Discussing COVID-19 on Paizo.com

[ajs]

Set wrote:

I'm still perplexed that, after Swine Flu and Avian Flu, the flu that seems to have come from bats isn't called the Bat Flu.

Hi Set, I didn't see a response to this, and it's important so let me take a shot.

Swine Flu and Avian Flu are informal names given to diseases which were first seen to jump to humans from those animals.

As Nature discussed in its November 2020 article, "Coronaviruses closely related to the pandemic virus discovered in Japan and Cambodia," there are known strains of coronavirus in bats that are closely related to SARS-Cov-2 (the virus that causes COVID-19 in humans). However, there has never been any conclusive evidence that bats were the immediate vector for this disease jumping to humans. It was an early hypothesis due to the number of wild bats sold at markets in Wuhan, but was never conclusively confirmed.

That being said, this disease is caused by a coronavirus, not the influenza virus, so even if a conclusive link were found, it would be inaccurate to call it "bat flu" because it's not a flu (short for influenza).

So on two different counts, "bat flu," would be incorrect.

COVID-19 is short for "Coronavirus disease, 2019" and that's pretty descriptive of what this disease is and what we know about it.

[DonnaHart]

Thx you for information!

[zoeyw]

I had wondered about how Covid-19 came about. Very useful information. Thanks!

[TwilightKnight]

I don't see a need to have a pro or anti-vaxx discussion as it relates to Covid-19. The only issue that matters is, does an event or venue require a mask and/or vaccine? Why you have or have not been vaccinate is not relevant. Either you are or you aren't. If the event required vaccination, then you get it or you don't get it. Its as simple as that. I attended a convention this past weekend that required all attendees, staff and vendors to be vaccinated. Yes, attendance was down, but it was still an enjoyable event for those of us who attended.

[captain yesterday]

I don't know why you wouldn't get vaccinated, it's a couple of shots and then you don't have to worry about dying anymore and crosswalks be damned!

And I'm a person who is deeply afraid of needles!

[GM_Beernorg]

I never would have guessed that Cap, it's the hair ;).

That said I am not over fond of them myself, but I also rolled up the sleeve and took two for the team (dislike not being alive or being in the hospital WAY MORE).

[captain yesterday]

Yeah, I'm afraid of needles, outhouses and heights. And bridges, especially extension bridges.

[Mightypion]

I can walk you through how vaccines work, or how antibody maturation works and thus why the m-RNA (and to a lesser extent Vaccines based on vectors, who also only show a subset of viral proteins) differs from conventional vaccines in relevant ways.

pro and cons of mRNA vaccines:

The issue is that m-RNA only shows one protein, albeit a well chosen one, to the immune system. This is fact.. Pfizer says so on the tin.
My understanding is that there are currently capacity issues associated with putting more then 10-20kDA worth of mRNA into the mRNA vaccines, although I expect that the "m-RNA"-limit (as in how much m-RNA can you put in one) will increase in the future as the technology matures.

Mass immunisation with an m-RNA vaccine will, unless it miracolously and logistically unfeasibly, happens everywhere at once, leave Covid with millions to literally billions of opportunities to escape m-RNA vaccine mediated immunity, which, unless the spike protein has several sufficiently distant from each other antibody binding sites, (which is immunologically speaking likely, on account of the spike protein having distinct subunits, but is not certain) could possibly take the virus as little as a single mutation.
In contrast, escaping conventional vaccine immunity or naturally aquired immunity will require a greater number of mutations, probably, pulling figure out of my arse here, 6-8. The probability of Covid pulling off the latter is rather remote, as the odds of a succesfully mutating out of the immunity for a virus decrease exponentially with the number of required mutations.

One could then try to play armsrace, by constantly assessing viral protein development and changing the specific m-RNA that one inserts to match currently dominant strains, but this seems an iffy proposition as doing this would unfortunately but unavoidably in this case require a new approval process (which would take months even in the most rushed forms), thus ensuring that the vaccine will lag behind the the current virus, giving the latter time to establish.
Even though practically speaking, loading the mRNA vaccine with a new mRNA-load that matches the spike protein mRNA that is currently prevalent would take about a weekend or so on the vaccine producers side.
Which is by the way really cool.

The case for m-RNA vaccines is that you can get them produced/developed quickly, since all you need to know is the genomic information of the virus, which can be gained in days or even hours after the pathogen is first isolated or idenfitied, and one can be pretty certain that you this will have a short term effect which is highly relevant for protecting vulnerable populations.
One also gets around the practical problems of mass producing conventional vaccines. If you are aiming to vaccinate with essentially killed/attenuated Covid (which is what f.e. sinovac is), you have the somewhat difficult but solvable challenges of safely storing and handling considerable amount of "living covid" (Covid is a virus and thus never really "alive", but thats getting into semantics), as well as some other practical things.
M-RNA vaccines have a place as they offer a new toolset, I expect them to contribute to intelligent anti epidemic measures in the future, but they are not what one should use to immunize whole populations if conventional alternatives are available, which they are outside of the west, for supposed "regulatory reasons".

If you are telling me that exposing the immune system to only one protein of the virusses will confer the same protection, including against yet unknown variants, as exposing the immune system to all proteins of the virus you are making a highy extraordinary immunuological claim, which require extraordinary evidence.
It would be close to a revolution in immunology for that to be scientifically correct.

The west is overall underperforming in handling Covid, in relation to the general state of its health care systems and its scientific capabilities, when compared with especially China or even Africa (this is inspite of the fact that Africa and China are more different from each other, in terms of what is being done, then the west is from China).

Yes, politization, and also econominisation of scientific facts (the latter is why you partly end up with this being so politicized) is wrong. It is not the so called "anti-vax" side that is exclusively doing it. One could also ask why the "get the mRNA jab" side is implicitly "anti-Sinovac" and thus also "anti-vax".

Again, mRNA vaccines have a place. Their intrinsic development speed cannot be matched by conventional vaccines. They will however be highly susceptible to having immunity conferred by them be evaded by mutations, and thus likely display relatively short periods of protection against constantly evolving viral threats.

There are certainly pathways to improve their characteristics, both by increasing the number of proteins that are presented by an mRNA vaccine, or by perhaps adding adjuvans to increase the immune response (first option probably less risky then the second one).
mRNA vaccines are a new technology, gains to be expected from the maturation of that technology are likely to be highly significant.

[thejeff]

Mightypion wrote:

I can walk you through how vaccines work, or how antibody maturation works and thus why the m-RNA (and to a lesser extent Vaccines based on vectors, who also only show a subset of viral proteins) differs from conventional vaccines in relevant ways.

** spoiler omitted **...

And yet the mRNA vaccines aren't the only vaccines approved for Covid-19 around the world. So far though, whatever your theories about the virus finding a way to escape vaccine immunity, the mRNA vaccines remain the most effective. So far, the problem isn't mutations that make the vaccines ineffective, but simply that immunity isn't complete and drops over time. That's true for all the vaccines and for natural immunity from having had a case of the disease.

You're constructing a vague theoretical argument that doesn't match what's happening in the real world.

[Mightypion]

This concern is not vague, although it is theoretical as in you would recognice the arguments from theoretical immunology courses.
It is also partly born from harsh lessons learned from stupidity/callousness on part of the Russian penintiary system resulting in the mostly accidental creation of multi resistant tuberculosis strains.

Are you aware that the most commonly administered vaccine worldwide is Sinovac, which is inactivated virus rather then mRNA or vector based and accounts, by itself, for almost half of the total doses given?
There is also the curious case that countries using mostly mRNA vaccines are underperforming vs covid 19, especially relative to their healthcare resources and scientific and administrative capabilities (as a counterpoint to this argument, non-mRNA Russia is also underperforming relative to its scientific/administrative potential).

I would take Sinovac, or Valnevas (EU based manufactorers conventional vaccine, I think its in early phase 3 atm) upcoming product, and would furthermore suggest to making WHO approved vaccinations approvied everywhere and ideally multilaterally accept each others vaccinations.

The latter is of course explicitly a pro Vaccine position.

[Heather F]

I'm locking this thread because there is nothing to be gained by arguing back and forth.