Fear and Loathing, a Rat Flu Odyssey

[jono]

If it were me, and speaking as a veritable robot (aside from losing my shit on TGR from time to time), I'd let the emotional argument win. Living arrangements are emotional things.

[Yonder_River]

Question for the epidemiologist dentites here.

Sister and BIL were in a room with a marriage councilor 9 days ago. Everyone was masked and 6 feet apart, 50 minutes.

The Councilor called today to let them know that she found out she had been exposed the day before and tested positive today and contacted all her client that she had seen after the exposure.

BIL wants to get tested. I told my sister that it was probably a waste of time and that going in for a test puts them at some risk of another exposure.

Thoughts?

I'd get tested if I were them as there is a significant chance they got it if they wore the basic cloth masks and in a closed room. If testing is not drive up, I would probably wear a mask with a filter.

My brother and family currently have it. As far as he can tell he gave it to his running buddy earlier this week when they spent an hour together. Never inside and just running a few feet away side by side. That type of spread caught me off guard and I have a healthier respect for outdoor situations now.

[Bunion 2020]

My brother and family currently have it. As far as he can tell he gave it to his running buddy earlier this week when they spent an hour together. Never inside and just running a few feet away side by side. That type of spread caught me off guard and I have a healthier respect for outdoor situations now.

Vibes, gotta wonder if it is the new supposedly more virulent strain.

RE the family: Will a test be corrupted if they have been vaccinated?

[Benny Profane]

Is this where things go South and we start turning into Zombies?

And this sketchy ski season comes to a screeching halt.

[jono]

RE the family: Will a test be corrupted if they have been vaccinated?

Seems not--ModeRNA trial used RT-PCR (and symptoms and blood tests) to identify infections.

[tetzen]

What's the currently understood lag time between an exposure and becoming infectious to others at this point? 2-10 days?

[old goat]

Vibes, gotta wonder if it is the new supposedly more virulent strain.

RE the family: Will a test be corrupted if they have been vaccinated?

According to Mofro no. I asked that question. The test detects nucleic proteins, not the spike proteins the vaccine produces.

A friend of ours, vaccinated twice (over 65, does PT in nursing home) who my wife walks with--distanced, masks, just tested positive. One data point re the "does the vaccine prevent transmission" question. Possible that she acquired the virus while the second dose was still ramping up, but the first dose obviously didn't prevent it. The friend is asymptomatic.

[jono]

It sure would be nice to hear that someone is tracking that, testing her daily, etc. Feels like doing a phase 3 via mass rollouts as you've described would be good until we lost all the data that wasn't collected. You know, the sort of basic thing we could have taken for granted until recently.

[Tri-Ungulate]

RE the family: Will a test be corrupted if they have been vaccinated?

Bunion, the question is more complicated, like much in the biology realm. It's actually a really good question.

Short answer is "probably" no, albeit theoretically possible.

Edit to add "almost certainly no" for reasoning at the end:

The subtlety exists in that there are several different CLIA-approved COVID19 tests out there, both nucleic acid (PCR) based as well as protein (antibody) based. In fact, Intermountain Health Care uses two different PCR assays, both in wide use, which target different parts of the SARS CoV2 transcript for detection (actually, one of the assays targets the spike protein, which is what is coded for by both the ModeRNA and Pfizer mRNA vaccines).

In general, the extant PCR and antibody tests should target a part of the virus that isn't the same as that coded for by the vaccine, and therefore be able to distinguish between the two, but TBH, I can't tell if this is the case myself, as I can't actually find the primer sequences the PCR tests use, nor all the epitopes the different antibody tests are designed to recognize.

I can only assume that there's no overlap, 'cuz this issue should (almost certainly) have been anticipated by those designing and approving the tests. There's also redundancy and Quality Control built into the assays that oughta minimize the possibility of false positives in immunized patients.

I guess my point is that in a sense, its kind of a Wild West scenario in many ways, with plenty of unknowns and unexpected twists and turns, and the medical and scientific community is refining the approach as they go. Which is as it should be.

[old goat]

It sure would be nice to hear that someone is tracking that, testing her daily, etc. Feels like doing a phase 3 via mass rollouts as you've described would be good until we lost all the data that wasn't collected. You know, the sort of basic thing we could have taken for granted until recently.

We'd be relying on post-marketing surveillance, as is currently done with all drugs. Anyone vaccinee who tests positive is reported by their doctor or test facility along with whether they were symptomatic. It certainly wouldn't be as accurate as a randomized controlled trial but it should give a good idea fairly quickly if the efficacy is 20% or 80%. I don't believe either Pfizer or Moderna has done routine follow up testing after the second dose, have they, or have they just not reported it---so even those trials were not as comprehensive as they could have been.

Scientists want science. They want data as precise as they can get it. Doctors want enough information to make or keep people well. I think the medical approach is what is required at this time. If we get the pandemic under control and the virus becomes endemic people can go back and do more careful studies--probably with comparative controls, not placebos.

And it's not just the thousands dying every day or the tens of thousands of cases. It's also the people who will never get sick will have their lives ruined by the economic catastrophe who deserve a more aggressive approach.

[jono]

Don't get be wrong, I think you're right about what should happen. There are a lot of kinds of useful data, as AstraZeneca has obviously argued successfully elsewhere. I just expect we've gone far enough down this road that now we'll look to add 2 more vaccines to emergency use and continue the emergency for as long as it takes. At least, that looks like the near-term plan--sure would be nice to be wrong, but even with the will, how fast can the ship be turned?

[Casey E]

Keep the restrictions in place in the meantime, a modeling attempt says

https://www.nytimes.com/interactive/...e=articleShare

[glademaster]

Keep the restrictions in place in the meantime, a modeling attempt says

https://www.nytimes.com/interactive/...e=articleShare

What restrictions? I live in a county with the highest incidence rate in the state and it looks distressingly like "business as usual" around here. Big crowds, long lines, shitty mask compliance, a total disregard for social distancing, etc. Your odds of getting COVID here now are about 1000x higher than your odds of getting a vaccine.

[Kinnikinnick]

What restrictions? I live in a county with the highest incidence rate in the state and it looks distressingly like "business as usual" around here. Big crowds, long lines, shitty mask compliance, a total disregard for social distancing, etc. Your odds of getting COVID here now are about 1000x higher than your odds of getting a vaccine.

Restaurants are open for full occupancy in person dining?



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[Ted Striker]

@glade, where did you move to again?

[AK47bp]

@glade, where did you move to again?

Freedom County in the Wuhan District I think.


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[k2skier112]

So sorry aboot that.

fify

[seano732]

Bunion, what are the test sites like where your sister and BIL would get tested? The main one here is drive thru, very low exposure risk......

[bodywhomper]

What disturbing to me is the scale of societal burn-out. Many SMEs predicted that we will be entering the worst of times now, and they are now saying that their predictions are ringing true (easy prediction), but shit keeps opening up more and more. High schools, restaurants, and other indoor venues. Heard about restaurants in Chicago? Small bubbles/pods are opening up. New president, implementing actual solutions, etc., people are letting their guard down.

[Bunion 2020]

What disturbing to me is the scale of societal burn-out. Many SMEs predicted that we will be entering the worst of times now, and they are now saying that their predictions are ringing true (easy prediction), but shit keeps opening up more and more. High schools, restaurants, and other indoor venues. Heard about restaurants in Chicago? Small bubbles/pods are opening up. New president, implementing actual solutions, etc., people are letting their guard down.

If our Governor has his way it will be back to the usual by March.

[yeahman]

It's inevitable. Human beings are social creatures.

[LongShortLong]

Myocarditis (heart injury) in 60% of post-Covid athletes. Study shows



Somewhere after the 51 minute mark, Dr. Seheult says usual treatment is to avoid exertion until you're good and sure the heart muscle is back to normal. Listen to your own doc.

[LongShortLong]

What's the currently understood lag time between an exposure and becoming infectious to others at this point? 2-10 days?

I think CDC is saying something like this. I also think the evidence shows about 20% are infectious after 10 days. Sorry, no reference handy. Some international or national health body should have this evidence.

And to Bunion's concern, if the councilor was in fact infected the previous day, they most likely weren't yet infectious when your sister and BIL visited. Ofc, some folks are less proactive about notifying contacts of exposure, so councilor could have been exposed earlier, and infectious earlier. I commend that councilor for demonstrating honest and proactive behavior, would hire.

[tetzen]

LSL, is your understanding earliest infectious date is usually 2 days then, post-exposure?

[BobMc]

Bunion, what are the test sites like where your sister and BIL would get tested? The main one here is drive thru, very low exposure risk......

Same here. When I got my test I never left my vehicle. Pulled in to first lot, rolled down my pass window, woman fully PPE’d up like an astronaut handed me instructions and a vial. Parked, filled the vial with saliva, followed instructions to add some kind of fluid, shake, call phone number and drive to next lot to drop off the vial to another astronaut.

No exposure to anyone.