Coronavirus (COVID-19)

[WizeGuy]

This is a very interesting read regarding the new variant found in South Africa and what Moderna's quote about their vaccine being '6 fold lower' really means. An Immunologist responded to the question with this:

"6-fold lower does not mean 6 times less effective. As far as we can tell without seeing the raw data, in this case 6-fold lower means no change in effectiveness.

With many systems, you don’t see a simple linear relationship between antibody concentration and ability to block an infection. At low concentrations, there may be a roughly linear relationship, but at some point there’s a threshold at which all the incoming virus is completely neutralized and it doesn’t make any difference if you are at that level, twice as high, or a thousand times higher - you still completely block the infection.

With SARS-CoV-2 we assume there’s that kind of linear-then-threshold pattern, but we don’t know for sure and (importantly) we don’t know where the threshold is. If we did know where the threshold was, we could use that as a correlate of protection, and be able to predict if someone is protected simply by testing their antibody concentration.

What Moderna is telling us here is that their vaccine apparently gives antibody levels that are more than 6 times as high as they need to be, for the standard strain. That means that even though the B.1.351 strain is 6-fold more resistant, antibodies are still over its threshold even so.

We don’t know how far over the threshold we are (at least, again, not without the raw data, and even then it’s not simple to be sure - especially since the Moderna studies are based on test animals, not humans - though it should be comparable). Perhaps the typical vaccine recipient has antibody levels a thousand times higher than you’d need to control the .351 variant, perhaps it’s only 1.1 times.

(*Edit*, the data are available in a preprint, [mRNA-1273 vaccine induces neutralizing antibodies against spike mutants from global SARS-CoV-2 variants](https://www.biorxiv.org/content/10.1101/2021.01.25.427948v1.full.pdf).

I don’t see any concerns with the data in a quick look.)

But from the press release, it’s still over the threshold and able to control all the strains we know of today."

 

Source:

 

It seems the current vaccines should still provide an extremely high degree of protection.

Edited January 26, 2021 by WizeGuy

[Deadpulse]

I know I was one of the people touting the worry for different strains popping up, however, given that the vaccine blocks the protein the virus uses to enter the body I am significantly less worried. My assumption was that the vaccine would be similar to a flu vaccine; that was wrong. 

[WizeGuy]

59 minutes ago, ramssuperbowl99 said:

It's a fair point.

The way I'm looking at it is that right now, we're talking about being able to immunize roughly 10% of the population/month. And realistically, that number is going to go up over the next few months with approvals, funding, and less stringent access requirements. So in a few weeks, I think the political strategy to "stepping it back" is delaying additional opening steps and letting the vaccine distribution go. 

And it's not like this is wildly radical either; 25% capacity, outdoor dining, and COVID protocols are in place. That's similar to what the initial post-lockdown restrictions were. I'm sure a smaller baby step exists, but at the governor level when you have tens of millions of people to look out for, that feels like sticking your toe in the water to see how the temp is. 

There's also the compliance factor here. We're somewhere around 30-40% immune right now, and that number is going to go up. Immunized people aren't going to behave, full stop. We learned that lesson with non-immunized people this year, so offering an immediate, quality of life benefit to getting the vaccine would also incentivize people who are on the fence to get it.

This is what Cuomo alluded to earlier this month. He said we cannot wait until mass vaccination before opening up, but it needs to be done wisely. Honestly, NY hasn't locked-down since the spring even when we were holding adult COVID patients in our children's hospital this winter (upstate NY), so I don't think you're going to see anymore drastic measures by governors. It'll be very localized responses. Hell, New York was targeting zip codes that became hot spots rather than shutting down the entire city this winter. That's probably going to be the idea going forward. Try to sniff out outbreaks via testing and contact tracing and other means.

I think by summer time it's going to be relatively normal unless hospitalizations start to sky rocket again, but honestly- I don't see that happening as vaccinations increase and natural immunity provides protection. I think we're already at a solid base for herd immunity to mitigate the spread of this nasty booger in my community. Now, the rules and regulations are obviously playing a factor in this all, too. If we didn't have vaccines available I'd assume it's possible for this virus to have another jab left in it, but the vaccines may allow us to avoid that scenario all together. Vaccinations will be increasing amongst the general population as we begin to lift regulations, so you have an interesting concept evolving where the more risk we incur by opening up is countered with more protection with the vaccine. 

That being said, I'm not sure how much of an impact vaccinations have made thus far. I would guess they haven't had a huge impact unless one dose provides a strong amount of protection. I was one of the first to be vaccinated in our county, and I just received my second dose three Fridays ago, and that's the Pfizer vaccine, which has the second dose given in 21 days compared to Moderna which is 28 days. I'd assume a strong majority of those vaccinated are still waiting on their second dose.

Edited January 26, 2021 by WizeGuy

[ramssuperbowl99]

40 minutes ago, WizeGuy said:

This is a very interesting read regarding the new variant found in South Africa and what Moderna's quote about their vaccine being '6 fold lower' really means. An Immunologist responded to the question with this:

"6-fold lower does not mean 6 times less effective. As far as we can tell without seeing the raw data, in this case 6-fold lower means no change in effectiveness.

With many systems, you don’t see a simple linear relationship between antibody concentration and ability to block an infection. At low concentrations, there may be a roughly linear relationship, but at some point there’s a threshold at which all the incoming virus is completely neutralized and it doesn’t make any difference if you are at that level, twice as high, or a thousand times higher - you still completely block the infection.

With SARS-CoV-2 we assume there’s that kind of linear-then-threshold pattern, but we don’t know for sure and (importantly) we don’t know where the threshold is. If we did know where the threshold was, we could use that as a correlate of protection, and be able to predict if someone is protected simply by testing their antibody concentration.

What Moderna is telling us here is that their vaccine apparently gives antibody levels that are more than 6 times as high as they need to be, for the standard strain. That means that even though the B.1.351 strain is 6-fold more resistant, antibodies are still over its threshold even so.

We don’t know how far over the threshold we are (at least, again, not without the raw data, and even then it’s not simple to be sure - especially since the Moderna studies are based on test animals, not humans - though it should be comparable). Perhaps the typical vaccine recipient has antibody levels a thousand times higher than you’d need to control the .351 variant, perhaps it’s only 1.1 times.

(*Edit*, the data are available in a preprint, [mRNA-1273 vaccine induces neutralizing antibodies against spike mutants from global SARS-CoV-2 variants](https://www.biorxiv.org/content/10.1101/2021.01.25.427948v1.full.pdf).

I don’t see any concerns with the data in a quick look.)

All of this is accurate, the only thing I would add having looked at the paper very briefly is that we do have some very rough estimate of the relative strength.

The paper uses a titer unit, or titration system. What they did was start with the raw sample at no dilution, then they ran it and got a positive test. Then, they diluted the sample, and ran it again. If the test was still positive, they kept going. The number of dilutions is called a "titer", and in this case, they were able to dilute the sample 300x and still get a positive result, compared to a 2000x dilution normally.

I see titer values all the time, and both of those say the same thing to me. Really, really, really positive. 

[WizeGuy]

Moderna will be able to distribute 100 million doses by the end of March, then another 100 million in the following three months. 

 

Pfizer will be able to distribute 120 million doses by the March. 200 million by the April.

 

Biden said the vaccine should be available for anyone who wants it by the spring.

 

Lots of good news coming out on the vaccine front today.

[BobbyPhil1781]

Local report that hospitalizations, involving covid, are down "significantly" in my area. 1/7 people as opposed to 1/4 60 days ago. Lowest number since early November.

It coincides w/ this graph suggesting the countries R value is the lowest it's been since that time also (note this is on a 3 day lag):

https://reproduction.live/world/US

I know it's not something to live by but these estimations are based on data so they do warrant some merit unless someone can tell me why they do not.

Hopefully there's no surges for whatever reason that might cause people to not give a ****. If not, we're in good shape.

Edited January 26, 2021 by BobbyPhil1781

[Xenos]

52 minutes ago, BobbyPhil1781 said:

Local report that hospitalizations, involving covid, are down "significantly" in my area. 1/7 people as opposed to 1/4 60 days ago. Lowest number since early November.

It coincides w/ this graph suggesting the countries R value is the lowest it's been since that time also (note this is on a 3 day lag):

https://reproduction.live/world/US

I know it's not something to live by but these estimations are based on data so they do warrant some merit unless someone can tell me why they do not.

Hopefully there's no surges for whatever reason that might cause people to not give a ****. If not, we're in good shape.

That last part is key since it’s what happened over the summer. Though I suppose having Memorial Day and July 4th didn’t help.

[BobbyPhil1781]

11 minutes ago, Xenos said:

That last part is key since it’s what happened over the summer. Though I suppose having Memorial Day and July 4th didn’t help.

The next big "event" in the country in Mardis Gras. I have heard that even NO canceled it but I'm sure that won't stop bars from celebrating.  VDay isn't a party or group day so if we can get through MG and friggin' St Paddy's Day, we should be in the clear. Luckily the latter is still 1.5 months away so we can get to vaccinating more people. 

[squire12]

29 minutes ago, BobbyPhil1781 said:

The next big "event" in the country in Mardis Gras. I have heard that even NO canceled it but I'm sure that won't stop bars from celebrating.  VDay isn't a party or group day so if we can get through MG and friggin' St Paddy's Day, we should be in the clear. Luckily the latter is still 1.5 months away so we can get to vaccinating more people. 

you have never heard of spring break?

 

[BobbyPhil1781]

21 minutes ago, squire12 said:

you have never heard of spring break?

 

Not sure how I could forget about that lol. Been focused too much on an actual calendar. Good call. Basically the month of March is ****ed.

[squire12]

4 minutes ago, BobbyPhil1781 said:

Not sure how I could forget about that lol. Been focused too much on an actual calendar. Good call. Basically the month of March is ****ed.

young college kids gathering in large masses to drink, swap various body fluids in jam packed venues.   A communicable virus' dream set up

[BobbyPhil1781]

Any of you science folk heard about Plitidespin? This looks extremely.... great... in nonhumans:

https://science.sciencemag.org/content/early/2021/01/22/science.abf4058

[BobbyPhil1781]

Just now, squire12 said:

young college kids gathering in large masses to drink, swap various body fluids in jam packed venues.   A communicable virus' dream set up

I feel like at this point, we have to assume any college kid who will be attending any events has probably had exposure one or twice..... or a dozen times so hopefully whatever the body does to protect itself renders the virus useless so others cannot contract it.

My wife and I were planning our first trip in forever down to Florida in mid-April. If cases start skyrocketing in March, that will have to be delayed.

[ramssuperbowl99]

1 hour ago, BobbyPhil1781 said:

Any of you science folk heard about Plitidespin? This looks extremely.... great... in nonhumans:

https://science.sciencemag.org/content/early/2021/01/22/science.abf4058

I haven't, but I wiki'd it. The short version is that it's worth investigating, but it won't help us.

It's in the clinic, but for cancer, so we may not even have safety data in healthy adults. We've got some in vitro efficacy data, so that's good, but small molecule antivirals have a really low success rate. The ones that work in a test tube often have other issues (they can't be absorbed into the bloodstream, or they don't get to the tissues they need to go to, or our enzymes chew them up right away), and the ones that don't have those issues to such a level tend to only work at doses that are too high. Behind Alzheimer's and cancer, it's among the toughest other areas.

As a therapy, this is a ways away and may never amount to much. But if it was safe, effective, and we could produce it, this might be helpful. Imagine there's a local area with an outbreak because of low vaccination rates, probably most often in poorer countries. Even if that outbreak won't balloon into a pandemic any more, we'll still want to have something to treat the people we can't vaccinate.

Edited January 26, 2021 by ramssuperbowl99

[Xenos]

Here’s hoping we get nearly everyone vaccinated by end of summer then.

https://www.npr.org/sections/president-biden-takes-office/2021/01/26/960857706/the-biden-administration-is-working-to-buy-200-million-more-covid-19-vaccine-dos

 

Quote

President Biden will announce Tuesday that his administration is working to purchase an additional 200 million doses of the two COVID-19 vaccines that have been authorized for emergency use, with the goal, the White House says, of having enough vaccine supply for nearly the entire U.S. population by the end of the summer.

The administration says it plans to buy an additional 100 million doses each from both Moderna and from Pfizer, which has a vaccine with its German counterpart BioNTech.