords.

Is it that you think the protection afforded by infection would be more comprehensive therefore harder for the virus to evade?

If so, it seems this (legitimate) possibility can be addressed by the fact that the mRNA vaccines can be quickly retargeted and expanded to target multiple binding sites if they become ineffective against a new variant.

It seems like another battle front in the never ending war between humans and the bugs that want to kill us or at least use us as hosts.

--Dean 

[Gordo]

On 8/22/2021 at 5:16 PM, Dean Pomerleau said:

So are the Turks in on the conspiracy too, since that was a clinical trial conducted at a Turkish hospital which happens to be registered at the FDA's clinical trial website? And are the Turkish authors in on it too? Or did the "powers that be" get to them, threatening to kill them if they tried to post a pre-print about their miracle covid prevention protocol? Or are the pre-print servers part of the conspiracy, filtering out papers that don't fit the official narrative?

You are sounding more and more like Alex Jones.

On the cover of marketwatch.com right now:

Haha!

 

[Todd Allen]

18 hours ago, Dean Pomerleau said:

Is it that you think the protection afforded by infection would be more comprehensive therefore harder for the virus to evade?

If so, it seems this (legitimate) possibility can be addressed by the fact that the mRNA vaccines can be quickly retargeted and expanded to target multiple binding sites if they become ineffective against a new variant.

Yes natural immunity does produce selective pressure for a virus to become more transmissible but the immunity is broad and single mutations tend to produce modest changes towards more successful reproduction and transmission in the context of natural immunity.  When a virus is raging through a population the current strains are reproducing so effectively a modestly more transmissible strain will not quickly rise to dominance.  In this situation a mutation which in addition to being more infectious also produces more severe symptoms is even less likely to significantly spread as more seriously sick and dead hosts tend to be less active in spreading infection.

Not all natural immunity is equivalent.  Asymptomatic infections are disproportionately handled by innate immune processes with less activation of adaptive immune responses and thus there is minimal lasting immunity and reinfection is more likely.  Worse asymptomatic infections produce stronger selective pressure for immune escape as less virus is shed and only more potent strains are likely to produce new infections.  Our current covid-19 vaccines produce large numbers of asymptomatic infections with a narrowed immune response increasing selection for strains escaping the vaccines.

Here's a paper published in April consistent in prediction with what has transpired this summer describing processes by which our current vaccination campaign can produce vaccine escape perhaps faster than we can develop new vaccines and it also touches on ADE which could result in increased susceptibility, especially for the vaccinated:
Risk of rapid evolutionary escape from biomedical interventions targeting SARS-CoV-2 spike protein

Quote

Our modeling suggests that SARS-CoV-2 mutants with one or two mildly deleterious mutations are expected to exist in high numbers due to neutral genetic variation, and consequently resistance to vaccines or other prophylactics that rely on one or two antibodies for protection can develop quickly -and repeatedly- under positive selection.
... 
Currently, most of the SARS-CoV-2 genome is not under positive selection [19], but if nAbs are widely present in the population, mutations that confer resistance via immune evasion will expand rapidly under positive selection pressure. Evidence from multiple experimental studies showing that single RBD point mutations can lead to resistance [36] to neutralizing convalescent plasma from multiple donors [16,39,40] suggests that specific single mutants may be able to evade spike-targeting vaccinal immunity in many individuals and rapidly lead to spread of vaccine-resistant SARS-CoV-2. One variant that can escape convalescent plasma neutralization is already circulating in South Africa [41] and could experience greater positive selection pressure once vaccines are deployed widely.
 
This has implications for SARS-CoV-2 disease control strategies, as one possible solution to the problem of immune evasion by SARS-CoV-2 that has been proposed is to develop a new vaccine update every year, similar to influenza [42]. In practice, such a solution will only work in the face of a moderate pace of evolution of SARS-CoV-2 and a low degree of clonal diversity among various clades of SARS-CoV-2 as they evolve to evade the current crop of vaccines. Further, if within-host evolution of SARS-CoV-2 contributes to population-level immune evasion, the valley-crossing mechanism described in this paper could accelerate the emergence of vaccine-resistant strains in the months following vaccine deployment. To the extent that new strains of SARS-CoV-2 are antigenically distinct, this may also lead to increased risk of antibody-dependent enhancement (ADE), as one mechanism for ADE involves antibodies that bind to the pathogen but fail to neutralize it [43]. Finally, our work suggests that immune evasion requiring one to two mutations occurs within months, raising the prospect that this phenomenon will further shorten the duration of natural immunity, which is already limited by the relatively short duration of the humoral [44,45] and cellular [46] responses to SARS-CoV-2 infection.

I strongly believe our current crop of vaccines were excellent for emergency use in the most highly vulnerable subset of our population where the majority of severe illness and death occurred but by their very design were inappropriate for mass vaccination as they likely have a negative effect on reaching herd immunity and accelerate the rise of more virulent strains.  There are vaccines in development with more promising potential for mass vaccination if they achieve a better mix of blocking infection and transmission and producing broader immune responses less susceptible to evasion by targeting more diverse antigens.  For respiratory virus such as covid-19 inhaled vaccinations could stimulate primary mucosal immunity more effectively reducing infection and transmission versus the secondary humoral immunity produced by injected vaccines.

Here are detailed answers to a large number of common questions about our current vaccination campaign including some of yours.  I don't have the expertise to judge it in detail but it is largely consistent with what I believe and have read elsewhere.

https://www.geertvandenbossche.org/faq

Edited August 25, 2021 by Todd Allen

[Todd Allen]

11 hours ago, Gordo said:

On the cover of marketwatch.com right now:

I wouldn't take horse paste as we have chickens and have long used Ivomec a dilute ivermectin solution that is administered to chickens in their drinking water.  Both cheaper and easier to dose.  Although I considered it last year as I became more convinced of its value I was already losing concern for my risk from this virus.

Here's another take on this from the blog of Dr. John Day

From http://www.johndayblog.com/2021/08/consulted-more-fortunate-countries-of.html

People have not been able to get doctors to prescribe ivermectin for COVID treatment and prevention, so they have bought veterinary ivermectin to use, mostly the horse-paste, but there are also some horse pills. A horse weighs about 10 times as much as a human, so people who take a horse pill, at 10X the human dose are getting nausea, vomiting, diarrhea and dizziness, but that's all. No deaths, and the one "hospitalization" in Mississippi, does not appear to be confirmed. Take the right dose. If you can't do math, get help from a farm-boy who can. These horse products are used on goats, rabbits, farmers and farmers children, at the correct scaling doses. Ask a farmer with critters. FDA resorts to shouting and public shaming, because it's hard to fear safer-than-Tylenol ivermectin.

The FDA Is Begging You Not to Take Horse Dewormer for Covid-19
“You are not a horse. You are not a cow,” the Food and Drug Administration said about using the drug that hosts on Fox News have been pushing

https://www.rollingstone.com/politics/politics-news/fda-horse-dewormer-covid-fox-news-1215168/

 

American Journal of Therapeutics: 

Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.

https://journals.lww.com/americantherapeutics/fulltext/2021/08000/ivermectin_for_prevention_and_treatment_of.7.aspx

[corybroo]

Marginal Revolution has a comparison of testing availability for the US and other countries.

Why Doesn’t the United States Have Test Abundance?!

“Tests are easily available at the supermarket or the corner store and they are cheap, five tests for 3.75 euro or less than a dollar each. … In Great Britain you can get a 14 pack for free. The Canadians are also distributing packs of tests to small businesses for free to test their employees.

In the United States, the FDA has approved less than a handful of true at-home tests and, partially as a result, they are expensive at $10 to $20 per test, i.e. more than ten times as expensive as in Germany.”

I agree with the author’s sentiment that the US should increase the availability of affordable, at home Covid-19 tests like Germany, United Kingdom, and Canada.  This could be done without subsidies simply by increasing competition.

[Dean Pomerleau]

Todd,

Thanks for expanding on your perspective.

13 hours ago, Todd Allen said:

I strongly believe our current crop of vaccines were excellent for emergency use in the most highly vulnerable subset of our population where the majority of severe illness and death occurred but by their very design were inappropriate for mass vaccination as they likely have a negative effect on reaching herd immunity and accelerate the rise of more virulent strains.  There are vaccines in development with more promising potential for mass vaccination if they achieve a better mix of blocking infection and transmission and producing broader immune responses less susceptible to evasion by targeting more diverse antigens.  For respiratory virus such as covid-19 inhaled vaccinations could stimulate primary mucosal immunity more effectively reducing infection and transmission versus the secondary humoral immunity produced by injected vaccines.

I agree with you that a vaccine that is able to definitively block infections by the current variants would be strongly preferable and hopefully new vaccines under development will be able to do so. Given that such improved vaccines aren't available currently, I'm much less convinced that it was a bad idea to use the vaccines we've got in a mass vaccination campaign. I would agree that the current batch of vaccines have the potential to increase selection pressure towards finding variants that can evade the less-than-complete protection from transmission that such vaccines afford.  But at the same time they do appear to reduce the pool of infected people in whom such mutations might arise, and certainly reduce the rate of severe outcomes in those that do get infected.

Regarding my question about whether in the absence of vaccines (or their limited use) we would eventually and inevitably get to a situation of high selection pressure for variants to evade the immune response in order to reinfect people who've already had covid, it appears to me that the expert you point to Dr. Geert Vandenbossche (who indeed does appear to know his stuff - thanks for the pointer) agrees. I found his Q&A #17 to be perhaps the clearest explanation of his perspective:

Q: Do you think that if the pandemic had been treated differently, it would have been extinguished by itself? Is that what happened in other pandemics in the past (such as the Spanish flu or the polio pandemic)? And if so, is it expected that many people would die before the pandemic fades away? (What is exactly the difference between natural pandemic and artificial pandemic as you call the current situation?)

A: Please see my lecture on this topic. Due to its potential to spread through asymptomatic carriers and the high prevalence of asymptomatically infected subjects, the ‘natural’ evolution of Sars-CoV-2 towards more infectious variants is in my opinion inevitable. Unless overcrowding and poor personal and environmental hygienic conditions prevail (as is, for example, the case in India), infection prevention measures are more likely to lead to selection and adaptation of more infectious variants. Under all circumstances mass vaccination campaigns will further expedite the infectiousness of circulating variants and ultimately result in resistance to vaccinal Abs or to Abs induced as a result of previous natural infection. In contrast to a natural pandemic, an artificial pandemic is featured by unprecedented massive human intervention such as large scale infection prevention measures and mass vaccination campaigns. Unlike the natural Flu pandemic of 1918 or the SARS-CoV-1 pandemic of 2002-2004 (which was in fact more of an epidemic than a pandemic), a natural Sars-CoV-2 pandemic would in my opinion take a much higher toll on human lives before it gets extinguished. Because of the self-perpetuating cycle of enhanced infectiousness, such a pandemic may only come to an end when the vast majority of the remaining population has a level of innate immunity that even highly infectious variants can no longer break through. However, the evolution of a natural Sars-CoV-2 pandemic would definitely leave more time for vaccines inducing sterilizing immunity to be developed (as the number of more infectious variants and the level of their infectiousness viral infectiousness would increase less rapidly).
As far as polio and smallpox are concerned, one should not forget that the success of these vaccination campaigns was to a large extent due to the deployment of LIVE attenuated vaccines. None of the current vaccines used in the fight against this Covid-19 pandemic are live vaccines.
 

So he seems to be saying that because covid is so mutable and transmissible, more transmissible variants are inevitable with or without a mass vaccination campaign. The only endgame for this pandemic is when everyone left alive has a comprehensive enough immune response that even the more infectious variants can't infect people. That can be achieved in either of two ways:

The "natural" way by which variants keep getting more transmissible in order to reinfect people with only partial immunity due to the limited immune response induced by previous mild or asymptomatic infections. When such reinfected people get sick enough, they will either die or their immune system will kick into high gear, beat the infection and importantly, get riled up enough by the experience to built a comprehensive immunity against future infections.

The "unnatural" way by which variants keep getting more transmissible in order to (re)infect people with only partial immunity due to the vaccine or due to mild/asymptomatic prior infections. The presence of the vaccinated group will expedite the evolution of more transmissible variants since the selection pressure will be greater to find a way to infect the larger population of partially protected individuals. Again it is only when these (re)infected people get sick enough to either die or develop a comprehensive immune response that prevents future infections by ever more infectious variants that the virus will be stopped.

Vandenbossche seems to suggest that the "natural" route (without vaccines or with limited use of vaccines) would slow the evolution but in the end would likely result in more deaths ("...take a much higher toll on human lives before it gets extinguished"). But he says on the plus side it would give scientists more time to develop what he believes to be the real solution (i.e. a third way to comprehensive immunity), namely a sterilizing vaccine that doesn't allow breakthrough infections and hence deprives the virus of hosts in which to mutate to find more transmissible variants.

His explanation certainly seems plausible to me and it certainly seems apparent given what we're seeing  that the current batch of vaccines are less than perfect since they allow asymptomatic infection and transmission. Hopefully either the virus won't be clever enough to keep getting more transmissible and/or will mutate to get less deadly. Alternatively, we gotta hope that the next generation of covid vaccines will be effective at preventing transmissions as well as hospitalizations/deaths from future variants.

--Dean

[Dean Pomerleau]

I found this preprint [1] interesting (pop press article). It looked at antibody levels between Aug 2020 and July 2021 in several hundred people after covid infection and/or after receiving one of several of the most common vaccines. Here is the main figure:

It appears that the mRNA vaccines trigger significantly more antibodies than the J&J vaccine in covid-naive people. The mRNA vaccines also triggered more antibodies than a confirmed covid infection. 

--Dean 

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[1] Comparison of Antibody Levels in Response to SARS-CoV-2 Infection and Vaccination Type in a Midwestern Cohort

Laura Remy, Chieri Tomomori-Sato, Juliana Conkright-Fincham, Leanne M. Wiedemann, Joan W. Conaway,  View ORCID ProfileJay R. Unruh

doi: https://doi.org/10.1101/2021.08.16.21262036

This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

Abstract

We present preliminary data in an ongoing observational study reporting SARS-CoV-2 spike protein reactive antibody levels from a convenience cohort of over 200 individuals in Kansas City. We observe stable antibody levels over 11 months in individuals who recovered from COVID19 infection caused by SARS-CoV-2. Our data revealed higher-than recovered levels from naïve individuals vaccinated with Pfizer or Moderna vaccines and similar-to recovered levels from Johnson & Johnson (J&J) recipients. For all vaccines, inoculation after recovery resulted in higher antibody levels than vaccination alone. Responses to Pfizer and Moderna vaccines decreased over time from high initial levels but at the time of publication remain higher than those for recovered or J&J recipients. Within our limited cohort we did not see strong demographic trends other than higher antibody levels in recovered female indivi duals.