[HN Gopher] Vaccines should end the pandemic, despite the varian...
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       Vaccines should end the pandemic, despite the variants, say experts
        
       Author : mrfusion
       Score  : 93 points
       Date   : 2021-03-13 19:50 UTC (3 hours ago)
        
 (HTM) web link (news.harvard.edu)
 (TXT) w3m dump (news.harvard.edu)
        
       | yaledioma wrote:
       | So also the digitalizzation and 4th industrial revolution will
       | end... Let's hope to don't see the army on the street before 2026
        
         | weakfish wrote:
         | Why the FUD?
        
       | williesleg wrote:
       | Biden ended the pandemic. And the good news is Facebook has
       | pictures of all of us in masks and without masks.
        
       | superkuh wrote:
       | This is a hopeful but possible take. But the 501Y.V2 (B.1.351)
       | and 501Y.V3 (P1) lineages have the mutation within the conserved
       | region for coronaviruses near the spike protein cleavage site.
       | These show massively (1000x) decreased monoclonal antibody
       | binding for original genetic sequence designs. It's better for
       | the mRNA vaccine produced human-body-made antibodies which show
       | only 5-10x reduction in binding.
       | 
       | But antibody binding isn't the full story and there may be T-cell
       | stuff helping too. The data seems to indicate updated spike
       | protein designs will be needed but if there's other stuff going
       | on we don't know about old spike vaccines could still work. I
       | can't say it will definitely _help_ because the vaccine rollout
       | is so slow and air travel is so fast that this negative pressure
       | will probably provoke more variants as long as host numbers
       | remain high.
       | 
       | ref: "Antibody Resistance of SARS-CoV-2 Variants B.1.351 and
       | B.1.1.7" [pdf]
       | https://www.nature.com/articles/s41586-021-03398-2_reference...
       | https://i.imgur.com/8co1IoL.jpg "SARS-CoV-2 VoC B.1.1.7 and
       | B.1.351 neutralization evasion" table.
       | 
       | https://covariants.org/variants/S.501Y.V2
       | https://covariants.org/variants/S.501Y.V3
        
         | hanklazard wrote:
         | The monoclonal data is less concerning since the human antibody
         | response is polyclonal. It's not surprising that this virus can
         | escape from a single targeted antibody and if I were in pharm,
         | this is why I wouldn't spend billions on a mAb drug. I agree
         | that the decreased convalescent plasma effectiveness is not
         | ideal but I doubt this virus will be able to fully escape the
         | mRNA vaccines on a population level.
         | 
         | Polyclonal antibodies against spike + t-cells + herd immunity
         | _should_ be enough to quell this pandemic. At least I hope so.
        
         | Pyramus wrote:
         | Thank you for the references!
        
         | randomsearch wrote:
         | How does a 5x reduction in binding actually impact infection?
        
       | cybert00th wrote:
       | >Galit Alter, professor of medicine at Harvard Medical School and
       | the Ragon Institute of MGH, MIT, and Harvard, said the fast-
       | spreading U.K. variant seems able to evade some vaccine
       | protection, and the South African variant appears able to skirt
       | even more. Despite that, she said, none have completely escaped
       | the body's post-vaccination immune responses.
       | 
       | Weak on facts and strong on persuasive language:
       | 
       | >seems able to evade
       | 
       | Either they can evade or they can't, there's no seeming to about
       | it!
       | 
       | >appears able to skirt even more
       | 
       | Either it can skirt around or it can't, there's no appearing
       | about it!
       | 
       | And anyway, herd immunity to these kinds of viruses comes from
       | full-blown exposure - not hiding behind a vaccine.
       | 
       | After all is said and done, this is all about money and power - a
       | great pile of public money and the opportunity to concentrate the
       | power to run countries in the hands of a few for as long as
       | possible.
       | 
       | And then too, the opportunity for academicians to puff their CVs
       | and to ensure their place in the sun of scholarly tenure and
       | advancement.
       | 
       | I rest my m'lud.
        
         | throwaway72h9a wrote:
         | Yeah I make it a point to never trust the opinion of "experts"
         | on such matters which can potentially create panic in society.
         | It's just far easier to sound assuring than tell the naked
         | truth as it is.
         | 
         | Most of these experts earlier said that the UK variant was
         | nothing to worry about. Now we know it not only spreads faster
         | but is also much deadlier. Same thing might happen here.
        
           | h3cate wrote:
           | Here in the UK we've already been warned that the new
           | Brazilian variant is unlikely to be stopped by vaccines. It's
           | surprising to see this story pop up all of a sudden.
        
             | [deleted]
        
       | credit_guy wrote:
       | What I don't understand is this: with tens of millions of people
       | already vaccinated, why aren't we seeing a huge drive to collect
       | plasma from vaccinated people with high level of antibodies? In
       | the early days of the pandemic (about 1 year ago), I remember
       | China sent a large amount of plasma to Italy.
       | 
       | Why can't the US do the same now? The US is sitting on millions
       | of AstraZeneca vaccines (that are not even approvad by the FDA),
       | and doesn't want to share. How about sending plasma?
        
         | sm4rk0 wrote:
         | Maybe because it's not profitable?
        
           | mensetmanusman wrote:
           | Here the billboards are advertising $700 for plasma donation.
        
         | xadhominemx wrote:
         | Because it's a lot easier to manufacture and distribute the
         | vaccines
        
       | bsaul wrote:
       | i'm very surprised to see remdesivir mentionned in this article
       | at all... Isn't this drug officialy not working at all against
       | covid-19 , and as such should be banned because of perfusion
       | side-effects ? (in addition to the fact that it seems to be known
       | to increase the amount of virus genetic mutations in people
       | treated with it)
        
         | inglor_cz wrote:
         | Here in the Czech Republic, doctors in Brno are trying a
         | combination of remdesivir and convalescent plasma in
         | oncological Covid patients. They say that the combo has, so
         | far, worked much better than either of the components in
         | isolation. Out of the small cohort, they lost no one so far.
         | 
         | Source in Czech:
         | https://ct24.ceskatelevize.cz/jihomoravskykraj/3278822-brnen...
        
           | mfkp wrote:
           | That's the treatment that I got back in September in the US.
           | I think they stopped using Remdesivir since then because it
           | didn't correlate with any positive outcome. It also was
           | destroying my liver, so they had to cut off the treatment
           | halfway through.
           | 
           | https://www.forbes.com/sites/jvchamary/2021/01/31/remdesivir.
           | ..
        
             | inglor_cz wrote:
             | Maybe the total balance of results is better for
             | immunosuppressed oncologic patients.
             | 
             | Or maybe it is just a form of medical nationalism, given
             | that the leader of the Remdesivir scientific team, Tomas
             | Cihlar, is a Czech scientist.
             | 
             | We had some critical patients improve and heal on
             | remdesivir, though. I wonder how big of a role genetic
             | diversity plays. There are many uncertain suspicions that
             | Covid hits some people harder than others based not just on
             | lifestyle, but things such as blood groups.
             | 
             | Research into that will be a good PhD material for years to
             | come.
        
           | nl wrote:
           | One thing I've learnt from the whole C19 treatment debacle is
           | to never ever trust any single study.
           | 
           | Unlike computer science where if you test something and it
           | works once you and then you expect it to work for everyone,
           | in medical research if you see an effect in one treatment
           | study you probably won't see the same effect elsewhere.
           | 
           | For treatments (unlike controlled vaccine studies) the
           | cohorts are too small and there are too many other variables.
        
             | inglor_cz wrote:
             | Absolutely. The study may even be valid in certain
             | conditions, but still fail to replicate elsewhere.
             | 
             | People differ. Healthcare systems differ. Too many small
             | details, too small to document, differ.
        
         | Robotbeat wrote:
         | I'm as skeptical of your last parenthetical as you should be
         | about remdesivir's overall effectiveness. In any case, the
         | effects are too small to matter.
        
         | marcodiego wrote:
         | Isn't remdesivir being used only in cases of viral pneumonia on
         | ICU patients?
        
       | thepangolino wrote:
       | These kind of pandemic tend to end themselves after about 20-30
       | months. We're about half way there anyway.
        
         | 2-tpg wrote:
         | You are correct. The pandemic may end after about 20-30 months,
         | but this novel coronavirus will stick around. It is going to be
         | a community virus, such as the Spanish flu turned into seasonal
         | influenza. People pushed back hard against the experts when
         | they started talking about preparing for herd immunity and 70%+
         | infected. So, this messaging has become more careful.
         | 
         | A few months later the debate will turn to this being leaky
         | vaccines (vaccinated still shed virus, but may not get really
         | sick). Officially, this is also: We just don't know, we are
         | monitoring it. But all the monkeys showed shedding. Trial
         | participants showed shedding. This is a leaky vaccine. What
         | happened to the targeted disease, when we used a leaky vaccine
         | in life stock can be read here:
         | https://en.wikipedia.org/wiki/Marek%27s_disease
         | 
         | Edit: I'd like a single expert predicting that our current
         | vaccines will eradicate novel coronavirus. That would prove the
         | downvoted post wrong. You'll find many experts agreeing that
         | novel coronavirus is going to mutate and live among humans for
         | a long long time after the crisis is over. Facts, people.
        
           | zamfi wrote:
           | > A few months later the debate will turn to this being leaky
           | vaccines
           | 
           | Made a bit more complicated by the fact that not all vaccines
           | have the same properties here...somehow seems the mRNA
           | vaccines do better at preventing shedding than the
           | adenovirus-based ones [0].
           | 
           | [0]: https://www.nejm.org/doi/full/10.1056/NEJMoa2024671
        
           | 1996 wrote:
           | I can't believe you are getting downvoted!
           | 
           | This is a real risk!
           | 
           | Relevant quote:
           | 
           | > Under normal conditions, highly virulent strains of the
           | virus are not selected. A highly virulent strain would kill
           | the host before the virus would have an opportunity to
           | transmit to other potential hosts and replicate. Thus, less
           | virulent strains are selected. These strains are virulent
           | enough to induce symptoms but not enough to kill the host,
           | allowing further transmission. However, the leaky vaccine
           | changes this evolutionary pressure and permits the evolution
           | of highly virulent strains.[12] The vaccine's inability to
           | prevent infection and transmission allows the spread of
           | highly virulent strains among vaccinated chickens. The
           | fitness of the more virulent strains are increased by the
           | vaccine.
           | 
           | (...)
           | 
           | > Highly virulent strains have been selected to the point
           | that any chicken that is unvaccinated will die if infected.
           | Other leaky vaccines are commonly used in agriculture. One
           | vaccine in particular is the vaccine for avian influenza.
           | Leaky vaccine use for avian influenza can select for virulent
           | strains which could potentially be transmitted to humans.[13]
        
             | alkonaut wrote:
             | > This is a real risk!
             | 
             | I never heard this discussed as a big "risk". As far as I
             | know this was always more or less known to be the endgame
             | and not even a dangerous outcome but the "good" scenario.
             | 
             | Once it's an established coronavirus, it can be like the
             | other known human coronaviruses we already have. The reason
             | you don't die from OC43 at age 75 now is because you
             | probably cought it a few times before that. It's not
             | necessarily because OC43 doesn't have a high IFR at high
             | ages. We don't know that because we don't have a large
             | sample of it. For all we know, one or more of the existing
             | HCOVs may have been quite a deadly disease back when it
             | entered the population.
             | 
             | We aren't going to exterminate SARS-COV2. Especially
             | obvious since it's not limited to humans (present in mink,
             | cats, primates, ...). And that's not going to be a big
             | problem.
        
           | xiphias2 wrote:
           | It's the first time we have mRNA vaccines available, which
           | makes it much easier to update / mix different variations of
           | the virus than earlier technologies. The mass production is
           | still not optimized, but at least the incentives are huge at
           | this point.
        
         | loloquwowndueo wrote:
         | Citation needed.
        
           | 2-tpg wrote:
           | Maybe China can help with a cite. They did have a 5-6 month
           | head start and first encountered: brain-blood barrier pass,
           | blood cloths and brain/lung aneurisms, reinfection, patient
           | 0, airborne COVID, effect of mask wearing, pets getting
           | infected, and more.
           | 
           | Too bad they don't allow the WHO full access to investigate,
           | nor share critical information with the rest of the world,
           | now suffering thousands of deaths. Most likely is a lab leak
           | accident (Israel, UK, and US all said as much!). But
           | unfortunately, the "China Virus" has become a political
           | issue, and you won't find cites in the popular media anymore.
           | Just articles about xenophobic conspiracy theories, and to
           | listen to health experts when they tell you masks are not
           | protective, go eat at China Town to show your support, don't
           | worry about losing weight, and that vitamin D deficiency is a
           | hoax.
        
         | hannob wrote:
         | Which other pandemic do you think is even remotely comparable
         | to Covid-19? (All pandemics with a comparable transmission rate
         | happened in times that simply aren't comparable to the modern
         | world in terms of mobility, which obviously affects the way
         | this goes.)
        
           | ArkanExplorer wrote:
           | COVID is different because it is occurring against a backdrop
           | of extremely aged and obese populations, in a year (2020)
           | which followed a weak flu season (2019), and in an election
           | year in the USA (2020) where all health decision were heavily
           | politicised.
           | 
           | https://www.medrxiv.org/content/10.1101/2020.11.11.20229708v.
           | ..
           | 
           | "In Sweden, the observed increase in all-cause mortality
           | during Covid-19 was partly due to a lower than expected
           | mortality preceding the epidemic and the observed excess
           | mortality, was followed by a lower than expected mortality
           | after the first Covid-19 wave. This may suggest mortality
           | displacement."
           | 
           | Sweden had about the same mortality spike in 2009 from Swine
           | flu: https://swprs.org/wp-content/uploads/2020/10/sweden-
           | monthly-...
        
         | spicybright wrote:
         | How?
        
           | qbasic_forever wrote:
           | If we're lucky the virus mutates into a very transmissible
           | but not very symptomatic or damaging to humans variant. It's
           | speculated that's how the 1918 flu pandemic eventually ended.
        
             | simonh wrote:
             | That's true, but before that happened it appears to have
             | mutated into a considerably more virulent and deadly form
             | that dominated in the second wave. COVID probably would
             | eventually burn itself out into a less lethal form, but
             | there's no telling how long or rocky the road to that could
             | be.
        
         | stormbrew wrote:
         | The last pandemic with a death toll anything like (actually
         | much worse than) COVID-19 is the still-ongoing HIV pandemic.
         | It's entering its 40th _year_.
        
           | Trasmatta wrote:
           | It's crazy to think about how HIV has killed some ~32 million
           | people, and yet we rarely hear about it anymore. COVID
           | probably won't even hit 4 million deaths (barring some much
           | deadlier variant that we can't easily produce a new vaccine
           | for).
        
             | monoideism wrote:
             | Yeah, but that's > 3 million over 12 months vs 32 million
             | over 40 years, the majority before 2010.
             | 
             | AIDS was a huge deal back when there was no treatment for
             | it.
        
               | Trasmatta wrote:
               | Right, I don't mean to downplay the severity of COVID at
               | all. It's just interesting that we generally don't hear a
               | lot about HIV/AIDS anymore, even though there were still
               | 690,000 deaths associated with it in 2019.
               | 
               | I also realize that probably depends largely on where you
               | live.
        
           | mensetmanusman wrote:
           | 1 million per year... endemic versus epidemic
        
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