A (possible) solution to Covid-19 • Hacker News Board

Re: A (possible) solution to Covid-19

#291

Post by ajross » Fri, Apr 10, 2020, 1:36 PM UTC

buboard wrote: post #278

ajross wrote: post #275

Earlier quoted context omitted.

Serious question: are we not? People are sequencing these things like crazy (c.f. the nextstrain.org data). Epidemiologists are working like mad to come up with data on severity in regions all over the globe. Virologists everywhere are dropping what they're doing otherwise to work on covid. It sorta strains reason to argue that none of these people thought of looking for an attenuated strain. Isn't the simpler truth…

they re probably not sequencing asymptomatic people's virus, it would require some specific expedition. it doesn't even sound hard or expensive reply to @ajross: how would they know someone is asymptomatic? afaik they are mostly testing people who have symptoms , and their contacts (who will have contracted the same , symptomatic strain) I think in germany they did antibody testing, or PCR of swabs of people who most…

> how would they know someone is asymptomatic? afaik they are mostly testing people who have symptoms

There was literally a paper published yesterday (or the day before) on a blanket screen done on a population in germany to get some data on the undercount of asymptomatic cases. It was front page news on all the mainstream news sites...

I gotta be honest. This whole discussion has an "amateur hour" vibe. I have a hard time believing that professional academics in a long-established and very competetive field really failed to remember how the measles vaccine worked.

It's not that I think this is a bad idea, just that (1) it's almost certainly someone else's idea already, (2) is therefore probably harder to do than presented and (3) is thus not the magic bullet people are looking for.

To wit: stay the fuck home. Maybe someone will save us. They probably won't. We beat this with isolation or we wait for a vaccine.

Re: A (possible) solution to Covid-19

#292

Post by carlob » Fri, Apr 10, 2020, 1:36 PM UTC

I see one potential drawback to this (as opposed to a vaccine), and that is the impossibility to protect immunodeficient subjects: if you have an effective vaccine you can be fairly certain that people with leukemia or full blown AIDS can be protected by herd immunity when surrounded by people who have been vaccinated. In this case it's not clear to me whether this would work. I have to say I'm no virologist, but I find the fact that this milder strain can still propagate on its own some kind of a double edged sword.

Maybe someone who knows more about this than I do could comment.

Re: A (possible) solution to Covid-19

#293

Post by shiftpgdn » Fri, Apr 10, 2020, 1:37 PM UTC

Geenkaas wrote: post #287

The Netherlands is testing with plasma from a recovered patient right now: Source: https://nos.nl/artikel/2330036-nederlandse-coronapatient-hee... NB: I am NOT a microbiologist and do not know how far this is related.

I am in an open source Christmas lights community that sources pixels from China. About a month and a half ago one of the Chinese vendors posted that the PRC is full steam ahead on Plasma therapy. He also stated his elderly father had gotten covid and was recovered within 24 hours.

It seems very promising.

Re: A (possible) solution to Covid-19

#294

Post by IdoRA » Fri, Apr 10, 2020, 1:39 PM UTC

danieltillett wrote: post #269

IdoRA wrote: post #259

A naturally attenuated strain would still be regulated. In the US, 21 USC §321(g): > (1) The term "drug" means… (B) articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals; CBER would be the responsible center for the FDA. Other countries have analogous regulations. Could you come to market with a naturally attenuated strain? Yes. Would it take less ti…

There are plenty of shortcuts in medicine. Think how you would stop this strain from being spread by individuals once it was identified. This strain will spread no matter what the FDA says. Personally I think the regulatory authorities would rapid approve it based on the epidemiology data collected in the process of finding the strain. The FDA has already shown that it can move faster than its usual glacial pace give…

I don’t see that any regulatory authority would approve something that is capable of spreading, regardless of the possible benefits: it would violate medical ethics. Reread the Belmont Report.

There are many teams all over the world that are looking for less deadly (and more deadly!) strains to guide development of therapies. They’re too busy right now to post on message boards or speak to reporters. It’s however extremely unlikely that a less deadly strain will become the therapy, although it could be the basis of a therapy (but I think this too is unlikely).

Re: A (possible) solution to Covid-19

#295

Post by new299 » Fri, Apr 10, 2020, 1:39 PM UTC

danieltillett wrote: post #263

new299 wrote: post #253

Earlier quoted context omitted.

Perhaps I’ve missed something in your argument then. I’d need to understand exactly how you are planning to promote the spread of the attenuated form. If you’re talking about a “sequencing driven” Pox party [1] then I suspect you will run into issues. Particularly if you were to say that the Pox party will infect you with an attenuated form of the virus and vaccinate. Both the diagnostic (sequencing or otherwise) and…

I am not planning on doing anything other than trying to look for the attenuated strain. How it is used is for others - what I am suggesting is once such a strain is found is it will be impossible to stop people spreading it around on their own.

But you do seem to be suggesting that "people spreading it around on their own" is a "solution to Covid-19"?

Otherwise, what is your plan for this attenuated strain? Don't get me wrong, I think large scale sequencing or COVID19 is interesting. But think that attempting to spread a attenuated strain without regulatory approval is probably a very bad idea.

Re: A (possible) solution to Covid-19

#296

Post by danieltillett » Fri, Apr 10, 2020, 1:39 PM UTC

buboard wrote: post #280

IdoRA wrote: post #259

A naturally attenuated strain would still be regulated. In the US, 21 USC §321(g): > (1) The term "drug" means… (B) articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals; CBER would be the responsible center for the FDA. Other countries have analogous regulations. Could you come to market with a naturally attenuated strain? Yes. Would it take less ti…

i doubt that , if this magical strain does exist, any regulation is going to stop people from just getting themselves infected

I doubt the regulators would even try to stop it. They can move fast when they want.

The process of finding any useful strain is going generate good data that it is safe anyway.

Re: A (possible) solution to Covid-19

#297

Post by nickthemagicman » Fri, Apr 10, 2020, 1:42 PM UTC

"We have a choice of taking some small risk now, or face the certainty of a much worse problem later. Time to accept some risk and do something."

Agreed 100%.

What about simply letting the people who young and healthy or immune go about their lives?

Letting the young and healthy get sick and then become immune is essentially using an attenuated human instead of an attenuated virus. Same outcome though.

This would both build herd immunity and keep the economy going.

Re: A (possible) solution to Covid-19

#298

Post by danieltillett » Fri, Apr 10, 2020, 1:42 PM UTC

IdoRA wrote: post #294

danieltillett wrote: post #269

Earlier quoted context omitted.

There are plenty of shortcuts in medicine. Think how you would stop this strain from being spread by individuals once it was identified. This strain will spread no matter what the FDA says. Personally I think the regulatory authorities would rapid approve it based on the epidemiology data collected in the process of finding the strain. The FDA has already shown that it can move faster than its usual glacial pace give…

I don’t see that any regulatory authority would approve something that is capable of spreading, regardless of the possible benefits: it would violate medical ethics. Reread the Belmont Report. There are many teams all over the world that are looking for less deadly (and more deadly!) strains to guide development of therapies. They’re too busy right now to post on message boards or speak to reporters. It’s however ext…

All the attenuated live viral vaccines spread. This is one of the reasons they are so effective since they keep herd immunity up. For example, every kid that gets the live polio vaccine spreads it around to their peers and parents.

Re: A (possible) solution to Covid-19

#299

Post by usrusr » Fri, Apr 10, 2020, 1:46 PM UTC

baybal2 wrote: post #162

danieltillett wrote: post #19

Earlier quoted context omitted.

I am a virologist - well I have published many papers in this area. I have a PhD in molecular microbiology and have been a tenured professor (I now work in the biotech sector). This is not intended to be a scientific paper, but a layman’s summary of the idea so non-technical people can understand the idea. It is not risky to go looking for a naturally attenuated virus. This is the first step that needs to happen.

Wouldn't an attenuated strain vaccine still require years of paperwork and clinical trials too?

It would only be logical to require a "vaccine-strain" that has the capability for uncontrolled spread to go through much more stringent trials and paperwork than one that is limited by distribution.

The whole argument about attenuated strains being a possible shortcut seems to be a variation of the "natural medicine" fallacy.

Re: A (possible) solution to Covid-19

#300

Post by Robotbeat » Fri, Apr 10, 2020, 1:46 PM UTC

danieltillett wrote: post #184

baybal2 wrote: post #162

Earlier quoted context omitted.

Wouldn't an attenuated strain vaccine still require years of paperwork and clinical trials too?

Yes. This is why I am suggesting an alternative. It is all in the blog post.

This is an attenuated live vaccine, though. So the risks are similar or worse than just doing a real, engineered vaccine.

If it's mere paperwork, we can solve that with a regular vaccine just as fast. And the regular vaccine would be more likely to be safe, even at an early stage. (Note: I'm a rando, not a medical or biological professional.)