Neverending Covid-19 Coronavirus

There's a new variant out of Brazil. This one looks like it could be vaccine resistant and it also looks like it could re-infect people who got a different variant of the disease earlier. It also spreads rapidly.

"If you were to ask me right now, what's most concerning of all the things that I've heard so far, it's the fact that they are reporting a sudden increase in cases in Manaus, Brazil," virus expert Jeremy Luban at the University of Massachusetts told NPR two weeks ago before the variant arrived in the United States. "Manaus already had 75% of people infected [in the spring of last year]."

The concern with P.1 is twofold: Scientists don't understand why the variant has spread so explosively in Brazil, and the variant carries a particularly dangerous set of mutations.

While the variant from the U.K. took about three months to dominate the outbreak in England, P.1 took only about a month to dominate the outbreak in Manaus. In addition, Manaus had already been hit extremely hard by the virus in April. One study estimated that the population should have reached herd immunity and the virus shouldn't be able to spread easily in the community. So why would the city see an even bigger surge 10 months later? Could P.1 be evading the antibodies made against the previous version of the virus, making reinfections easier? Could it just be significantly more contagious? Could both be true?

 
There's a new variant out of Brazil. This one looks like it could be vaccine resistant and it also looks like it could re-infect people who got a different variant of the disease earlier. It also spreads rapidly.

"If you were to ask me right now, what's most concerning of all the things that I've heard so far, it's the fact that they are reporting a sudden increase in cases in Manaus, Brazil," virus expert Jeremy Luban at the University of Massachusetts told NPR two weeks ago before the variant arrived in the United States. "Manaus already had 75% of people infected [in the spring of last year]."

The concern with P.1 is twofold: Scientists don't understand why the variant has spread so explosively in Brazil, and the variant carries a particularly dangerous set of mutations.

While the variant from the U.K. took about three months to dominate the outbreak in England, P.1 took only about a month to dominate the outbreak in Manaus. In addition, Manaus had already been hit extremely hard by the virus in April. One study estimated that the population should have reached herd immunity and the virus shouldn't be able to spread easily in the community. So why would the city see an even bigger surge 10 months later? Could P.1 be evading the antibodies made against the previous version of the virus, making reinfections easier? Could it just be significantly more contagious? Could both be true?

Surely all of the Facebook virus experts calling for heard immunity figured on virus mutations right?
 
Canada is about to join other countries in forcing returning travelers into hotel quarantine, at the travelers' cost. There has been a mandatory 14 day quarantine here for year, with big fines for failure to comply. But it's been hard to reinforce as people give themselves permission to circumvent them (though others have no problem reporting this behavior when it's noticed). The emergence of variants around the world as Canada is once again flattening its curve is precipitating this. But truth be told, some of the variants are already here and the damage may already be done (at least for the UK variant - there may still be hope to hold back the others).

 
And a potential new treatment! Mouse studies look promising.

SARS-CoV-2 viral proteins interact with the eukaryotic translation machinery and inhibitors of translation have potent antiviral effects. Here we report that the drug plitidepsin (aplidin), which has limited clinical approval, possesses antiviral activity (IC90 = 0.88 nM) 27.5-fold more potent than remdesivir against SARS-CoV-2 in vitro, with limited toxicity in cell culture. Through the use of a drug resistant mutant, we show that the antiviral activity of plitidepsin against SARS-CoV-2 is mediated through inhibition of the known target eEF1A. We demonstrate the in vivo efficacy of plitidepsin treatment in two mouse models of SARS-CoV-2 infection with a reduction of viral replication in the lungs by two orders of magnitude using prophylactic treatment. Our results indicate that plitidepsin is a promising therapeutic candidate for COVID-19.

 
And a potential new treatment! Mouse studies look promising.

SARS-CoV-2 viral proteins interact with the eukaryotic translation machinery and inhibitors of translation have potent antiviral effects. Here we report that the drug plitidepsin (aplidin), which has limited clinical approval, possesses antiviral activity (IC90 = 0.88 nM) 27.5-fold more potent than remdesivir against SARS-CoV-2 in vitro, with limited toxicity in cell culture. Through the use of a drug resistant mutant, we show that the antiviral activity of plitidepsin against SARS-CoV-2 is mediated through inhibition of the known target eEF1A. We demonstrate the in vivo efficacy of plitidepsin treatment in two mouse models of SARS-CoV-2 infection with a reduction of viral replication in the lungs by two orders of magnitude using prophylactic treatment. Our results indicate that plitidepsin is a promising therapeutic candidate for COVID-19.


It was a really long time ago, but my PhD was on translation, in particular eIF4E.
 
My wife was pretty sad last night... one of the reps she deals with regularly over the phone just died of COVID in Georgia. She spoke to him exactly a week ago and he was fine. It's just crazy you can go so quickly.
 
The vaccine rollout for seniors has been a complete shit show here in Massachusetts.

Until last week only healthcare professions and people considered high risk could get a vaccine. Last week they expanded it to all seniors.

However, to make an appointment to get a vaccine for seniors was such a burden it was a complete joke.

The only way to make an appointment at a vaccine clinic site as of this time is via the internet. A calling center is coming soon, maybe later this week. Many seniors don't have computers, so they had to rely on their children to make the appointments for them. The state website was described as nearly impossible to use giving you noting but a spinning wheel. Landing an appointment was like winning the lottery. For those who got appointments, it took hours of trying and chances are the appointments they got where not at the closest vaccination clinic. For example, one women has to drive her mother from the Cape to Springfield MA, more than 2 hours a way to get the vaccine because that was the only available option they could get. And this is a common story of people from the western part of the state having to drive out east and those out east having to drive out west. Just crazy.



This leads to another issue. Transportation. Many seniors don't have cars, don't drive or only drive locally. Not to mention many vaccination clinics require you to wait in your car until it is time for your appointment.

Vaccination centers in the cities where there is no parking available on site, thus not having the wait in your car option, saw seniors standing inline outside for up to 2 hours on the coldest day of the year this past Friday with temperatures in the single digits. Many appointments were abandoned yet the line still persisted for those who waited.

This week they hope to have a handle on the lines, reducing the number of appointments per day and telling everyone to not show up early.
 
This leads to another issue. Transportation. Many seniors don't have cars, don't drive or only drive locally. Not to mention many vaccination clinics require you to wait in your car until it is time for your appointment.
I remember being introduced to this problem when I was working for child special health services. We had a ton of problems finding parents reliable transportation to their children's appointments. I encountered this same problem again when working in private insurance with dialysis patients. Many of our dialysis patients would call an ambulance to get them to their appointment. One big problem we had in both communities was that there was the potential of large chairs or other mobility aides that might not always be able to be accommodated by a taxi or uber. Other problems included them relying on someone else for rides that couldn't make it, getting off of work to get to an appointment (or your ride getting off of work), and finding the money to pay for the ride. The assumption that people can get to appointments is a huge, and largely unrealistic assumption when you are talking about a large metro area. I hate it when people who don't have a background in community health are put in charge of community health initiatives like this. This is a huge oversight that anyone who has ever worked with low income communities wouldn't make.
 
The vaccine rollout for seniors has been a complete shit show here in Massachusetts.
It really has been a nightmare. Every one of my friends has had to do the legwork to get their parents appointments. And these are 75-80 year olds who use the internet in their daily lives. I cannot imagine the older crowds.

My in-laws in Kentucky both had their first vaccine last week. I'm not sure what their registration process was like in KY, but over Thanksgiving I spent 30 minutes (unsuccessfully) explaining the difference between internet and wifi to my mother-in-law, so it couldn't have been too difficult!

All that said, my parents are supposed to get their vaccine this afternoon. Hopefully this snow holds off.
 
My wife got her second shot on Friday at around 4:30 pm. (Moderna)
She was fine all night, and by morning we figured she was one of the people that didn't have any effects. But right around 3 pm Saturday it hit suddenly. Mild fever, 99.6 at the highest, and a little bit of nausea. She just laid down for the night (she has been recouping from knee surgery anyway) and by Sunday morning she felt fine. She has been in touch with coworkers after their second doses and it seems about 50/50 among them as far as the side effects from #2.
 
It really has been a nightmare. Every one of my friends has had to do the legwork to get their parents appointments. And these are 75-80 year olds who use the internet in their daily lives. I cannot imagine the older crowds.

My in-laws in Kentucky both had their first vaccine last week. I'm not sure what their registration process was like in KY, but over Thanksgiving I spent 30 minutes (unsuccessfully) explaining the difference between internet and wifi to my mother-in-law, so it couldn't have been too difficult!

All that said, my parents are supposed to get their vaccine this afternoon. Hopefully this snow holds off.
My dad was able to get his last week which is a huge relief for me since he's a transplant patient. My mom couldn't get hers yet.
 
Next in things that I didn't think I needed to say...it seems that if you don't have a public health surveillance system in place to collect data, you don't really have the data you need to define the problem, let alone address the problem.

National data on COVID-19 testing is incomplete, "critical gaps in the medical supply chain" remain, and a lack of data has stalled delivering key resources to people who need it most, a nonpartisan federal watchdog, the Government Accountability Office (GAO), has found.

Why it matters: The findings come as the rise of more contagious variants ensures that Americans’ risk remains high, despite a three-week decline in the number of COVID infections in the U.S. A greater number of people are also dying from the coronavirus over less time.

What GAO found: Incomplete and inconsistent COVID testing data from states have hindered getting resources to areas and people that need it most.

 
My mom told me last night that one of her friends died of COVID, he was 58. But the way she said it was "Well, he had other issues, they're just calling it COVID"

I don't know how to talk to my parents anymore. They're resistant to safety practices, both refuse to get the vaccine. They're in their mid-60's.

My best plan is when my wife's family is all vaccinated, along with us, we'll take a bunch of pictures hugging and hanging out. Then when my mother tries to guilt me into doing the same, I'll refuse until they're vaccinated. I feel like it's my only course.
 
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