Interesting news from our night/morning reads….

This report perhaps explain why its worse in Europe and East Coast vs. China – Also highlights the difficulties in developing a vaccine or cure but also highlights our computer powers to track this virus which we didn’t have in 1918 – https://www.biorxiv.org/content/10.1101/2020.04.29.069054v1.full

“…revealed that viruses bearing the mutation Spike D614G are replacing the original Wuhan form of the virus rapidly and repeatedly across the globe (Fig. 2-3). We do not know what is driving this selective sweep, nor for that matter if it is indeed due the modified Spike and not one of the other two accompanying mutations that share the GISAID “G-clade” haplotype.”

“Increased infectivity would be consistent with rapid spread, and also the association of higher viral load with G614 that we observed in the clinical data from Sheffield, England (Fig. 5)”

“To date, mutations are extremely rare in the Spike RBD, but the mutation G476S is directly in an ACE2 contact residue. The mutation L5F occurs in many geographic regions in many distinct clades, suggesting it repeatedly arose independently, and was selected to the extent that was frequent enough to be resampled. Finally, the mutation S943P seems to have been transferred by recombination into diverse viral backbones that are co-circulating in Belgium (Fig. 6); we also found strong evidence of recombination in other regional sample sets (Fig. S8). Recombination among pandemic SARS-CoV-2 strains is not surprising, given that it is also found among more distant coronaviruses with higher diversity levels (Graham and Baric, 2010; Li et al., 2020; Rehman et al., 2020).”

“recombination provides an opportunity for the virus to bring together, into a single recombinant virus, multiple mutations that independently confer distinct fitness advantages but that were carried separately in the two parental strains.”

Positive news – patients infected do develop some form of immunity – also the residual positive confirmation are not likely reinfections – https://www.medrxiv.org/content/10.1101/2020.04.30.20085613v1

“the vast majority of confirmed COVID19 patients seroconvert, potentially providing immunity to reinfection. We also report that in a large proportion of individuals, viral genome can be detected via PCR in the upper respiratory tract for weeks post symptom resolution, but it is unclear if this signal represents infectious virus.”

“our findings suggest that IgG antibodies develop over a period of 7 to 50 days from symptom onset and 5 to 49 from symptom resolution, with a medianof 24 days from symptom onset to higher antibody titers, and a median of 15 days from symptom resolution to higher antibody titers. This suggests that the optimal time frame for widespread antibody testing is at least three to four weeks after symptom onset and at least two weeks after symptom resolution. In our survey, we did not find evidence for a decrease in IgG antibody titer levels on repeat sampling.”

Patience is needed to test for the antibody!

“Although we do not yet know what, if any, immunity is conferred by IgG or the duration of the IgG response, at this time it seems likely that IgG to SARS-CoV-2 may confer some level of immunity based on what is known about viral immunity to other pathogens. In prior studies of SARS-CoV-1 and Middle East Respiratory Syndrome patients, IgG peaked within months of primary infection and waned over time. Similar observations have been made with human coronaviruses were immunity can confer at least limited protection.”

Some of vanity fair pieces have somewhat been balanced – this is not – https://www.vanityfair.com/news/2020/05/whistleblower-complaint-rick-bright-blasts-team-trumps-pandemic-response

“..which had been cobbled together by a cryptocurrency investor and a New York City lawyer…” Missing from story he is an MD from Columbia University – perhaps limited on the amount of words they can put into a story? The google doc does point to studies done way before Covid

2005 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

Therefore show HCQ is not an out of the box crazy idea to look into

“Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection. In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds.”

2010 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2973827/

Paper shows that Zinc does something to viruses is the point of paper and perhaps HCQ ability to help absorption of zinc leads to a positive outcome.

“In summary, the combination of zinc ions and the zinc-ionophore PT efficiently inhibits nidovirus replication in cell culture.”

Vanity Fair failed to highlight some issues with the study they conclude caused the scale back of cheerleading – “Only after a study of veterans with COVID-19 found that patients treated with chloroquine died at twice the rate of those who didn’t get the drug did Trump scale back his cheerleading.”

Number 1 not a study – but a math exercise of putting past data into a matrix to draw a conclusion. No discussion of dosage or timing or interview conducted with doctors on their decisions. Authors had ties to Gilead Science. Many cited were ophthalmologist – nothing against them but its not really their specialty.

To characterized HCQ as a lethal drug would not make sense in terms of how many millions have taken the drug for malaria and lupus. At least there is data on the side effects and which patients should not take it vs. drugs who have not been taken by millions around the world? Is it the cure all – not likely but several test are sure indicating it to be a good tool to have in your war against Covid – it would be a shame if politics got in the way of using a tool that when administered right – even if not directly effective to eliminating Covid – has showned to have limited to no side effects per millions of documented cases.

US back to above 2K death reporting. Russia reports more confirmation but their deaths are amazing low vs. how many confirmed.

This time NY is not a even a top 3 state in terms of death. PA(341), NJ(334), and IL(175) top3.

PA is similar to NY – in that the issue is focused to a particular part of the state – Philadelphia.

Mexico likely the next hotspot. They have quite a high death/confirmed and they have still quite a bit of testing that needs to be done. Note Russia under 1% death/confirmed.

Japan has surpassed their previous peak in daily death change so it looks like they are in a second wave – however their confirmation numbers are still way low compared to the peak so it should still be manageable.

Pakistan and India are both rising.