What if there is no cure?

khalessi

JP Liz V1 wrote: »

What about TB vaccine, I think I got this as a kid, ages ago now so probably not still useful

As a frontline worker, when I was 19 I was tested for immunity to TB based on BCG given in 70s and I wasn't immune so had to get it done again, as they wouldn't let us on the wards without it.

Its now nearly 35 years later and I presume based on previous experience to have no immunity and would need BCG agaim

DeVore

Obvious Desperate Breakfasts wrote: »

Zoonotic diseases are indeed rare but this coronavirus is one of them, that's pretty much established. Whether it passes between big cats and humans is academic. It's already passed from an animal to a human.

When a virus jumps from one species to the next, it has to use the cellular mechanics of the new species to replicate itself. That does not always produce a virus that can jump directly back to humans. The virus jumped (its believed) from Bats to Pangdolin, not directly to Humans because the bat virus was too foreign. The intermediate step of Pangdolin was needed to make it compatible with humans.
Dont get me wrong, jumping to Cats is not a good start but I want to deal with certainties as much as possible and until we see that it can jump back, we dont need to slaughter Mr Squiggles juuuust yet

DeVore

Obvious Desperate Breakfasts wrote: »

Well, no, it's also to stop people from catching it. I can't afford to catch it at all because I have a diffuse kind of lung metastases so I'd be very lucky for it not to take me out, even with ventilation. And yes, I will die in the next few years anyway but I have a lot of treatments still available to me and that few years could be five years. I'm 36 years old and I do care if it's two months or two years I have left.

This.

This is why we need to do this.

People like ODB deserve a shot. I have a friend (illustrative case, not anecdotal evidence) who have been diagnosed with terminal cancer with very poor outcomes... like, 0% chance of getting past 5 more years. Buuut, 2 years into it, along comes an experiemental protocol. he goes on it. PSA drops from 4.1 to 0.1. 10 years later he's happy and healthy as get out. Medical advances happen.

People deserve a shot.

timmy_mallet

Obvious Desperate Breakfasts wrote: »

Honestly, it's alarming to hear that there are already vaccines at the human trial stage. The first part of vaccine discovery has been expedited by new technology but the animal and human trials still take as long as ever and I have to wonder what's been jettisoned to allow these vaccines to already be at the human trials stage.

Very very worrying. Especially when your Minister for Health is a fan of government mandates for vaccination.

There's a race to be first to market with a vaccine, and the billions in profit that would be generated from being so will lead to behaviours which are not conducive to concern for public health.

DeVore

There is a pervasive idea that this is a "sick and old peoples" illness... and yes, it predominantly affects the elderly (60+) and the prior-sick.

But it doesnt ONLY affect them.

So lets look at the numbers:
Half of Irish pop is under 37 (https://www.indexmundi.com/ireland/demographics_profile.html )

Death rates for those with no prior conditions is 1% compared with about 7% for those with. (https://ourworldindata.org/coronavirus#case-fatality-rate-of-covid-19-by-preexisting-health-conditions ) (remember some people are going to have had UC's but not known about them!)

However thats basically saying "if you get this, this is your odds".

For age the data is here: https://ourworldindata.org/coronavirus#case-fatality-rate-of-covid-19-by-age

So we see that under 37s have a 0.2% mortality. (This is the current CFR, its probably going to trend downards... )

Thats still 4,000 people under 37 dying from this (trending down). Car crashes for a year is about 350...
Now some of those are going to be people with UC's sure, but by far and away the majority of UC's are also in the "older than 37" cohort.
How many? Anyones guess, but blood pressure, cardiac and diabetes track with age.

Young people without UC's arent exempt from this, they have a much MUCH better chance but its not by any measure 0.

timmy_mallet

DeVore wrote: »

There is a pervasive idea that this is a "sick and old peoples" illness... and yes, it predominantly affects the elderly (60+) and the prior-sick.

But it doesnt ONLY affect them.

So lets look at the numbers:
Half of Irish pop is under 37 (https://www.indexmundi.com/ireland/demographics_profile.html )

Death rates for those with no prior conditions is 1% compared with about 7% for those with. (https://ourworldindata.org/coronavirus#case-fatality-rate-of-covid-19-by-preexisting-health-conditions ) (remember some people are going to have had UC's but not known about them!)

However thats basically saying "if you get this, this is your odds".

For age the data is here: https://ourworldindata.org/coronavirus#case-fatality-rate-of-covid-19-by-age

So we see that under 37s have a 0.2% mortality. (This is the current CFR, its probably going to trend downards... )

Thats still 4,000 people under 37 dying from this (trending down). Car crashes for a year is about 350...
Now some of those are going to be people with UC's sure, but by far and away the majority of UC's are also in the "older than 37" cohort.
How many? Anyones guess, but blood pressure, cardiac and diabetes track with age.

Young people without UC's arent exempt from this, they have a much MUCH better chance but its not by any measure 0.

Alot of that is crap in, crap out, data is just not reliable for now.

No 'known' underlying health condition. I'd be extremely surprised if it did for anyone that age without one, whether diagnosed prior or not.

Wibbs

timmy_mallet wrote: »

Alot of that is crap in, crap out, data is just not reliable for now.

Exactly. It's of almost no value, beyond telling us that older sicker people are the majority of cases and even then, among older sicker people the vast majority won't die from this virus. And them's the figures of diagnosed patients.

Yes we must "flatten the curve" so the health services aren't overwhelmed and more older sicker people die when they didn't have to, never mind those sick because of other conditions entirely not being able to access health care, never mind the burnout of the health workers on the front lines. However there is an absolute metric shit tonne of arm waving and near hysterical figures bandied about around data that is next to bloody useless. Of course if you have serious health issues or are elderly then please please stay safe and the rest who don't, have to sack up and stay the hell at home to help them keep safe until we have viable treatments that flatten the curve even more.

Away With The Fairies

What is the Irish protocol when treating patients in hospital or on ventilator?

A doctor in New York thinks they're treating the wrong disease and symptoms resembles more like high altitude sickness.

Wibbs

You can pretty much ignore one doctor, unless he can show clear results, even preliminary ones. And what does he mean anyway? Lack of oxygen? I'm sure they turn that way up on a ventilator? What does he suggest? Put them in a hyperbaric chamber and crank it up? Then again... The Italians have been working with those "fish bowl" type helmets with positive pressure so...

4068ac1elhodqr

Fear not (maybe), Bill Gates is pouring billions into his own brand of computer whizz medicine.

1st it was $10m, then $100m, now it's billions and a load of factories to make it also on a huge commercial scale.
The chap behind id2020.org has been eagerly planning for a global pandemic for a while now.
Even had a big simulation performed Nov 2019.

Has just packed in his seat at Microsoft (good time to sell the stock), to ensure he can get the entire planet vaccininated with his own special brew.

So the question is, would you accept Bill's (not a virologist) vaccine cure?

Away With The Fairies

Wibbs wrote: »

You can pretty much ignore one doctor, unless he can show clear results, even preliminary ones. And what does he mean anyway? Lack of oxygen? I'm sure they turn that way up on a ventilator? What does he suggest? Put them in a hyperbaric chamber and crank it up? Then again... The Italians have been working with those "fish bowl" type helmets with positive pressure so...

The doctor is Cameron Kyle Sidell. Patients seems to have a lack of oxygen, when they intubate and put them on ventilators, they are using high pressure settings for treating ARDS. He thinks the high pressure is doing more damage to the lungs.

timmy_mallet

Averie Drab Terrier wrote: »

Fear not (maybe), Bill Gates is pouring billions into his own brand of computer whizz medicine.

1st it was $10m, then $100m, now it's billions and a load of factories to make it also on a huge commercial scale.
The chap behind id2020.org has been eagerly planning for a global pandemic for a while now.
Even had a big simulation performed Nov 2019.

Has just packed in his seat at Microsoft (good time to sell the stock), to ensure he can get the entire planet vaccininated with his own special brew.

So the question is, would you accept Bill's (not a virologist) vaccine cure?

Give it 5 to 10 years of any vaccine being administered to the general population after being trialled like this one will be, and then we can talk.

ITman88

Averie Drab Terrier wrote: »

Fear not (maybe), Bill Gates is pouring billions into his own brand of computer whizz medicine.

1st it was $10m, then $100m, now it's billions and a load of factories to make it also on a huge commercial scale.
The chap behind id2020.org has been eagerly planning for a global pandemic for a while now.
Even had a big simulation performed Nov 2019.

Has just packed in his seat at Microsoft (good time to sell the stock), to ensure he can get the entire planet vaccininated with his own special brew.

So the question is, would you accept Bill's (not a virologist) vaccine cure?

That Bill Gates story is incredibly unsettling the more one research’s.

He’s a f***** weirdo

Wibbs

Or someone who used his mind, listened to better minds in the field and realised this was coming. He's been throwing money at fighting malaria too, which kills and debilitates millions. People have been warning about a global pandemic that we wouldn't be prepared for for a long time. Not just Gates. It's a staple of drama on TV and film. And since I'm not a half educated bible bashing prepper from the back roads of Kentucky tugging his wire reading the books of the apocalypse hoping for the rapture, then I'd prefer to go with the widely available to read and understand science. But that's just me.

hatrickpatrick

Obviously this is a hypothetical worst case scenario and I am in no way suggesting that it's likely or even indicated at this stage. This thread is just for speculation.

As Simon Harris and others have pointed out, some viruses - those which directly target and weaken the immune system's attempts to fight them - aren't possible to vaccinate for. It's possible that COVID-19 will be one of those. Can't be vaccinated, can't be treated, and can re-infect a person who has already recovered, on account of conferring no permanent immune response. We don't know any of this yet; again, this is purely a hypothetical possibility at this stage.

Having said all that: What's the end game if this is the case? What happens to society? Do we enter a permanent state of semi-quarantine? Do we never again attend events or venues with large groups of strangers - from smaller ones such as restaurants, bars, cinemas, theatres, conferences, workplaces, schools, colleges, and all the way up to large ones such as festivals, public appearences by leaders and celebrities, and high-attendance sporting events? Do we permanently maintain social distancing, never gathering in groups, keeping two metres apart at all times, not entertaining house guests, etc? Do we self-isolate or "cocoon" indefinitely?

Alternatively, do we simply let the virus run its course, decimating the population, killing millions of people and eventually burning itself out after having killed everyone susceptible and leaving behind only those few with the proper immune configuration to fight it off? Do we essentially sacrifice those who cannot survive the virus in order to return society to normality?

Is there a middle ground in which those who are susceptible have to permanently "cocoon" themselves so that everyone else can safely engage in transmission-risk social behaviour without risking infecting those who are likely to be seriously impacted?

If none of the above - what? If it proves impossible to either prevent or treat this particular virus, and if being infected by it does not naturally provoke an immune "upgrade" to prevent future infection - if it turns out that this virus running rampant in society is a permanent fact of life about which we can do nothing - then what's the end game? How do we proceed as a species from this?

looksee

Then this is what all those people building underground bunkers and storing toilet rolls have been waiting for.

The people buying guns in the US are proposing to barricade themselves in till they starve to death.

In the end it will turn out that a few people have immunity and after a lot of apocalyptic stuff, they will inherit the earth.

suicide_circus

Don't fear the reaper.

hatrickpatrick

looksee wrote: »

Then this is what all those people building underground bunkers and storing toilet rolls have been waiting for.

The people buying guns in the US are proposing to barricade themselves in till they starve to death.

In the end it will turn out that a few people have immunity and after a lot of apocalyptic stuff, they will inherit the earth.

That may be, but what happens policy-wise in the meantime? That's more what I'm wondering. Various people in government have acknowledged that the longer you ask a social species to isolate themselves, the more knock-on problems that causes and the less people are willing to comply. So if it does turn out to be an incurable and unvaccinable virus, what direction does quarantine policy take? Ever stricted and lengthier restrictions with more and more severe enforcement, or let the virus run rampant, come what may?

I'm just wondering what the plan B is - if the restrictions we're currently living with are stated to remain until either a vaccine or treatment is developed, and no such thing materialises over time, what then? From a government policy point of view?

Let's suppose, hypothetically, that we get as far as December and there's no let-up in sight in terms of infections or a treatment thereof. Christmas is approaching, people still aren't allowed to visit eachothers' homes or congregate in groups, public spaces and social businesses - cafes, restaurants, bars, theatres, cinemas etc - are still closed. There's absolutely no way the public will continue to comply with social distancing for that length of time - certainly not to the extent that people have been doing so far. So what happens then, from a policy point of view?

bennyineire

No point in speculating, first a treatment will be available by Autumn then followed by a vaccine. We have literally the whole scientific world and in particular virologists working on this right now.

Most likely there already is an effective vaccine developed as there are already numerous medical trials taken place right now followed by many more soon.

A vaccine and an effective treatment WILL be found and delivered, it's just a matter of time

CoBo55

All very valid points to be fair, in a nutshell, nobody knows. From my teeny tiny knowledge of this virus ( there's very little actual information available) being a coronavirus it's easier to manufacture a vaccine than if it were a common cold type virus I can't remember what it's called.

Harry Palmr

Welcome to my world!

At the extreme we would gradually be reduced to a basic world based on socially distanced agri-communities living roughly like a monk, pleasant in the April-Oct period and fecking miserable in the winter early spring.

hatrickpatrick

bennyineire wrote: »

A vaccine and an effective treatment WILL be found and delivered, it's just a matter of time

The HIV and Malaria viruses would like a word - some viruses evade or hijack the immune system to such an extent that it isn't possible to train it with a vaccine.

As far as treatments go, some of those unvaccinable viruses require lifelong treatment with very heavy medication that causes all kinds of side effects.

It's definitely not as clear cut as saying that every virus can be prevented. Obviusly most can and we're all hoping that this is one of them, but it's not a certain thing by any means.

hmmm

Firstly, this is unlikely. For every scientist saying we won't have a vaccine, there are 20 scientists saying we will. Even partial success would be a good thing. There are over 80 vaccines in development at the moment, and at least 5 are already in human trials. Johnson & Johnson are investing billions to produce their vaccine, even before testing is finished.

Just speculating what the alternative is - development of massive rapid testing. A medical passport for everyone. You wouldn't be allowed into a building or onto public transport without a test which will take seconds/minutes. Anyone over 70 will ask visitors to take a test at their door.

We're going to be trying a smaller, slower version of that over the rest of this year. Tests will get faster as science develops.

Long_Wave

hatrickpatrick wrote: »

That may be, but what happens policy-wise in the meantime? That's more what I'm wondering. Various people in government have acknowledged that the longer you ask a social species to isolate themselves, the more knock-on problems that causes and the less people are willing to comply. So if it does turn out to be an incurable and unvaccinable virus, what direction does quarantine policy take? Ever stricted and lengthier restrictions with more and more severe enforcement, or let the virus run rampant, come what may?

I'm just wondering what the plan B is - if the restrictions we're currently living with are stated to remain until either a vaccine or treatment is developed, and no such thing materialises over time, what then? From a government policy point of view?

Let's suppose, hypothetically, that we get as far as December and there's no let-up in sight in terms of infections or a treatment thereof. Christmas is approaching, people still aren't allowed to visit eachothers' homes or congregate in groups, public spaces and social businesses - cafes, restaurants, bars, theatres, cinemas etc - are still closed. There's absolutely no way the public will continue to comply with social distancing for that length of time - certainly not to the extent that people have been doing so far. So what happens then, from a policy point of view?

The country will have ran out of money before Christmas if this keeps up.

I think it's likely some sort of treatment will be available to prevent the worst outcomes in a few months, from existing medications. Then we will be able to go back to more or less normal, as the health services won't be overwhelmed.

A vaccine will be probably 2 years away, by which time everyone will be infected already.

Otherwise we will all die of starvation from the total collapse of civilisation. On a positive note, climate change will have been solved.

quokula

It's extremely unlikely that neither a vaccine or treatment will be developed.

There are other mitigation methods like faster, more accurate and more widespread testing, more investment in contact tracing, refitting business premises with more protection like separators between desks, sanitisation stations etc, getting more widespread availability of PPE in a variety of settings.

hatrickpatrick

CoBo55 wrote: »

All very valid points to be fair, in a nutshell, nobody knows. From my teeny tiny knowledge of this virus ( there's very little actual information available) being a coronavirus it's easier to manufacture a vaccine than if it were a common cold type virus I can't remember what it's called.

This is based on the fact that Coronaviruses don't mutate nearly as quickly or easily as those which cause more common infections. What's got me wondering about this is that there have been a couple of sporadic reports (and this is very, very, very far from a sure thing which is why I'm speaking hypothetically here) that COVID might be a virus which directly attacks the immune system's T-cells and leaves them unable to fight it off. That's where reports that being infected once doesn't necessarily convey immunity to those recovered patients have been originating over the last couple of weeks. If this is the case, a vaccine against COVID would be useless since vaccines trigger the immune system to respond, but if the virus itself disables that immune response then whether or not the immune system has a response ready for it becomes a moot point.

I'm just wondering what people reckon will happen from a policy point of view if, after a year or two of testing, the scientists working on this come back and say "look we're trying our best, but all indications are that we just have to live with this virus being rampant in the community and there's nothing we can do to stop it other than indefinite quarantine".

weldoninhio

bennyineire wrote: »

No point in speculating, first a treatment will be available by Autumn then followed by a vaccine (speculation). We have literally the whole scientific world and in particular virologists working on this right now.

Most likely there already is an effective vaccine developed (more speculation) as there are already numerous medical trials taken place right now followed by many more soon.

A vaccine and an effective treatment WILL be found and delivered, it's just a matter of time (even more speculation)

Yeah defo no point speculating hahahha

hatrickpatrick

hatrickpatrick wrote: »

I'm just wondering what people reckon will happen from a policy point of view if, after a year or two of testing, the scientists working on this come back and say "look we're trying our best, but all indications are that we just have to live with this virus being rampant in the community and there's nothing we can do to stop it other than indefinite quarantine".

Then it will run rampant. Society will fall apart after a few more months of this. The government can't pay everyone's wages indefinitely.

hatrickpatrick

Deleted User wrote: »

I think it's likely some sort of treatment will be available to prevent the worst outcomes in a few months, from existing medications. Then we will be able to go back to more or less normal, as the health services won't be overwhelmed.

A vaccine will be probably 2 years away, by which time everyone will be infected already.

Otherwise we will all die of starvation from the total collapse of civilisation. On a positive note, climate change will have been solved.

So in other words, the scenario you're describing would mean that while contracting COVID-19 would be an ongoing risk, those who are likely to suffer dangerous and severe symptoms would be able to get a pill or injection of some kind which would prevent that particular outcome and leave them with an illness no worse than a bad cold or flu?

Are there any examples you can think of where this is the case with other viruses? I don't know much about it myself but I do know that HIV, while incurable and so far not possible to vaccinate for, can now be managed through long term medication.