New Approaches to Covid-19: Rapid Testing, Herd Immunity, and the Role of Narrative
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- Опубліковано 12 сер 2020
- In this UCSF Medical Grand Rounds, we discuss three new approaches for addressing Covid-19 that are gaining traction. Michael Mina, of the Harvard T.H. Chan School of Public Health, talks about the evidence supporting the move from highly sensitive PCR-based viral tests to more rapid, cheaper, and less sensitive tests. Trevor Bedford, of the University of Washington and the Fred Hutchinson Cancer Research Center, describes his theory that, in hard-hit regions, we may be closer to herd immunity than previously thought. Finally, Emily Silverman and Ashley McMullen, both of UCSF, discuss the role of the narrative in deepening our understanding of Covid by giving voice to clinicians and patients. The session is moderated by UCSF Department of Medicine chair Bob Wachter.
Program
Bob Wachter: Introduction
00:05:53 - Rapid Testing: Michael Mina, Assistant Professor, Epidemiology, Harvard T.H. Chan School of Public Health
00:23:58 - Q&A
00:38:48 - Herd Immunity: Trevor Bedford, Affiliate Associate Professor, Epidemiology and Genome Sciences, University of Washington; Associate Professor, Fred Hutchinson Cancer Research Center
00:52:43 - Q&A
01:05:36 - The Role of Narrative: Emily Silverman, Assistant Professor, Division of Hospital Medicine, ZSFG, UCSF; Founder and Host, The Nocturnists
01:19:18 - The Role of Narrative: Ashley McMullen, Assistant Professor, Division of General Internal Medicine, San Francisco VA Health Care System, UCSF; Host, Black Voices in Healthcare
01:25:44 - Q&A
01:28:16 - Bob Wachter: Closing
Learn more about the Nocturnists here:
thenocturnists.com
thenocturnists.com/blackvoices
See previous Covid-19 Medical Grand Rounds:
• August 6: A Conversation with Ashish Jha
• Covid-19 Grand Rounds:...
• July 30: An Update on Covid-19 Testing, Treatments, and Vaccines
• An Update on Covid-19 ...
• July 23: Covid-19: Reports of New Surges from Miami, Atlanta, Houston, and UCSF
• Covid-19: Reports of N...
• July 16: How the Virus Gets in and How to Block It: Aerosols, Droplets, Masks, Face Shields, and More
• Covid-19: How the Viru...
See all UCSF Covid-19 grand rounds, which have been viewed more than 750,000 times, here: medicine.ucsf.edu/covid-19-ne...
For those interested, we have a 5-minute video highlight/summary of Dr. Michael Mina's ideas about COVID-19 testing (from an interview we did with him) posted to our channel
Nice to see Mina's ideas taking hold.
❤️❤️ preventive help for coronavirus. Speak quietly out loud or in normal voice "God, please make my health perfect and completely free from harmful virus. Thank you." Repeat every 1-2 hours (8-16 times a day) as long as the pandemic lasts and until a safe vaccine or other cure is available. God is love. This helps. No cost. www.howtocallongodforhelp.com Healing can happen on different levels. We're not just physical beings. Consciousness, thought, and prayer is not well understood yet plays a major role in healing. We all have a name. Yet science can't identify our name by any chemical or physical markers through careful examination of the human body. Healing is both mind and body. "A problem exists today regarding some know how to call on God for help while others do not. This loving help is available to all of us regardless of moral character, religious views, and personal beliefs. God does not punish and helps anyone asking correctly. God is love." Social distancing helps prevent infected droplets, splatter, and aerosol particles from entering the lungs. Reducing viral concentration will give the body better odds at handling infection. First line workers are at high risk because of continuous exposure to the virus, thus greater susceptibility to Covid19. Fever, cough, shortness of breath, and sudden loss of smell and taste are common characteristics of the coronavirus. Covid19's cytokine storm can cause long term tissue and organ damage and mental health problems. From Mayo Clinic www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351 Masks, face shields, washing hands and disinfecting surfaces slow down the spread of this virus. Look into foods high in Vitamin C (avoid harmful synthetic Vitamin C supplements), Vitamin D (20 minutes daily sunlight or Vitamin D supplement with Vitamin K2), and zinc. Please share. Thank you. ❤️
One thing Dr. Mina failed to mention is that testing every day with these cheap tests, would stop transmission by asymptomatic individuals. Considering that a large percentage of the infected are asymptomatic, this could have significant benefit. With out current testing strategy, the asymptomatic individuals are almost never tested, so they can be prolific spreaders.
I am wondering what evidence you have of asymptomatic people being infectious, my impression is that while it ie not impossible it does not account for a really significant amount of infections, this would help to explain some of the behaviour of the virus in the community, the concentration of infections in relatively isolated clusters is more consistent with the majority of new cases being the result of infections from a relatively small number of sources, the very large number of asymptomatic 'victims' circulating in society would indicate a much faster and wider spreading.
The answer is in the first presentation. Whether one develops symptoms or not, the viral load is similarly high at the time when symptoms would normally start manifesting (avg 5th day from the infection). Given we know the virus is transmitted via the air route, it doesn't leave much doubt that an asymptomatic person would be just as a viable spreader.
@@annabracha7278 This notion that the virus is transmitted by the air route is still rather unclear, I am under the distinct impression that the two main modes, aerosol and droplet, differ significantly in infectiveness, while close proximity large droplet airborne transmission from very ill patients to their carers is not uncommon and aerosol transmission via closed circuit air circulation systems for long periods is not unlikely neither case involves transmission from asymptomatic sufferers especially under conditions of very brief exposure. The very fact that this virus has stopped spreading in the wider community at anything like the rate it was going to start with implies that firstly there was a vast number of infected people let loose on the population, probably returning tourists, and now that has eased there is not so much about, and the infectiousness never really was as bad as it first looked, also there is now a significant amount of immunity in the population, although that is still confined to the locations of the worst outbreaks!.
On the understanding that when it was at its peak back in April there were far fewer people being tested and there is good reason to suppose that at least four fifths of those infected were very mild or asymptomatic there must have been over one hundred thousand infected people in the small localised clusters that are typical, and if the asymptomatic were that infectious the number of new infections would have risen much faster, not just fallen away!. The evidence emerging from parts of northern Africa suggest that as many as eighty percent of infected people are never infectious at all!.
@David Smith High David, thank you for this, I take it that by 'answer' you refer to the question 'how many people have a positive test', my response to that is 'so what!', knowing how many people have been infected is no help at all!, we need the people that are actually infectious to know that they are, so that they can behave appropriately!, there is very little anyone else can do!. That is the reason that the less sensitive 'paper' test could be very useful, it will not be available any time soon because there is no way the 'authorities' here i Europe and the US want us to control our own lives!, and that idea is far too radical!.
There is a good deal of useful research that could be encouraged, to establish more precisely what the infection thresholds are, but that research is of very little commercial value!.
This is probably a moot issue. He is minimizing what will be substantial costs and Congressional members own calculators, by default.
$1 x 300,000,000 x 365 = 1.095 e11 or, unless I’m in error, $109,500,000,000, plus there will be the additional, likely substantial, costs of distribution, etc.-while the norm is for such products to double and triple from their proposed cost to the taxpayers, after approval- means this is not ‘low’ relative to either the previous or proposed stimulus proposals.
(Then there’s the issue of compliance in a part of the population that’s been ‘taught’ that the rights of freedom not only don’t require responsibility, they conflict with it. But, I’m not optimistic at present. Hopefully, uh, there’s hope.)
Sad to hear grand rounds is going on hiatus. You are my primary source for reliable info.
Might I recommend TWiV (This Week in Virology) on MicrobeTV at this URL:
www.microbe.tv/twiv/
And MedCram Coronavirus Pandemic Updates at this URL:
www.medcram.com/courses/coronavirus-outbreak-symptoms-treatment
Both TWiV and MedCram video podcasts are also on UA-cam (but are occasionally removed by UA-cam if the topic later becomes "misinformation" as the science evolves).
A major problem is processing the test. Beginning in 2010, in the US every privately owned laboratory in my county closed. They were not chosen as providers for the new healthcare insurance plans. Most insurance plans that I am aware of provide reimbursement only for either Quest or LabCorp. Specimens must be gathered and transported to the labs for processing. The laboratories typically are open Monday through Friday during the day. Specimens delivered on Friday afternoon are not processed until Monday. Now, about the local department of health. 15-20+ years ago our local health department provided a pediatric and adult medical clinic and a dental unit. They also actively offered immunization, hepatitis, TB, HIV & STD testing and reporting. Those services are no longer provided. Each health department appears to determine what services they will offer.
Thanks for another great presentation!
Great presentation , Dr Mina! Too bad FDA is guestioning ID-now rapid test. Would be nice to use it for PAT’s before elective procedures. I’d like to know the progress of FDA approving it for preoperative screening. We screen patients 4-5 days before with PCR tests but have no idea if they are real time asymptomatic negative when they come for surgery...
Please lets make this happen. Thank you, Dr. Mina.
Thank you so much, y'all.
It would have been useful if the talk on herd immunity had a discussion of the model by Gomes that is described in the paper titled "Individual variation in susceptibility or exposure to SARS-CoV-2 lowers the herd immunity threshold". The discussion after the talk touched on this issue but made no reference to this recent paper by Gomes.
Yes, an interesting paper.
Here's one regarding Spanish immunity after their outbreak... www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31483-5/fulltext
The death rate is dropping and the infectious rate is climbing, as always happens with every single flu/corona type pandemic. This is causes by two fundamental biological factors, first, antigenic shift (mutation) which always weakens a viruses virulence and invariably strengthen the infectiousness level. Second by natural antibody T-Cell immunization (herd immunity) which attacks, then deciphers and transcribes the viral RNA and memorizes and stores the genetic information within our own bone marrow for future recall. When under attack again from the same pathogen our immune systems understand exactly how to combat that particular microbial invader and will snuff it usually before we even know. This is how it's been happening for as long as viruses and humans have co-existed together and is well understood empirical science in the immunological/ epidemiological world for almost a century, at least until now when the politics , the media, and the science has sadly become indistinguishably the same thing and the internet is fueling the irrational mass hysteria.
It's clear that a vaccine is totally unnecessary
the word is out!! Gomes is doing well (and Gupta). ua-cam.com/channels/25-gYYgupNNLTVQoS6Y-dw.html
Another excellent Medical Great Round
Heard on TWiV this morning: "No models are correct, but some are useful."
Re: rapid testing and the FDA.
The analogy would be blood pressure for example: it doesn't mean you will get a stroke, but it is treatable. We do have many biomarkers that are actionable. We can pull away from calling it a COVID-19 test and instead calling it a safe-to-leave-home test. There are many people who have undiagnosed hypertension for years without getting adverse effects. The parallel here is that if your test is positive it doesn't mean you will transmit the virus, but you want to be careful, and it's time limited.
Very informative. UC does a great job.
Emily & Ashley are great!
Very interesting and thought provoking .... Thank
You
Hooray for Dr. Mina. He has the key to waiting out the arduous months before we have wide distribution of a decent vaccine. The New York Times ran a great opinion piece supporting the Rapid Testing strategy and it is fantastic to see UCSF coming on board with the push to get wider public support. Now if we can only get Washington to listen up...someone has to say this: get.out.the.freaking.vote. Write letters. OK YT biomed community, can somebody post the best links to those template letters to send our Members of Congress?
On the "This Week in Virology" (TWiV) video blog they were talking about collecting people's letters for promoting Dr. Mina's rapid testing strategies and at least some of those sample letters are posted at this URL:
www.microbe.tv/twiv/testing-letters/
It would have been more useful if the presentation on herd immunity had modeled the situation on board the Diamond Princess where there were two populations - 1) the crew with average age 33 and not susceptible to a high level of infection due to well operating innate T cell responses and 2) the passengers with an average age of 65 that according to the experts made them all susceptible to infection due to a declining innate immunity and comorbidites with age. In the event, "herd immunity" was established at a 20% infection rate of which 46% were asymptomatic and a fatality rate of 0.36% close to that of a normal flu. This suggests that 80% of the population were able to resist the virus through an innate T cell response.
These data are supported by those from New York where "herd immunity" appears to have been established at infections rates per borough between 15% and 35%, depending on factors like exposure through work, ethnicity and metabolic impairment like low vitamin D3 level, diabetes and obesity - the latter explaining some of the differences between States. So the calculations and graphs shown need to allow for the susceptible population based on these factors and appears to be in the rage 10% to 40%, with an average of 20% required to achieve herd immunity when combined with the 80% T cell response. On this basis, masks, lock down play minor roles, as has been shown in Sweden where none of these except sensible social distancing and limits on crowd size have occurred and yet the epidemic is now contained.
Where do we get these tests? Today?
We need them for our schools and our communities.
Wait 3 months, with luck they will be available then. In the mean time everyone should be assulting their politicians with letters, e-mails, phone calls, arm twisting and bribes (whatever it takes) to become active supporters of Dr. Mina's strategy of daily cheap rapid testing.
what is the R noght in CALI now ?
Can an iphone photo app be designed to "read" a rapid paper LFA test to improve their sensitivity?
@David Smith David I was about to call you an idiot but maybe I just don't understand what you're saying. Can you elaborate why improving the sensitivity of a home test will reduce its usefulness or applicability to reducing infectious people from the public.
My understanding of the whole paper test argument is that although they are not as sensitive, they do not need to be (for the purpose they serve) if priced cheap enough to do daily or every other day. But you're saying making them MORE sensitive (although not necessary) will make them LESS effective?
@David Smith No, you are not an idiot and I'm glad I didn't put my foot in my mouth. Thanks.
I'd be curious to know to what effect compliance (or lack thereof), has on Michael's plan for rapid, cheap testing. Does such a plan only work if *everybody* uses such tests, or some majority percentage of people? At what point, assuming there may be such a point, would such a plan fail because of lack of compliance?
@David Smith Precisely so!
To play devils advocate for a moment, let's look at the extreme case-- if only ONE person uses the cheap, fast test, while it might save a few people from being exposed to that one person who now can detect when they're sick and self-quarantine, it seemingly is not yet enough to "control the outbreak." Is there some critical mass of conformance that is required before it can be said it can render an outbreak "under control?"
@David Smith I'm all in favor of rapid tests, this is not an argument against that at all-- I'm just trying to understand how well a rapid test plan to get the virus under control would work in an environment like we have-- one where compliance can be a real problem.
Another benefit for rapid tests would be in high risk individuals, say 70+ with co-morbidities, a positive test could trigger them to immediately contact their doctor then get immediate eary treatment with anti virals to reduce the severity of disease course.
Sounds like dealing with a threshold that can be maintained but if people maintain a level of protection e.g. masks the spikes will be less severe but there will still be spikes due to increased activity
With due respect, I'm not sure I can agree with Dr. Bradford (the 2nd presenter) on the assumption that we have lower case volumes now despite no reduction in mobility is solely due to immunity in the population.
There are many other variables that affects "Alpha", ie Human Behavior in your equation, beyond Mobility. Wearing masks, washing hands, avoiding poorly ventilated places, etc all could also affects Alpha and eventually R Naught.
Another point is the portion of people that participates in the collection of mobility data. Do they represent the majority of people in those states shown?
IMHO, at this point, it seems a bit of a rush to assume we're nearing 'hear immunity' in those states just from looking at Mobility data alone.
What's about cross-immunity of Covid-19 from other coronaviruses
Could be high cross immunity. Addressed in MedCram Update 101.
Great presentation. Enjoyed all three. However, was very disheartened when the moderator said that this approach would not have as much interest if there was a two day turn around with the PCR testing. He just doesn’t get it. The tests complement one another and serve different purposes.
The first time I saw Mina discuss this on Medcram a few weeks ago I knew he found the golden ticket. You are correct the test compliment eachother. We need both.
@David Smith Not really. qPCR, using Ct (cycle threshold) values, gives you viral load, and an estimate similar to the antigen test as to infectiousness. Iceland with border testing (international travellers) is using qPCR and Ct, plus antibodies tests to determine if viral positive, viral load, and how long ago infection occurred (antibodies IgM & IgG). These give a good indication of infectiousness, so not all the travellers have to do 14 day quarantine. I think they may also do a follow up testing to catch any presymptomatic, infected but not infectious on arrival.
Plus they don't have the problem of labs being overloaded, nor long timelines to get samples to the labs , so can get PCR results within 3 or 4 hours.
But these antigen tests that give results under 30 minutes would also be very useful for border surveillance.
Also, Iceland does genome sequencing of every single PCR positive case in the country, therefore they can use these sequences to track community transmission pathways. They also do follow up genome sequencing of individual cases to track whether mutations are occurring, over time (sequenced nearly 700 mutations unique to Iceland) . Plus similar repeat testing with PCR of positive cases, up to 80 days after no symptoms for a week in covid-19 cases, found 12.5% still testing PCR positive.
David Smith I don’t think it is a matter of wanting to more than practical logistical ability. Iceland has a population of 364000 and 1983 cases.
David Smith That remains to be seen in any country. The Chinese sent rapid testing kits to Europe that didn’t give reliable results. They took advantage of lax eu regulations to supply them before they were approved in China. Didn’t work. This is still theory.
300,000 M $ /Tests per day in Rapid tests? An over estimation. Not every American would be able to use this diagnostic. But a really good idea.
Dr. Mina is brilliant.
David Smith He is not talking to the general population. Medical Grand Rounds programming is produced for clinicians to exchange ideas. They just made the talks available for the general public to view for COVID.
Why is the FDA involved. These tests should be required by insurance companies as a condition of insurance
@David Smith I don't want to start a debate but would like to offer a different but possible scenario. He should sweep away all obstructions to rapid progress but he is not a scientist and might be or might have been getting tainted advice. I don't want to debate or try to change your view, but you seem to be a science minded person and therefore probably willing to look at situations from different angles. Which angle is the right one - I don't know.
Len Bergman That is very astute. Insurance companies drive legislation and the way we do everything. If insurance wanted it we would have it.
@@johnjefferson1 Exactly. They are not very vocal about anything to do with the rona but must be driving policy from the shadows.
From the total lack of comments about the "Role of the Narrative" it's pretty obvious everyone bailed at that point.
Stats Florida/Arizona - comparison of the waves, obvious what causes but why not just barrel through? That is the only way to herd immunity - so why prolong? Uptick cases, yes, but the fatalities is the number to watch carefully plus continue the quarantine of the elderly? Remember NY high fatalities were COVID19 patients brought to eldercare facilities.
Of course, interesting but focused basically on only 1 of our 5 current issues, the disease Covid 19, caused by the SARS-Cov-2 virus. The things which you don't really address are the other 4:- Effects on children & their education, caused by the response to Covid 19. Effects on the work, lives & wellbeing of people, caused by the response to Covid 19. Effects on our culture, caused by the response to Covid 19. Effects to other patients, caused by our response to Covid 19.
Our Governor of Ohio took the Quidel test before he was to meet with the POTUS. Positive result. A few hours later he took the PCR test at Ohio STate Medical Center and result was negative. 3 days later another negative. So we were told the Quidel gave a false positive but I'm hearing it's rare to have false positives. No one has adequately explained what would cause a false positive so we in Ohio are extremely skeptical at this point about any test.
Interestingly the concept of public health as a solution was introduced. I have not heard of any country capable of testing 100% pop let alone daily testing of any number of individuals.
Public Health employs multiple stratgies in parallel to suppress an epidemic: social isolation, 6 foot distancing, wearing masks and eye protection, washing hands frequently & thoroughly, and now, daily rapid Covid testing. If all these are followed by a majority of the population, it should not be difficult to stem the spread of the pandemic. We do not need 100% compliance, and perhaps only 50 percent compliance is needed. However, the more people we can convince to go along with these public health strategies, the quicker the epidemic will ebb and the less suffering people will have to tolerate.
William Moore I’m sorry I thought we were discussing testing every individual every day. The idea of doing so was not introduced today. Possible ways to simplify production therefore logistics was the subject discussed. Public health care was offered as a solution to aid in daily testing of every individual in the USA. Unless I am mistaken, the public health care mentioned referred to socialized medicine. As of today, no country including those offering socialized health care are able to test everyone every day. I thought it was interesting a scientist would extend that opinion when it did not seem to correlate with the subject matter.
Could the prevalence of of immunity in FL and AZ be higher than in the 20s% since the chance of asymptomatic spread is higher vs symptomatic spread with the use of masks?
There's no support for this idea whatsoever, that wearing a mask will cause lesser symptoms if you get infected.
@@ronyan1 if you enjoyed this presentation, maybe you'd like this one too ua-cam.com/video/Cio3rh6ta3w/v-deo.html
(See 29 - 48 minutes)
The way people go to restaurants have changed. We sit outdoors. And of course wearing masks.
Lol
Doctors, please try newly discovered treatments for COVID-19 so that more people don't have to die.
The uptick seems to happen when there is a holiday among groups of different people. They go to religious services, socialized indoors etc without wearing a mask and not social distancing.. No. Looks for an uptick in all states after Thanksgiving, Christmas, Easter, Passover, and Ramadan.
You can check on the current situation on the following link.
Forgotten link?
$300 million per day x 365 days = ~$110 billion/year. That is a lot of money some company would like to make! Let's get it done!
If the virus propagates within high-connectivity environments faster than immunity can be generated, of course seroprevalence/infection rate is going to be high.
Don't forget the jacked stats. From every fed agency.
The language of fear, coupled with the implied intention of using scientific methods for the purposes of surveillance and control, are off putting here.
More about cheap rapid testing including sample letters to governors and congress to help make this happen: www.rapidtests.org/
links for Gabriela Gomes ua-cam.com/channels/25-gYYgupNNLTVQoS6Y-dw.html
You lost me at not coming back for a month!!! #longhaulers
Those people who are saying antigen or antibody test will be useful
They should know these tests have 50% sensitivity
And till the time they detect the infection
The person will be able to detect by his own symptoms
So making antigen / antibody tests are no game changer
Low cost RT PCR can be a game changer
PCR is not only very expensive, it's SLOW. The results take days to weeks to get back. This makes PCR inappropriate for rapid testing, irrespective of cost. Please see 12:43 -15:22.
@@Firebuck PCR is expensive but if antigen test are unable to detect virus at low viral load
Then is there any other choice than pcr ?
( If resources are increased it will be able to give test reports in less time )
US Govt. Yeah, right.
NO! 20% ain't gonna cut it!
Role of vitamin D deficiency, and how does this relate to racial disparities of covid-19?
Dark skinned people tend to have vitamin D deficiencies due to reduced conversion of vitamin D. Most Older individuals regardless of race have this issue. Both are at risk groups for COVID as well as other respiratory virus.
"If you're sick, stay home.", doesn't work in prison.
Assuming for a minute that these rapid tests eventually get produced and distributed, I'm still concerned about the American public's willingness to surrender their "freedoms" and take these tests every day for the greater good. They've already proven they won't do that with masks.
If schools, businesses, and other employers require the tests, then there might be higher compliance. My concern might be with low (or no) income people who might not have enough money to pay for a course of tests, so some philanthropic outreach program may also be needed. We don't need 100% compliance, perhaps 75% compliance would be enough to reduce the Rt (reproducton rate) of the virus where the spread of the virus would peter out. The higher the compliance, the quicker this pandemic will be brought under control.
The main reason that there is such a problem in the US is due to the fact that the federal government imposed lockdowns on the whole nation when there were serious outbreaks in just a few states, the states with little or no infections became increasingly disillusioned with 'rules' that were not appropriate!, it is not just that they are stupid it is also because they are treated like idiots.
@@richardharvey1732 I don't believe the federal government ever imposed a lockdown on the whole nation. It is my understanding that stay at home orders came from state and local (county) authorities.
@Mitch Jackson I don't know a single person anywhere on the political spectrum that opposes private at-home testing. As long as there isn't a medical privacy invasion angle, this will see widespread support.
@David Smith Hi David, again, oh! if only it were that simple, right from the the start when the silly in-effective lockdown was imposed in the UK it was quite obvious that a large proportion of the population was only too willing to sacrifice their freedom for the illusion of safety!, I too would very much like to see the population take control of itself, the places where the local authority is dealing with local outbreaks with appropriate local measures is the only good sign I have seen so far, as to the rest of us it seems that we will continue to submit to ludicrous 'rules' imposed arbitrarily when ever the statisticians working for Boris throw another scare into him!.
When you have community spread, as in all of the states covered in the second, epidemiology talk (very encouraging), testing is useless. Perhaps memory T cell testing would be very helpful, as a number of recent publications have shown. Florida has the additional "burden" of a high population of elderly, and since >90% of deaths are age 60 or older, that should be an important factor in modeling.
Sweden was much reviled for their "herd immunity" approach (no lockdowns, no masks), but now their daily death rate is one of the lowest in Western Europe. They (like most Western countries) badly mishandled their nursing homes, resulting in the bulk of their deaths. Theoretically, the best approach is to lock down and protect the vulnerable (easier said than done with a super-infectious virus like SARS-COV2), and leave the young and healthy to handle covid-19 and develop at least partial immunity (if they don't already have it from common cold coronaviruses).
As Hawaii and Alaska, and all Asian countries have done, locking down their borders which allows testing, tracking and quarantining of the trickle of infections that get in and their contacts, was a much better approach, although they will be dependent on vaccines or better pharmaceuticals without the immunity (and deaths) that occurred over most of Western Europe and the North East US, and is occurring in Florida, Texas and California (the three most populous states) at present.
Recommended: the short read from June by immunologist Beda M Stadler in medium.com /@vernunftundrichtigkeit/coronavirus-why-everyone-was-wrong-fce6db5ba809
Nothing I enjoy more than a good plandemic. We can all organize things to useful and employ our skills.
And shove people around and sit on them and nobody can touch us cuz we are defending da public from da dedly disease.
We need more !
1,000,000 virus show up?
The death rate is dropping and the infectious rate is climbing, as always happens with every single flu/corona type pandemic. This is causes by two fundamental biological factors, first, antigenic shift (mutation) which always weakens a viruses virulence and invariably strengthen the infectiousness level. Second by natural antibody T-Cell immunization (herd immunity) which attacks, then deciphers and transcribes the viral RNA and memorizes and stores the genetic information within our own bone marrow for future recall. When under attack again from the same pathogen our immune systems understand exactly how to combat that particular microbial invader and will snuff it usually before we even know. This is how it's been happening for as long as viruses and humans have co-existed together and is well understood empirical science in the immunological/ epidemiological world for almost a century, at least until now when the politics , the media, and the science has sadly become indistinguishably the same thing and the internet is fueling the irrational mass hysteria.
@@ghwk-phd2784 You absolutely correct! Find out about viruses here www.nationalgeographic.co.uk/science-and-technology/2020/04/there-are-more-viruses-stars-universe-why-do-only-some-infect-us & www.virology.ws/2013/09/06/how-many-viruses-on-earth/ & www.ncbi.nlm.nih.gov/pmc/articles/PMC3427559/ & ua-cam.com/video/y1bZhNwrHuM/v-deo.html With over 500,000 strains having been discovered so far, it is not known how many are capable of affecting humans and indeed, it is not known how many more viruses have not yet been discovered. Tests are incapable of identifying individual viruses and they mutate so quickly. Anyone taking a test should always have a positive result. Viruses float in the air, are found on the ground an almost on every surface. Swabs that have never encountered human contact will almost always provide a positive result! Testing positive for a virus is NOT a reason to panic and lock up those that test positive!
@@ghwk-phd2784 There are known to be 100000000000000000000000000000000 viruses on our planet. There are trillions of viruses on and in every human. They are between 10 and 100 times smaller than bacteria and outnumber bacteria by a factor of 10. Most provide beneficial benefits to our overall health! For instance, many kill off and control harmful bacteria!
The host refers to people as Trumpers. A true professional would not throw insults at people. As if someone that supports the president can’t/doesn’t follow rules and would harm others. This is shameful. It’s unsurprising that the country is divided and Covid is uncontrolled. I am not a Trump supporter so there is no need for hate replies.
Q Stop it! You are insulting 50% of the US. You have no right to do this.
@ Q V you sound like a knuckle dragger. You need to grow up.
Cindy, I didn't catch that. Can you tell us the time code? If he did, he's a clown.
@You obviously don't get out much. I suspect you'll be bawling like the baby you are in November.
Isn't the medical community having success treating COVID? Apparently much less deadly, no?
@David Smith More than that,learning how to treat symptoms, e.g. "cytokine storm" and many physicians prescribe drug therapy, e.g. HCQ and steroids etc.
The death rate is dropping and the infectious rate is climbing, as always happens with every single flu/corona type pandemic. This is causes by two fundamental biological factors, first, antigenic shift (mutation) which always weakens a viruses virulence and invariably strengthen the infectiousness level. Second by natural antibody T-Cell immunization (herd immunity) which attacks, then deciphers and transcribes the viral RNA and memorizes and stores the genetic information within our own bone marrow for future recall. When under attack again from the same pathogen our immune systems understand exactly how to combat that particular microbial invader and will snuff it usually before we even know. This is how it's been happening for as long as viruses and humans have co-existed together and is well understood empirical science in the immunological/ epidemiological world for almost a century, at least until now when the politics , the media, and the science has sadly become indistinguishably the same thing and the internet is fueling the irrational mass hysteria.
How about doing what works? Preventive hydroxychloroqine zinc vitamin D3 and C
The open veil provisionally screw because rabbit longitudinally dream underneath a draconian mandolin. rigid, late kettle
The billowy poet nutritionally empty because squid unexpectedly excite against a innate use. selective, petite trapezoid
If I boil grapefruit skin and make tea I can have HCQ
Hmmmmmmmmm. And what if u had posted this on Facebook or Twitter?
Variations on this Nazi Science is a switch, but it is 2020 after all. New ways of attacking the global psyop propaganda is also fairly interesting. Just talk fast and break things, namely reason and logic can be mangled but speed is paramount.
Why is this bull in my threads