Likely COVID Scenarios, Oxford Vaccine.

The first scenario is the development of a safe and effective vaccine sometime in 2021. There are a lot of moving pieces to create a vaccine, and make sure it’s safe, and to produce enough and distribute it.

There are promising trials — too numerous to mention. Following those closely will be lots of ups and downs. Things that seem promising early often fade. Things don’t work on everyone. And it’s possible that a vaccine will be safe, but only partly effective or offer a partial inoculation. If that’s the case it may be used in health care workers on the frontline and in nursing homes, and high risk people.

The second scenario I spent a lot of time discussing today is Covid-19 as a chronic disease without a reliable vaccine. While initially jarring to contemplate, there is good evidence and history that this would be a manageable nor a crippling situation.

Currently, the conditions brought on by severe Covid-19 are scary & mysterious. It attacks the lungs and travels to other organ systems. We’re still learning about it. But with the help of supercomputers and data, we will learn fast. We’re not sure which therapies work in later stages (we know which don’t). But we have good anecdotal evidence that they work to reduce the viral load and lethality if given early.

We are quickly learning what is causing our immune systems to react. There’s evidence that it’s the level of d-dimer in the body. In fact it may not be the severity of the strain but the peculiarities of our own immune systems which could determine the severity of the virus.

So while antibodies may be the most effective treatment, it may in fact be things which prohibit the virus from replicating in our body that’s the key, if we can do it early. Biologics, protease inhibitors, or even steroids could be effective.

There’s a third scenario where the virus is destroyed completely by something far simpler — a reusable, cleanable highly functional and nearly free mask. Viruses can’t survive with nowhere to go. Cutting the virus off at the pass may be simplest done by never letting the droplets get into the air. The more some think about the third scenario, the more the first two become less scary and less important.

In this third scenario, lots of things — compliance, culture change, fit, ubiquity, fashion, ease of use, breathability, and equitable distribution — are all factors. Even if you don’t welcome the idea of wearing a mask for a period of time (and I would argue, why not?), the larger point is we are not powerless in the face of this virus. We have science, ingenuity, and collective action.

The Antibody Problem

Antibody tests have been plagued by concerns of accuracy. Such tests look for signals that a person’s body has encountered SARS-CoV-2, rather than hunting for the virus itself. But finding those signals is more complicated than simply diagnosing the disease.

On Monday, the White House acknowledged that complexity, suggesting that the U.S. should perhaps use two antibody tests at a time to gain a more accurate picture of how many people in the country have actually contracte the virus. In a document detailing the U.S. national strategy to expand testing efforts, the Trump administration said that the use of two tests at once would allow for the results to be checked against each other, producing, in theory, data that is more reliable.

A running start for a vaccine at Oxford

Here’s promising news in the worldwide race to develop a vaccine to ward off the coronavirus. The Jenner Institute at Oxford University has one that seems to work in lab animals and is ready to test its effectiveness in humans, if regulators approve.
The institute had a big head start, our correspondent David D. Kirkpatrick reports. Its scientists had an approach that they already knew was safe: They had proved it in trials last year for a vaccine to fight MERS, a respiratory disease caused by a closely related virus.
That has enabled the institute to skip ahead and schedule tests of its new Covid-19 vaccine on more than 6,000 people by the end of May, hoping to show not only that it is safe, but also that it works.
Scientists at the National Institutes of Health’s Rocky Mountain Laboratory in Montana got very good results when they tried out the Oxford vaccine last month on six rhesus macaque monkeys. The animals were then exposed to heavy quantities of the coronavirus. After more than four weeks, all six were still healthy.
“The rhesus macaque is pretty much the closest thing we have to humans,” said Vincent Munster, the researcher who conducted the test.
Immunity in monkeys doesn’t guarantee that a vaccine will protect people, but it’s an encouraging sign. If the May trials go well and regulators grant emergency approval, the Oxford scientists say they could have a few million doses of their vaccine available by September — months ahead of other vaccine projects.

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