[conspire] When to get a covid test, brains, and a weird case, and a cardiology vs. immunology joke

[Deirdre Saoirse Moen]

> On Aug 7, 2020, at 02:27, Ivan Sergio Borgonovo <mail at webthatworks.it> wrote:
> 
> Can somebody explain what heard immunity without a vaccine really means?

There are two possibilities:

A. Infect a sufficiently large percentage of the population. Thanks to the Brooklyn Purim study (previously posted on the list, but I can repost the link), we know that’s *at least* 61% seropositive in dense urban areas.

B. Designer antibodies! Which has never been tried before.

https://www.sciencemag.org/news/2020/08/designer-antibodies-could-battle-covid-19-vaccines-arrive 

So option A is really really REALLY bad, and here’s why. There are, among other things:

1. Lung anomalies, even in *asymptomatic* patients (21 of 37): 
https://www.nature.com/articles/s41591-020-0965-6 

(this has been found elsewhere, but it would only be found where asymptomatic patients were hospitalized, so in practice South Korea, Singapore, and China where we’d see the papers)

2. Heart anomalies.
https://jamanetwork.com/journals/cardiology/articlepdf/2768916/jamacardiology_puntmann_2020_oi_200057.pdf

>> Taken together, we demonstrate cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%) with recent COVID-19 illness, independent of pre-existing conditions, severity and overall course of the acute illness, and the time from the original diagnosis. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.

3. Brain anomalies (started this thread).


> Waiting people die and get ill, just slower? or faster?

Pretty much.

> Slower is better than nothing since it won't put too much stress on health care infrastructure and will probably lower death rates etc...

I don’t think nerfing hundreds of thousands of brains, hearts, and lungs is good public health.

> But considering that at this point there is no reliable scientific evidence that the virus is "weakening", up to my understanding "herd immunity" is just another way to say: let it be.

One of the big problems is that we haven’t yet come to terms with the actual fact that this is fecal-oral. It’s generally believed that coated RNA viruses won’t survive into the gut (for reasons I don’t understand), but it’s worth realizing that most coronaviruses are fecal-oral, and SARS-CoV-2 is fecal-oral in bats.

> If you check the death rates of the most hit zones (eg. Bergamo where you could have reasonably reliable data and a reasonably good health care system), and you project them worldwide you're talking about millions of dead people.

Depends on what the case fatality rate winds up being, especially once health care workers start falling. Once that infrastructure goes, we’re all screwed.

> Considering that worldwide there are at least 6M active cases and there are countries that seem not to care, it's a bit annoying to keep quarantining your country because someone else didn't do its homework properly and then complain about China.
> 
> Especially as Rick says it has been proved by several countries there is a better working strategy.

Certainly beats this one:

https://twitter.com/rachel/status/1289410966136864770

Deirdre
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