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Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

blogs.sciencemag.org

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Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#201

Post by entee »

RcouF1uZ4gsC wrote: post #29

I know Derek Lowe is an expert. However, sometimes, experts think that because things have always been a certain way throughout their career, they will always be like that. Drug development has been very conservative especially in the US for the past several decades. The FDA is all about making sure they never have a thalidomide incident and would rather lose a lot of good drugs than approve a bad drug. This is the s…

The article makes it very clear that he is speaking of the immediate forecast (next 3-6 months) not the longer term (6 months to 1 year or more). The virus is already all over the globe, so technically it's already edging near a pandemic. The question to ask (and the article asks it) is do we have something that will materially alter spread in hand today or at most within the month. If the answer is "No" then the virus is likely to spread. "No" is a correct reading of the facts as they stand today.

This isn't about FDA conservatism or anything like that, it's "what do we have in hand?" No matter how promising current experimental treatments might be (perhaps Remdesivir will work well), they WILL NOT stop the spread in the short term. They WILL MAYBE help with treating acute cases and lower fatality rate. Still, good confirmation is a few months out, so for March/April we're still looking at very little.

The only therapeutic that could stop the spread is a vaccine. That's even further out, they're just starting some tests, but it's not going to be ready for wide deployment for another year. You don't want to inject things into healthy people on a massive scale without doing a few controls.

All of these approaches suffer from production questions too: it takes a while to ramp, but yes that could be helped by a massive effort.

In short, wash your hands. A lot. Don't touch your face. If you're sick, quarantine. In 6 months we'll hopefully be better equipped therapeutically, but don't expect that to solve the immediate problem.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#202

Post by francisofascii »

hprotagonist wrote: post #5
Bender wrote: post #2

It is interesting to me that people are so laser focused on test kits and vaccines. In my less than humble opinion, people should focus on improving their immune system. You can reduce the load on your immune system by not eating sugar and reducing carbs as much as you can. We also know from history and science that every plague that killed people from respiratory virus infections was due to a lack of vitamin D3 and…

Cite every sentence above, please, or cut out the idle speculation; it's foolish at best. NPIs -- handwashing, avoiding close contact with people sneezing like mad, not touching your face -- are the only things that actually work right now that everyone can and should be doing.

It has been widely reported that CORVID-19 affects the lungs, and that smoking may play a role in the severity of symptoms. Also there have been plenty of studies linking high sugar diets with reduced immune response.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#203

Post by carapace »

mellavora wrote: post #181

Looking at this thread as an interesting datapoint. Typically HN is thoughtful, well reasoned, and well informed. This thread is not holding that same level. Wonder what this says about the level of concern over this bug.

It says approximately nothing unless you're somehow tracking individual users' behavior over time.

- - - -

Don't panic.

Stay home and encourage others to stay home. We can't stop the virus (yet) but we can slow it down and buy time.

"The only way to fight a pandemic is decency." (I'll link to the source if I can find it, I think it was an article in the Atlantic that went by here on HN this week.)

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#204

Post by cygx »

mhb wrote: post #188
metalliqaz wrote: post #170

Earlier quoted context omitted.

It's about psychology, not numbers. the parent post referenced Thalidomide. a disaster like would seriously shake public confidence in medicine, across the board

The public seems able to understand that there is a cost/benefit tradeoff in driving cars. They could probably understand that idea in the case of drug approval also.

The anti-vaxx movement would like a word...

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#205

Post by ars »

carapace wrote: post #197
lm28469 wrote: post #182

Earlier quoted context omitted.

Like serious side effects? If you want to vaccinate virtually the whole world and your vaccines turns out to have serious side effects in 1% of people because you rushed its development and didn't go through the regular extended long term tests it wouldn't be that good

> Like serious side effects? Like what ? What can a vaccine do that's worse than a pandemic? Anti-vaxxers aren't rational people rationally concerned about real side-effects of vaccines, they are superstitious fools who think vaccines give kids autism. (There is NO scientific evidence for this idea whatsoever.) Remember the Mayan Apocalypse? Remember how everybody stopped talking about it about fifteen minutes after…

The original rotavirus vaccine caused intussusception. Vaccines are not magical risk free things, even if they don't cause autisim.

There's a reason we say "risk vs benefit". Current vaccines clearly fall under the reward part of that. A new vaccine? Who knows. That's why you have to test.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#206

Post by elihu »

To be fair, it's possible that we discover that an existing, already-approved drug or treatment is more effective at reducing the death rate of people experiencing the worst symptoms than what we're doing now.

A vaccine is probably very far away, though.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#207

Post by ars »

partingshots wrote: post #138
Dirlewanger wrote: post #127

Earlier quoted context omitted.

Summer hit the Northern Hemisphere.

So how likely is it that when summer comes the same will happen with the current coronavirus epidemic?

It's summer in Brazil, and other southern countries, so we can just watch them and see.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#208

Post by asdfman123 »

bluGill wrote: post #134
dekhn wrote: post #114

Earlier quoted context omitted.

The obvious risk here is that you're combining a rush job with limited oversight, and large-scale distribution. So any mistake that would have been caught by the existing process will instead have the potential to roll into a global disaster.

Compared to 2% chance of death from the virus? I'll take a 2% chance of blindness over 2% chance of death for example. Of course we don't know what the odds are for the negative side effects.

Just to be clear, a 2% mortality rate does not apply to everyone. It hits the sick and old way harder. As a healthy person in my early 30s, my best guess for my own mortality rate is 0.4%. However, that does mean it is extremely dangerous for the elderly or otherwise compromised.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#209

Post by asdfman123 »

dgacmu wrote: post #174
anu7df wrote: post #154

Yes. It is worse than a regular flu. But, if you look at statistics from S. Korea, the only country with a substantial infection and trust worthy numbers (as in they test heavily), the death rate is around 0.6% overall. So not the end of the world, but nothing to be complacent about either. If the White house will get out of the way and let the system work, we may still have time to mitigate the worst here in the USA…

You're making a somewhat dangerous mistake in your analysis. South Korea's death rate is not well established yet: 7% of their cases were new just in the last day, and they've had very few people with confirmed recovery yet. There are likely to be more deaths to come.

To correctly analyze the morality rates you have to take a lot of things into account: hardly anyone is being honest (South Korea is better, but not perfect), testing is rate limited, death rates are a lagging indicator, etc. etc. etc.

Lots of experts have made guesses with these assumptions factored in, but at this point, there is so much uncertainty it's hard for anyone to tell.

Re: Get Real: no drug or vaccine will avoid a very big coronavirus epidemic

#210

Post by asdfman123 »

hackeer wrote: post #178
jennyyang wrote: post #130

Earlier quoted context omitted.

A single individual getting coronavirus isn't a big deal. Chances are they will be fine. The problem is that it's very infectious, R0 could be 6+ where the flu is about 1-2. That means it's 3-6 times more contagious than the flu, so it spreads very very quickly. At the same time, it causes severe symptoms in 15-20% of cases. When these people have access to medical care, they will likely survive. But if they don't ge…

where are you getting the info to say only 15-20% percent of the cases show symptoms?

I believe reading that 14% of cases are severe, so it sounds roughly accurate. I think a lot more show symptoms, though, even if they're mild.
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