Children develop robust and sustained cross-reactive immunity after Covid • Hacker News Board

Re: Children develop robust and sustained cross-reactive immunity after Covid

#211

Post by jacquesm » Fri, Dec 24, 2021, 11:26 PM UTC

lamontcg wrote: post #200

johnchristopher wrote: post #152

Earlier quoted context omitted.

> Good vaccines + mild severity illness are basically the best case. If it was a common cold or a flu ? Maybe. > “Although COVID-19 has been described as a respiratory syndrome, evidence supports the involvement of multiple organ systems, with fibrosis, and inflammation in the lung, heart, kidneys, central nervous system (CNS), liver, adrenal glands, bone marrow, lymph nodes, and gastrointestinal tract. SARS-CoV-2 in…

We clearly do not have a choice about endemicity. It will be endemic given that it very clearly evolves antigenically to achieve escape from waning neutralizing antibodies and it has animal reservoirs all over the place, including white tailed deer. It was pretty easy to see eradication was off the table in summer of 2020. At this point is kind of fucking stupid to talk about it. Even if you could snap your fingers a…

> The "its just a flu" people were dead wrong in 2020, but very soon they're going to be entirely right.

This is quite infuriating. We had a pretty good window when we could have done something about this and we totally squandered it.

> You'd have to eradicate all the deer, mink and every species you don't know about that has been infected with it

How much transfer is there in animal populations? Do we have any idea of the size of the populations affected? How does this translate to the original spillover event? After all, there must have been an animal reservoir prior to someone in Wuhan becoming the index patient.

We do similar things for various other animal borne plagues with varying degrees of success but there is more than one example of a successful eradication.

Re: Children develop robust and sustained cross-reactive immunity after Covid

#212

Post by chana_masala » Fri, Dec 24, 2021, 11:29 PM UTC

jacquesm wrote: post #206

chana_masala wrote: post #203

Earlier quoted context omitted.

Who wants to win a million dollars? The author has a $1 million dollar offer to debate him and prove him wrong.

Let's see the escrow first. Seriously though, VAERS is not meant to be used in this way. Let me try to describe how I understand the mechanism, I'm sure there are people on HN that would be more than happy to correct me if anything is out of whack: - VAERS allows for the reporting of suspected side effects - this information is then made available again to ensure transparency - the suspicion of a side effect is not t…

> Within that context the debate is pointless: VAERS is not intended to settle arguments, it is intended to gather possibly useful data.

Sounds like you've got this one in the bag, then!

Re: Children develop robust and sustained cross-reactive immunity after Covid

#213

Post by jacquesm » Fri, Dec 24, 2021, 11:30 PM UTC

lotsofpulp wrote: post #105

standardUser wrote: post #49

Earlier quoted context omitted.

The primary concern form day one has been the capacity of our healthcare systems. "Peak pandemic mortality" includes scores of people dying from unrelated illness due to lack of care. Does anyone truly think its acceptable to let people die in ambulances outside of hospitals because a highly contagious disease filled all the hospital beds and medical staff is too fatigued to work? Maybe people with a political axe to…

> Does anyone truly think its acceptable to let people die in ambulances outside of hospitals because a highly contagious disease filled all the hospital beds and medical staff is too fatigued to work? Maybe people with a political axe to grind pretend to think that. Given widespread availability of vaccines, I think it is acceptable to turn away any non vaccinated people without medical exemptions to preserve hospit…

That's not how healthcare works, besides that it puts the rest of the population at risk. This isn't the best comment in this thread by a long shot.

Re: Children develop robust and sustained cross-reactive immunity after Covid

#214

Post by lamontcg » Fri, Dec 24, 2021, 11:31 PM UTC

jacquesm wrote: post #208

lamontcg wrote: post #205

Earlier quoted context omitted.

> We have vaccines that work for a limited time This is flat out FALSE. There are two different possible endpoints for vaccine efficacy. One is efficacy against infection, one is efficacy against severe disease and death. Efficacy against infection is very difficult because it is mediated by circulating neutralizing antibodies. It is just difficult to get sterilizing immunity against a muscosally invading respiratory…

The mutation rate and the number of infected people is what is driving this, as long as we have this many people infected at the same time mutations will be hitting us to the tune of a new one every four to five months or so. The vaccines are quite effective against a variant that is no longer in play and hasn't been for quite a while.

The vaccines are quite effective against severe disease and death from Omicron due to somatic hypermutation.

The people who are vaccinated against original Wuhan-Hu-1 make memory B-cells against Omicron as well. Even after boosting with Wuhan-Hu-1 spike antigen the neutralization titers against Omicron in the blood are high, even after all the spike mutations.

And again, there are around a thousand T-cell epitopes to spike and around 80% of them are conserved with Omicron, and there is very, very good reason to think that number doesn't ever get close to zero.

Your naive model of how the immune system works like a key and lock where if you change one of the pins then the vaccine stops working entirely is deeply flawed.

The human immune system is the end product of a hundreds of millions of years arms race between organisms and pathogens, and this isn't its first trip around the block with a pandemic virus that mutates. The whole way the humoral/memory immune system works is designed to deal with mutations.

Re: Children develop robust and sustained cross-reactive immunity after Covid

#215

Post by jacquesm » Fri, Dec 24, 2021, 11:32 PM UTC

lamontcg wrote: post #210

jacquesm wrote: post #207

Earlier quoted context omitted.

Another factor (though I'm not sure how large that factor is) is that a chunk of the susceptible population isn't around any more.

Literal survivorship bias. There may also be a hard-to-infect/hard-to-seroconvert portion of the population left that could practically walk unmasked through a COVID ward in a hospital and not get infected. If they exist then the seronegative proportion of the population will start to be composed mostly of them over time through "purifying selection". This is also why I'm somewhat skeptical about all the vaccine effi…

That's a good point: having a control group is pretty much a must to be able to get reliable numbers on efficacy and any future vaccine or medicine is going to have to some extent work with corrupted data from day #1.

Re: Children develop robust and sustained cross-reactive immunity after Covid

#216

Post by jacquesm » Fri, Dec 24, 2021, 11:34 PM UTC

chana_masala wrote: post #212

jacquesm wrote: post #206

Earlier quoted context omitted.

Let's see the escrow first. Seriously though, VAERS is not meant to be used in this way. Let me try to describe how I understand the mechanism, I'm sure there are people on HN that would be more than happy to correct me if anything is out of whack: - VAERS allows for the reporting of suspected side effects - this information is then made available again to ensure transparency - the suspicion of a side effect is not t…

> Within that context the debate is pointless: VAERS is not intended to settle arguments, it is intended to gather possibly useful data. Sounds like you've got this one in the bag, then!

I will bow out here, if you don't mind.

Re: Children develop robust and sustained cross-reactive immunity after Covid

#217

Post by dragonwriter » Fri, Dec 24, 2021, 11:34 PM UTC

novok wrote: post #158

smugglerFlynn wrote: post #119

Earlier quoted context omitted.

Will it be you turning these people away? Always puzzles me to see people suggesting all these “just let them die” silver bullet algorithms.

It wouldn't be explicit turning away, but if your in a triage situation, most doctors and medical systems will focus on the most time serious and the people they are most able to save if they have limited capacity. And if your not vaccinated, the ability to save you will be less than the vaccinated and the people with other acute medical issues that are not COVID. That is what will happen in practice in such a regime…

> And if your not vaccinated, the ability to save you will be less than the vaccinated

Is there any evidence that this is true at the point of presenting with equal acute symptoms? Sure, your symptoms are likely to be less acute if you are vaccinated, but that's not the issue, the issue is response to treatment given similar symptoms.

Re: Children develop robust and sustained cross-reactive immunity after Covid

#218

Post by oezi » Fri, Dec 24, 2021, 11:38 PM UTC

chana_masala wrote: post #202

oezi wrote: post #197

Earlier quoted context omitted.

There was an excellent refutation of using Adverse Events Reports for anything but safety signalling. The author of the linked substack could have uploaded the death reports himself. And he didn't even think about comparing his numbers to expected numbers. So, no: children don't die from the vaccine.

The author has a $1 million dollar offer to debate him and prove him wrong.

Sounds like he is part of the anti-vax bullshit industry.

Question is why you are regurgitating it? Do you believe any of it?

Re: Children develop robust and sustained cross-reactive immunity after Covid

#219

Post by jacquesm » Fri, Dec 24, 2021, 11:39 PM UTC

lamontcg wrote: post #214

jacquesm wrote: post #208

Earlier quoted context omitted.

The mutation rate and the number of infected people is what is driving this, as long as we have this many people infected at the same time mutations will be hitting us to the tune of a new one every four to five months or so. The vaccines are quite effective against a variant that is no longer in play and hasn't been for quite a while.

The vaccines are quite effective against severe disease and death from Omicron due to somatic hypermutation. The people who are vaccinated against original Wuhan-Hu-1 make memory B-cells against Omicron as well. Even after boosting with Wuhan-Hu-1 spike antigen the neutralization titers against Omicron in the blood are high, even after all the spike mutations. And again, there are around a thousand T-cell epitopes to…

> Your naive model of how the immune system works like a key and lock where if you change one of the pins then the vaccine stops working entirely is deeply flawed.

That isn't fair on your part.

The bit that you picked out is factually correct. It is also correct that the vaccines + previous immunity will give an improved chance at a positive outcome.

But it's not the same as it was for the first wave, the vaccines were very specifically developed and tested in that setting and every future mutation had a worse response, due to attenuation due to time and mismatch with the target. This is not a 'lock that doesn't fit the key', it is a vaccine that simply works less well on things that it wasn't very specifically designed for, and that is totally expected. The degree to which the difference materializes changes with time and further mutations, with each of those contributing some element to the final efficacy calculation. How much is impossible to tell ahead of time.

Re: Children develop robust and sustained cross-reactive immunity after Covid

#220

Post by lamontcg » Fri, Dec 24, 2021, 11:45 PM UTC

jacquesm wrote: post #211

lamontcg wrote: post #200

Earlier quoted context omitted.

We clearly do not have a choice about endemicity. It will be endemic given that it very clearly evolves antigenically to achieve escape from waning neutralizing antibodies and it has animal reservoirs all over the place, including white tailed deer. It was pretty easy to see eradication was off the table in summer of 2020. At this point is kind of fucking stupid to talk about it. Even if you could snap your fingers a…

> The "its just a flu" people were dead wrong in 2020, but very soon they're going to be entirely right. This is quite infuriating. We had a pretty good window when we could have done something about this and we totally squandered it. > You'd have to eradicate all the deer, mink and every species you don't know about that has been infected with it How much transfer is there in animal populations? Do we have any idea…

> This is quite infuriating. We had a pretty good window when we could have done something about this and we totally squandered it.

I honestly doubt it. We could have blunted the impact but it was out of Wuhan and in Italy before any doctors in Wuhan even knew about it or suspected. We were never going to lock down the entire world the way that China locked down. Even if the Western world did, then what would your plan be for Africa? What about the slums of Bangladesh and other areas in SE Asia?

We fucked it all up and a lot of people died who didn't need to, but I doubt the virus was ever stoppable starting from the first day it was even suspected.

> How much transfer is there in animal populations? Do we have any idea of the size of the populations affected?

Estimates are that around 1/3rd of the white tailed deer are infected and it readily transmits from deer to deer. According to the CDC:

> Recent experimental research shows that many mammals, including cats, dogs, bank voles, ferrets, fruit bats, hamsters, mink, pigs, rabbits, racoon dogs, tree shrews, and white-tailed deer can be infected with the virus. Cats, ferrets, fruit bats, hamsters, racoon dogs, and white-tailed deer can also spread the infection to other animals of the same species in laboratory settings.

Deer so far are the only known species where it is spreading epidemically in them in the wild, but there's likely to be others. We probably don't even know exhaustively all the species in the world that it might infect through having similar enough ACE-2 receptors, and you can't miss one.

And we've never eradicated a virus that has an animal reservoir. Successful eradication is only something you can really attempt if you don't have an animal reservoir (or you need to do something about the reservoir like wiping out the mosquitoes that feed on humans).