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Thread: ☣ Coronavirus ☣

  1. #3876
    Member
    Registered: Mar 2005
    Location: Netherlands
    So, Starker, faetal et al, are you still of the opinion that omicron is not more infectious but makes people less sick? Because that's not at all what I've been hearing from pretty much every news outlet over here and reports coming in from countries like the UK, Denmark and Spain. The overall consensus I keep hearing is that it does spread more quickly but that people get less ill from it. For example that the number of infections rises very quickly, but the number of hospital admissions rises far less quickly, and of the covid patients in the hospital, fewer people have to be moved to the ICU and can instead stay on regular wings until they get better. I bow to the knowledge of people like faetal, but it does look more and more like the early reports of it being more infectious but the infections being less severe are true.

    Not being argumentative, but genuinely curious for your opinions.

  2. #3877
    Member
    Registered: May 2004
    I don't think faetal ever said one way or another, but here's where I'm at...

    My opinion is closely tied to the virologists I follow, particularly on TWiV. When people who have had decades of experience in the lab and are keeping up with the literature are claiming something, I can't easily dismiss them over TV pundits, if not for any other reason than I simply don't have the knowhow to refute their arguments. But what they say does make sense to me and it is based on solid reasoning and data.

    And it's not like this means the virus is necessarily unchanged in its transmissibility/virulence, it's just that we currently have no reason to believe so, until there's evidence for it. It's not that I trust scientists, necessarily, but I do have a large degree of trust in the scientific process (which is not flawless or infallible by any means).

    Also, it's not like it's a dogmatic belief -- they constantly review the evidence for and against and give a honest try to overcome their biases and do change their mind from time to time if there's good reason to believe otherwise, from what I've seen.

  3. #3878
    Member
    Registered: Aug 2009
    Location: thiefgold.com
    In my area, they're now taxing the willingly unvaccinated. I can't say I'm against it

  4. #3879
    Member
    Registered: May 2004
    Oh, sorry, I forgot to actually answer the question. Yes, I still do think that way.

    I think the virus causing less severe disease is more easily explained by changes in the host than the virus -- people who have been vaccinated or have been previously infected are having better outcomes, because their immune systems have adapted to the virus, not vice versa. This seems to be supported by the ICU data, where there seems to be a large disparity between vaccinated and unvaccinated people. And (especially unvaccinated) people still do get very ill and die with the Omicron variant, so at the very least it's still fairly dangerous.

    And as for the virus not having to become more transmissible to spread better, I think the Dutch viral transmission expert (Ron Fouchier) I linked to previously made very convincing arguments on TWiV in that regard, especially in comparison with the flu. And I think these arguments are still as valid as they were pre-Omicron.
    Last edited by Starker; 11th Jan 2022 at 20:14.

  5. #3880
    Member
    Registered: Aug 2009
    Location: thiefgold.com
    Quote Originally Posted by Starker View Post
    I think the virus causing less severe disease is more easily explained by changes in the host than the virus -- people who have been vaccinated or have been previously infected are having better outcomes, because their immune systems have adapted to the virus, not vice versa. This seems to be supported by the ICU data, where there seems to be a large disparity between vaccinated and unvaccinated people. And (especially unvaccinated) people still do get very ill and die with the Omicron variant, so at the very least it's still fairly dangerous.
    I'm reading it is indeed less virulent overall


    A shift in symptoms reflects those trends, del Rio says. In the hospital, patients are showing up less often with pneumonia-like symptoms and hyperactive immune systems, as seen in previous waves. Instead, they’re more often presenting with congestion and scratchy throats. “In Omicron, the symptoms are more like a head cold,” he says.
    Unlike previous variants, Omicron appears unable to infect lung cells as efficiently, which in turn makes it less damaging and the symptoms less severe. Viral loads are significantly lower in the lungs of Omicron-infected rodents in some studies. But in the upper respiratory tract, which includes the nose and sinuses, Omicron seems to replicate more than a hundred times faster than Delta.

    That mix of changes—the preference for the upper airway, better immune invasion, and high transmissibility—reflects how evolution pushes the virus to ensure its own future by replicating and spreading even when that does not make individuals sicker.

  6. #3881
    Member
    Registered: Mar 2005
    Location: Netherlands
    Quote Originally Posted by Starker View Post
    Oh, sorry, I forgot to actually answer the question. Yes, I still do think that way.

    I think the virus causing less severe disease is more easily explained by changes in the host than the virus -- people who have been vaccinated or have been previously infected are having better outcomes, because their immune systems have adapted to the virus, not vice versa. This seems to be supported by the ICU data, where there seems to be a large disparity between vaccinated and unvaccinated people. And (especially unvaccinated) people still do get very ill and die with the Omicron variant, so at the very least it's still fairly dangerous.

    And as for the virus not having to become more transmissible to spread better, I think the Dutch viral transmission expert (Ron Fouchier) I linked to previously made very convincing arguments on TWiV in that regard, especially in comparison with the flu. And I think these arguments are still as valid as they were pre-Omicron.
    Yeah, maybe faetal didn't actually say that, sorry about that. Still, I would be interested in his opinion given the recent data.

    I don't follow these in-depth virology sites and videos as well as you do, Starker, and I respect the time and effort you're putting into that. But in all fairness, I don't get my news from TV pundits either (not really a thing here in the Netherlands), I watch the 8 o'clock news on public tv, follow several reputable news sites and read a quality newspaper everyday. If they talk about the signs showing that omicron is more transmissible but the infections are less severe, it's because they consult experts who claim that. They're frequently talking to world renowned experts like Marion Koopmans and Ab Osterhaus. And as Azaran showed, it's easy to find news sources online that claim the same thing.

    Also, but this is just my own opinion, it just makes sense. Here in the Netherlands we're seeing a very steep rise in infection numbers. You might chalk it up to the vaccines becoming less effective over time, but the rise is too sudden and too steep, and coincides too perfectly with omicron becoming the dominant strain, for me to chalk it up to that. Also, omicron becoming the dominant strain happened so quickly after it was introduced here, that I find it most likely it's more transmissible. Otherwise I would expect it becoming dominant would take far longer, or delta and omicron would co-exist in more or less equal amounts. As it happens delta is quickly fading, most new infections are omicron. As for people becoming less sick, it's a bit too soon to tell with the Dutch data, because it takes some time for a rise in infection numbers to show up in the number of hospital admissions. That number is stable at the moment, we'll have to see how it develops. But with taking the data from other countries into account, it does appear to me that the infections are less severe. The TWiV experts might claim differently, but as I said, experts who do claim more transmissibility and less severity are also easily found.
    Last edited by Harvester; 12th Jan 2022 at 04:41.

  7. #3882
    Member
    Registered: Dec 2020
    Starker, what's your take on the current daily new cases? worldometers has the current outbreak at 2.6 million positive cases a day worldwide. The previous peak number of cases per day was 820,000. Something is going on with the case numbers with Omicron, they completely eclipse anything seen in either the original or Delta outbreaks. And it's still going pretty much straight up at the moment, so it's hard to say what the peak number of daily cases will be here.

    https://www.worldometers.info/coronavirus/

  8. #3883
    Member
    Registered: Dec 2006
    Location: Berghem Haven
    Quote Originally Posted by Azaran View Post
    In my area, they're now taxing the willingly unvaccinated. I can't say I'm against it
    Here in Italy for the over 50.

    100 euro. Una Tantum.
    LOL (a good thermometer cost, you risk way more parking your car where it's not allowed)

  9. #3884
    Member
    Registered: Dec 2006
    Location: Berghem Haven
    Quote Originally Posted by Azaran View Post
    I'm reading it is indeed less virulent overall
    And it's all we're hoping for.

  10. #3885
    Member
    Registered: May 2004
    Quote Originally Posted by Azaran View Post
    I'm reading it is indeed less virulent overall
    But this is all covered ground? We talked about these claims already. People who have been vaccinated or previously infected have less severe illness upon reinfection. That doesn't mean the virus itself has become less virulent, but rather that there is a degree of immunity conferred by vaccines and previous infections that allows the immune system to deal with the virus before people become seriously ill.

    And with South Africa in particular being cited as proof, there are some things to take into account -- the demographics skew much younger, a lot of the hospitalisations were actually reinfections, and a lot of the people who tested positive were in the hospital for unrelated reasons, meaning they were asymptomatic. But the newspaper article doesn't mention any of that, just that there were less hospitalisations with Omicron.

    Also, ironically, it cites a paper that actually claims the opposite to what the article is saying:

    National Geographic:
    Omicron is between two and four times more contagious than Delta
    The paper it cites:
    Our findings confirm that the rapid spread of the Omicron VOC primarily can be ascribed to the immune evasiveness rather than an inherent increase in the basic transmissibility.

    Quote Originally Posted by Harvester View Post
    They're frequently talking to world renowned experts like Marion Koopmans and Ab Osterhaus. And as Azaran showed, it's easy to find news sources online that claim the same thing.
    That's fair, but I showed where the National Geographic article was leaping to conclusions, and if a publication of that caliber makes such mistakes, why wouldn't others? It's easy to find experts that already agree with what you're trying to say and for some reason, I don't see them seeking out opinions contrary to that? For sure, though, I'd be interested in reading these experts' explanations why it's more transmissible / less virulent, if they have any proof that it's the case. But pointing to case numbers and hospitalisation rates isn't really proof in and of itself, if there's a good alternative explanation for it.

    Quote Originally Posted by Harvester View Post
    Also, but this is just my own opinion, it just makes sense. Here in the Netherlands we're seeing a very steep rise in infection numbers. You might chalk it up to the vaccines becoming less effective over time, but the rise is too sudden and too steep, and coincides too perfectly with omicron becoming the dominant strain, for me to chalk it up to that.
    Ah, it's not that the vaccines are becoming less effective. I'm sorry if I gave that impression anywhere. As far as I know, the vaccines are as effective as they have been for what they were designed to do -- preventing disease and death. But they weren't designed to prevent infection, from what I've heard. Apparently, of all the vaccines that we have (for any disease), only two are able to do that and only one of them is for humans.

    Quote Originally Posted by Cipheron View Post
    Starker, what's your take on the current daily new cases?
    According to most of the scientists I follow, the increased fitness of the virus and people's changed behaviour at the post-vaccination holiday season are enough to explain the current wave. I don't have the know-how to assess it myself, so I'm relying on their expertise in this matter.

  11. #3886
    Member
    Registered: Mar 2005
    Location: Netherlands
    Quote Originally Posted by Starker View Post
    That's fair, but I showed where the National Geographic article was leaping to conclusions, and if a publication of that caliber makes such mistakes, why wouldn't others? It's easy to find experts that already agree with what you're trying to say and for some reason, I don't see them seeking out opinions contrary to that? For sure, though, I'd be interested in reading these experts' explanations why it's more transmissible / less virulent, if they have any proof that it's the case. But pointing to case numbers and hospitalisation rates isn't really proof in and of itself, if there's a good alternative explanation for it.
    To be honest, I haven't read any papers by scientists arguing for or against my position. I only wanted to report on the consensus of mainstream media outlets over here in the Netherlands. Last weekend I read an interview with my newspaper's science reporter answering questions from readers about the virus, and he said he does read Lancet papers and such in his spare time to keep his knowledge up-to-date. So some reporters might be clueless but that isn't the case for all of them.

    Quote Originally Posted by Starker View Post
    Ah, it's not that the vaccines are becoming less effective. I'm sorry if I gave that impression anywhere. As far as I know, the vaccines are as effective as they have been for what they were designed to do -- preventing disease and death. But they weren't designed to prevent infection, from what I've heard. Apparently, of all the vaccines that we have (for any disease), only two are able to do that and only one of them is for humans.
    No, I know that vaccines are effective, it's just that people have had their shots like 6 months ago and by now the antibody count is much lower (though the T-cells are still doing their thing). That's why we give booster shots, the Netherlands has made a slow start with the booster campaign but we're catching up. I've already had mine. So what I meant to say is that one could say that the sudden rise in infection numbers is due to diminishing effects of the original two shots, but I personally believe the numbers are rising too suddenly and too quickly for that to be the sole cause.

    I know that the purpose of the covid vaccines is to prevent serious illness, hospitalizations and deaths, but that you can still get infected. The whole "you can still get infected so the vaccines clearly don't work" is a bullshit argument frequently trotted out by anti-vaxxers.

  12. #3887
    Member
    Registered: May 2004
    Quote Originally Posted by Harvester View Post
    To be honest, I haven't read any papers by scientists arguing for or against my position. I only wanted to report on the consensus of mainstream media outlets over here in the Netherlands. Last weekend I read an interview with my newspaper's science reporter answering questions from readers about the virus, and he said he does read Lancet papers and such in his spare time to keep his knowledge up-to-date. So some reporters might be clueless but that isn't the case for all of them.
    I don't think it's a matter being clueless. It's more that this is such a specific field and things can get very counterintuitive very quickly. I too thought naively I'd be able to get some answers from reading papers, but I quickly became aware just how far out of my depth I am. The only way I'm able to follow the discussion even a little bit is by having watched a basic virology course online and by listening to scientists discuss the papers in terms that make it more understandable to laypeople. But I have no illusions I'd be able to draw conclusions from them myself. I have to rely on the actual experts to explain to me whether the paper shows what it claims or whether there are flaws in its methodology that undermine its claims.


    Quote Originally Posted by Harvester View Post
    So what I meant to say is that one could say that the sudden rise in infection numbers is due to diminishing effects of the original two shots, but I personally believe the numbers are rising too suddenly and too quickly for that to be the sole cause.
    Yeah, this could be part of the reason, but from what I understand, it's the increased immune evasion of the virus making it able to reinfect people and infect vaccinated people (so-called breakthrough infections) that's said to be the culprit for the current spread. And of course holiday behaviour and people relaxing their guard post-vaccination could well be exacerbating this. But the evidence is still early on it and conclusive answers are hard to get. Even the Danish paper I cited earlier for the support of this claim is still a pre-print and not yet peer reviewed.

  13. #3888
    verbose douchebag
    Registered: Apr 2002
    Location: Lyon, France
    What I've read of Omicron is that it tends to proliferate higher up in the respiratory tract which reduces risk of respiratory distress & pneumonia (the main causes of death) and increases the rate of transmission (more virions expelled during breathing / talking / coughing / singing = higher average inoculum). So it seems to be a lot less dangerous in terms of respiratory risks, but this is slightly countered by the much higher transmissibility and infectiousness. People are still dying and going to ICU and suffering long terms effects from it, so more people infected is still a worry.

    I'll wait until enough time has passed for epidemiologists to do their work and get a decent enough consensus, but my hip-shot opinion is that it is overall less dangerous, but is causing absolute havoc due to the rate of infection. What the average person on the street can't easily appreciate (no fault of theirs; a lot of training is required to bypass gut feel & bias, and even then is far from perfect) is that you don't gauge the impact of a pandemic by simply counting the dead - it is a massively complex situation involving:

    > Public health (mortality AND morbidity*, health system & care capacity)
    > Logistics (materials, staff, admin processes being overwhelmed, etc)
    > Economics (lockdown impacts economy, but so does a long period of frequent absences caused by disease, as well as cumulative elimination of working / consumer population via mortality & morbidity+ long term fear of returning to normal without triggering another wave)
    > Politics (looking after your own while letting third-world countries stay largely unvaccinated and incubate current variants while throwing out new ones is rewarded by higher domestic approval, etc)
    > Morals (do we throw the elderly and the vulnerable under the bus to reduce inconvenience on the healthy? etc)

    * The morbidity impact will be monitored over decades. The real impact of COVID could be a large bulge of deaths in the coming decades from cardiovascular illness brought on or provoked by the epithelial inflammation caused by COVID leaving lasting damage in blood vessels. A particular worry for parents will be the Kawasaki-like disease which can sometimes be caused by COVID and which might have life-long health implications for the affected children: 1, 2, 3, 4
    Last edited by faetal; 12th Jan 2022 at 09:55.

  14. #3889
    verbose douchebag
    Registered: Apr 2002
    Location: Lyon, France
    I'm not sure what Starker's background is, but his posts are making a lot of sense.

    Just to add a bit of immunology knowledge to this part:

    Quote Originally Posted by Starker View Post
    Ah, it's not that the vaccines are becoming less effective. I'm sorry if I gave that impression anywhere. As far as I know, the vaccines are as effective as they have been for what they were designed to do -- preventing disease and death. But they weren't designed to prevent infection, from what I've heard. Apparently, of all the vaccines that we have (for any disease), only two are able to do that and only one of them is for humans.
    This is correct, vaccines tend to work over time and historically have mostly been employed for severe illnesses where herd immunity already existed to a large extent, so the slowing down which vaccines do by reducing symptoms, eliminating virus / bacteria more rapidly than a novel infection lead to eventual elimination, or as close to as possible. Smallpox was eliminated, Measles nearly was, but this was thwarted by Andrew Wakefield and the new anti-vax movement (an entertaining summary of that bullshit is here).

    ANYWAYS, with SARS-CoV-2, we are rolling out a vaccine at the height of the pandemic, so the slow-down is not being helped along by masses of herd immunity, particularly because the immune response from COVID-19 itself appears to be somewhat dysfunctional.

    (Next bit is simplified for brevity - I am leaving lots out)
    Vaccines essentially give you 2 lines of defence: cellular & humoral.

    Cellular refers to the priming and proliferation of antigen-specific T cell populations, whose job is either to kill infected cells (CD8+ "killer" T cells), or to hang around a site where its antigen is detected and holler for other immune cells to get involved (CD4+ "helper" T cells).

    Humoral refers to antigen-specific B cells and plasma cells (note, I am a T cell guy, so my knowledge here is of a lower level than with T cells) whose job is to pump out various classes of antibodies, which bind their target, which can interfere with the function and binding of target proteins and also label pathogens for encapsulation and clearance by things like macrophages (you'll have maybe seen a video of one of these "eating" a bacteria).

    During infection and clearance, there will be a lot of active cells patrolling areas of infection (usually highlighted by inflammatory processes, tissue damage, and general "danger signals") and doing their thing. Once the infection has passed and all of the inflammation / danger signalling dies down, the active cells will either die or enter an inactive state called "anergy". What remains are memory cells, which means that the next time you encounter the pathogen, a response can be mounted far more quickly.

    The best way to reduce the chance of infection is for virions entering the body to be rapidly coated in antibodies, preventing cell entry and promoting clearance (though T cell elimination of infected cells can also play an early role). If you look at the numbers I posted for France above, you'll see that the boosted cohort had the lowest rate of positive tests, while the <6m since vaccination and >6m since vaccination showed little difference. This is possibly due to the presence of circulating antibodies in the boosted cohort giving a higher chance to avoid infection altogether on contact. But worth noting that it is also significantly lower in the non-boosted + vaccinated vs the unvaccinated (and remember, a lot of the unvaccinated will have had COVID before).

    Hope that helps in some way - happy to clarify anything murky and if I made any mistakes (entirely possible as I've been out of research for over 5 years now), then let me know and I will correct.

  15. #3890
    Member
    Registered: Aug 2009
    Location: thiefgold.com
    Probiotic supplements appear to improve long Covid


    Many of us take supplements on a regular basis, to feel better and boost vitamin levels.

    One of these, a probiotic, has now been identified as likely to help treat long covid, according to research from a number of NHS Trusts.

    A year-long investigation was undertaken by experts at Cambridge University Hospitals (CUH) NHS Foundation Trust, Bedfordshire Hospitals NHS Foundation Trust, the University of Bedfordshire, and volunteer patients across both counties.

    It found treating the gut to a blend of five different friendly bacteria called lactobacillus probiotics, combined with a chicory-rich ingredient known as an inulin, could help with acute and long-term covid symptoms.

    The study involved 126 people, a third of whom had an acute Covid infection with the majority reporting a wide variety of longer term symptoms lasting over 100 days.

    Results, analysed by university statisticians showed that cough, fatigue, gut and well-being scores improved.

    Many said gut symptoms suffered for years were also resolved.

    Probiotics can be purchased in pill form from a number of health stores and pharmacies.

  16. #3891
    Member
    Registered: Aug 2004
    ...

    A study of just 126 people. They gave them fiber (among other things) and found it improved their gut health, for both recent and prior gut issues.

    Groundbreaking research, here.

    And the headline goes with probiotics, even though a study such as this gives no evidence of probiotic efficacy given that fiber efficacy is known and included.

    No link or other specific reference to the study, either.

  17. #3892

  18. #3893
    Member
    Registered: Aug 2004
    Thank you, that helps. The study itself

    There's no control group.

    ...a chicory-rich inulin. (Inulin is a prebiotic which helps feed the lactobacillus in the capsule and other friendly bacteria in the gut)
    It's dietary fiber, FFS. I almost feel like there's a concerted effort to disguise the fact that the pill studied included fiber. Although, at 200mg/day, it's not much fiber.

  19. #3894
    verbose douchebag
    Registered: Apr 2002
    Location: Lyon, France
    Studies like that have a lot of potential confounding effects, so controls need to be tight.

    That said, probiotics fall into the category of being fairly harmless - so the worst case is enjoying some placebo effect and maybe improving gut health.

    [EDIT] Wow, yeah, the study is not great if it doesn't have a control group with double blinding. How are they controlling for placebo effect?

    From the study:

    Methods: From May 2020 to May 2021, we evaluated 126 participants with Covid-19, with an average duration of symptoms of 108 days, who were given 30 days of this pre and probiotic capsule within the ongoing UK national Phyto-v study. Symptoms were recorded using the validated Cough Symptom Score, the Subjective Well-Being questionnaire and the Chandler fatigue questionnaire. The group was analysed as a whole and then subdivided into 40 (32%) in an early phase of infection (average symptoms 10 days before baseline) and the 86 (68%) in a chronic phase (average symptoms 120 days before trial baseline).

    Also, they just did statistical tests for decrease in symptoms between day 0 and day 30, to that's 2 factors not being controlled for - placebo effect and time.
    Last edited by faetal; 17th Jan 2022 at 20:35.

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