COVID-19

[Weave]

28 minutes ago, Claude_Verret said:

Throw this into the pot as a potential cause for the rise in cases. As I said before changes on the micro level, in this case a single amino acid mutation in the spike protein domain involved in ACE2 receptor binding, can have effects as well. Appropriate grain of salt as this is a single study in a lab and has to be taken in context of all the other studies in this sub field being published.

 

In summary, we show that an S protein mutation that results in more transmissible SARS-CoV-2 also limits shedding of the S1 domain and increases S-protein incorporation into the virion. Further studies will be necessary to determine the impact of this change on the nature and severity of COVID-19.

 

https://www.scripps.edu/news-and-events/press-room/2020/20200611-choe-farzan-sars-cov-2-spike-protein.html

Can you translate this in English?

[Weave]

It’s too bad @biodorkisn’t active on this site any more.  Would be interesting to hear from additional voices with medical research experience.  Claude adds an interesting perspective to the conversation.

Edited July 1, 2020 by Weave

[Claude_Verret]

9 minutes ago, Weave said:

Can you translate this in English?

The S protein, or spike protein, is how the virus attaches and infects cells. The human cell membrane surface protein that it attaches to is the ACE2 (angiotension something) receptor. This group showed that the D614G (D=aspartic acid, 614=the amino acid number, or residue, in the S protein and G=glycine) showed greater infectivity. So the mutation that causes a change in the S protein at residue 614 from aspartic acid to glycine shows a higher ability to infect cells than the aspartic acid or D614 form of the virus in these experiments. 

[Stoner]

2 hours ago, Claude_Verret said:

Right. So youre validating your sources how exactly?  Im sure its by going to the peer reviewed literature and assessing the study design, methodology, results and conclusions. 

As usual, you're clueless.

 

I'll be waiting for the "let's chill out a little," "be better or be quiet" and "we don't do that here" responses from board management.

Is hand-washing proven to prevent the spread of viruses?

[Claude_Verret]

8 minutes ago, PASabreFan said:

I'll be waiting for the "let's chill out a little," "be better or be quiet" and "we don't do that here" responses from board management.

Is hand-washing proven to prevent the spread of viruses?

I'll do what you do best time and time again and simply ignore the content of the post I'm responding to and ask a ridiculous question instead.

Does giving a patient motrin and subsequently watching their fever subside tell you anything about the cause of the fever?

 

[Stoner]

2 hours ago, Claude_Verret said:

Right. So youre validating your sources how exactly?  Im sure its by going to the peer reviewed literature and assessing the study design, methodology, results and conclusions. 

As usual, you're clueless.

I said evaluate, not validate. There's a lot of good, reliable information on the Internet. We're about 15 years past the idea of, "I wouldn't trust Bob's Epidemiology Blog."

Did you know anyone can log in to Medscape?

[Claude_Verret]

1 hour ago, Curt said:

I think Claude and some others are talking right past each other, with little attempt from either side to make themselves clearly understood or find common ground.

Basically, a totally unproductive dialogue.

I think I've made a sincere attempt to clarify my positions.  I'm certainly open to clarify them further if asked direct questions on what I've actually posted.

[Claude_Verret]

1 minute ago, PASabreFan said:

I said evaluate, not validate. There's a lot of good, reliable information on the Internet. We're about 15 years past the idea of, "I wouldn't trust Bob's Epidemiology Blog."

Did you know anyone can log in to Medscape?

You're right. Now we're into social media to to get our 'reliable' information.  Its even worse.

[Stoner]

24 minutes ago, Claude_Verret said:

I'll do what you do best time and time again and simply ignore the content of the post I'm responding to and ask a ridiculous question instead.

Does giving a patient motrin and subsequently watching their fever subside tell you anything about the cause of the fever?

Please stop with the attacks.

Is the analogy: does prescribing mitigation to a state or region and watching disease subside tell you anything about the cause of the disease? I'm not sure I get it. I think what you're after is what was the cause of the decline in fever.

Do we know for sure it wasn't the virus doing virus things in NY to explain the decline in cases or the virus doing virus things in Florida to explain the increase, and not mitigation/reopening? Probably not. How long's it going to take to figure that out?

[shrader]

12 hours ago, Claude_Verret said:

And how often do you read anything from pubmed beyond the abstract?

Wait, you read more than just the title there?

[Claude_Verret]

10 minutes ago, PASabreFan said:

Please stop with the attacks.

Is the analogy: does prescribing mitigation to a state or region and watching disease subside tell you anything about the cause of the disease? I'm not sure I get it. I think what you're after is what was the cause of the decline in fever.

Do we know for sure it wasn't the virus doing virus things in NY to explain the decline in cases or the virus doing virus things in Florida to explain the increase, and not mitigation/reopening? Probably not. How long's it going to take to figure that out?

Attacks? The pattern I called out in your debating style is a tactic you've employed here for quite some time whether you're doing it consciously or not.

I guess we are talking past each other since your questions indicate not having a grasp on how scientific studies and progress actually works. I posted something yesterday in response to liger  that attempted to explain my thoughts on that.

 

[kas23]

2 hours ago, Claude_Verret said:

Throw this into the pot as a potential cause for the rise in cases. As I said before changes on the micro level, in this case a single amino acid mutation in the spike protein domain involved in ACE2 receptor binding, can have effects as well. Appropriate grain of salt as this is a single study in a lab and has to be taken in context of all the other studies in this sub field being published.

 

In summary, we show that an S protein mutation that results in more transmissible SARS-CoV-2 also limits shedding of the S1 domain and increases S-protein incorporation into the virion. Further studies will be necessary to determine the impact of this change on the nature and severity of COVID-19.

 

https://www.scripps.edu/news-and-events/press-room/2020/20200611-choe-farzan-sars-cov-2-spike-protein.html

I’m sure you agree that it’s a bit too early to definitively say that D614G is responsible for the uptick in cases or increased infectivity in vivo. These studies were done in a cultured cell line and who knows if this translates to increase infectivity within a living system. The increased prevalence of this mutation over time certainly indicates this, but viruses mutate often and more so at particular hot spots. Could it just be the natural history of the virus? Maybe, but don’t know. Could it be that there are different viruses depending on US geography and mitigation measures have been poorly rolled out in these different locales? Maybe, but again, don’t know for sure. 
 

I agree with what your are writing on here. There is too much we don’t know and anyone with definitive answers is usually someone to ignore. But, in medicine, we never know things for certain, so decisions always come down to risk/benefit ratio. In the case of masks, we don’t know for certain if they are limiting infection. Same goes for the silly plexiglass we see everywhere. However, the risk/benefit ratio for wearing a mask is highly favorable, so I think everyone in the country should be wearing one if we are past the point of demanding everything to close down. 

[nfreeman]

1 hour ago, PASabreFan said:

I'll be waiting for the "let's chill out a little," "be better or be quiet" and "we don't do that here" responses from board management.

Did you not kick off that little exchange with your tweak about doctors over the age of 60?  And then when someone snaps back at you (or as the millenials say, "claps back"), you air a grievance about board management?

Board management prefers to let things settle down by themselves (or, even better, for people to act like grownups and not sling poop at each other) and not to get involved unless it's really necessary.

 

[Claude_Verret]

14 minutes ago, kas23 said:

I’m sure you agree that it’s a bit too early to definitively say that D614G is responsible for the uptick in cases or increased infectivity in vivo. These studies were done in a cultured cell line and who knows if this translates to increase infectivity within a living system. The increased prevalence of this mutation over time certainly indicates this, but viruses mutate often and more so at particular hot spots. Could it just be the natural history of the virus? Maybe, but don’t know. Could it be that there are different viruses depending on US geography and mitigation measures have been poorly rolled out in these different locales? Maybe, but again, don’t know for sure. 
 

I agree with what your are writing on here. There is too much we don’t know and anyone with definitive answers is usually someone to ignore. But, in medicine, we never know things for certain, so decisions always come down to risk/benefit ratio. In the case of masks, we don’t know for certain if they are limiting infection. Same goes for the silly plexiglass we see everywhere. However, the risk/benefit ratio for wearing a mask is highly favorable, so I think everyone in the country should be wearing one if we are past the point of demanding everything to close down. 

Yes, and why I put the appropriate grain of salt caveat at the end of my post.

[SwampD]

2 hours ago, Claude_Verret said:

The S protein, or spike protein, is how the virus attaches and infects cells. The human cell membrane surface protein that it attaches to is the ACE2 (angiotension something) receptor. This group showed that the D614G (D=aspartic acid, 614=the amino acid number, or residue, in the S protein and G=glycine) showed greater infectivity. So the mutation that causes a change in the S protein at residue 614 from aspartic acid to glycine shows a higher ability to infect cells than the aspartic acid or D614 form of the virus in these experiments. 

Interesting and scary, although, I still think Occum’s razor is at play here as to the rise in cases.

And PA is right. We all know how to use Google by now

[atoq]

1 hour ago, nfreeman said:

Did you not kick off that little exchange with your tweak about doctors over the age of 60?  And then when someone snaps back at you (or as the millenials say, "claps back"), you air a grievance about board management?

Board management prefers to let things settle down by themselves (or, even better, for people to act like grownups and not sling poop at each other) and not to get involved unless it's really necessary.

 

Actually, Claude brought up the topic of internet literacy when he dismissed Doohickie's (correct) point about the wealth of empirical evidence on the benefits of masks, contact tracing etc. Claude wrote off that point as Doohickie using google to get the response he was looking for. Then again its probably below (most) board management to participate in a game of "you started it!".

[Neo]

I just finished John Berry's "The Great Influenza".  What a fascinating book.  He writes of the Pandemic Spanish* Flu (that originated in Kansas). Tour de force is an overused description when describing arts and letters, so I'm hesitant to use it when describing this book to others.  It was a wildly entertaining and informative ride.  The book took me through history and around the world as experimentation and the scientific method replaced observation and deduction as sources for advancing medicine.  Today, I know as much about epidemiology and the behavior of germs as I ever will, which speaks more to my limitations than to my accomplishments.   Read it.

I see us discussing and debating three things, all the while swimming in the slimy pool that is politics and tribalism.

1)   We will play dodge ball with the virus and hope something good happens before we're dead or living in the stone age.

2)   We will be saved by a brilliant, tireless, and lucky scientist who finds a cure.

3)   We will live modified lives until the virus mutates itself away.

We all want number 2.   We're deciding if we prefer choice 1 or choice 3 in the meantime.   I'm an anti-intellectual individualist who sees choice 3 > choice 1.

Lightbulb moment.  Today's novel corona virus is not yesterday's, and tomorrow's will not be today's. 

In true Ground Hog Day film fashion, the informed, rational and reasonable Claude pops his head in and gets a brick between the eyes.  Wawrow was half right.   He simply left out the charming and informative side of so many conversations.

I posted +/- one week ago about my plans to visit New York in July.   I think some people read complaint or inconvenience into my post.   Life's good.  I have no complaints and it's hard to make me feel inconvenienced.  I was angry, but the source of my anger was the empty confidence and cynical posturing that is endemic (pun intended) in our leadership and the tribalism that causes us to echo same without making a case.   One good poster suggested I was over thinking.   I can certainly over think.   I'm just not sure my post required very much wattage in this particular instance.   Another good poster suggested I was merely trying to follow the rules as they were announced.   He was right.   I called, I asked, and ....

... I surrendered.

I hosted a ZOOM meeting with my family on Sunday night.   My first time as HOST; I am so modern.   I told them I would not be coming up in July.   There are some truly important family events we were to celebrate together.   I have a son who's graduating from UB, at age 30, with a wife and five kids, after six years in the United States Navy, working full time nights and weekends and going to college during the day.   I have in laws in their mid eighties celebrating a wedding anniversary.   I'm not sure how many they have left.   On July 15, my oldest daughter and her fiancé will decide whether or not to have a September wedding.  For those reading this ... I am not complaining or inconvenienced.   I am sad.  I'm also charging ahead and making new plans.   I am a virus, mutating every day.

I made the decision based on the best information I have and my assessment of caused and assumed risk.  It's the same process I use when I get into a car or swing a golf club.  The equations, the variables, the expected values and the consequences are all different, of course.  My daughter's a Type 1 diabetic.  So am I.  My in-laws are elderly.  The political environment is unstable.  Easy call, border rules and curve-buster chest swelling both irrelevant.

If you tell me anybody not called doctor, or anyone who lives in one state and not another, speaks with more wisdom than I do ... well, have at it, you brilliant conformist, you!

PS .... PA, you mentioned something about a punch and a kiss ... well, some of my most memorable evenings involved both, oh, so long ago.

*  The flu was initially spread by US Soldiers going abroad in WWI.  Spain was neutral, and its press was free.  Warring nations censored the press and deliberately under reported the flu.  It would expose a vulnerability.  The world became aware of the illness on a grand scale when Spanish papers published stories about symptoms, spread and death.  Oh, and Woodrow Wilson ... near ground zero of another plague that still stalks the world, today.

Edited July 2, 2020 by Neo

[Neo]

15 hours ago, Claude_Verret said:

Kind of. There is certainly data out there in controlled lab environments that show that masks work to control the spread of virus. Im more saying that even knowing about this data, if you observe a rise in cases around the same time you see people not following recommended guidelines and you immediately pin that rise on the ignoring of guidelines, then that's unscientific reasoning and it ignores many of the other variables that could be contributing, like the study that I linked to above. Im not going to even pretend to be an epidemiologist, so I don't know how or if they even can tease out something like mask use and its impact from the data being gathered. The bottom line is that we can use the public health measures as best we can to get a handle on this thing, but the virus itself has a say in all of this as well.

John Barry ...   deduced from observation.  Justified leeches for centuries.

[inkman]

14 hours ago, Claude_Verret said:

I'll do what you do best time and time again and simply ignore the content of the post I'm responding to and ask a ridiculous question instead.

Does giving a patient motrin and subsequently watching their fever subside tell you anything about the cause of the fever?

 

Fired up Claude is kinda hot. 

[North Buffalo]

On 7/1/2020 at 7:54 AM, Claude_Verret said:

Kind of. There is certainly data out there in controlled lab environments that show that masks work to control the spread of virus. Im more saying that even knowing about this data, if you observe a rise in cases around the same time you see people not following recommended guidelines and you immediately pin that rise on the ignoring of guidelines, then that's unscientific reasoning and it ignores many of the other variables that could be contributing, like the study that I linked to above. Im not going to even pretend to be an epidemiologist, so I don't know how or if they even can tease out something like mask use and its impact from the data being gathered. The bottom line is that we can use the public health measures as best we can to get a handle on this thing, but the virus itself has a say in all of this as well.

Not following guidelines including quarantining if coming from or living in a hotspot... not just mask wearing, social distancing and hand washing.  Yeh it doesnt preclude other reasons for the spread but it has shown stats wise if not purely scientifically to reduce the spread.  Problem is scientist dont know who is carrying it so controlled studies are still being evaluated.  Though the reduction in cases in NY and Westchester all suggest if not prove the point of wearing a damn mask... socially distancing reduces your potential exposure or transmitting.  All I need to know is my wife and kids didnt get it because I went to a hotel room at first sign of a fever.  We wore masks inside around kids when virus first hit.   And my wife and I work different shifts.  Washed hands cleaned surfaces, bagged scrubs as soon as we came inside.  Wiped down inside of cars.  We both were in the middle of it in hospitals.  Me more than her.  So go ahead and ignore protocols at your own risk.  This debate is inane and frankly pisses me off after seeing so many deaths. Scientifically proven debate at this point is a waste of time when stats show mask wearing and social distancing works even if not perfectly.

[SwampD]

I wonder what the forefathers who sacrificed in the trenches of Europe would think of their grandkids who can’t wear a mask in the grocery store.

[North Buffalo]

1 hour ago, SwampD said:

I wonder what the forefathers who sacrificed in the trenches of Europe would think of their grandkids who can’t wear a mask in the grocery store.

Cant or wont... guessing you meant wont

[MakeSabresGrr8Again]

1 hour ago, SwampD said:

I wonder what the forefathers who sacrificed in the trenches of Europe would think of their grandkids who can’t wear a mask in the grocery store.

You expect them to wear a mask? They can't (or won't) even follow the arrows for traffic flow in the stores. Or in the parking lot.

[SwampD]

1 hour ago, North Buffalo said:

Cant or wont... guessing you meant wont

 

3 hours ago, SwampD said:

I wonder what the forefathers who sacrificed in the trenches of Europe would think of their grandkids who can’t "couldn't possibly wear a mask in the grocery store because they are arrogant self-absorbed turds".

Fixed

[shrader]

3 hours ago, SwampD said:

I wonder what the forefathers who sacrificed in the trenches of Europe would think of their grandkids who can’t wear a mask in the grocery store.

To be fair, those grandkids have been dead for  around 200 years.  So they in fact cannot wear a mask.

Edit: Oops, you said Europe.  I see forefathers and I think revolution days.

Edited July 2, 2020 by shrader