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Coronavirus/COVID-19, Thread 2

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Re: Coronavirus/COVID-19, Thread 2 

Post#1741 » by SuperDeluxe » Thu May 6, 2021 8:44 pm

Read on Twitter
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Re: Coronavirus/COVID-19, Thread 2 

Post#1742 » by exculpatory » Thu May 6, 2021 9:03 pm

steefP2 wrote:
La Flame wrote:
exculpatory wrote:


Annual vaccinations? And that's okay to you?



I mean, I'm not knowledgeable about the science etc but if yearly vaccinations are necessary then yes that's an inconvenience.

But then it beats dying or getting sick or transmitting a deadly virus so yeah it's ok to me.

Nobody is doing this for fun. There's very little if any malice here. It's not someone deciding to screw the people by just saying yearly vaccinations haha !

It'll take what it takes.



That would be a mature & wise response.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1743 » by exculpatory » Thu May 6, 2021 9:13 pm

SuperDeluxe wrote:
Read on Twitter


Good stuff, SD!
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Re: Coronavirus/COVID-19, Thread 2 

Post#1744 » by SuperDeluxe » Thu May 6, 2021 9:26 pm

exculpatory wrote:
SuperDeluxe wrote:
Read on Twitter


Good stuff, SD!

Yep, that would be the next frontier -- a therapy. For the time being, we need to keep spreading the word about getting vaccinated, so that hesitancy can be reduced as much as possible.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1745 » by exculpatory » Thu May 6, 2021 9:29 pm

SuperDeluxe wrote:
exculpatory wrote:
SuperDeluxe wrote:
Read on Twitter


Good stuff, SD!

Yep, that would be the next frontier -- a therapy.

For the time being, we need to keep spreading the word about getting vaccinated, so that hesitancy can be reduced as much as possible.


10000+
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Re: Coronavirus/COVID-19, Thread 2 

Post#1746 » by steefP2 » Thu May 6, 2021 11:14 pm

Getting my vaccinations soon, either late may or early June here in Finland. Honestly, I can't wait.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1747 » by exculpatory » Fri May 7, 2021 12:48 am

exculpatory wrote:
Green89 wrote:
exculpatory wrote:
"Our data from the CDC today suggests that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials but it's also in real-world data," CDC Director Dr. Rochelle Walensky told Rachel Maddow on Monday, March 29. Walensky was describing the results of a new CDC study of vaccinated Americans, which found that they not only had very high resistance to COVID-19, but also to asymptomatic infections of the SARS-CoV-2 virus – and, by extension, are very unlikely to spread it to other people.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm

In answer to your second question:
I can tell you right now that reinfection after a bout of Covid happens infrequently (sometimes due to a variant), and infection after full vaccination is ALSO very infrequent. I will find you the exact numbers - but it is extraordinarily unlikely.
Found it - as of 4/20/2021:
“Walensky said that of the 84 million people who have been fully vaccinated in the United States, fewer than 6,000 have gotten sick with COVID-19 more than two weeks after being fully dosed. Of those, nearly 400 were hospitalized and around 75 died, according to CDC data. Some of the hospitalizations and deaths were not due to COVID-19 infections.”
6000/84,000,000 = 0.007% Low enough for you? :D

PS I apologize for sounding haughty before.


No problem. The stuff you posted is encouraging that vaccinated people are rarely going to get full blown covid, or even asymptomatic covid, This will greatly reduce spreading. And yes, .007 is very low, but as you said, the covid reinfection rate out of the 32 million cases is also rare and that percentage should be just as low if not lower. It's safe to say that both methods work, and as far as which one being better, there may just need to be more time passed as we go further months into the post vaccine research, to be able to tell which protects you more.

Yup. But the sophisticated immunologic data to date suggests/predicts that, in the case of Covid, vaccination is better than natural infection in producing sustained immunity.


Do you know if they can add multiple strains of the covid variant into 1 shot, like they do with the flu shot?

Absolutely.
The mRNA platform for the Pfizer & Moderna vaccines can be readily modified to produce a vaccine which better protects against important variants. The process already began a month or 2 ago. I believe that annual Covid vaccinations are in our future.




This was published TODAY.

This is VERY good news if indeed a booster becomes necessary.

https://www.medscape.com/viewarticle/950650
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Re: Coronavirus/COVID-19, Thread 2 

Post#1748 » by threrf23 » Fri May 7, 2021 2:21 am

SuperDeluxe wrote:
Read on Twitter


There are three medicines already under rolling review by the EMA: the Regeneron antibody combination, the Celltrion monoclonal antibody, and the monoclonal antibodies from Eli Lilly, which offered evidence of reducing the risk of hospitalisation and death by 87%.


Practically if not technically, these drugs sound a lot like the current vaccines, no? I mean I guess there's a clear difference between developing antibodies versus being injected with them, but I imagine the end effect should be similar.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1749 » by exculpatory » Fri May 7, 2021 2:57 am

threrf23 wrote:
SuperDeluxe wrote:
Read on Twitter


There are three medicines already under rolling review by the EMA: the Regeneron antibody combination, the Celltrion monoclonal antibody, and the monoclonal antibodies from Eli Lilly, which offered evidence of reducing the risk of hospitalisation and death by 87%.


Practically if not technically, these drugs sound a lot like the current vaccines, no? I mean I guess there's a clear difference between developing antibodies versus being injected with them, but I imagine the end effect should be similar.


The actual interaction of the humoral antibody with the spike protein of the Corona virus is similar.
But the exogenously administered antibodies are obviously only present for as long as you treat the patient.
Vaccination-induced antibodies are there long term, & memory B cells produce more antibodies when exposed to viral antigen. In addition, there is the critically important T cell immunity induced by vaccination. Our understanding of the immune response was quite involved when it was first taught to me eons ago. The state of the art today is overwhelmingly complex. I know the essence of it. I otherwise gladly defer to immunologists (just as they defer to me regarding my endocrinological expertise).
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Re: Coronavirus/COVID-19, Thread 2 

Post#1750 » by exculpatory » Fri May 7, 2021 3:52 pm

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Re: Coronavirus/COVID-19, Thread 2 

Post#1751 » by CeltsfanSinceBirth » Fri May 7, 2021 10:53 pm

My part of the world reported 502 new cases today (our previous daily high was 516 as a reference point). Here’s the promising news though - 70% of the new cases consist of people under the age of 40, who, up until today, weren’t eligible for vaccines yet. Vaccine is pretty effective.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1752 » by exculpatory » Sat May 8, 2021 5:55 am

Green89 wrote:
Also, there's no factual evidence that vaccinated people can't transmit it.



You categorically stated a few days ago that “there's no factual evidence that vaccinated people can't transmit it.” You apparently did not think that there was any evidence that vaccination was effective in curbing the spread of Covid by asymptomatic patients (beyond the fact that vaccination DRAMATICALLY diminishes symptomatic & severe disease both in the clinical trials & MULTIPLE real world post-emergency approval studies).

And I told you at the time that was untrue & that there is excellent peer reviewed evidence accruing suggesting that vaccinated people are much less likely to transmit the virus.

Enclosed below are TWO excellent publications indicating that vaccination indeed decreases asymptomatic infection - thereby, by extension, dramatically decreasing the likelihood of fully vaccinated people spreading the virus.

1. A study published on 5/6/2021 in the prestigious JAMA:

https://www.mdlinx.com/news/covid-19-vaccine-is-associated-with-fewer-asymptomatic-sars-cov-2-infections/1wwq9821YdVUL0BYD1i8k0?show_order=6&tag=Evening&utm_campaign=ealert_050721&ipost_environment=m3usainc&utm_source=iPost&utm_medium=email&iqs=9z2zoi6evkikkj3fenpskqk5uuv2j5k66lbh7t77l9g

“Protection was even greater for employees who completed two doses. A week or more after receiving the second dose, vaccinated employees were 96% less likely than unvaccinated workers to become infected with SARS-CoV-2. When researchers looked just at asymptomatic infections, vaccination reduced the risk by 90%.”

2. CDC in 4/2021

https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm

"Our data from the CDC today suggests that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials but it's also in real-world data," CDC Director Dr. Rochelle Walensky told Rachel Maddow on Monday, March 29. Walensky was describing the results of a new CDC study of vaccinated Americans, which found that they not only had very high resistance to (symptomatic) COVID-19, but also to asymptomatic infections of the SARS-CoV-2 virus – and, by extension, are very unlikely to spread it to other people.”

I hope this information somewhat allays your concerns.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1753 » by threrf23 » Sat May 8, 2021 6:44 am

exculpatory wrote:
"Our data from the CDC today suggests that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials but it's also in real-world data," CDC Director Dr. Rochelle Walensky told Rachel Maddow on Monday, March 29. Walensky was describing the results of a new CDC study of vaccinated Americans, which found that they not only had very high resistance to (symptomatic) COVID-19, but also to asymptomatic infections of the SARS-CoV-2 virus – and, by extension, are very unlikely to spread it to other people.”



Also Rochelle Walensky, a couple weeks later...

“I would encourage people to continue, once they’re vaccinated, to use all the prevention measures that we’ve been talking about when they’re outside their home, including masking and distancing and whatnot. And all of that should be active in the workplace.”

“Assuming you take those prevention measures in the office place and outside the home, I think you’re very safe in the home,” Walensky said.


https://www.deseret.com/coronavirus/2021/4/14/22381628/covid-19-breakthrough-cases-side-effects

For the record, it's clear that the vaccine, at the least, meaningfully reduces transmission and significantly reduces the consequences of infection. That's fine by me and I'm not worried about whether the vaccine by itself prevents transmission as well as some studies show (or as well as Rochelle Walensky claims).
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Re: Coronavirus/COVID-19, Thread 2 

Post#1754 » by exculpatory » Sat May 8, 2021 6:54 am

threrf23 wrote:
exculpatory wrote:
"Our data from the CDC today suggests that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials but it's also in real-world data," CDC Director Dr. Rochelle Walensky told Rachel Maddow on Monday, March 29. Walensky was describing the results of a new CDC study of vaccinated Americans, which found that they not only had very high resistance to (symptomatic) COVID-19, but also to asymptomatic infections of the SARS-CoV-2 virus – and, by extension, are very unlikely to spread it to other people.”



Also Rochelle Walensky, a couple weeks later...

“I would encourage people to continue, once they’re vaccinated, to use all the prevention measures that we’ve been talking about when they’re outside their home, including masking and distancing and whatnot. And all of that should be active in the workplace.”

“Assuming you take those prevention measures in the office place and outside the home, I think you’re very safe in the home,” Walensky said.


https://www.deseret.com/coronavirus/2021/4/14/22381628/covid-19-breakthrough-cases-side-effects

For the record, it's clear that the vaccine, at the least, meaningfully reduces transmission (by decreasing asymptomatic disease) and significantly reduces the consequences of infection (severe disease)

AND dramatically decreases de novo PCR + symptomatic or asymptomatic disease - both in the clinical trials & MULTIPLE*** real world post-emergency approval studies.

***and here is the citation for 1 of those real world studies published in the world famous NEJM on 2/24/2021
- https://www.nejm.org/doi/full/10.1056/NEJMoa2101765

That's fine by me and I'm not worried about whether the vaccine by itself prevents transmission as well as some studies show (or as well as Rochelle Walensky claims).


1. Walensky did not “claim” anything. She reported the published CDC data - see the link above.
2. And I totally support her maximally conservative & cautious recommendation to continue to avoid outdoor crowds & to mask when indoors with strangers. She & I are BOTH maximally cautious physicians. That recommendation should NOT change until we are much closer to or at herd immunity.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1755 » by Mr Loggins » Sun May 9, 2021 10:39 am

I’m a pulm/cc physician in minneapolis (educated in the new england area, worked in longwood for a few years before med school, hence why I follow the boston threads).

Anecdotally, the peak we’re seeing now seems to be the 40-60yo unvaccinated person. (which I’m sure will be born out when the latest epidemiology is released). I tend to be more easy going, but one of my more academic colleagues (loves to pimp the residents and fellows...just the type of guy he is) always asks “and why not?” about vaccination.

Whatever answer given always seems a little silly when the patient himself is on high flow/bipap, or the family is answering for their recently intubated family member....
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Re: Coronavirus/COVID-19, Thread 2 

Post#1756 » by exculpatory » Sun May 9, 2021 11:30 am

Mr Loggins wrote:I’m a pulm/cc physician in minneapolis (educated in the new england area, worked in longwood for a few years before med school, hence why I follow the boston threads).

Anecdotally, the peak we’re seeing now seems to be the 40-60yo unvaccinated person (which I’m sure will be born out when the latest epidemiology is released). I tend to be more easy going, but one of my more academic colleagues (loves to pimp the residents and fellows...just the type of guy he is) always asks “and why not?” about vaccination.

Whatever answer given always seems a little silly when the patient himself is on high flow/bipap, or the family is answering for their recently intubated family member....


The proverbial cow would already be out of the proverbial barn.

As you know, there already is a bushel of epidemiologic data demonstrating a marked reduction in the mean age of hospitalized Covid patients - consequent to more VAX of older people.

I have always been a very demanding student/resident/fellow pimper.
During the last decade in particular, I have come across more & more snowflakes amongst the 20-35 year old medical generation - which has made my teaching much less fun.

I have always been very interested in the endocrine aspects of critical care - hypo or hyper ANY electrolyte (including too often neglected hypophosphatemia & hypomagnesemia), CIRCI, thyroid storm etc.


How often do you see Covid-associated coagulopathy? How closely does it overlap classic DIC?
How are you treating it?

Internal and Emergency Medicine https://doi.org/10.1007/s11739-020-02601-y
COVID‐19 coagulopathy: is it disseminated intravascular coagulation?
Marcel Levi and Toshiaki Iba
Received: 5 November 2020
Abstract
One of the significant complications of severe COVID-19 infections is a coagulopathy that seems to be related to the occurrence of venous and arterial thromboembolic disease. The coagulation changes mimic but are not identical to disseminated intravascular coagulation (DIC). The vast majority of patients with COVID-19 do not meet the criteria for usual forms of DIC. In addition, there seem to be features of a strong local pulmonary thrombotic microangiopathy and direct endothelial cell infection and injury by the virus that affect the coagulopathic response to severe COVID-19. It seems COVID-19 leads to a distinct intravascular coagulation syndrome that may need separate diagnostic criteria.


How does Covid-associated ARDS compare with classic sepsis-associated ARDS?

To the best of my knowledge, we are the only docs who regularly post here.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1757 » by Mr Loggins » Sun May 9, 2021 2:18 pm

exculpatory wrote:
Mr Loggins wrote:I’m a pulm/cc physician in minneapolis (educated in the new england area, worked in longwood for a few years before med school, hence why I follow the boston threads).

Anecdotally, the peak we’re seeing now seems to be the 40-60yo unvaccinated person (which I’m sure will be born out when the latest epidemiology is released). I tend to be more easy going, but one of my more academic colleagues (loves to pimp the residents and fellows...just the type of guy he is) always asks “and why not?” about vaccination.

Whatever answer given always seems a little silly when the patient himself is on high flow/bipap, or the family is answering for their recently intubated family member....


The proverbial cow would already be out of the proverbial barn.

As you know, there already is a bushel of epidemiologic data demonstrating a marked reduction in the mean age of hospitalized Covid patients - consequent to more VAX of older people.

I have always been a very demanding student/resident/fellow pimper.
During the last decade in particular, I have come across more & more snowflakes amongst the 20-35 year old medical generation - which has made my teaching much less fun.

I have always been very interested in the endocrine aspects of critical care - hypo or hyper ANY electrolyte (including too often neglected hypophosphatemia & hypomagnesemia), CIRCI, thyroid storm etc.


How often do you see Covid-associated coagulopathy? How closely does it overlap classic DIC?
How are you treating it?

Internal and Emergency Medicine https://doi.org/10.1007/s11739-020-02601-y
COVID‐19 coagulopathy: is it disseminated intravascular coagulation?
Marcel Levi and Toshiaki Iba
Received: 5 November 2020
Abstract
One of the significant complications of severe COVID-19 infections is a coagulopathy that seems to be related to the occurrence of venous and arterial thromboembolic disease. The coagulation changes mimic but are not identical to disseminated intravascular coagulation (DIC). The vast majority of patients with COVID-19 do not meet the criteria for usual forms of DIC. In addition, there seem to be features of a strong local pulmonary thrombotic microangiopathy and direct endothelial cell infection and injury by the virus that affect the coagulopathic response to severe COVID-19. It seems COVID-19 leads to a distinct intravascular coagulation syndrome that may need separate diagnostic criteria.


How does Covid-associated ARDS compare with classic sepsis-associated ARDS?

To the best of my knowledge, we are the only docs who regularly post here.



There's certainly is a pro-thrombotic propensity; our approach has been to follow daily d-dimers and adjust heparin/lovenox as needed. In terms of a DIC-like disease, we see some similar markers but so far have just been chalking it up to a consumptive coagulopathy associated with sepsis (seems like what the article suggests)

Covid ARDS has some differrences - main things is that they seem to have lower airway pressures and better compliance than classic ARDS. Early on there was suggestion that certain modes of ventilation (mainly bi-level) shouldn't be used in covid, but thats since been disregarded and for all intents and purposes the two are managed similarily now.

On the back end, a lot of the intubation survivors have to wait far longer than usual for their vent needs to be low enough to safely trach (4-6 weeks or longer) so post LTACH we're seeing a lot more issues with tracheal stenosis, granulation tissue and other airway problems.
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Re: Coronavirus/COVID-19, Thread 2 

Post#1758 » by exculpatory » Sun May 9, 2021 3:45 pm

Mr Loggins wrote:
exculpatory wrote:
Mr Loggins wrote:I’m a pulm/cc physician in minneapolis (educated in the new england area, worked in longwood for a few years before med school, hence why I follow the boston threads).

Anecdotally, the peak we’re seeing now seems to be the 40-60yo unvaccinated person (which I’m sure will be born out when the latest epidemiology is released). I tend to be more easy going, but one of my more academic colleagues (loves to pimp the residents and fellows...just the type of guy he is) always asks “and why not?” about vaccination.

Whatever answer given always seems a little silly when the patient himself is on high flow/bipap, or the family is answering for their recently intubated family member....


The proverbial cow would already be out of the proverbial barn.

As you know, there already is a bushel of epidemiologic data demonstrating a marked reduction in the mean age of hospitalized Covid patients - consequent to more VAX of older people.

I have always been a very demanding student/resident/fellow pimper.
During the last decade in particular, I have come across more & more snowflakes amongst the 20-35 year old medical generation - which has made my teaching much less fun.

I have always been very interested in the endocrine aspects of critical care - hypo or hyper ANY electrolyte (including too often neglected hypophosphatemia & hypomagnesemia), CIRCI, thyroid storm etc.


How often do you see Covid-associated coagulopathy? How closely does it overlap classic DIC?
How are you treating it?

Internal and Emergency Medicine https://doi.org/10.1007/s11739-020-02601-y
COVID‐19 coagulopathy: is it disseminated intravascular coagulation?
Marcel Levi and Toshiaki Iba
Received: 5 November 2020
Abstract
One of the significant complications of severe COVID-19 infections is a coagulopathy that seems to be related to the occurrence of venous and arterial thromboembolic disease. The coagulation changes mimic but are not identical to disseminated intravascular coagulation (DIC). The vast majority of patients with COVID-19 do not meet the criteria for usual forms of DIC. In addition, there seem to be features of a strong local pulmonary thrombotic microangiopathy and direct endothelial cell infection and injury by the virus that affect the coagulopathic response to severe COVID-19. It seems COVID-19 leads to a distinct intravascular coagulation syndrome that may need separate diagnostic criteria.


How does Covid-associated ARDS compare with classic sepsis-associated ARDS?

To the best of my knowledge, we are the only docs who regularly post here.



There's certainly is a pro-thrombotic propensity; our approach has been to follow daily d-dimers and adjust heparin/lovenox as needed. In terms of a DIC-like disease, we see some similar markers but so far have just been chalking it up to a consumptive coagulopathy associated with sepsis (seems like what the article suggests)

Covid ARDS has some differrences - main things are that they seem to have lower airway pressures and better compliance than classic ARDS. Early on there was a suggestion that certain modes of ventilation (mainly bi-level) shouldn't be used in covid, but thats since been disregarded and for all intents and purposes the two are managed similarly now.

On the back end, a lot of the intubation survivors have to wait far longer than usual for their vent needs to be low enough to safely trach (4-6 weeks or longer), so post LTACH we're seeing a lot more issues with tracheal stenosis, granulation tissue and other airway problems.


Thank you much for your clinical insights!

I posted this publication from our 3/2021 Journal of Clinical Endocrinology & Metabolism (JCEM) a couple of months ago.

https://academic.oup.com/jcem/article/106/3/622/6009077

A potential link between Endocrinology & Pulmonology!

‘Excessive mineralocorticoid receptor activation by cortisol’ in the lungs may be a critical component of a pathophysiologic cascade which results in COVID-related ARDS & thrombotic coagulopathy. It lays the groundwork for evaluating a new & UNiQUE therapeutic intervention (dexamethasone PLUS an aldosterone receptor antagonist).

From the article:
“The loss of the angiotensin-converting enzyme 2 (ACE2) receptor, which is used by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus to get into endothelial and type II alveolar cells, plays a major role in the development of the complications of the infection, acute respiratory distress syndrome (ARDS) and clotting abnormalities.
The loss of the ACE2 receptor results in high levels of angiotensin II, which stimulate nicotinamide adenine dinucleotide phosphate (NADP) oxidase to produce reactive oxygen species (ROS). This removes a key protective mechanism for the pulmonary mineralocorticoid receptor (MR), which now can be activated by cortisol and is no longer aldosterone selective.
Activation of the MR releases adenosine 5′-triphosphate (ATP) from the cells. This then has a paracrine effect on purinergic receptors resulting in calcium entry into the cells.
Increased intracellular calcium results in exocytosis of Weibel-Palade bodies (WPBs) from the cells. These contain the von Willebrand factor (VWF), which spreads like a spiderweb, attracts platelets, and results in microthrombi. The bodies also contain angiopoietin-2, which markedly increases capillary permeability and hence pulmonary edema.
MR blockade with spironolactone has been shown in vitro to block exocytosis of WPBs.
This paper suggests that, on the basis of these hypotheses, there should be trials of dexamethasone to suppress cortisol secretion together with an MR antagonist such as spironolactone or eplerenone.”

FYI, there is precedence for cortisol ‘taking over’ the MR from aldosterone. There is an unusual hereditary syndrome called SAME (syndrome of apparent mineralocorticoid excess) (consequent to the genetic absence of the 11 beta hydroxysteroid dehydrogenase (HSD) type 2 enzyme - which normally deactivates/converts cortisol to cortisone in the kidney) wherein excessive renal cortisol excessively stimulates the MR resulting in hypertension & hypokalemia (mimicking primary hyperaldosteronism).

I think this is mind blowing & fascinating!

Has there been anything about this in your literature?

Have such clinical trials been initiated to your knowledge?
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Re: Coronavirus/COVID-19, Thread 2 

Post#1759 » by Green89 » Sun May 9, 2021 11:42 pm

exculpatory wrote:
Green89 wrote:
Also, there's no factual evidence that vaccinated people can't transmit it.



You categorically stated a few days ago that “there's no factual evidence that vaccinated people can't transmit it.” You apparently did not think that there was any evidence that vaccination was effective in curbing the spread of Covid by asymptomatic patients (beyond the fact that vaccination DRAMATICALLY diminishes symptomatic & severe disease both in the clinical trials & MULTIPLE real world post-emergency approval studies).

And I told you at the time that was untrue & that there is excellent peer reviewed evidence accruing suggesting that vaccinated people are much less likely to transmit the virus.

Enclosed below are TWO excellent publications indicating that vaccination indeed decreases asymptomatic infection - thereby, by extension, dramatically decreasing the likelihood of fully vaccinated people spreading the virus.

1. A study published on 5/6/2021 in the prestigious JAMA:

https://www.mdlinx.com/news/covid-19-vaccine-is-associated-with-fewer-asymptomatic-sars-cov-2-infections/1wwq9821YdVUL0BYD1i8k0?show_order=6&tag=Evening&utm_campaign=ealert_050721&ipost_environment=m3usainc&utm_source=iPost&utm_medium=email&iqs=9z2zoi6evkikkj3fenpskqk5uuv2j5k66lbh7t77l9g

“Protection was even greater for employees who completed two doses. A week or more after receiving the second dose, vaccinated employees were 96% less likely than unvaccinated workers to become infected with SARS-CoV-2. When researchers looked just at asymptomatic infections, vaccination reduced the risk by 90%.”

2. CDC in 4/2021

https://www.cdc.gov/mmwr/volumes/70/wr/mm7013e3.htm

"Our data from the CDC today suggests that vaccinated people do not carry the virus, don't get sick, and that it's not just in the clinical trials but it's also in real-world data," CDC Director Dr. Rochelle Walensky told Rachel Maddow on Monday, March 29. Walensky was describing the results of a new CDC study of vaccinated Americans, which found that they not only had very high resistance to (symptomatic) COVID-19, but also to asymptomatic infections of the SARS-CoV-2 virus – and, by extension, are very unlikely to spread it to other people.”

I hope this information somewhat allays your concerns.


I guess the main skepticism to this would be the same reasoning and reporting behind there being more symptoms and side effects of the vaccine coming out after millions got it, as opposed to the just those within the trials before vaccine approval. They stated reported and new side effects would certainly arise when more people than the smaller trials end up getting into the mix. Therefore, these studies being based on smaller numbers at this present time, could feasibly change in time as more people get vaccinated. Also, not just the small numbers, the small amount of time we're basing these reports on. While the chance of the spread after vaccine is being found to be that low (based on your data, which does seem factual to me) the concern is the variance in these results as time goes by. How much does that chance of spread decrease with every week, month, etc, that passes, to the point of 6 months when they're saying people should consider getting vaccinated again?

This also draws a fine line between the remarks of how they would consider in the next month or two, that masking indoors can come off, and how people interpret it. I mean, do you want to be in an unmasked all day conference in a hotel room in July, when half the vaccinated people could have gotten the shot in December, 7 months prior? We haven't even been a year since the first people vaccinated, so how can anyone know right now how long both immunity, and the low percentage of spreading it will even last?
exculpatory
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Re: Coronavirus/COVID-19, Thread 2 

Post#1760 » by exculpatory » Sun May 9, 2021 11:55 pm

There are many VERY experienced & smarter than hell epidemiologists, infectious disease physicians & immunologists involved with these studies.

I trust their projections.

The chances are excellent that the data reported in the outstanding citations I provided will hold up when additional data is obtained/analyzed as time goes by in huge numbers of patients. We shall see.

The duration of immunity is expected to be considerable. We shall see.

The need for an additional VAX down the road will be contingent on which variant is expected to predominate in the next wave of Covid, the susceptibility of that variant to the current vaccines, & the duration of immunity induced by the current vaccines to the original wild type virus.
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