Having said that, we have a good demographic understanding of who tends to get severe Covid-19, and a large testing capacity, so a cheap anti-viral treatment with few side effects could still be effectively deployed.
Having said that, we have a good demographic understanding of who tends to get severe Covid-19, and a large testing capacity, so a cheap anti-viral treatment with few side effects could still be effectively deployed.
Sure, there will always be sceptics, but for large parts of people, organisations and governments having less perverse incentives might improve things a lot.
The vaccine-hesitant aren't going to go for treatment until the outlook is dire.
Additionally, in my experience, physicians aren't terribly concerned about infections in vaccinated individuals. When I was last tested, the physician essentially just assured me that vaccinations have been shown to drastically reduce the likelihood of complications, and not to really worry about it. Granted, I could have had a less rigorous physician, or it could that I'm totally healthy.
Does every discussion of about post-exposure prophylaxis have to have comments about vaccination?
> And it works great without the constant need for testing.
A primary reason for testing has been to help stop the spread of the virus (test positive = isolate), not necessarily to let people with mild symptoms or no symptoms know that they're infected.
Vaccinated individuals can still spread the virus and some people are at higher risk even when vaccinated, so testing is still of value.
> I have to imagine that anyone willing to undergo treatment at the very start of getting covid, would have also been willing to be vaccinated.
That's quite an assumption. Without passing judgment about his decision not to get vaccinated and to throw the kitchen sink at COVID once he was infected, Joe Rogan is an example of a person who is willing to treat an infection but not get vaccinated. I doubt he's the only one.
> Additionally, in my experience, physicians aren't terribly concerned about infections in vaccinated individuals.
Vaccination certainly reduces the incidence of hospitalization and death, and the data to date suggests that vaccinated individuals are less likely to develop "long COVID" symptoms. But there's still a lot we don't know. Research indicates that individuals with breakthrough infections can have viral loads that are as high as unvaccinated individuals, and some percentage report courses of illness that are virtually identical to a typical course of illness in unvaccinated individuals (respiratory symptoms, extreme fatigue, etc.) so I think it's premature to make too many assumptions. Especially since in immunologically naive people, some with "mild" or even largely asymptomatic infections also report lasting issues too.
I think results like vaccinated individuals “can” have viral loads as high as unvaccinated individuals are next to useless. I need to know how likely I am to have high viral loads and my understanding of the science there is that vaccines still do a decent job of lowering the odds. I know you aren’t really arguing against vaccination here, but it seems like it needed to be said and I think the “vaccinated individuals can have high viral loads” line is particularly bad
https://www.medrxiv.org/content/10.1101/2021.09.28.21264262v...
https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim...
How is a statement about what some researchers are finding "particularly bad"? If vaccinated individuals routinely have viral loads as high as those seen in unvaccinated individuals, it warrants more research into how the virus affects their bodies and what, if any, risks they might face both short term and long term.
According to one study[1], vaccination reduces the risk of long COVID by 49%. Given that some studies have found the incidence of long COVID is in the double digit percentages[2], exploring this issue is not purely academic. It is pertinent to the hundreds of millions of vaccinated individuals who are still at risk of infection, even if their risk of hospitalization and death has been significantly reduced.
Science works when we ask and investigate important questions. It doesn't work when we ignore these questions because we're afraid of the optics and how they might be misconstrued by some people.
In fact, when it comes to COVID generally, it seems evident to me that shying away from difficult questions has had the opposite of the intended effect. It has probably caused more people to adopt anti-science views and reject beneficial measures like vaccination.
[1] https://www.usnews.com/news/health-news/articles/2021-09-02/...
[2] https://www.medicalnewstoday.com/articles/more-than-one-thir...
Trying to avoid the sort of bias that comes from trying to reinforce rather than question existing views, but I do still think the statement "No Significant Difference in Viral Load Between Vaccinated and Unvaccinated, Asymptomatic and Symptomatic Groups Infected with SARS-CoV-2 Delta Variant" despite being much more precise is still a bit unintuitive in it's implication. Because essentially what this means right is that they sampled people's viral loads, and then cut out everyone below a value they choose to mean "infected". It's still true that even if I had symptoms because I'm vaccinated my odds of having a high viral load are much lower. Presumably if you didn't remove all the samples with less than some concentration you'd see significant differences.
I think that something the scientists got wrong consistently with covid was not unflinchingly communicating what was likely to be true mostly out of a fear that the public would take interventions that only moderately improved their safety like wearing a mask, and start doing riskier things or because of a bias towards doing nothing when clear evidence didn't exist. It can feel like similar things are happening with vaccination where it does seem pretty clear that getting vaccinated reduces your risk of passing on covid both because you're less likely to ever get a colony of the virus sufficient to count as "infected" and because you're likely to have a shorter infection.
Huh? Please cite the part of the study you're referring to to argue that the title of the study means the exact opposite of what it says.
Every manufacturer of a PCR test specifies a Ct cutoff above which the result is considered false.
> It's still true that even if I had symptoms because I'm vaccinated my odds of having a high viral load are much lower. Presumably if you didn't remove all the samples with less than some concentration you'd see significant differences.
The study says the exact opposite:
> There were no statistically significant differences in mean Ct-values of vaccinated (UeS: 23.1; HYT: 25.5) vs. unvaccinated (UeS: 23.4; HYT: 25.4) samples. In both vaccinated and unvaccinated, there was great variation among individuals, with Ct-values of <15 to >30 in both UeS and HYT data (Fig. 1A, 1B). Similarly, no statistically significant differences were found in the mean Ct-values of asymptomatic (UeS: 24.3; HYT: 25.4) vs. symptomatic (UeS: 22.7) samples, overall or stratified by vaccine status (Fig. 1B). Similar Ct-values were also found among different age groups, between genders, and vaccine types (Supplemental Figure 1).
Maybe I'm misinterpreting the study. I interpreted that as being among the fraction of people who are infected both because that's what the title says, and because they say later that "75% of the positive samples were from unvaccinated individuals" which would seem to be inconsistent with the groups having similar viral loads.
I thought we were dealing with a random variable composed something like this
VIRAL_LOAD = INFECTED ? LOAD_FOR_INFECTED : LOAD_FOR_UNINFECTED
And the study is saying that the random variable `LOAD_FOR_INFECTED` isn't correlated with vaccination status. That's indeed an interesting fact, but since `INFECTED` still was correlated (I think) overall for some random person `VIRAL_LOAD` would be too. Honestly a table would make all of this more clear.
With no offense intended, I think you're misunderstanding the whole concept of "viral load". If you are not infected with SARS-CoV-2, you don't have a SARS-CoV-2 "viral load".
I neither stated nor implied any such thing and these sorts of PSAs are really not constructive. HN I believe has a generally well-educated and technical audience that is capable of having intelligent, nuanced conversation about scientific research.
In fact, with all due respect, given that you've repeatedly misconstrued and misunderstood the research presented, and by your own admission abused terms, all in an effort to argue something that was totally unrelated to what was being discussed, I'd suggest your efforts are actually counterproductive.
That's why the CDC website says Covid (leaky, non-sterilizing) vaccines only provide protection (in blood) against serious illness, not infection (in nose). A future nasal vaccine may provide sterilizing immunity (what most people assume they are getting from a "vaccine", like their personal experience with the MMR vaccine).
What? No, there isn't. The Covid vaccines we have today are not sterilizing. Period. This isn't a conspiracy theory or anything like that, it's just a simple fact.
BBC article on immunity, https://www.bbc.com/news/health-58270098
> There is a whole different suite of antibodies (known as immunoglobulin As) in the nose and lungs, compared with those (immunoglobulin Gs) that we measure in the blood. The former is more important as a barrier to infection. Natural infection, because it is in the nose rather than a jab in the arm, may be a better route to those antibodies, and nasal vaccines are being investigated too.
Intramuscular (arm injection) vs intranasal (inhaled) vaccines: https://news.ycombinator.com/item?id=28165287
Nasal vaccine trials: https://news.ycombinator.com/item?id=28284504
This is conjecture. It's a hypothetical effect to take into consideration, but it's certainly not borne out in data that the vaccines increase asymptomatic transmission, much less for this reason.
> Based on evolving evidence, CDC recommends fully vaccinated people get tested 5-7 days after close contact with a person with suspected or confirmed COVID-19.
For many people, this description could apply to daily activity, e.g. riding on public transit. So the CDC is recommended regular testing of vaccinated people. Since the vaccine can suppress symptoms, testing can be used to detect infection earlier, enabling isolation and/or treatments which only work early in the progression of Covid.
In a July 2021 paper from academics advising UK SAGE, https://www.gov.uk/government/publications/long-term-evoluti...
> Whilst we feel that current vaccines are excellent for reducing the risk of hospital admission and disease, we propose that research be focused on vaccines that also induce high and durable levels of mucosal immunity in order to reduce infection of and transmission from vaccinated individuals. This could also reduce the possibility of variant selection in vaccinated individuals.
Note the reference to transmission from vaccinated individuals. There was also a study of Vietnamese healthcare workers, showing that 70% of infections were pre-symptomatic, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3897733
> 69 healthcare workers were tested positive for SARS-CoV-2. 62 participated in the clinical study. 49 were (pre)symptomatic ... Breakthrough Delta variant infections are associated with high viral loads, prolonged PCR positivity, and low levels of vaccine-induced neutralizing antibodies, explaining the transmission between the vaccinated people. Physical distancing measures remain critical to reduce SARS-CoV-2 Delta variant transmission.
If 2021 consumer media is offering variable definitions, Cui Bono?
But that's totally expected (depending of course on how you define "some"). If the vaccine had 100% efficacy, it would be shocking. The fact that it doesn't is not a surprise.
I'm assuming the point you're trying to make is vaccines aren't as good as expected. If the point is just that there is still value in developing treatments even with vaccines, than yes i agree with you.
No, I was responding to "Additionally, in my experience, physicians aren't terribly concerned about infections in vaccinated individuals" and pointing out that there's still a lot we don't know about the risks associated with infection after vaccination and arguing that these things deserve additional scientific study.
It’s about ‘the vaccine does not protect against getting infected and being infectious in over 50% of cases’.
Many of them seem quite willing to get ivermectin (whether it works or not is another issue). This is a tribal thing: one tribe has determined that the vaccine isn't something their tribe gets, but many of them seem willing to try other treatments that are acceptable to the tribe. (and yes, that's not rational, but humans are often irrational)
As for J&J, yes it’s generally the fact that it’s one and done so it feels less risky to people that didn’t want to get vaccinated. Then there’s the whole mRNA thing as well.
That made zir not fit in, and accelerated zir dropping out of CS and discovering the LGBT community, and non-binary identity.
The JJ mechanism of action is better understood and less risky, in my view at least it is more acceptable for emergency approval.
I don't buy the first model year of a car, very rarely take an on patent drug, and I won't inject myself with a medical device before the long term studies have been completed.
There is no substitute for time. Very few people have had the vaccine for more that 1 year. None have had it more than 5.
Not trolling here, I'm genuinely interested and thank you for sharing.
The vaccine doesn't even need to be "safe" for it to be worthwhile. A person with a short enough expected lifespan (elderly or comorbid) may derive a great benefit from a drug with real long-term risks.
For long term risks, nothing can substitute for time. I'm relatively young. I have an expected lifespan of 40+ more years. Ideally, I would want 40+ years worth of long term data. Realistically, I will settle for 5 years of good data. That should give good enough information to make an informed decision.
The biggest hurdle to overcome is censorship. A large portion of the media and big tech is censoring "misinformation". Its not just social media like Facebook, Reddit, Twitter, etc. nor main stream media like CNN, Fox, MSNBC, etc. Companies like Google are removing advertisement from pages if it says something they disagree with. With this heavy handed skew, can you really trust the information that comes out?
It's not surprising people are far more willing to try out sprays and tablets than injections, even if there wasn't any misinformation and tribal politics
I have personally heard of a number of pretty bad breakthrough cases where a person has had a fever for almost a month, another was extremely sick and there are still people who are afraid of covid for this very reason(and they are vaccinated). Having an effective anti-viral solution will bring down the fear about these scenarios and get people back to work and bring normalcy to society again.
Also, Isreal is no longer vaccine heavy. They were an early leader, but many other countries exceed their vaccine rates these days.
SARS-CoV-2 is clearly not a death sentence, because more than 99% survive if they contract it. And there is a factor of natural immunity, which the US government is oddly trying to smokescreen/astroturf into "get vaccinated anyway".
I am not "anti-vaccination". I had my shots. I am simply against government coercion to push not the best, but the most profitable solutions.
Don’t you think that cocktails of novel antiviral drugs are a higher profit margin solution then the vaccines that are already available? A remdesivir course costs almost two orders of magnitude more than an mRNA vaccine (in the US). Can’t really imagine these novel antiviral drugs will be much more affordable. To be clear, I do think both are important tools that we should use.
Is there some other pragmatic solution you have in mind?
And saying it isn't a death sentence is ignorant, we've lost over 700k Americans alone to it, no idea how many people globally. I dare you to go to someone who's lost a loved one and say that its not a death sentence, because to so many it is.
And bad faith argument? There's no astroturfing. Its a good idea and way more than 50% of the US population supports it. You been drinking the kool aide.
You have a huge important point about all this that I almost missed reading your response, because its mired in 'I'm not an anti vaxer' mixed with hints of conspiracy theories. Big pharma is getting fat off this. Its a problem. It needs to be fixed for the sake of the american people.
We need intelligent people like you to fight for that.
This statement should always come with information about the relative rate at which it occurs.
One "can still" get pregnant despite using contraception. This is not an argument against using it, because the relative rate is far lower than if one did not use it at all.
I'm a teacher and vaccinated. If I found out that I was exposed, and then tested positive... post-exposure prophylaxis sounds great.
Also there's my dad, who has an immune condition due to old age. He's vaccinated, but who knows how effective the vaccine was for him. The existence of PEP could make it possible for him to do more at a similar level of safety... vs. the current option of staying in a small bubble for the rest of his life despite being otherwise able-bodied and capable.
https://www.covid19treatmentguidelines.nih.gov/therapies/ant...
https://www.medicalnewstoday.com/articles/molnupiravir-vs-co...