Are vaccines the light at the end of the tunnel?

[TeeRick]

There is a new NEJM article on the early clinical results (safety and immunogenicity) of the Moderna mRNA vaccine (mRNA-1273) and its use in the group ages 56-70 and another group 70+.  Small study but very good results IMO.

https://www.nejm.org/doi/full/10.1056/NEJMoa2028436

[BigAl94]

https://www.bbc.co.uk/news/health-54371559 appears to confirm that not a lot will change in 2021

[nocl]

10 hours ago, BP99 said:

Hi,

I think that the monoclonal antibody therapy is a great approach to treating

patients with covid. However (IMO), all FDA approved monoclonals for

other diseases (eg. cancer) are outrageously expensive. They are expensive

to produce and deliver. To be used as a preventative would be costly

(unlike most vaccines).

 

The one place where I would disagree would be along the lines of one of the trials Lilly is doing.  It is a very specific preventative trial in a nursing home environment, where there is a COVID outbreak actively occurring.  That kind of limited scope application as a preventative could very easily be both medically and economically reasonable.  When one compares the cost of a number of patients having to be transferred to a hospital for treatment including potentially several days in intensive care and the use of ventilators the numbers would tilt pretty quickly to use the MAB. if the trial shows it to be effective in such settings.  But even there you would be talking fairly small number of doses  for a limited period to stop an active outbreak. Even there it would be expensive, but not in comparison to a couple of people spending a few days in intensive care.

 

I have seen MAB cost of product per dose in the  $1000 to $2000 range. They will sell for much more but mostly due to the price for MAB treatments are driven by two factors 1. limited market size  2. Economic benefit compared to other treatments.

A MAB that cures an illness at $100,000 is cheap compared to the cost of controlling a chronic condition for years.

 

Also the prices reported tend to be annual costs, not single dose costs.  A drug whose annual costs are $100,000 might have an dose cost of less than $10k

 

The biggest issue is that many MABs are small market, with small production runs.  There is an interesting paper from 2009 that discusses the potential for dramatic cost reductions with newer technology and larger size runs.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759494/

Edited October 1, 2020 by nocl

[BP99]

1 hour ago, nocl said:

The one place where I would disagree would be along the lines of one of the trials Lilly is doing.  It is a very specific preventative trial in a nursing home environment, where there is a COVID outbreak actively occurring.  That kind of limited scope application as a preventative could very easily be both medically and economically reasonable.  When one compares the cost of a number of patients having to be transferred to a hospital for treatment including potentially several days in intensive care and the use of ventilators the numbers would tilt pretty quickly to use the MAB. if the trial shows it to be effective in such settings.  But even there you would be talking fairly small number of doses  for a limited period to stop an active outbreak. Even there it would be expensive, but not in comparison to a couple of people spending a few days in intensive care.

 

I have seen MAB cost of product per dose in the  $1000 to $2000 range. They will sell for much more but mostly due to the price for MAB treatments are driven by two factors 1. limited market size  2. Economic benefit compared to other treatments.

A MAB that cures an illness at $100,000 is cheap compared to the cost of controlling a chronic condition for years.

 

Also the prices reported tend to be annual costs, not single dose costs.  A drug whose annual costs are $100,000 might have an dose cost of less than $10k

 

The biggest issue is that many MABs are small market, with small production runs.  There is an interesting paper from 2009 that discusses the potential for dramatic cost reductions with newer technology and larger size runs.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759494/

Hi,

I agree with all your comments. 

However, the present cost is unknown and I'm only repeating 

what I read (it's expensive). Even if it's $1000 or $10,000 it's

still an expensive procedure that many people/countries may not

be able to afford.

The mAb are difficult and expensive to produce. Even Lilly said

in August that it would take till the end of the year to make 100,000 doses.

How long would it take to make 100's of million doses?

They also mention that the cost would be affordable but did not

give any dollar figure.

Also they are "usually" given intravenously which is an  expensive

delivery (several hundred dollars even for a saline iv drip).

You need an experienced nurse. 

To decrease cost they are looking for more potent mAb that would lower

the dose needed. Also, by modifying the mAb they can increase

it's half life and be more effective for a longer period.

 

 

[TeeRick]

17 hours ago, nocl said:

The one place where I would disagree would be along the lines of one of the trials Lilly is doing.  It is a very specific preventative trial in a nursing home environment, where there is a COVID outbreak actively occurring.  That kind of limited scope application as a preventative could very easily be both medically and economically reasonable.  When one compares the cost of a number of patients having to be transferred to a hospital for treatment including potentially several days in intensive care and the use of ventilators the numbers would tilt pretty quickly to use the MAB. if the trial shows it to be effective in such settings.  But even there you would be talking fairly small number of doses  for a limited period to stop an active outbreak. Even there it would be expensive, but not in comparison to a couple of people spending a few days in intensive care.

 

I have seen MAB cost of product per dose in the  $1000 to $2000 range. They will sell for much more but mostly due to the price for MAB treatments are driven by two factors 1. limited market size  2. Economic benefit compared to other treatments.

A MAB that cures an illness at $100,000 is cheap compared to the cost of controlling a chronic condition for years.

 

Also the prices reported tend to be annual costs, not single dose costs.  A drug whose annual costs are $100,000 might have an dose cost of less than $10k

 

The biggest issue is that many MABs are small market, with small production runs.  There is an interesting paper from 2009 that discusses the potential for dramatic cost reductions with newer technology and larger size runs.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759494/

You make an excellent point about control of an outbreak in an isolated facility like a nursing home.  But at least in the USA, will private health insurance or most likely Medicare cover a monoclonal Ab preventative therapy for SARS-CoV-2 infection? Remember that it is not for actual COVID disease in this case.  Prevention of becoming positive for the virus.  Positive cases in the majority do not lead to COVID or serious, life threatening COVID.  I have a very good BC/BS policy and I on occasion run into being denied coverage because the particular procedure or test or drug is considered (by them) to still be "experimental" or "investigational".  It takes a long time to have them move it over to an "approved" list.  Even if widely used.  I don't see automatic coverage for the prophylactic use of a mAb to prevent COVID being much of a reality.  But I guess some wealthy individuals could choose to pay to protect themselves or their loved ones out of pocket.

[nocl]

3 hours ago, TeeRick said:

You make an excellent point about control of an outbreak in an isolated facility like a nursing home.  But at least in the USA, will private health insurance or most likely Medicare cover a monoclonal Ab preventative therapy for SARS-CoV-2 infection? Remember that it is not for actual COVID disease in this case.  Prevention of becoming positive for the virus.  Positive cases in the majority do not lead to COVID or serious, life threatening COVID.  I have a very good BC/BS policy and I on occasion run into being denied coverage because the particular procedure or test or drug is considered (by them) to still be "experimental" or "investigational".  It takes a long time to have them move it over to an "approved" list.  Even if widely used.  I don't see automatic coverage for the prophylactic use of a mAb to prevent COVID being much of a reality.  But I guess some wealthy individuals could choose to pay to protect themselves or their loved ones out of pocket.

I would not expect insurance coverage to ever be available for preventative use of a MAB for COVID in the general public. I would expect, if the Lilly trial is successful, and their MAB gets approval for a preventive indication in an institutional setting, that government programs would add it for that specific use, inside of an institution that is experiencing an active outbreak.  In this setting almost all coverage is under government programs, not commercial policies.  Probably requiring prior authorization.  In that setting it would make economic sense.

 

As I mentioned earlier the major benefit of the FDA doing emergency approvals, was not for increased use, but instead would enable reimbursement (for use that was already occuring), for those therapies under government programs, that otherwise would prevent use (usually by using prior authorization requirements) for unapproved applications.

[cangelmd]

https://www.medscape.com/viewarticle/938514?src=mkm_covid_update_201002_mscpedit_&uac=121125HX&impID=2600117&faf=1

 

 

Final, modified recommendations from the National Academy of Science about prioritizing Covid vaccine. This is a little different than what was discussed on another thread, or maybe just stated more clearly. Most adults over age 65 will be vaccinated before phase 4.

[ABoatNerd]

Thank you cangelmd.

 

Why would folks over 65 not be phase 1 - the highest priority? Could you let me know?

Thanks so much for your knowledge.

 

Love Mobile and Gulf Shores and Daphne, our most wonderful place in dear American.

Hope to get there soon!

[TeeRick]

13 hours ago, cangelmd said:

https://www.medscape.com/viewarticle/938514?src=mkm_covid_update_201002_mscpedit_&uac=121125HX&impID=2600117&faf=1

 

 

Final, modified recommendations from the National Academy of Science about prioritizing Covid vaccine. This is a little different than what was discussed on another thread, or maybe just stated more clearly. Most adults over age 65 will be vaccinated before phase 4.

Thank you!  Let's see what happens as these are only recommendations.  The final decision I think is still with HHS as the article states.  Of interest is how each phase / category is exactly defined.  For example, does the 40% of the US population officially categorized as obese (and half of those morbidly obese) qualify in phase 1 since obesity is a known risk factor for severe COVID? 

Edited October 3, 2020 by TeeRick

[cangelmd]

12 hours ago, ABoatNerd said:

Thank you cangelmd.

 

Why would folks over 65 not be phase 1 - the highest priority? Could you let me know?

Thanks so much for your knowledge.

 

Love Mobile and Gulf Shores and Daphne, our most wonderful place in dear American.

Hope to get there soon!

I guess the easiest explanation is logistics.

First realize that in this set of recommendations ALL persons over the age of 65 are in Phase 1 or Phase 2 - that change is why I posted this, that wasn’t clearly stated in the first draft, or maybe they actually changed the recommendation, I’m not certain.

 

i think it’s a given that HCWs and first responders need to go first - it is very difficult for FRs to socially distance, and it’s even hard often for them to mask (I want to communicate clearly with the guy holding a gun on me, whether I’m the FR or the citizen!). Next is fairly obvious, too, NH residents, medically fragile folk in group living situations, are next.

After that, I think logistics step in to dividing group 1 from group 2. Group 2 is not just people who can be reached as a group like all the residents of a NH or all the police officers in a city, it starts to involve individuals being certified as higher risk by some practitioner or by age. That implies that people have to be motivated to come in and get their certification to be vaccinated and vaccine either has to go out to lots of places in small amounts or the person has to go to a central location. 
Motivated, mobile people over 65 will be able to get vaccinated if they seek it out very soon after HCWs.

Now I think that they will hold up Phase 2 until enough vaccine goes out for phase 1 and all the HCWs get vaccinated, plus 3 weeks for vaccine to “take”. I think it will be that way to allow time to collect safety on the much bigger group of HCWs and to get more logistics into place. After that, the phases may move more simultaneously. I doubt that phases will be held up to make more vaccine, sadly I think enough people will be reluctant to go,first that there will be vaccine available.

 

[cangelmd]

23 minutes ago, TeeRick said:

Thank you!  Let's see what happens as these are only recommendations.  The final decision I think is still with HHS as the article states.  Of interest is how each phase / category is exactly defined.  For example, does the 40% of the US population officially categorized as obese (and half of those morbidly obese) qualify in phase 1 since obesity is a known risk factor for severe COVID? 

Honestly, I think logistics and amount of vaccine available will supersede  all these recommendations. What I think will really happen is that after HCWs, first responders and nursing home residents get their shots, they will start shipping vaccine for schools and essential workers to the health depts. at that point, health depts will likely have vaccine clinic hours, and motivated people will be able to go there and get vaccinated, either by age or with a doctor note. Eventually, you will be able to get a shot at MDs office, or more likely at CVS, but that will take awhile.

What I think they’re scrambling to figure out is how to do what needs to be done with health depts as gutted as they are now - there aren’t enough bodies to do mass vaccinations and it will take time to ship small batches of vaccine to all the little places that do them now.

 

i hope they draft the hospital systems to do mass vaccination clinics - drive through, like the testing, that makes the most sense to me as a ready trained source of labor.

[ch175]

1 hour ago, TeeRick said:

Thank you!  Let's see what happens as these are only recommendations.  The final decision I think is still with HHS as the article states.  Of interest is how each phase / category is exactly defined.  For example, does the 40% of the US population officially categorized as obese (and half of those morbidly obese) qualify in phase 1 since obesity is a known risk factor for severe COVID? 

I guess I am curious as to what the best strategy for society as a whole is. I admit to not understanding a lot of the policy behind this.

 

Why are we talking about grouping in terms of personal risk factors - such as age, obesity, etc? Why can’t you group in terms of how likely people are to be spreaders of Covid? So vaccinate those with jobs, or packed tightly in cities, who come in contact with the most people? So focus on reducing spread to protect those who would be most at risk? Or would that be a losing strategy?

Edited October 3, 2020 by ch175

[TeeRick]

22 minutes ago, ch175 said:

I guess I am curious as to what the best strategy for society as a whole is. I admit to not understanding a lot of the policy behind this.

 

Why are we talking about grouping in terms of personal risk factors - such as age, obesity, etc? Why can’t you group in terms of how likely people are to be spreaders of Covid? So vaccinate those with jobs, or packed tightly in cities, who come in contact with the most people? So focus on reducing spread to protect those who would be most at risk? Or would that be a losing strategy?

You are definitely on to something here.  There is an increased focus on the so-called super-spreaders.  Here is an excellent article on this. 

https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/

 

Also a study from two states in India encompassing over 575,000 people just published in the journal Science supports this point of view.

 https://science.sciencemag.org/content/early/2020/09/29/science.abd7672

[UnorigionalName]

4 hours ago, ch175 said:

Why can’t you group in terms of how likely people are to be spreaders of Covid? So vaccinate those with jobs, or packed tightly in cities, who come in contact with the most people? So focus on reducing spread to protect those who would be most at risk? Or would that be a losing strategy?

 

Because of the way science works.

 

It is relatively straight forward to see if a vaccine is effective in preventing your chosen endpoint (infection, death, hospitalization, serious morbidity) in the vaccinated individual from COVID in a clinical trial.  It just requires enough numbers and enough disease around.

 

On the other hand, how would you possible go around designing a clinical trial to answer the question "is a vaccine effective in preventing the vaccinated individual from spreading COVID"?  It would require a monstrous amount of effort and be nigh impossible.  

 

Common sense would say that a vaccine good at the first one should be good at the second, but yesterdays common sense ends up often being wrong tomorrow when it comes to science.  Without evidence you can't really design a policy around it.

 

also, we don't really yet know why some people are super spreaders and some aren't.  Maybe in a few years we will know better for the next coronavirus pandemic.

Edited October 3, 2020 by UnorigionalName

[nocl]

6 hours ago, cangelmd said:

I guess the easiest explanation is logistics.

First realize that in this set of recommendations ALL persons over the age of 65 are in Phase 1 or Phase 2 - that change is why I posted this, that wasn’t clearly stated in the first draft, or maybe they actually changed the recommendation, I’m not certain.

 

i think it’s a given that HCWs and first responders need to go first - it is very difficult for FRs to socially distance, and it’s even hard often for them to mask (I want to communicate clearly with the guy holding a gun on me, whether I’m the FR or the citizen!). Next is fairly obvious, too, NH residents, medically fragile folk in group living situations, are next.

After that, I think logistics step in to dividing group 1 from group 2. Group 2 is not just people who can be reached as a group like all the residents of a NH or all the police officers in a city, it starts to involve individuals being certified as higher risk by some practitioner or by age. That implies that people have to be motivated to come in and get their certification to be vaccinated and vaccine either has to go out to lots of places in small amounts or the person has to go to a central location. 
Motivated, mobile people over 65 will be able to get vaccinated if they seek it out very soon after HCWs.

Now I think that they will hold up Phase 2 until enough vaccine goes out for phase 1 and all the HCWs get vaccinated, plus 3 weeks for vaccine to “take”. I think it will be that way to allow time to collect safety on the much bigger group of HCWs and to get more logistics into place. After that, the phases may move more simultaneously. I doubt that phases will be held up to make more vaccine, sadly I think enough people will be reluctant to go,first that there will be vaccine available.

 

Keep in mind the priority list determination of risk includes 2 primary factors 1. potential for harm if infected  and 2. potential for exposure to virus.

 

While people over 65, in good health might be more at risk for harm than the general population, they are at less risk, if they follow good practices for exposure prevention (social distance, wear masks, no large groups, stay out of indoor environments when others are present.

 

On the other hand medical personnel, first responders might suffer less risk for harm, but the very nature of their jobs puts them a far greater exposure risk.

 

Those people in an institution such as managed care setting are at high risk for harm, and by the nature of the institution have less ability to prevent exposure.

 

In the case of military you have low individual risk for harm, but due to the mission requirements and the military housing structure, especially for Navy and Marines, you do have high risk for exposure.

 

There was a lot of discussion about prisons.  When society decides that it must lock someone up for the benefit of society for either criminal or psychological reasons it must take on the responsibility of caring for those individuals.  Since that populations does include some older members at risk for harm, and since they have zero ability to protect themselves from exposure, with the crowded setting making them very high risk for exposure.  That is why prisons tend to be higher on the priority list than some prefer.

 

The personal desires of a group to do things outside of good practices to avoid exposure, such as travel, is a personal decision and not part of the ethical decisions followed in putting together a priority list.

 

That is why there are other groups about the healthy over 65 group.

Edited October 3, 2020 by nocl

[phoenix_dream]

21 minutes ago, nocl said:

....................

There was a lot of discussion about prisons.  When society decides that it must lock someone up for the benefit of society for either criminal or psychological reasons it must take on the responsibility of caring for those individuals.  Since that populations does include some older members at risk for harm, and since they have zero ability to protect themselves from exposure, with the crowded setting making them very high risk for exposure.  That is why prisons tend to be higher on the priority list than some prefer.

 

The personal desires of a group to do things outside of good practices to avoid exposure, such as travel, is a personal decision and not part of the ethical decisions followed in putting together a priority list.

 

That is why there are other groups about the healthy over 65 group.

I wanted to add my two cents to the comments about prisons, even though truthfully I go back and forth myself about what is the "right" thing to do.  Regarding society deciding to lock someone up - not untrue, but the root of the problem is that the prisoner decided to commit a crime which caused him/her to be put in prison.  It was their choice to do that - no one forced them to commit the crime in the first place.  The commission of that crime is what is now putting them in harms way. 

 

Perhaps most importantly, there are prisons, and sections of other prisons, which hold people who have committed the most heinous of crimes - murder, serial killing, child molestation, rape and the like.  Is it really the right thing to do to prioritize those types of individuals just because they are at very high risk for exposure?  I think of my sons - in their late 40's, good health, working but not in "essential" roles.  It sickens me to think a serial killer gets priority over them, perhaps for months at a time.

[Arizona Wildcat]

On 9/28/2020 at 3:46 PM, phoenix_dream said:

I agree with what you are saying.  It still seems sad to me that there will be those who fight for prisoners who have created heinous crimes, rather than fighting to save the lives of healthy seniors.   I doubt they will prioritize them (prisoners) like the rest of us - too much paperwork and bureaucracy - not the government's finest skills for sure.  And based on the proposal we were discussing, there is no priority for people over 65 that I can see, at least the healthy ones.  I don't think they are considering age an underlying condition, or they wouldn't be specifically mentioning seniors in nursing homes, etc.  All they would need to say is people 65+.  I know it is too early to know what will finally happen, but going by the specific wording as a healthy 69 year old I would be at the end of the pack.  Time will tell.

Prisoners are people too and about 99% will return to society.  Some in a short time and others after a number of years.

This discussion May be missed the fact that by being over 65 years old, your age is an underlying condition.  This is now clearly stated in the guidelines.

Also vaccine production will ramp up very quickly.  That many millions have said they will not be vaccinated and millions more will wait for a few months to ensure safety of the vaccine makes the initial rollout manageable within a shorter period of time.  Drop children and you have a group in the 75-100M area.  Doable.

Edited October 3, 2020 by Arizona Wildcat

[phoenix_dream]

1 hour ago, Arizona Wildcat said:

Prisoners are people too and about 99% will return to society.  Some in a short time and others after a number of years.

This discussion May be missed the fact that by being over 65 years old, your age is an underlying condition.  This is now clearly stated in the guidelines.

Also vaccine production will ramp up very quickly.  That many millions have said they will not be vaccinated and millions more will wait for a few months to ensure safety of the vaccine makes the initial rollout manageable within a shorter period of time.  Drop children and you have a group in the 75-100M area.  Doable.

I know full well prisoners are people too.  And most (not 99%, but the statistics I read were 95%) will eventually get out.  But unlike those in nursing homes, hospitals, etc.., they were put there because of their own actions - they chose to commit crimes, no one forced them to.  And most importantly,  I still feel a serial killer should not take priority over my 40-50 year old sons.  I am not against them being vaccinated, but to prioritize them over law abiding citizens has its own ethical questions in my opinion.

 

I am not sure what guidelines you are referencing.  The ones I originally read did not include healthy seniors until the end.  That may have changed by now.  We also don't really know what the final guidelines will be and if states will be required to follow them.  If recent history is any proof, states may be able to set their own individual guidelines.  And I only hope you are right about the vaccine.  Depending who you listen to, people at the end of the priority list may be able to get vaccines sometime in the spring, or as late as end of next year.  I'm hoping for the former.

Edited October 3, 2020 by phoenix_dream

[Arizona Wildcat]

15 minutes ago, phoenix_dream said:

I know full well prisoners are people too.  And most (not 99%, but the statistics I read were 95%) will eventually get out.  But unlike those in nursing homes, hospitals, etc.., they were put there because of their own actions - they chose to commit crimes, no one forced them to.  And most importantly,  I still feel a serial killer should not take priority over my 40-50 year old sons.  I am not against them being vaccinated, but to prioritize them over law abiding citizens has its own ethical questions in my opinion.

 

I am not sure what guidelines you are referencing.  The ones I originally read did not include healthy seniors until the end.  That may have changed by now.  We also don't really know what the final guidelines will be and if states will be required to follow them.  If recent history is any proof, states may be able to set their own individual guidelines.  And I only hope you are right about the vaccine.  Depending who you listen to, people at the end of the priority list may be able to get vaccines sometime in the spring, or as late as end of next year.  I'm hoping for the former.

Since there are some 2.5 million+ incarcerated on average with 9 million cycled through jails - most of those not ever convicted of any crime - and as of 2018 some 600K released from prisons controlling COVID in that population is important as so many in that population infect others.  It also if far cheaper to vaccinate that treat them for COVID using your and my $$.  Totally agree they should not be first in line and they are not.

 

The CDC Interim playbook dated 16 September said -

"Final decisions are being made about use of initially available supplies of COVID-19 vaccines. These decisions will be partially informed by the proven efficacy of the vaccines coming out of Phase 3 trials, but populations of focus for initial COVID-19 vaccination may include: (see Section 4: Critical Populations) • Healthcare personnel likely to be exposed to or treat people with COVID-19. • People at increased risk for severe illness from COVID-19, including those with underlying medical conditions and people 65 years of age and older • Other essential workers"

 

The distribution will be to Federal Institutions such as the military and the states.  Am sure some states will be efficient and others not so good.  Last I heard after 30-45 days there will be plenty of vaccine.

[TeeRick]

If you might recall as soon as I saw the interim guidelines I pointed out that the prisoner issue would be a political hot potato in the US.  It definitely will be and it is already being discussed here in this thread.  I would politely request that we just drop it and move on.  Something like this can take over a thread and then get it closed.

[Doris&Nereus]

Hi, Pres. Trump is taking the monoclonal antibodies from Regeneron. Dr. Peyer Hotez who is an expert on Vaccines and coronavirus from Baylor college in Houston was on CNN today, and he said that monoclonal antibodies may have saved Trump's life. And that they are the most powerful meds we have. He didn't mention that they are still being studied.

[Homosassa]

1 hour ago, Doris&Nereus said:

Hi, Pres. Trump is taking the monoclonal antibodies from Regeneron. Dr. Peyer Hotez who is an expert on Vaccines and coronavirus from Baylor college in Houston was on CNN today, and he said that monoclonal antibodies may have saved Trump's life. And that they are the most powerful meds we have. He didn't mention that they are still being studied.

The Regeneron antibodies are most definitely still under study. A quick Google search would have lead you to this statement to attract investors.  https://investor.regeneron.com/news-releases/news-release-details/regenerons-regn-cov2-antibody-cocktail-reduced-viral-levels-and

 

It, of course, is very rosy in its statements, but read closely; all the conclusion's are based on a grand total of 275 human subjects. Unfortunately, this seems to be an updated version that deleted the link to data being submitted to the peer reviewed New England Journal of Medicine that was included in the version I read on Friday.

 

Yes, I clicked on the link and went through the data. The biggest take away was that no one died and the systemic adverse reactions were somewhat mild.

 

Also, please note that one of the results of taking the dexamethasone would be to lower the body's natural immune response and probably destroying the antibodies that were infused 24 (?) 48 (?) hours before use of the steroid.

 

By the way, anyone whose doctor might decide to try this investigational treatment needs to understand that Trump did an end run around the clinical trial which is a double blind randomized trial with a placebo arm.  

[BP99]

29 minutes ago, Homosassa said:

The Regeneron antibodies are most definitely still under study. A quick Google search would have lead you to this statement to attract investors.  https://investor.regeneron.com/news-releases/news-release-details/regenerons-regn-cov2-antibody-cocktail-reduced-viral-levels-and

 

It, of course, is very rosy in its statements, but read closely; all the conclusion's are based on a grand total of 275 human subjects. Unfortunately, this seems to be an updated version that deleted the link to data being submitted to the peer reviewed New England Journal of Medicine that was included in the version I read on Friday.

 

Yes, I clicked on the link and went through the data. The biggest take away was that no one died and the systemic adverse reactions were somewhat mild.

 

Also, please note that one of the results of taking the dexamethasone would be to lower the body's natural immune response and probably destroying the antibodies that were infused 24 (?) 48 (?) hours before use of the steroid.

 

By the way, anyone whose doctor might decide to try this investigational treatment needs to understand that Trump did an end run around the clinical trial which is a double blind randomized trial with a placebo arm.  

Hi,

Could you please tell me where you read that dexamethasone destroys

pre infused antibodies. Thanks.

[Homosassa]

1 hour ago, BP99 said:

Hi,

Could you please tell me where you read that dexamethasone destroys

pre infused antibodies. Thanks.

Here is one of the many articles available on the effects of dexamethasone on the immune system and the use of immunotherapy agents.  https://jitc.biomedcentral.com/articles/10.1186/s40425-018-0371-5

[mimbecky]

On 10/3/2020 at 12:37 PM, nocl said:

In the case of military you have low individual risk for harm, but due to the mission requirements and the military housing structure, especially for Navy and Marines, you do have high risk for exposure.

 

This got me to thinking.  I volunteer weekly both at Navy/Marine Corps Relief Society as well as the USO (currently one employs  a walk up window and the other is currently serving outside).  I wonder if that would be somehow considered in the prioritizing, or if because it is voluntary and my choice, it would not. I am not yet 65 and have no underlying so figured I would be dead (oops, let's hope not) last.

M