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Covid round two!


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2 hours ago, knehrke said:

Professor of Medicine in the Nephrology Division at the University of Rochester Medical Center, PhD in Biochemistry, 20+ years of experience in the field of molecular biology, genetics, and genetic engineering, 62 peer-reviewed publications in decent journals (not Nature, Science, or Cell, but my h-index is ~39, which suggests that my work has had a decent impact on the fields I work in), bunch of other reviews, editorials and whatnot, review grants extensively for NIH, NSF, foundations...postdoc'd 3 years for Larry Tabak, who's now Director of NIH (how's that for name-dropping lol?).

https://pubmed.ncbi.nlm.nih.gov/?term=nehrke k AND rochester&sort=date&ac=yes

https://www.nehrkelab.com/

I'm never going to offer a "clinical" opinion, since in the interest of full transparency I am not an MD. But I interact on a daily basis with some of the top docs at URMC, and I can often offer an informed opinion - which like all opinions, can be mistaken. I take ownership of my mistakes and believe strongly that candid dialog, an open mind, and anti-demagoguery is the only way to get out of this mess.

 

Excellent post !!

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29 minutes ago, knehrke said:

Quick answer - and I want to acknowledge that education doesn't necessarily make somebody smart - I personally opted to be vaccinated, and had no qualms when my daughter chose likewise. I personally feel that the benefits outweighed the risks, particular at the beginning of this pandemic. As the disease evolves, like many viruses, toward an endemic, less virulent strain, my opinion may change, but for now, I do feel that the benefits still outweigh the risks, particular with a year of vaccines under our belts. And yes, I absolutely think that mandates, at this point in time, are overkill. I could envision a situation where I would support mandates, but we are far from that - and I think that how you weigh civil liberties against a public health crisis is a deeply personal choice.

Conversation helps. Trying to understand other folks' opinions helps. Not having to win an argument or demonize your opponent helps. 

Okay, having finished putting the handle on a new flippin' stick that I'm building, I'm off to go ice fishing, before the storm craps all over us. 

Yes engaging in good faith conversation and allowing empathy to shape the interaction is good. It would be a much better world if we all did this more frequently.

But take caution with folks hellbent on disseminating falsehoods. Engaging in sincere conversation with them paradoxically lends credibility to their position and makes a typically disengaged reader more likely to then believe the demonstrably incorrect position (no matter how well you explain the facts).

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You equate taking precautions as being scared?

Fear is very scary to you, huh? An unspeakable assault to a fragile masculinity, something you could never allow yourself feel? Lol, only sheep fear. Lions tough. 

There are people still scared. I’m asking you and them when will you not be scared? The 4th shot? Or 5th?

Separately, are you the type of guy who orders boneless wings? Or steak well done?


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Yes engaging in good faith conversation and allowing empathy to shape the interaction is good. It would be a much better world if we all did this more frequently.
But take caution with folks hellbent on disseminating falsehoods. Engaging in sincere conversation with them paradoxically lends credibility to their position and makes a typically disengaged reader more likely to then believe the demonstrably incorrect position (no matter how well you explain the facts).

No the end of this is when it is at a manageable level for our healthcare system


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16 minutes ago, Biz-R-OWorld said:


There are people still scared. I’m asking you and them when will you not be scared? The 4th shot? Or 5th?

Separately, are you the type of guy who orders boneless wings? Or steak well done?


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There are people still scared. I’m asking you and them when will you not be scared? The 4th shot? Or 5th?

-I’m young and healthy enough (and vaccinated) that I will likely not experience severe illness by the current common variants. I am scared for the people I love who aren’t young and healthy and I fear that they may experience severe illness and maybe even succumb to the disease. But this fear isn’t paralyzing nor do I see at as shameful assault to my masculinity as you would. My concern will subside once hospitals and ICUs stop cycling in and out of crisis mode  


Separately, are you the type of guy who orders boneless wings? Or steak well done?

-Dude, if you need to use your food choices to signal the type of man you are, you’re in even bigger trouble than I thought. 

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3 hours ago, knehrke said:

See, that's where you lose me - saying "it's obviously not about health". I think that most health care professionals would argue that it absolutely is about health. I won't argue logistics with you, because I appreciate that won't get me anywhere. But there's a very simple argument to be made.  I don't know a doctor or prof who hasn't raced to have their kids vaccinated as soon as it was available. Why would they do that for their loved ones, considering that they are both informed and that a personal decision about your kids doesn't push any agenda - if they didn't believe that the jab protects against disease? Yeah, there's bound to be a few who think otherwise, or who argue against vaccination on civil grounds, and good for them, but if most of the folks who really understand the underlying risks/rewards are rushing to vaccinate their kids, I'm fairly confident that expert consensus is that there are health benefits. If you think that your opinion is better informed that folks who have studied this stuff for decades, then good for you. Who am I to say otherwise? But saying, "it's obviously not about health" dismisses the educated decisions that others have made independently. 

Now, if you were to say that it's not ONLY about heath, I can agree with you. Money, power, politics, I'm sure they all play a role. But so does health. And I'm fairly certain that's not easily refuted.

First off, I want you to know I always enjoy reading and learning from your posts. My question to you is how can the experts say they’re safe and effective?  We have no idea of long term effects. Time will tell and I pray I’m wrong, but I think we’re going to see the numbers of vaccine injuries rising as time goes on.  Effective?  Yes, at lessening your illness, not preventing it like originally said.

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There are people still scared. I’m asking you and them when will you not be scared? The 4th shot? Or 5th?
-I’m young and healthy enough (and vaccinated) that I will likely not experience severe illness by the current common variants. I am scared for the people I love who aren’t young and healthy and I fear that they may experience severe illness and maybe even succumb to the disease. But this fear isn’t paralyzing nor do I see at as shameful assault to my masculinity as you would. My concern will subside once hospitals and ICUs stop cycling in and out of crisis mode  

Separately, are you the type of guy who orders boneless wings? Or steak well done?
-Dude, if you need to use your food choices to signal the type of man you are, you’re in even bigger trouble than I thought. 

Sounds like the type of response I expected from a guy who wears a mask when driving in a car


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Among all the vaccines I have known in my life (diphtheria, tetanus, measles, rubella, chickenpox, hepatitis, meningitis and tuberculosis), I want to also add flu and pneumonia, I have never seen a vaccine that forced me to wear a mask and maintain my social distance, even when fully vaccinated.
I have never heard of a vaccine that spreads the virus even after vaccination. I have never heard of rewards, discounts and incentives to get vaccinated. I never saw discrimination against those who didn't.
 
If you hadn't been vaccinated, no one tried to make you feel like a bad person. I had never seen a vaccine that threatens the relationship between family, colleagues and friends. I had never seen a vaccine used to threaten livelihoods, work or school. I had never seen a vaccine that would allow a 12-year-old to override parental consent.
 
Of all the vaccines I listed above, I have never seen a vaccine like this one, which discriminates, divides and judges society as it is.   It does all these things but provides no IMMUNIZATION.  If we still need a booster dose after we are fully vaccinated, and we still need to get a negative test after we are fully vaccinated, and we still need to wear a mask after we are fully vaccinated, and still be hospitalized after we have been fully vaccinated, it is time for us to admit that we've been completely deceived.
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4 hours ago, Grouse said:
Among all the vaccines I have known in my life (diphtheria, tetanus, measles, rubella, chickenpox, hepatitis, meningitis and tuberculosis), I want to also add flu and pneumonia, I have never seen a vaccine that forced me to wear a mask and maintain my social distance, even when fully vaccinated.
I have never heard of a vaccine that spreads the virus even after vaccination. I have never heard of rewards, discounts and incentives to get vaccinated. I never saw discrimination against those who didn't.
 
If you hadn't been vaccinated, no one tried to make you feel like a bad person. I had never seen a vaccine that threatens the relationship between family, colleagues and friends. I had never seen a vaccine used to threaten livelihoods, work or school. I had never seen a vaccine that would allow a 12-year-old to override parental consent.
 
Of all the vaccines I listed above, I have never seen a vaccine like this one, which discriminates, divides and judges society as it is.   It does all these things but provides no IMMUNIZATION.  If we still need a booster dose after we are fully vaccinated, and we still need to get a negative test after we are fully vaccinated, and we still need to wear a mask after we are fully vaccinated, and still be hospitalized after we have been fully vaccinated, it is time for us to admit that we've been completely deceived.

Exactly!!!

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18 hours ago, outdoorstom said:

First off, I want you to know I always enjoy reading and learning from your posts. My question to you is how can the experts say they’re safe and effective?  We have no idea of long term effects. Time will tell and I pray I’m wrong, but I think we’re going to see the numbers of vaccine injuries rising as time goes on.  Effective?  Yes, at lessening your illness, not preventing it like originally said.

You are absolutely correct, with only a year under our belt, we don't know the long term effects of vaccination. We also don't know the long term effects of COVID, although it's looking like there are some significant concerns emerging. I sincerely hope that it's more like flu than scarlet fever. And so we need to weigh these potentials ourselves to make the right choice for us.

Safe and effective is a relative term. Crossing the street is both safe and effective - at least according to the chicken who wanted to get to the other side. And yet folks get hit by cars every day.

As for prevention, the odds are ever in your favor. More so for severe disease, but there's still a 6-7 fold reduced rate of transmission with vaccination. It would have been nice if this turned out to be a forever vaccine, but frankly, at the start of the pandemic I was betting that we wouldn't even be able to develop an effective vaccine at all, given that this is a coronavirus. I was happy to have been wrong.

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37 minutes ago, knehrke said:

You are absolutely correct, with only a year under our belt, we don't know the long term effects of vaccination. We also don't know the long term effects of COVID, although it's looking like there are some significant concerns emerging. I sincerely hope that it's more like flu than scarlet fever. And so we need to weigh these potentials ourselves to make the right choice for us.

Safe and effective is a relative term. Crossing the street is both safe and effective - at least according to the chicken who wanted to get to the other side. And yet folks get hit by cars every day.

As for prevention, the odds are ever in your favor. More so for severe disease, but there's still a 6-7 fold reduced rate of transmission with vaccination. It would have been nice if this turned out to be a forever vaccine, but frankly, at the start of the pandemic I was betting that we wouldn't even be able to develop an effective vaccine at all, given that this is a coronavirus. I was happy to have been wrong.

Do you feel any concerns for another variant that becomes worse rather than lesser symptoms like Omicron?  We have shown we basically have no defense against this as Omicron just showed us.  We have pea shooters in an all out war.  If a worse variant develops we are in definite trouble.....  

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45 minutes ago, knehrke said:

, but frankly, at the start of the pandemic I was betting that we wouldn't even be able to develop an effective vaccine at all, given that this is a coronavirus. I was happy to have been wrong.

Thats just it, We haven't developed an effective vaccine.

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1 hour ago, knehrke said:

You are absolutely correct, with only a year under our belt, we don't know the long term effects of vaccination. We also don't know the long term effects of COVID, although it's looking like there are some significant concerns emerging. I sincerely hope that it's more like flu than scarlet fever. And so we need to weigh these potentials ourselves to make the right choice for us.

Safe and effective is a relative term. Crossing the street is both safe and effective - at least according to the chicken who wanted to get to the other side. And yet folks get hit by cars every day.

As for prevention, the odds are ever in your favor. More so for severe disease, but there's still a 6-7 fold reduced rate of transmission with vaccination. It would have been nice if this turned out to be a forever vaccine, but frankly, at the start of the pandemic I was betting that we wouldn't even be able to develop an effective vaccine at all, given that this is a coronavirus. I was happy to have been wrong.

Due to the fact that you appear to be one of the most knowledgeable members of this forum vis-a-vis virology in general, I was hoping you could answer a few questions that I havent been able to obtain satisfactory answers to:

1) Where and how do the viral mutations occur? Is it during transcritpion , translation, or both? 

2) If someone is truly asymtomatic, can they still transmit the virus to others ? If so , how and why? What factors promulgate transmission? If not, then why are we so concerned with social transmission and, in particular, mask wearing?

3)When you test positive for the virus, what does that mean exactly? Does it mean the virus is replicating in your cells and propagating? If so , can it also mutate , vaxxed or unvaxxed?

 

 

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20 hours ago, Versatile_Hunter said:

There are people still scared. I’m asking you and them when will you not be scared? The 4th shot? Or 5th?

-I’m young and healthy enough (and vaccinated) that I will likely not experience severe illness by the current common variants. I am scared for the people I love who aren’t young and healthy and I fear that they may experience severe illness and maybe even succumb to the disease. But this fear isn’t paralyzing nor do I see at as shameful assault to my masculinity as you would. My concern will subside once hospitals and ICUs stop cycling in and out of crisis mode  


Separately, are you the type of guy who orders boneless wings? Or steak well done?

-Dude, if you need to use your food choices to signal the type of man you are, you’re in even bigger trouble than I thought. 

Well some people get the flu vax every year lot of people will probably do the same with the covid vaccine . Thats basically what's going to happen

 

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I'm conservative and republican in principle and in life choices, for the most part. I also am vaccinated with the booster. I chose to do so based on the information I could glean and best determine truthful. It was my decision and I own that decision regardless of outcome. I won't be a sheep if it ends up making me grow a third nipple or cancer. I won't be a sheep if it helps me shed a COVID bout easier. I made my decision and I am comfortable with it. I sleep fine at night.

Regardless of aisle side you are all choosing to stand on, it might be better if you all just do the same and chill out.

Life is about choices. It's not about fair choices or inherent right or wrong. There is a difference.

 

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36 minutes ago, phantom said:

Well some people get the flu vax every year lot of people will probably do the same with the covid vaccine . Thats basically what's going to happen

 

That’s exactly what’s going to happen and if they would have said that and not made this a kill all agenda pushing propaganda by the left people would have stood in line for the poke. I know many who will not get the Covid shot yet get the flu and shingles shot yearly without hesitation. 

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I also lean conservative and Republican, in most things. This is rare I feel in an academic, and I've had a tough time holding firm to the middle through this pandemic. The extremes (on both sides) make me reconsider whether I want to be associated with either in any way, even as I ultimately agree with some of their conclusions. But that's neither her nor there.

So, I don't want to position myself as a "know it all" on this forum - I'm pleased to respond to a pm, in as much as I have the time - so I'm going to answer Northcountryman and Rob, then get back to work.

Quick one first: we may see worse variants emerging, but generally the opposite is the trend. Easier to catch, but not as hard on you. That's how in my understanding the Spanish Flu went, and hopefully this will follow the same route. It's good to be cautiously optimistic, while remaining vigilant. 

RNA viruses like Coronavirus mutate faster than DNA viruses, with mutation frequency determined by both viral and host processes (such as cytidine/adenine deaminases). Mutations occur at the level of nucleic acid processing rather than translation, where errors would not lead to heritable transmission. These processes include things like proofreading and fidelity of the enzymes that process the nucleic acid. 

Asymptomatic carriers can pass on the virus - with the caveat that asymptomatic may simply be presymptomatic. Also, please be aware that cycle threshold (Ct) values from PCR tests are not direct measures of viral load and are subject to error, hence false positives can occur easily when considering that the Ct based on CDC guidelines is 40 cycles - that means the end product is 2 to the 40th power, or 40 doublings of what you've started with. But better to have false positives than false negatives.

Masks can help slow droplet spread, but are certainly not an answer on their own. They are likely most valuable in crowded situations. And they can help prevent viral spread from presymptomatic carriers.

The more viral replication, the greater the chance of mutation, vaxed or unvaxed - but the ultimate drivers of mutagenesis within individual populations are not completely understood. Vaccinations prime your immune system to recognize an antigen on the stalk of the protein that the virus uses to enter your cells. Hopefully, that allows you to respond more quickly to encounters, or to neutralize some of the most detrimental consequences. When the stalk region is mutated, the virus can evade the vaccine. Ultimately, it's a game of odds, and vaccination alone is just one piece of the puzzle.

KK. That went longer than I wanted. Back to reviewing applicants.

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It was interesting to see during the Bills/Patriots game Saturday night how you could see the player’s breath after a play.  It really makes it clearer to understand how far droplets can travel.  The wind direction was very evident to down on the field. 

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