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

Re: A (possible) solution to Covid-19

#301

Post by jseliger » Fri, Apr 10, 2020, 1:47 PM UTC

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…

Robin Hanson has been covering variolation: http://www.overcomingbias.com/2020/04/variolation-test-desig... and part of the issue is that the FDA is poorly equipped and set up to respond to a pandemic. One obvious solution is to cut through the bureaucracy and make emergency exceptions, but no one with political power in the US seems to know this, or understand it.

Re: A (possible) solution to Covid-19

#302

Post by nabla9 » Fri, Apr 10, 2020, 1:47 PM UTC

danieltillett wrote: post #279

nabla9 wrote: post #237

Earlier quoted context omitted.

> Nobody known the true infection fatality rate. It can be estimated with increasing accuracy. > There the infection fatality rate is 1.8% and rising as the cases age out and people in the ICUs die. You continue citing case fatality rate (CFR) numbers and call them infection fatality rate numbers (IFR). Can you please go back to your sources and read what they say. I bet they are case fatality rates. In South Korea o…

These lower estimates are all estimates. Really it is not important from the perspective of doing something about this pandemic as a huge number of people will die at all estimated levels.

Maybe you can now correct the "killing between 1% to 3.5% of the people it infects" part. It's horribly misleading.

IFR < CFR and IFR estimates go always down over time and never up due to the skewed nature of the data. Antibody tests are coming in already and based on them you get very accurate numbers.

Re: A (possible) solution to Covid-19

#303

Post by TeMPOraL » Fri, Apr 10, 2020, 1:48 PM UTC

czep wrote: post #286

Finding an attenuated strain that spreads as easily but is less deadly does sound like our best hope. Such a strain would "crowd out" the deadly strain, effectively blocking it from causing harm. If life was a Star Trek episode, Picard would be saying "Make it so" right about now.

"Captain's log, stardate 73740.9. The Enterprise has taken on board a distinguished Federation virologist, dr. Daniel Tillett, to help him with his search for a less harmful strain of the virus that's currently ravaging several planets in Federation space. The doctor is confident that such an attenuated strain could be used to swiftly end the ongoing pandemic."

I would watch that episode. Hell, I'd watch any new episode; unfortunately, the only proper Star Trek we've had since Enterprise stopped airing is The Orville.

Re: A (possible) solution to Covid-19

#304

Post by danieltillett » Fri, Apr 10, 2020, 1:48 PM UTC

ajross wrote: post #291

buboard wrote: post #278

Earlier quoted context omitted.

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 har…

I think what you are missing here is what is the novel part of my idea and what is the conventional. It is not novel to think of an attenuated vaccine, what is novel is to look for an attenuated strain in a pandemic using genome sequencing. I hope someone else has thought of this, but so far I haven’t seen any evidence of this.

Waiting for vaccine is not a good option. This is a situation with only hard choices.

Re: A (possible) solution to Covid-19

#305

Post by sharken » Fri, Apr 10, 2020, 1:49 PM UTC

It is commendable to search for solutions to the Corona virus.

But the author is doing himself a disservice by saying that tens of millions of people worldwide will die.

And why is it a bad thing to have to be vaccinated on a yearly basis, poor African countries have not been hit hard that is a fact.

The areas being hit the hardest can afford to be vaccinated yearly and is accustomed to it with the yearly flu shot.

Other than that, keep up the good work !

Re: A (possible) solution to Covid-19

#306

Post by jseliger » Fri, Apr 10, 2020, 1:50 PM UTC

carlob wrote: post #292

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 f…

Right now it is also impossible to protect immunodeficient subjects, but herd immunity could help. I don't think the author ever says, "We should do this and only this in lieu of a vaccine."

The argument is, "This can be done now, or soon, while a vaccine will take 12 - 18 months, if not longer."

Re: A (possible) solution to Covid-19

#307

Post by danieltillett » Fri, Apr 10, 2020, 1:50 PM UTC

jseliger wrote: post #301

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…

Robin Hanson has been covering variolation: http://www.overcomingbias.com/2020/04/variolation-test-desig... and part of the issue is that the FDA is poorly equipped and set up to respond to a pandemic. One obvious solution is to cut through the bureaucracy and make emergency exceptions, but no one with political power in the US seems to know this, or understand it.

Ultimately a decision to use or not use any attenuated strain found will be a political decision.

Re: A (possible) solution to Covid-19

#308

Post by banachtarski » Fri, Apr 10, 2020, 1:51 PM UTC

sharken wrote: post #305

It is commendable to search for solutions to the Corona virus. But the author is doing himself a disservice by saying that tens of millions of people worldwide will die. And why is it a bad thing to have to be vaccinated on a yearly basis, poor African countries have not been hit hard that is a fact. The areas being hit the hardest can afford to be vaccinated yearly and is accustomed to it with the yearly flu shot. O…

You’re ignoring the fact that this virus Is an order of magnitude more lethal than the flu, and I would guess that most individuals in poorer countries skip the vaccine altogether.

Re: A (possible) solution to Covid-19

#309

Post by m_mueller » Fri, Apr 10, 2020, 1:52 PM UTC

sharken wrote: post #305

It is commendable to search for solutions to the Corona virus. But the author is doing himself a disservice by saying that tens of millions of people worldwide will die. And why is it a bad thing to have to be vaccinated on a yearly basis, poor African countries have not been hit hard that is a fact. The areas being hit the hardest can afford to be vaccinated yearly and is accustomed to it with the yearly flu shot. O…

OP didn't say that, he said without depression-causing economical restrictions this is going to be a likely headcount. I.e. right now there is a difficult choice between killing the economy and killing millions of people.

Re: A (possible) solution to Covid-19

#310

Post by elmolino89 » Fri, Apr 10, 2020, 1:52 PM UTC

londons_explore wrote: post #77

danieltillett wrote: post #71

Earlier quoted context omitted.

Yes. What we really want is a strain that has infected a whole lot of people and all of them have had a mild case.

You probably won't find that... You might find a strain where 99.9% of people get a mild case. Who is going to be the person to recommend deliberately spreading that strain to the world population, knowing that 0.1% of the world, 7 million people, will end up in a hospital and die? Sure, overall, fewer people might die, but the reality is whichever world leader makes that call has effectively just signed a death warr…

Agreed. But for the heard immunity one does not have to go and vaccinate/expose to an attenuated strain of virus the whole population. Even getting a majority of say under 50yo immunized should have a big effect.

These are special times. In reality it does not matter if this 0.1% +70yo will die after vaccination since the mortality rates in this age group infected with the wild type are bigger by about two orders of magnitude. But out of concern to human rights it will make sense not only to exclude any immunocompromised people but also make it voluntary to the groups where mortality rates are at certain level.