Air-conditioned rooms help spread COVID-19, research shows
https://nypost.com/2020/08/22/…-covid-19-research-shows/
In more humid rooms, virus droplets become heavier and fall faster in higher humidity, “providing less chances for other people to breathe in infectious viral droplets,” the team wrote, according to DW, a German news website.
https://onlinelibrary.wiley.com/doi/full/10.1111/pai.13271
This was published as a preprint in April - now peer reviewed. Fascinating discussion of how COVID hits us and why it is sometimes asymptomatic.
Take homes (with caution)?
The natural history of COVID‐19 caused by SARS‐CoV‐2 is extremely variable, ranging from asymptomatic or mild infection, mainly in children, to multi‐organ failure, eventually fatal, mainly in the eldest. We propose here the first model explaining how the outcome of first, crucial 10‐15 days after infection, depends on the balance between the cumulative dose of viral exposure and the efficacy of the local innate immune response (natural IgA and IgM antibodies, mannose‐binding lectin). If SARS‐CoV‐2 runs the blockade of this innate immunity and spreads from the upper airways to the alveoli in the early phases of the infections, it can replicate with no local resistance, causing pneumonia and releasing high amounts of antigens. The delayed and strong adaptive immune response (high‐affinity IgM and IgG antibodies) that follows, causes severe inflammation and triggers mediator cascades (complement, coagulation, and cytokine storm), leading to complications often requiring intensive therapy and being, in some patients, fatal. Low‐moderate physical activity can still be recommended. However, extreme physical activity and oral breathing with hyperventilation during the incubation days and early stages of COVID‐19 facilitates re‐inhalation and early direct penetration of high numbers of own virus particles in the lower airways and the alveoli, without impacting on the airway’s mucosae covered by neutralizing antibodies ("viral auto‐inhalation" phenomenon). This allows the virus to bypass the efficient immune barrier of the upper airway mucosa in already infected, young, and otherwise healthy athletes. In conclusion, whether the virus or the adaptive immune response reaches the lungs first is a crucial factor deciding the fate of the patient. This “quantitative and time‐/sequence‐dependent” model has several implications for prevention, diagnosis, and therapy of COVID‐19 at all ages.
Peer-reviewed citations of this are also interesting. Sorry - not all are linked; but you can get them from google scholar citations easily enough. And the complete papers are all open access.
Support for this thread's "Vit D is good" idea:
We read with great interest the review article by Matricardi and colleagues1 depicting mechanisms of disease for COVID‐19 and analyzing both viral and host factors influencing its course. We particularly agree with authors on the pivotal role of innate immunity in the very early phase of disease, being crucial for the subsequent evolution. Most known weapons of innate immune system are represented by natural antibodies, non‐specific antimicrobial proteins, interferons, cytokines, and cellular elements (ie, natural killer cells).1 However, innate immunity could be influenced by other, still underrecognized, factors.
At present, a solid proof of evidence is available on the ability of vitamin D in modulating immune response.2 Most of the data are available from the field of bacterial infections and sepsis,3 being low vitamin D levels associated with a higher risk of infection and mortality.4
In addition, vitamin D could play a role against viruses by maintaining physical barriers (ie, tight junctions and gap junction), enhancing natural immunity (ie, production of cathelicidin and defensins), and modulating adaptive immune response (ie, modulation of TH1/TH2 response and inflammation).5 On this connection, emerging data support the role of vitamin D supplementation in reducing the risk and severity of influenza.5 Both influenza and COVID‐19 show their maximum spread in winter season and the highest severity in elderly people. Reduced vitamin D levels could represent a possible pathophysiological explanation, among others, in both cases.5, 6 With this regard, it has been hypothesized that variations in vitamin D status across countries and latitudes could, at least in part, explain variations of mortality from COVID‐19.6, 7
However, at present the exact vitamin D status among COVID‐19 patients is unknown.7 Moreover, the role and mechanisms of vitamin D in the treatment of COVID‐19 are still unexplored and several interventional trials are ongoing. Should these hypotheses be confirmed, universal vitamin D supplementation would represent a possible and inexpensive strategy to enhance natural immunity against COVID‐19.
Why are older people harder hit (the research evidence):
The difference in morbidity and mortality between adult and pediatric coronavirus disease 2019 infections is dramatic. Understanding pediatric‐specific acute and delayed immune responses to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is critical for the development of vaccination strategies, immune‐targeted therapies, and treatment and prevention of multisystem inflammatory syndrome in children. The goal of this review is to highlight research developments in the understanding of the immune responses to SARS‐CoV‐2 infections, with a specific focus on age‐related immune responses.
Don't do competitive exercise!
From Constandt et al.’s survey of 13,515 Belgium respondents, regular physical activity can be successfully initiated and sustained during a lockdown, with appropriate social distancing measures. Documentation that 77% of highly active people and 58% of low active people exercised as much or more following the institution of a nationwide lockdown was impressive, given that the cases of COVID-19 were accelerating at that time. The Belgian government’s central promotion of exercise, to boost both the mental and physical health of the population, likely contributed to the health, tolerance, and ultimate success of lockdown. In this commentary, we wish to pose a follow-up query which highlights the potential detrimental effects of intense exercise (competition) performed without social distancing measures. The proposed graphical abstract elucidates these possible risks, in contrast to the favorable results outlined in Constandt et al.’s study.
Important if true - seems to indicate bad effect in older people might be NOT so much worse T-cell immunity, as that the cytokine storm is much more powerful
Children with Coronavirus Disease 2019 (COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and adults hasn’t been reported. Therefore we initiated this study to figure out the features of immune response in children with COVID-19. Sera and whole blood cells from 19 children with COVID-19 during different phases after disease onset were collected. The cytokine concentrations, SARS-CoV-2 S-RBD or N-specific antibodies and T cell immune responses were detected respectively. In children with COVID-19, only 3 of 12 cytokines were increased in acute sera, including interferon (IFN)-γ-induced protein 10 (IP10), interleukin (IL)-10 and IL-16. We observed an increase in T helper (Th)-2 cells and a suppression in regulatory T cells (Treg) in patients during acute phase, but no significant response was found in the IFN-γ-producing or tumor necrosis factor (TNF)-α-producing CD8+ T cells in patients. S-RBD and N IgM showed an early induction, while S-RBD and N IgG were prominently induced later in convalescent phase. Potent S-RBD IgA response was observed but N IgA seemed to be inconspicuous. Children with COVID-19 displayed an immunophenotype that is less inflammatory than adults, including unremarkable cytokine elevation, moderate CD4+ T cell response and inactive CD8+ T cell response, but their humoral immunity against SARS-CoV-2 were as strong as adults. Our finding presented immunological characteristics of children with COVID-19 and might give some clues as to why children develop less severe disease than adults.
Display Morehttps://onlinelibrary.wiley.com/doi/full/10.1111/pai.13271
This was published as a preprint in April - now peer reviewed. Fascinating discussion of how COVID hits us and why it is sometimes asymptomatic.
Take homes (with caution)?
- COVID exposure: small doses good - bad doses bad
- strenuous exercise bad (light exercise good because keeps immune system in good order)
The first, holistic immunological model of COVID‐19: Implications for prevention, diagnosis, and public health measures
The natural history of COVID‐19 caused by SARS‐CoV‐2 is extremely variable, ranging from asymptomatic or mild infection, mainly in children, to multi‐organ failure, eventually fatal, mainly in the eldest. We propose here the first model explaining how the outcome of first, crucial 10‐15 days after infection, depends on the balance between the cumulative dose of viral exposure and the efficacy of the local innate immune response (natural IgA and IgM antibodies, mannose‐binding lectin). If SARS‐CoV‐2 runs the blockade of this innate immunity and spreads from the upper airways to the alveoli in the early phases of the infections, it can replicate with no local resistance, causing pneumonia and releasing high amounts of antigens. The delayed and strong adaptive immune response (high‐affinity IgM and IgG antibodies) that follows, causes severe inflammation and triggers mediator cascades (complement, coagulation, and cytokine storm), leading to complications often requiring intensive therapy and being, in some patients, fatal. Low‐moderate physical activity can still be recommended. However, extreme physical activity and oral breathing with hyperventilation during the incubation days and early stages of COVID‐19 facilitates re‐inhalation and early direct penetration of high numbers of own virus particles in the lower airways and the alveoli, without impacting on the airway’s mucosae covered by neutralizing antibodies ("viral auto‐inhalation" phenomenon). This allows the virus to bypass the efficient immune barrier of the upper airway mucosa in already infected, young, and otherwise healthy athletes. In conclusion, whether the virus or the adaptive immune response reaches the lungs first is a crucial factor deciding the fate of the patient. This “quantitative and time‐/sequence‐dependent” model has several implications for prevention, diagnosis, and therapy of COVID‐19 at all ages.
Peer-reviewed citations of this are also interesting. Sorry - not all are linked; but you can get them from google scholar citations easily enough. And the complete papers are all open access.
Support for this thread's "Vit D is good" idea:
We read with great interest the review article by Matricardi and colleagues1 depicting mechanisms of disease for COVID‐19 and analyzing both viral and host factors influencing its course. We particularly agree with authors on the pivotal role of innate immunity in the very early phase of disease, being crucial for the subsequent evolution. Most known weapons of innate immune system are represented by natural antibodies, non‐specific antimicrobial proteins, interferons, cytokines, and cellular elements (ie, natural killer cells).1 However, innate immunity could be influenced by other, still underrecognized, factors.
At present, a solid proof of evidence is available on the ability of vitamin D in modulating immune response.2 Most of the data are available from the field of bacterial infections and sepsis,3 being low vitamin D levels associated with a higher risk of infection and mortality.4
In addition, vitamin D could play a role against viruses by maintaining physical barriers (ie, tight junctions and gap junction), enhancing natural immunity (ie, production of cathelicidin and defensins), and modulating adaptive immune response (ie, modulation of TH1/TH2 response and inflammation).5 On this connection, emerging data support the role of vitamin D supplementation in reducing the risk and severity of influenza.5 Both influenza and COVID‐19 show their maximum spread in winter season and the highest severity in elderly people. Reduced vitamin D levels could represent a possible pathophysiological explanation, among others, in both cases.5, 6 With this regard, it has been hypothesized that variations in vitamin D status across countries and latitudes could, at least in part, explain variations of mortality from COVID‐19.6, 7
However, at present the exact vitamin D status among COVID‐19 patients is unknown.7 Moreover, the role and mechanisms of vitamin D in the treatment of COVID‐19 are still unexplored and several interventional trials are ongoing. Should these hypotheses be confirmed, universal vitamin D supplementation would represent a possible and inexpensive strategy to enhance natural immunity against COVID‐19.
Why are older people harder hit (the research evidence):
Insight into the pediatric and adult dichotomy of COVID‐19: Age‐related differences in the immune response to SARS‐CoV‐2 infection
The difference in morbidity and mortality between adult and pediatric coronavirus disease 2019 infections is dramatic. Understanding pediatric‐specific acute and delayed immune responses to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is critical for the development of vaccination strategies, immune‐targeted therapies, and treatment and prevention of multisystem inflammatory syndrome in children. The goal of this review is to highlight research developments in the understanding of the immune responses to SARS‐CoV‐2 infections, with a specific focus on age‐related immune responses.
Don't do competitive exercise!
Is Exercise the Best Medicine during a COVID-19 Pandemic?
From Constandt et al.’s survey of 13,515 Belgium respondents, regular physical activity can be successfully initiated and sustained during a lockdown, with appropriate social distancing measures. Documentation that 77% of highly active people and 58% of low active people exercised as much or more following the institution of a nationwide lockdown was impressive, given that the cases of COVID-19 were accelerating at that time. The Belgian government’s central promotion of exercise, to boost both the mental and physical health of the population, likely contributed to the health, tolerance, and ultimate success of lockdown. In this commentary, we wish to pose a follow-up query which highlights the potential detrimental effects of intense exercise (competition) performed without social distancing measures. The proposed graphical abstract elucidates these possible risks, in contrast to the favorable results outlined in Constandt et al.’s study.
Important if true - seems to indicate bad effect in older people might be NOT so much worse T-cell immunity, as that the cytokine storm is much more powerful
Mild Cytokine Elevation, Moderate CD4+ T Cell Response and Abundant Antibody Production in Children with COVID-19
Children with Coronavirus Disease 2019 (COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and adults hasn’t been reported. Therefore we initiated this study to figure out the features of immune response in children with COVID-19. Sera and whole blood cells from 19 children with COVID-19 during different phases after disease onset were collected. The cytokine concentrations, SARS-CoV-2 S-RBD or N-specific antibodies and T cell immune responses were detected respectively. In children with COVID-19, only 3 of 12 cytokines were increased in acute sera, including interferon (IFN)-γ-induced protein 10 (IP10), interleukin (IL)-10 and IL-16. We observed an increase in T helper (Th)-2 cells and a suppression in regulatory T cells (Treg) in patients during acute phase, but no significant response was found in the IFN-γ-producing or tumor necrosis factor (TNF)-α-producing CD8+ T cells in patients. S-RBD and N IgM showed an early induction, while S-RBD and N IgG were prominently induced later in convalescent phase. Potent S-RBD IgA response was observed but N IgA seemed to be inconspicuous. Children with COVID-19 displayed an immunophenotype that is less inflammatory than adults, including unremarkable cytokine elevation, moderate CD4+ T cell response and inactive CD8+ T cell response, but their humoral immunity against SARS-CoV-2 were as strong as adults. Our finding presented immunological characteristics of children with COVID-19 and might give some clues as to why children develop less severe disease than adults.
Seems logical and matches much of what has been said here (and else where) over the past months. I did not see anything new than perhaps that vigorous exercise is likely detrimental.
Of course " early stages of COVID‐19 facilitates re‐inhalation and early direct penetration of high numbers of own virus particles in the lower airways and the alveoli, " this statement gives credence that wearing masks can be detrimental as well and will give some ammunition to the anti-maskers!
However, it would seem that the logical course then would be to wear masks while in public, close indoor contact and not wear them otherwise. It is very likely that the re-inhalation is indeed a serious concern and needs to be considered when where masks are concerned. This states explicitly exercise, but would be completely indicative of mask wearing. One will absolutely re-inhale virus within a mask. So balance between keeping foreign virus' out versus re-inhaling one's own will need to be considered.
Many states are now mandating masks at all times in public, even outdoors. I am unsure if the outdoor requirement is wise? If you do not have the virus, then sure... but then one never knows if you are infected early on.... A mask could make your case much, much worse if you are infected!
So much changes within a short time! I wonder when the HCQ "oh, it works afterall" memo will come out? Not until after the election for certain! (If it ever does)
Gilead's balm, Remdesivir, of uncertain clinical importance in moderate Covid
Diana M. Brainard, MD, Gilead Sciences,
Life, Liberty & Levin 8/23/20 | Breaking News Aug 23, 2020
- Interviews Yale epidemiologist Dr. Harvey Risch on HCQ
"There's been a massive disinformation campaign that stretches from the government to the
media that's either suppressing this message or it's countering it with a false message ... the
science is all one-sided. In fact, the science is so one-sided in supporting this result that it's
stronger than anything else I've ever studied in my entire career... Somehow we've let politics
overrule science, and it's an absurd situation ... it's beyond belief..."
Inhaled Corticosteroids Formoterol/Budesonide Shows Potential As Prophylactic And Treatment Drugs
https://www.thailandmedical.ne…actic-and-treatment-drugs
https://www.medrxiv.org/conten…08.19.20178368v1.full.pdf
Sky News Australia (Aug 24) -
Ivermectin - Why are governments letting people die unnecessarily?
Convalescent plasma , RCT evidence lacking yet.. as of August 6
https://www.medpagetoday.com/infectiousdisease/covid19/87936
It should work.. it appears to have worked in a small way for the Spanish flu, one hundred years ago.
Display MoreConvalescent plasma , RCT evidence lacking yet.. as of August 6
https://www.medpagetoday.com/infectiousdisease/covid19/87936
It should work.. it appears to have worked in a small way for the Spanish flu, one hundred years ago.
Convalescent plasma RCT:
https://www.medrxiv.org/conten…101/2020.07.01.20139857v1
stopped due to most patients having high antibody counts already (hence more antibodies do not help) and reduction in COVID rate. At point stopped no difference.
More positive editorial on it
https://jamanetwork.com/journals/jama/fullarticle/2766940
Some sign it helped less seriously ill patients. No difference for the seriously ill patients.
Comment on need for better RCT evidence:
https://ccforum.biomedcentral.…0.1186/s13054-020-03163-3
As with many of these things if you get it to patients early on (when they are not that ill) it is more likely to be of benefit. But also that subjects more patients who would recover anyway quickly to a treatment with possible side effects.
From obave links serious adverse side effects stand at around 1% - so you don't want to give it to everyone with COVID!
THH
N.Y. Times reports some good news:
Why Are U.S. Virus Cases Falling? Effective Restrictions, Experts Say
Infection rates remain among the world’s highest, but numbers are down. All states driving the decrease have at least some local mask mandates.
Display MoreConvalescent plasma , RCT evidence lacking yet.. as of August 6
https://www.medpagetoday.com/infectiousdisease/covid19/87936
It should work.. it appears to have worked in a small way for the Spanish flu, one hundred years ago.
yes, but they will want 3 randomized studies first. 
yes, but they will want 3 randomized studies first.
Maybe just one that is positive?
It does not help when the first RCT evidence is negative.
Why should doctors jump on treatments which appear not to work?
https://www.bbc.co.uk/news/world-us-canada-53892856
they switched between thinking the virus was a hoax, linked to 5G technology, or a real, but mild ailment.
Erin, a pastor in Florida, had existing health problems - she suffered from asthma and a sleeping disorder.
Her husband explained that the couple did not follow health guidance at the start of the pandemic because of the false claims they had seen online.
Brian continued to work as a taxi driver and to collect his wife's medicine without observing social distancing rules or wearing a mask.
They had also failed to seek help as soon as possible when they fell ill in May and were both subsequently diagnosed with Covid-19.
Brian said he and his wife didn't have one firm belief about Covid-19. Instead, they switched between thinking the virus was a hoax, linked to 5G technology, or a real, but mild ailment. They came across these theories on Facebook.
"We thought the government was using it to distract us," Brian explained, "or it was to do with 5G."
Recent TV news from France: First covid-19 cases already in November. Originally diagnosed as weird influenza! Diagnosed by comparing the lung lung damage and later confirmed by anti body tests!
So the date of laboratory outbreak Wuhan October seems to be OK! https://dash.harvard.edu/handle/1/42669767
Display Morehttps://www.bbc.co.uk/news/world-us-canada-53892856
they switched between thinking the virus was a hoax, linked to 5G technology, or a real, but mild ailment.
Man who believed virus was hoax loses wife to Covid-19
Erin, a pastor in Florida, had existing health problems - she suffered from asthma and a sleeping disorder.
Her husband explained that the couple did not follow health guidance at the start of the pandemic because of the false claims they had seen online.
Brian continued to work as a taxi driver and to collect his wife's medicine without observing social distancing rules or wearing a mask.
They had also failed to seek help as soon as possible when they fell ill in May and were both subsequently diagnosed with Covid-19.
Brian said he and his wife didn't have one firm belief about Covid-19. Instead, they switched between thinking the virus was a hoax, linked to 5G technology, or a real, but mild ailment. They came across these theories on Facebook.
"We thought the government was using it to distract us," Brian explained, "or it was to do with 5G."
And people who think like this can vote?
Dr Zelenko discusses COVID-19 pandemic and solutions to end it (August 24)
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EUA of Convalescent plasma.. no RCT..but there is an election..
https://www.fda.gov/media/141478/download
...
Health care providers can decide whether to use these units based on an
individualized determination of potential RISK:BENEFIT
FDA will continue to evaluate this authorization based on additional data that become available.
Current evidence also suggests that benefit is most likely in patients treated early in the course of the disease.
the clinical evidence supporting this EUA was not obtained from..(RCTs),
additional RCTs are needed.
CP should not be considered a new standard of care for the treatment of patients with COVID-19.
Side Effects
include transfusion transmitted infections (e.g. HIV, hepatitis B, hepatitis C), allergic reactions, anaphylactic
reactions, febrile nonhemolytic reactions, transfusion-related acute lung injury (TRALI),
transfusion-associated cardiac overload (TACO), and hemolytic reactions
Hypothermia, metabolic complications, and posttransfusion purpura have also been described.
Risks
the phenomenon of antibodydependent enhancement of infection (ADE).
ADE has been described in other viral infections,
such as dengue, and involves an enhancement of disease in the presence of certain antibodies.
For coronaviruses, several mechanisms of ADE have been proposed, including the theoretical
concern that antibodies to one type of coronavirus could enhance infection to another strain.
...
Another theoretical risk is that antibody administration may attenuate the immune response
and make patients more susceptible to re-infection
Fauci Flashback to 1989
1989 was an important year for LENR
but also for Fauci AZT and HIV
Fauci backed AZT
" Dr. Fauci, the head of NIH, proudly announced that a trial has been going on for “two years”
had “clearly shown” that early intervention will keep AIDS at bay.
Anyone who has antibodies to HIV and less than 500 T-4 cells should start taking AZT at once, he said.
That is approximately 650,000 people. 1.4 million Americans are assumed HIV antibody-positive,
and eventually all of them may need to take AZT so they don’t get sick, Fauci contended.
https://www.spin.com/featured/…feature-sins-of-omission/
https://www.independent.co.uk/…with-hiv-and-2320491.html
"
Still, nobody seemed quite ready for the news when the Concorde researchers released their preliminary report on April 1, 1993, in a brief letter to the editor in Lancet .[25]877 patients, asymptomatic upon entry into the study, had been randomized into the "immediate treatment" arm of the study and had received one thousand milligrams of AZT daily; 872 had been placed in the "deferred treatment" arm, receiving a placebo unless they became symptomatic,
at which point they were put on AZT.
In total, the study provided 5,328 person-years of data, making it the largest and longest study of its kind.
The researchers reported that the patients in the "immediate treatment" arm experienced more of a CD4-count boost, on average, than those in the "deferred treatment" arm. However, "by contrast with the differences in CD4 count,
there was no significant difference in clinical outcome between the two therapeutic strategies."
The three-year survival rate was 92 percent for those who had begun taking AZT early
and 93 percent for those who were put on the drug later.
This is not something strange. Note that the reinfection is very mild. Doesn't say it's because of the trained immune system or that the new strain was milder.
This is not something strange. Note that the reinfection is very mild. Doesn't say it's because of the trained immune system or that the new strain was milder.
This is a scare mongering story.
1st infection - 3 days after getting virus, admitted to hospital with no symptoms --> Immune system handled it
2nd infection - Said to have virus based on RT-PCR - not a valid test of disease! - and more obvious the second time, he never showed any indication of being sick
Of course this is 1 patient and there is nothing in the article to even prove what they say happened even happened. It could have been a successful clear of the virus not a reinfection.
Lastly, antibodies are not the entire story on the immune system.
The conclusion for the uneducated is "oh my god its dangerous and this brutal!" The reality is 180 degrees different.
This may be used to push vaccines.
I totally agree.
An interesting video of Prof. Bhakdi (german with subtitles) about the covid vaccination I highly recommend:
One question to people from UK or US: is there a political or scientific debate in the media about the corona measures and vaccines and all this stuff? Here in germany every news source shares the goverments opinion to 100%. People like Prof. Bhakdi are totally ignored or even censored. Today I saw this video from australia:
I am getting scared. Is it better in other parts of the world?
