Covid-19 Update Aggie Physician

1,296,220 Views | 3660 Replies | Last: 2 yr ago by tamc91
Reveille
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paterfamilias79 said:

"The alternative is relying on innate immunity (rather than adapative immunity from exposure or vaccination). Any individual with sufficient innate immunity to fight off the virus would still have that innate immunity during the suboptimal adaptive immunity phase. It isn't like the adaptive immunity turns off the innate immunity. The two processes actually work together. The entire point of the innate immunity is that it is always there. It is hard coded in the DNA, and either works agaisnt the virus or it doesn't. The point of the adaptive immunity is to augment the innate immunity (rather than replace it) such that the immune system can learn to respond to new threats."

I may have misheard Dr.Bossche, but I thought he was saying that the adaptive immunity would dominate the innate immunity, thus rendering your innate immunity ineffective going forward.
That is his hypothesis. There is no proof at all that this will actually happen. He speculates that the adaptive immunity will out compete the innate immunity potentially rendering the adaptive immunity useless. However, they traditionally work together to fight infections. Just because you have adaptive immunity it does not mean you will lose your innate immunity.

My t.u. friends now speculate that Sark will dominate all of Texas recruiting and they will win the National Championship within 3 years. Even if they do dominate recruiting you still have to develop players and be a good game day coach. So jjust like the above there is no proof that will happen even though they say it daily.
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BiochemAg97
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paterfamilias79 said:

"The alternative is relying on innate immunity (rather than adapative immunity from exposure or vaccination). Any individual with sufficient innate immunity to fight off the virus would still have that innate immunity during the suboptimal adaptive immunity phase. It isn't like the adaptive immunity turns off the innate immunity. The two processes actually work together. The entire point of the innate immunity is that it is always there. It is hard coded in the DNA, and either works agaisnt the virus or it doesn't. The point of the adaptive immunity is to augment the innate immunity (rather than replace it) such that the immune system can learn to respond to new threats."

I may have misheard Dr.Bossche, but I thought he was saying that the adaptive immunity would dominate the innate immunity, thus rendering your innate immunity ineffective going forward.


That may be what he said. If your adaptive immunity is effective against something, then yes, it will be far more effective than your innate immunity. But in that case, the vaccine worked, you are immune, and you aren't allowing the virus to hang around long enough to develop a new variant.

If the adaptive immunity isn't working, then you can rely on innate immunity. It isn't like adaptive immunity somehow turns the innate immunity off, it just works better against threats it recognizes.

Think of it this way. The innate immunity functions against things the adaptive immunity hasn't recognized yet, but the adaptive immunity has recognized other things. At some point you probably had a cold caused by a human CoV. You have adaptive immunity to that virus. That adaptive immunity probably doesn't work well against COVID, but it didn't turn off your innate immunity or somehow weaken it.

If the innate response is a 10, and the adaptive response is 1000, once the adaptive immunity is up to speed, the innate response doesn't matter so much, but it is still 10, it didn't suddenly go to 1.
Madagascar
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Reveille said:

My t.u. friends now speculate that Sark will dominate all of Texas recruiting and they will win the National Championship within 3 years. Even if they do dominate recruiting you still have to develop players and be a good game day coach. So jjust like the above there is no proof that will happen even though they say it daily.


Great analogy!
Reveille
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Today's update!

https://m.facebook.com/story.php?story_fbid=2974560389493565&id=1998386763777604&sfnsn=mo
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BiochemAg97
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Interesting switch from delusional sip friends to winning lotto numbers as examples of unproven statements/theories.
AlAggie
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I'm sure this situation has been asked about and answered already in this thread, but with 96 pages, i'm hoping someone will be kind enough to provide answers or insight into the current situation of one of my very good friends.
He's 48, with no known serious medical issues, besides back and knee problems. He spent last week in ICU, improved and was moved out to the a hospital in Katy for rehab. His oxygen levels improved enough after exercise that he was allowed to go home to continue his breathing rehab there. He made it one day, regressing as the day went on, and his wife took him to the ER the next morning. He was readmitted into ICU, and early this morning, was put on a ventilator.
I know the disease affects everyone differently, but generally speaking, have people recovered after having gone though such a long and tough time? Two weeks in ICU is very concerning. I would think there would be significant damage to his lungs. Is this truely a 50/50 situation, regarding the outcome?
Thank you for your feeedback.
Reveille
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BiochemAg97 said:

Interesting switch from delusional sip friends to winning lotto numbers as examples of unproven statements/theories.
Yep figured I better change that prior to putting on social media. My longhorn patients would probably laugh but people I don't know maybe not so much! Thanks for your help also.
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Reveille
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AlAggie said:

I'm sure this situation has been asked about and answered already in this thread, but with 96 pages, i'm hoping someone will be kind enough to provide answers or insight into the current situation of one of my very good friends.
He's 48, with no known serious medical issues, besides back and knee problems. He spent last week in ICU, improved and was moved out to the a hospital in Katy for rehab. His oxygen levels improved enough after exercise that he was allowed to go home to continue his breathing rehab there. He made it one day, regressing as the day went on, and his wife took him to the ER the next morning. He was readmitted into ICU, and early this morning, was put on a ventilator.
I know the disease affects everyone differently, but generally speaking, have people recovered after having gone though such a long and tough time? Two weeks in ICU is very concerning. I would think there would be significant damage to his lungs. Is this truely a 50/50 situation, regarding the outcome?
Thank you for your feeedback.


Really need more information to be able to say much. There is so many variables such as kidney functions, liver functions, d dimer levels, platelets, CRP, fibrinogen etc. These values help determine prognosis.

At this point best thing to do is pray for a full recovery. Typically the less oxygen used the better the prognosis.
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AlAggie
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Quote:


Really need more information to be able to say much. There is so many variables such as kidney functions, liver functions, d dimer levels, platelets, CRP, fibrinogen etc. These values help determine prognosis.

At this point best thing to do is pray for a full recovery. Typically the less oxygen used the better the prognosis.

Thank you for your response.
He passed today in the early afternoon.
cc_ag92
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So sorry for your loss
Madagascar
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Sorry for your loss!
AgsMyDude
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Awful, sorry to hear
samsal75
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Very sorry to hear.
Counterpoint
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BiochemAg97
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Sorry for your loss. Prayers for his family.
Reveille
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AlAggie said:


Quote:


Really need more information to be able to say much. There is so many variables such as kidney functions, liver functions, d dimer levels, platelets, CRP, fibrinogen etc. These values help determine prognosis.

At this point best thing to do is pray for a full recovery. Typically the less oxygen used the better the prognosis.

Thank you for your response.
He passed today in the early afternoon.


Terribly sorry to here of your loss! I will pray for you and his family! Unfortunately this has become a way to common story!
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AggieBaseball06
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https://www.eurekalert.org/pub_releases/2021-03/uocm-hvd031721.php

Quote:

High vitamin D levels may protect against COVID-19, especially for Black people

In a retrospective study of individuals tested for COVID-19, vitamin D levels above those traditionally considered sufficient were associated with a lower risk of COVID-19.


Dr. Rev called this nearly a year ago.
Diggity
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that's awful man.

Something very similar happened with my FIL's best friend several months ago. Healthy as can be but things just went downhill.

Do we have any stats on what % of people recover after being put on ventilator? Anecdotally, it seems like it's not a great number but I probably only hear about the worst cases.
Reveille
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AggieBaseball06 said:

https://www.eurekalert.org/pub_releases/2021-03/uocm-hvd031721.php

Quote:

High vitamin D levels may protect against COVID-19, especially for Black people

In a retrospective study of individuals tested for COVID-19, vitamin D levels above those traditionally considered sufficient were associated with a lower risk of COVID-19.


Dr. Rev called this nearly a year ago.



Thanks for the props!
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Reveille
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Today's update!

https://www.facebook.com/1998386763777604/posts/2984253901857547/
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
T Durden
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Doc, thanks for all you do. Do you have one of these updates that discusses immunity once you've been Covid positive?

Thanks again.
Reveille
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T Durden said:

Doc, thanks for all you do. Do you have one of these updates that discusses immunity once you've been Covid positive?

Thanks again.
Yes that was a long time ago. But in my patients most antibodies are lasting between 6 to 9 months. However, many people still have a strong T-cell (KIller cell) response long after this time.
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T Durden
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Thank you. I'll see if I can find it. Or are you aware of any papers out there on antibody term and T cell?
AgLA06
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Reveille said:

T Durden said:

Doc, thanks for all you do. Do you have one of these updates that discusses immunity once you've been Covid positive?

Thanks again.
Yes that was a long time ago. But in my patients most antibodies are lasting between 6 to 9 months. However, many people still have a strong T-cell (KIller cell) response long after this time.
What do you think this means for vaccination frequency? We talking boosters every 6 months or a yearly shot like the flu?
BiochemAg97
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AgLA06 said:

Reveille said:

T Durden said:

Doc, thanks for all you do. Do you have one of these updates that discusses immunity once you've been Covid positive?

Thanks again.
Yes that was a long time ago. But in my patients most antibodies are lasting between 6 to 9 months. However, many people still have a strong T-cell (KIller cell) response long after this time.
What do you think this means for vaccination frequency? We talking boosters every 6 months or a yearly shot like the flu?
6-9 months is basically how long we have data for. Could very well be longer than that. Additionally, I have seen studies that show higher antibody levels post vaccination than post infection, which should translate to an even longer time until the antibodies decline to low levels. It will be interesting to see any follow up on the phase 1 subjects this summer which will be a year post vaccination. But we are really going to have to wait until fall to see 9 mo-1 yr follow up on the larger phase 2 and 3 groups.

There is also the question about looking at freely circulating antibodies vs memory B cells (which produce the antibodies). There isn't much need to maintain high levels of antibodies if you aren't being exposed, as long as you can ramp up production quickly upon exposure. In this sense, the loss of antibodies may actually be a result of the isolation, social distancing, and masks reducing exposure.

Redo on the vaccine is more likely going to be the result of 1) variants that the vaccine isn't effective against if that happens, and 2) new corona viruses that make the jump to people in the future. Recall, we have had SARS, MERS, and now COVID in the past ~20 years.

Also COVID will be endemic and circulating in the population even if we aren't having large outbreaks. This could be good for regular exposure. But also we need to be concerned about the virus going between humans and animals. It has already been shown to infect mink, cats, and dogs.
BiochemAg97
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AgLA06 said:

Reveille said:

T Durden said:

Doc, thanks for all you do. Do you have one of these updates that discusses immunity once you've been Covid positive?

Thanks again.
Yes that was a long time ago. But in my patients most antibodies are lasting between 6 to 9 months. However, many people still have a strong T-cell (KIller cell) response long after this time.
What do you think this means for vaccination frequency? We talking boosters every 6 months or a yearly shot like the flu?
Also, flu shot isn't a booster. It is a different vaccine each year because there are different flu strains circulating each year. There is evidence of lifetime immunity to specific flu strains, with some 100+ yo women still immune to the flu virus that caused the 1918 flu.
Bruce Almighty
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So I guess we should expect some new coronavirus to pop up around 2030.
BiochemAg97
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Bruce Almighty said:

So I guess we should expect some new coronavirus to pop up around 2030.
If I'm placing bets, I would take the under.
AgLA06
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I get all that, but I don't believe you actually answered the question. it sounds like you're suggesting each year based on this.

"But we are really going to have to wait until fall to see 9 mo-1 yr follow up on the larger phase 2 and 3 groups."
BiochemAg97
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AgLA06 said:

I get all that, but I don't believe you actually answered the question. it sounds like you're suggesting each year based on this.

"But we are really going to have to wait until fall to see 9 mo-1 yr follow up on the larger phase 2 and 3 groups."



I don't think we will need a yearly booster, but we don't have the data to know yet.
AgLA06
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Thanks.
1982Ag
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Doc Rev, really appreciate all your hard work here and elsewhere - please know you've made a difference in the lives of many.

A couple of questions please.
* I tested positive yesterday, almost 3 weeks after my 2nd Pfizer shot. I hadn't felt great but not too bad for a couple of days, but needed proof of a negative test to be able to visit mom. And it was positive. So, what do I need to be on the lookout for (I'm monitoring pulse ox) and how do I know when I'm out of the woods?
* My wife is 3 weeks behind me on the vax schedule - is scheduled for her 2nd Pfizer tomorrow. Scheduling seems something of a crap shoot. Any reason not to get the 2nd shot tomorrow, or best to take chances of rescheduling?
Thanks again.
Reveille
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1982Ag said:

Doc Rev, really appreciate all your hard work here and elsewhere - please know you've made a difference in the lives of many.

A couple of questions please.
* I tested positive yesterday, almost 3 weeks after my 2nd Pfizer shot. I hadn't felt great but not too bad for a couple of days, but needed proof of a negative test to be able to visit mom. And it was positive. So, what do I need to be on the lookout for (I'm monitoring pulse ox) and how do I know when I'm out of the woods?
* My wife is 3 weeks behind me on the vax schedule - is scheduled for her 2nd Pfizer tomorrow. Scheduling seems something of a crap shoot. Any reason not to get the 2nd shot tomorrow, or best to take chances of rescheduling?
Thanks again.


I wouldn't worry too much. Most people after second shot have only minimal symptoms. Watch pulse ox for saturation. If you have risk factors I would get on supplements just to make sure you don't get severe disease.
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1982Ag
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Thanks doc. Any thoughts on getting 2nd shot after being exposed?
Reveille
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1982Ag said:

Thanks doc. Any thoughts on getting 2nd shot after being exposed?


She should be fine. Just might possibly have a few fever vm chills and night sweats.
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