September 4, 2020
Thursday, Harrison County had 7 new COVID cases whild Gregg had 16 and Smith 30.
Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19
SUMMARY: “In this prospective meta-analysis of clinical trials of critically ill patients with COVID-19, administration of systemic corticosteroids, compared with usual care or placebo, was associated with lower 28-day all-cause mortality.”(J. Harris: Dexamethasone is a concentrated, inexpensive type of ‘cortisone’ which has for many years been used widely via injection into the patient’s veins in respiratory distress situations of many types. This complicated article with statistics and results from many countries, centers, and hospitals makes some sense out of many different studies, doses, degrees of illness, and other variables. Yes, Dexamethasone helps survival. How much? I’m not sure, but I’d definitely want to take it were I very ill with COVID. After this report, it will be unethical to withhold the drug inthe future experinmental purposes, so better data, doses, and indications will be forthcoming soon.
VENTILLATION AND COVID TRANSMISSION REVISITED
With cold weather, schools, and closed windows coming, a review is in order.
Five Military Sites Chosen for Phase III Trial of COVID Vaccine Candidate
A common North American mouse can catch and spread the coronavirus in labs, studies show(J. Harris: This is a potential but not a current problem at this time.)
COVID-19 and mRNA Vaccines—First Large Test for a New ApproachCurrent antiviral vaccine designs can be described as falling into 2 camps: protein based or gene based.
1. Protein-based vaccines deliver the immune system–stimulating antigen to the body. This category includes whole-inactivated (killed) vaccines, as in the polio and flu shots, and subunit vaccines and virus-like particles, like in the hepatitis B and human papillomavirus vaccines.
2. Gene-based vaccines take a different tack. They carry the genetic instructions for the host’s cells to make the antigen, which more closely mimics a natural infection. In the case of coronaviruses, the antigen of interest is the surface spike protein the virus uses to bind and fuse with human cells. “You’re not giving them the protein—you’re giving them the genetic material that then instructs them how to make that spike protein, to which they make an antibody response that hopefully is protective,…Unlike conventional vaccines, mRNA vaccines aren’t grown in eggs or cells, a time-consuming and costly process. At their essence, these vaccines are simply chemicals catalyzed in test tube or a tank. This makes them easier to develop quickly and—at least theoretically—at scale, although they’ve never been mass-produced before.Even among the gene-based platforms, distinct advantages exist. In cutting out the viral vector, both DNA and mRNA vaccines eliminate the risk of preexisting immunity against it, which can limit effectiveness.’… mRNA vaccines also have a leg up on DNA vaccines. In a DNA vaccine, the genetic material must first enter the host cell’s nucleus. From there, messenger RNA is created, which travels out of the nucleus into the cytoplasm, where protein is formed from it. However, genetic information can only enter the nucleus when the cell is dividing, making the process inefficient…Researchers are trying to solve this problem using electric pulses to increase DNA uptake into cells at the time of vaccination. But the mRNA platform simply bypasses that step. “Ninety-five percent of cells that meet the RNA take it up and make protein, so it’s an incredibly efficient process,” …So far, in early COVID-19 trials, mRNA platforms have turned up encouraging results. “Certainly, these vaccines look like they’re generating the immune response that we need, and the reaction profiles have not been associated with severe reactions…But, “the real proof of the pudding will be the phase 3 trials where we see if the vaccine actually prevents disease.” The US Food and Drug Administration has said that a COVID-19 vaccine will need at least 50% efficacy to be approved.
(J. Harris: Note our local numbers are up a little. Opening school and the impending holiday may exacerbate our vulnerable situation. National experts are making dire predictions. Space out and wear your masks. Get your flu shots. Please.)
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