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Antiviral compound blocks SARS-CoV-2 from entering cells

medicine.wustl.edu

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Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#151

Post by __blockcipher__ »

phonypc wrote: post #150
__blockcipher__ wrote: post #121

Earlier quoted context omitted.

Fun fact: the trial you referenced failed to show any benefit of COVID vaccination in reducing all-cause mortality in the population they studied: https://www.medrxiv.org/content/10.1101/2021.07.28.21261159v... > During the blinded, controlled period, 15 BNT162b2 and 14 placebo recipients died; during the open-label period, 3 BNT162b2 and 2 original placebo recipients who received BNT162b2 after unblinding died. None…

> Fun fact: the trial you referenced failed to show any benefit of COVID vaccination in reducing all-cause mortality in the population they studied: Is the implication that we should have expected it to? The study endpoints are clearly "vaccine efficacy (VE) against laboratory-confirmed COVID-19 and safety data".

I think most people would have expected it to. Whether that's a reasonable expectation or not is up for debate. But yeah, many if not most people in the US were convinced that COVID was a threat so severe that it warranted completely uprooting life as we knew it. A sizeable minority of people are convinced that COVID vaccination is so important that people should be coerced into it by almost any means necessary. So I think understanding that we don't have a single randomized controlled trial that actually shows a reduction in all-cause mortality when given this intervention is pretty important.

It's a general principle of medicine (or at least, it used to be) that the important outcomes are the actually clinically relevant outcomes. Did people die less? Did they achieve a better quality of life? When you get into proxy metrics you get to this weird place where you can show that something is insanely effective for proxy metric X, and yet it makes no difference (or is even deleterious) in thing-you-actually-care-about Y.

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#152

Post by [deleted] »

speeder wrote: post #125
sterlind wrote: post #94

Earlier quoted context omitted.

My partner is ex-Christian Scientist (a faith-healing cult that doesn't believe in disease or medicine.) Zir whole family finally relented and got vaccinated, but they all got J+J. I don't know why that vaccine in particular (maybe because it's single-shot, so they only have to deal with hypocrisy once?) but that vaccine is popular with that cohort.

I wanted JJ because not mRNA and is accepted in several countries. The JJ mechanism of action is better understood and less risky, in my view at least it is more acceptable for emergency approval.

[deleted]

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#153

Post by mlyle »

grey413 wrote: post #141
mlyle wrote: post #90

Earlier quoted context omitted.

Yup. I'm a teacher and vaccinated. If I found out that I was exposed, and then tested positive... post-exposure prophylaxis sounds great . Also there's my dad, who has an immune condition due to old age. He's vaccinated, but who knows how effective the vaccine was for him. The existence of PEP could make it possible for him to do more at a similar level of safety... vs. the current option of staying in a small bubble…

FYI, your dad would most likely already qualify to receive the antiviral antibody treatments that have been given emergency authorization by the FDA. https://www.covid19treatmentguidelines.nih.gov/therapies/ant...

Oh sure-- if he got infected, we'd throw the kitchen sink at it-- remdesivir, monoclonals, etc. A "better remdesivir" which is supremely effective would improve the risk picture a lot.

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#154

Post by phonypc »

__blockcipher__ wrote: post #151
phonypc wrote: post #150

Earlier quoted context omitted.

> Fun fact: the trial you referenced failed to show any benefit of COVID vaccination in reducing all-cause mortality in the population they studied: Is the implication that we should have expected it to? The study endpoints are clearly "vaccine efficacy (VE) against laboratory-confirmed COVID-19 and safety data".

I think most people would have expected it to. Whether that's a reasonable expectation or not is up for debate. But yeah, many if not most people in the US were convinced that COVID was a threat so severe that it warranted completely uprooting life as we knew it. A sizeable minority of people are convinced that COVID vaccination is so important that people should be coerced into it by almost any means necessary. So I…

This study not finding an effect it wasn't designed to isn't incompatible with the more hyperbolic interpretations of the threat of COVID / the importance of vaccination.

Did we need RCTs demonstrating a reduction in all-cause mortality for polio or measles vaccines before it became blindingly obvious that they were a good idea?

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#155

Post by tiahura »

gizmo686 wrote: post #12
raphlinus wrote: post #5

I'm starting to get pretty optimistic. There seem to be a bunch of antivirals with very different mechanisms of action - this one blocks entry of the virus to cells, Molnupiravir fucks up accurate replication of the virus (nucleoside analog), others are protease inhibitors, which are very effective against HIV. There's a caveat, most treatments that look promising don't pan out, but there are a lot in the pipeline an…

A limiting factor for the effectiveness of anti-virals for Covid is time. Maximum viral load happens often happens before any symptoms are present, and the most severe diseases occurs weeks after infection as a result of the bodies inflammatory response instead of the virus itself. This means that by the time you know that a patient will have severe Covid-19, it is likely too late for any treatment that is based on i…

According to the founders of Ridgeback, Molnupiravir is being tested prophylacticly. They suggested that hopefully by sometime next year, if someone you’ve been in within close contact tests positive, you get on the cocktail of Molnupiravir + the upcoming Pfizer antiviral.

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#156

Post by LurkingPenguin »

bawolff wrote: post #127
LurkingPenguin wrote: post #58

Earlier quoted context omitted.

> I feel like I'm pointing out the obvious, but another, extremely effect and quick "treatment" is vaccination. Does every discussion of about post-exposure prophylaxis have to have comments about vaccination? > And it works great without the constant need for testing. A primary reason for testing has been to help stop the spread of the virus (test positive = isolate), not necessarily to let people with mild symptoms…

> Research indicates that individuals with breakthrough infections can have viral loads that are as high as unvaccinated individuals, and some percentage report courses of illness that are virtually identical to a typical course of illness in unvaccinated individuals But that's totally expected (depending of course on how you define "some"). If the vaccine had 100% efficacy, it would be shocking. The fact that it doe…

> I'm assuming the point you're trying to make is vaccines aren't as good as expected.

No, I was responding to "Additionally, in my experience, physicians aren't terribly concerned about infections in vaccinated individuals" and pointing out that there's still a lot we don't know about the risks associated with infection after vaccination and arguing that these things deserve additional scientific study.

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#157

Post by bsder »

ralusek wrote: post #91
space_fountain wrote: post #60

Earlier quoted context omitted.

Some quick googling doesn’t back this up and my understanding is that ivermectin has only shown itself to be effective at doses that are higher then are remotely safe. It also just isn’t the sort of thing there would be incentive to lie about. Probably then the straightforward story is true no it’s only effective as prescribed as treatment for parasites. If you’d like to provide some sources though or more explanatio…

I have no opinion whatsoever regarding whether or not ivermectin's purported mechanism of action against COVID is valid. However, this: > It also just isn’t the sort of thing there would be incentive to lie about is not true. There are two incentives to lie about this, if you are in any way associated with drug or vaccine manufacturers. 1.) Ivermectin is out of patent and dirt cheap; basically not profitable at all 2…

There are more countries in the world than the US and many of them would welcome something like ivermectin if it worked.

Sure, ivermectin is dirt cheap, but that doesn't mean somebody couldn't make a buck off of it. Not to mention that any doctor who actually proved something like that to be effective would be quickly hailed as a hero.

This is the problem with the "Covid Conspiracists"--magically everything is 100% worldwide unified action with perfect lockstep and no deviations--in spite of the fact that many of these countries have primal hatred for one another.

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#158

Post by LurkingPenguin »

space_fountain wrote: post #105
LurkingPenguin wrote: post #92

Earlier quoted context omitted.

> Because essentially what this means right is that they sampled people's viral loads, and then cut out everyone below a value they choose to mean "infected". Huh? Please cite the part of the study you're referring to to argue that the title of the study means the exact opposite of what it says. Every manufacturer of a PCR test specifies a Ct cutoff above which the result is considered false. > It's still true that e…

> The study says the exact opposite: Maybe I'm misinterpreting the study. I interpreted that as being among the fraction of people who are infected both because that's what the title says, and because they say later that "75% of the positive samples were from unvaccinated individuals" which would seem to be inconsistent with the groups having similar viral loads. I thought we were dealing with a random variable compo…

> Maybe I'm misinterpreting the study.

With no offense intended, I think you're misunderstanding the whole concept of "viral load". If you are not infected with SARS-CoV-2, you don't have a SARS-CoV-2 "viral load".

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#159

Post by space_fountain »

LurkingPenguin wrote: post #158
space_fountain wrote: post #105

Earlier quoted context omitted.

> The study says the exact opposite: Maybe I'm misinterpreting the study. I interpreted that as being among the fraction of people who are infected both because that's what the title says, and because they say later that "75% of the positive samples were from unvaccinated individuals" which would seem to be inconsistent with the groups having similar viral loads. I thought we were dealing with a random variable compo…

> Maybe I'm misinterpreting the study. With no offense intended, I think you're misunderstanding the whole concept of "viral load". If you are not infected with SARS-CoV-2, you don't have a SARS-CoV-2 "viral load".

I was sort of intentionally abusing the term, though I was trying to be clear that I was trying include explicitly people with a number of viral particles low enough to not be infected. My understanding is that a single covid virus infecting a cell won't result in a positive covid test and probably won't make someone sick especially if they're vaccinated. More broadly the point I'm trying to make is that vaccination lowers the expected value of covid shedding because even if they're actually infected they might spread just as well they're less likely to be infected and that phrases like vaccinated people have similar viral loads to unvaccinated individual obscures that point and helps lead people to think vaccines are useless

Re: Antiviral compound blocks SARS-CoV-2 from entering cells

#160

Post by Buttons840 »

Symmetry wrote: post #76
UncleOxidant wrote: post #62

Earlier quoted context omitted.

> The vaccine-hesitant aren't going to go for treatment until the outlook is dire. Many of them seem quite willing to get ivermectin (whether it works or not is another issue). This is a tribal thing: one tribe has determined that the vaccine isn't something their tribe gets, but many of them seem willing to try other treatments that are acceptable to the tribe. (and yes, that's not rational, but humans are often irr…

It's too bad we couldn't arrange it so that one vaccine could be the "Trump vaccine" that Republicans could get and another could be the "Fauci vaccine" for Democrats. Then people could express their political affiliations in their medical choices but still get vaccinated. There were a lot of Democratic politicians talking about not trusting rushed vaccines a year ago and if that could have focused on specific vaccin…

Most of the vaccine hesitancy started as made up Facebook posts. Make a video, draw a contrast between the vaccines and next thing you know millions might be repeating whatever you made up. It might actually have some benefit, but furthers harmful patterns. I know people who have expressed interest in new nasal vaccines which may or may not come, I think they know they need a vaccine, but are just looking for some way to get one without admiting they've been wrong all this time.
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