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The significance of the viral load in Covid-19 severity

Looks like this is getting some attention. Six months after the lockdown started - better late than never!

Some snippets (Probably what I left out will turn out more important :slightly_smiling_face:)

“How sick a person gets from a virus can depend on how much of the pathogen that person was exposed to and how much virus is replicating in their body — questions that are still open for the novel coronavirus.”

How it works: Viral dose is how much virus someone is exposed to when they are infected. Viral load is the amount of virus produced in someone’s body after they are infected.

  • A higher infectious dose of a virus and a higher viral load are linked to more severe disease from influenza, poxviruses and other viruses.

"For SARS-CoV-2, the virus that causes COVID-19, “there’s accumulating data on both sides of the equation,” Monica Gandhi, a professor of medicine and an infectious disease doctor at UCSF, tells Axios.

  • In a study of Syrian hamsters, for example, those infected with a higher dose of SARS-CoV-2 had worse outcomes than those with smaller amounts, supporting an earlier study on hamsters checking if “masks” helped prevent transmission, she points out.
  • Outbreak investigations show that where there’s universal masking of a population, the severity of disease goes down.
  • Some researchers suggest a decline in death rate and the rise in asymptomatic cases in the U.S. this summer — both coming at a time when mask-wearing became more common — indicate reducing the dose of the virus may reduce the severity of disease.

"It’s very interesting that it seems like it’s correlating with masking, this lower rate of severe illness," says Gandhi, adding that the hypothesis remains unproven but has some growing evidence behind it.

  • She co-authored a perspective piece in the NEJM this week that says universal adoption of masks could reduce infections and severity until an effective vaccine is distributed.
  • Last week, CDC director Robert Redfield suggested face masks are “more guaranteed” to offer protection against the coronavirus than a potential vaccine.

What’s happening: Evidence is emerging about the link between viral load and how severe COVID-19 is for a patient.

  • In a study of more than 3,000 patients in three New York City hospitals, nearly 40% who tested positive for COVID-19 and had a high viral load died in the hospital.
  • But the risk of dying was lower — dropping to about 15% — for patients with a low viral load, Michael Satlin, an infectious disease specialist at Weill Cornell Medicine and NewYork-Presbyterian, and colleagues reported last week in the journal Cancer Cell .
  • Of note: The study was done at the height of the city’s outbreak in the spring, and Satlin says that given improvements in caring for patients with COVID-19, he wouldn’t expect to see such high mortality rates today.
  • And the amount of virus the patients were exposed to or their viral load when symptoms started wasn’t known — connecting those dots will require more testing, he adds."

There’s also a Yes But…

Really interesting post @Evvy_dense. Monica Gandhi was one of the authors of the NEJM piece I linked to a few days ago.

It could mean that east Asian countries (like Taiwan with a grand total of 7 deaths) might be building up population immunity at practically zero cost, compared to our neo-liberal approach of letting our most vulnerable people die…

A sombre thought.

Cheers

So how do you reckon Taiwan did it, P? Any mechanism that you can suss out?

That’s a great question RG. I don’t have a detailed answer. Looking through reports like this one, it seems they did some very basic stuff right at the beginning when the case count was low. Quarantine for individuals, border controls. Importantly there was a high degree of trust between the populace and the govt, and the govt stepped in to support people who had to quarantine, with goods and other supplies. The other thing they did was the mass use of face masks.

The question in my mind is does the widespread use of face masks allow a “silent spread” of the disease somewhere like Taiwan? That would mean that immunity might be spreading through asymptomatic “cases”…

If so, then their early, community supported action really paid off.

Of course, that’s still an if. It’s not clear yet that facemasks have any such effect. But this feels like an important but if research to keep following…

Evidence certainly begins to suggest some possible useful effect of masks, much as I dislike them, and mistrust the mandating of them.

Don’t be seduced by this devious propaganda RG - Masks simply DON’T WORK! because they can’t! the holes are simply too big, even to stop the small droplets which mostly carry them in aerosols.
What the CDC said about masks being more promising than a vaccine was as true as their denial that the outbreak in Fairview retirement home in Washington last July was caused by an “unidentified” virus.
So although this looks like an admission of some things, it’s actually all about creating a new narrative to explain how it was that so many asymptomatic cases were ignored, and the consequent effects on the IFR.
The main object of the propaganda stream at the moment seems to be to make all the people now found to be “infected”, though mostlly asymptomatic, fear some strange complications into the future, so that the rest of us will accept all sorts of infringements of our liberties, like curfews, masking and social distancing, because we are so F**king scared of getting the infection. The ultimate deception yesterday on the BBC was claiming that rather than the high number of new cases being due to excessive sensitivity of the PCR test, it meant that “had the new testing procedures been used in the first outbreak, there would have been x million more cases found. Of course that’s true, because all those minor cases are now the basis for the development of the desired herd immunity, that the government and its Pharma partners are determined to avoid.
That’s how I see it anyway, and I don’t want to see any of you wearing a mask except to avoid being fined or attacked by the 'credulous” !! cheers David.

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That’s what the authorities in the West were saying, in the early stages of the outbreak, when people in China were under lockdown and having to wear masks.

My daughter, who works in Shanghai, told her mother than she and I should wear masks when the virus came to the UK. Because of anxiety about her, I have been paying attention to the virus situation since January. It all seemed to make sense, at first. I can make little sense of it all now, but I don’t think my memory can be playing tricks that devious.

(That is, unless my brain is in on the propaganda, without my mind knowing about it? Aha! “Stupid brain!”, as Homer Simpson might say … Excuse me. Where was I?)

So, who’s in this conspiracy? This Monica Gandhi person? @Evvy_dense? @PontiusPrimate? The government of China? Me? Please clarify.

(Forgive my sarcastic tone, if it turns out that I’m now so confused that I can’t even remember what I’ve been worrying about all year since January. That is just about possible, I suppose. But if I’m being gaslighted, I really don’t know who is doing the gaslighting.)

[P.S.@admin This thread presently lacks a category.]

Quite so Twirlip - and you’re not alone! I actually cannot understand the actions of the Chinese government, nor the Russian government, which is currently bemoaning the poor take up of mask wearing, on public transport and in supermarkets etc, where it’s advised. How can they also believe a) that it stops the virus transmission and b) that stopping the virus transmission is desirable? They are at least recommending that older people stay at home, and the public seems fairly relaxed. They’ve also used HCQ and vitamins widely, and now have their vaccine, in which I would have some confidence. and not saying they would be above a degree of the commercial corruption which sees the vaccine market evaporating in the face of self-acquired immunity.
What I feel, which may or may not be the case, is that the WHO has a lot to do with this, as health authorities in many countries are led by its advice, and even obliged to follow it.
I’m also not entirely convinced that some people in China didn’t play some part in the “scam”, as the Chinese CDC has been in line with the WHO, and never making claims the virus was engineered and released by the US. Perhaps that’s just because it was a joint project with Wuhan, and they don’t want to admit that they also were doing research on CV19 as a bioweapon…

Not convinced yet that masks are any use at all, David. And I find the brow-beating to wear them unacceptably intolerable. But keeping an open mind. Could be wrong, after all. But I doubt that they’re any use too.

One reads of people being yelled at to wear them even in the street, which is absurd.

Apologies if this is in the wrong thread.

Trump has appointed a new advisor to this Covid19 task force. The first thing is he said this about the CDC Directors testimony to Congress. "“I think that Dr. Redfield misstated something there. The immunity to the infection is not solely determined by the percent of people who have antibodies.”

He believes there is a large body of evidence that T-cell immunity last for many years and works against Coroni!

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And you can watch Rand Paul call out the lying doctor Fauci on lockdowns! Mind you, Fasuci has had so much practice at lying, he gets away with reasonably well.

Pity about Thau’s knee-jerk Trumpista-reddist anti-China babble. Best to discount that entirely. We really don’t have anything like a full picture of what China has been up to in this shambles, and why. No need to accede to Trump’s playing-politics line on that matter. Thau’s spelling wobbles sometimes too; apparently he’s semi-literate enough to confuse ‘breaks’ and ‘brakes’.

Still, with those caveats, his reporting of Atlas is exactly what I would have expected to come out, seeing as we do by now that the ‘pandemic’ is almost burnt out at this time of the year; as is usual, every year, with seasonal flus. Though it may be that this one happens to have one or two unusually nasty characteristics, causing ‘long-covid’ problems for some unlucky ones.

But all that said, anyone following Consigliere Tony Fauci’s line is automatically suspect, and deserves to be hauled over the coals.

Morning PatB. I’ve not read the link yet, but the T-cell immunity is clearly correct. It makes me wonder about one of the senior scientists in the unofficial SAGE committee, Karl Friston. He was saying back in May that it looked like there was some kind of “dark matter” that protected a portion of the population from infection.

At the time I couldn’t make any sense of it, but it looks like he was on to something. The Swedish Karolinska Institute (and many others now) have all shown that T-cells are a critical part of the immunity profile, and in fact a significant proportion of the population is most likely protected by them from previous exposure to other, similar Coronaviruses…