Did the CDC jump the gun?
bub said:
They really need to write the book for the next one, including not only how to speedily bring the new drugs on line but protocols and procedures for the rest of us to follow.
Coming up with drugs to treat an infection of whatever type is actually much harder than producing a vaccine. TL
R drugs take way way longer to prepare and we don't always have the time to wait for them to arrive on market. They already had drugs like remdesivir in the pipeline because they were candidates for treating other viruses.
Most of the vaccine process involved finding the right part of the virus (or other microbes) that elicits the best immune reaction. That is a combination of blood testing in those who contract the virus to see what parts of it are most vulnerable to antibodies *** that eliminate it or stop it somehow *** and then figuring out a way to produce just that (or those) bit and use a vaccine to somehow produce it in a person (or other target host animal). Sounds simple, right? Yeah, tell that to the millions of people worldwide who could have benefited from an HIV vaccine. Some viruses are not as easy to target at COVID-19. It was kinda like a fcuking miracle that effective vaccines were produced (by several independent efforts) so fast.
It turns out that our bodies produce antibodies to a few different locations on the surface of the COVID-19 virus but only some of them actually kill it off and not allow it to cause the infected person to have much symptomatology or even be asymptomatic. Attacking the receptor-binding domain is effective but some people don't produce those antibodies when dealing with a real infection. Their antibodies attack other points on the various viral proteins but they're not as important as the receptor site or others on the spike protein. Those people have not fared so well. If they were presented with a purified spike protein, the antibody production would have been focused on that offending thing. Remember my silly analogy of croutons in potato salad?
I haven't heard much further on it but there was one group that posited the notion that those patients' immune systems wound up trying to call in more drastic measures and caused much more collateral damage in addition to allowing the virus to still be able to successfully reproduce and invade more cells. That's possibly why dexamethasone (a cortisone derivative that suppresses some of the aggressive immune components) was helpful in some patients trying to ride out a sort of "all points nuke-out" immune response. The people who produced the more effective antibodies didn't need the more aggressive immune response.
Here's an article with a molecular model giving a nice visual of some antibody binding sites on the COVID-19 spike protein.
------------
Annnnyway, producing a drug used to be much harder to do before we could purify a target receptor or enzyme, etc. Much of the drugs we had were found by plain dumb luck, uhh I mean serendipity. (There are some great stories about this phenomenon, btw). Once they had a compound that did something desirable, they had medicinal chemists make derivates of it - and I mean hundreds and even thousands - and tested them to see if they performed better somehow. For example, a compound that did the same thing, only instead of getting metabolized in the liver, it was cleared through excretion of the unchanged molecule by the kidney. That way, people with liver failure could still be treated for a condition with that type of medicine just like people with kidney failure could. You just use a drug that doesn't need the organ that is failing to clear it or it will build up to toxic levels.
That process can take a very long time to find a candidate for a useful drug - and then there are the clinical trials which can take years.
Since they came up with X-ray crystallography, it was easier to analyze how a large protein behaves and how to make a molecule get into the active site on the surface and either make it work better (to stimulate a receptor) or **** it up somehow and stabilize an inactive conformation (one way of keeping it from being stimulated, thus blocking the receptor.) Sometimes, there's already something to work backward with like an enzyme's substrate or an endogenous neurotransmitter to make derivatives of. But even if that process only takes a week (by some miracle) there is still a lot of testing for toxicology and characterizing how well it gets into the body, where it goes, how the body gets rid of it. How long all that stuff takes and how much is needed for a dose. Blah blah blah.
And just to put a little politics in at the end. The Obama administration knew that potential viral threats are always brewing up with the possibility of jumping from animals to humans. We might not have the ability to fight them off without vaccines or drugs so what do you do in the meantime for those who get sick? Supportive devices like ventilators, protective gear to suppress transmission, etc. We had produced lots and lots of those things but they needed to be maintained. Our vigilance needed to be kept up. We had a plan and a good start on the response infrastructure.
Uh huh. But "Who knew something like this would happen? Nobody knew."
By the way, I was at Michigan getting my doctorate while Frankie was a professor at the medical school busy figuring out the gene defect for cystic fibrosis. That was a thrilling time. I was busy doing other stuff that was practically irrelevant by comparison.
I appreciate that the speed with which these vaccines were produced was a miracle by scientific standards. I'm jut not aware of anything our govt had in place beforehand that helped the process. Everything that was done seemed to be done after the fact on the fly in a panic. Shouldn't we, for example, have contracts in place before the next one that ensures or at last incentivizes mass production capacity? We are now in the begging stage to get people to take shots from a plentiful supply of vaccines but it wasn't long ago that we were wringing our hands about supply bottlenecks.
bub said:
I appreciate that the speed with which these vaccines were produced was a miracle by scientific standards. I'm jut not aware of anything our govt had in place beforehand that helped the process.
Sometimes the arrival of a new infectious threat cannot be predicted. The government could have taken steps to boost production of needed items but did not.
The Obama administration did provide a pandemic playbook.
https://assets.documentcloud.org/documents/6819268/Pandemic-Playbook.pdf
imo, not so much that they jumped the gun (since they're a lot more likely to understand the medical/public health part than i am), but i think the message could have been put out more accurately while still being celebratory. Less emphasis on the absolute "Inside and outside!!!" Rather, push the "2 out of 3" (is it "outdoors, far away, or brief"?) or some other more complete but still easy-to-remember message.
Or was it the reports/paraphrases that went for "Inside and outside!!" and not the CDC itself?
Indoor mask mandate for vaxxed people going away next Friday May 28. Good news.
I’m guessing most won’t. I think at this point employees would push back.
Follow the science.
Smedley said:
I’m guessing most won’t. I think at this point employees would push back.
Follow the science.
The science says that the store is an enclosed space where the employees must stay for long periods of time. Ventilation might help, but the employee is the captive, not the customer.
bikefixed said:
The science says that the store is an enclosed space where the employees must stay for long periods of time. Ventilation might help, but the employee is the captive, not the customer.
the science says that even vaccinated people run a slight risk of infection. And obviously people who spend long hours working among unmasked customers would run more of a risk. I don't understand why we would allow unvaccinated people to be on the honor system when it comes to mask mandates in stores. Wearing a mask is so minimally inconvenient.
I guess the front line workers aren't "heroes" any more. 
Trader Joe’s in Florham Park no longer requiring masks, as the local store has decided not to override the chain’s national non-mandate. Probably Millburn, too.
It’s such a minimal inconvenience. Indoor masking should stay the norm for a while in non-eating establishments.
bikefixed said:
Smedley said:
I’m guessing most won’t. I think at this point employees would push back.
Follow the science.The science says that the store is an enclosed space where the employees must stay for long periods of time. Ventilation might help, but the employee is the captive, not the customer.
Well presumably the CDC, and then separately NJ, are following science. No?
Is MOL science > CDC and NJ science?
Smedley said:
bikefixed said:
Smedley said:
I’m guessing most won’t. I think at this point employees would push back.
Follow the science.The science says that the store is an enclosed space where the employees must stay for long periods of time. Ventilation might help, but the employee is the captive, not the customer.
Well presumably the CDC, and then separately NJ, are following science. No?
Is MOL science > CDC and NJ science?
Saying vaccinated people can eschew masks but the non-vaccinated can't is problematic because it presumes non-vaccinated people will wear masks. Now, what are the odds of that happening? Instead, CDC's guidance is an excuse for everyone to stop wearing masks, even though the pandemic is not yet under control.
Assuming their pronouncement is the best guidance by labeling it "the science" is foolish. You have to look at the consequences.
Oh please. So referring to the guidance of the Centers for Disease Control and Prevention as science is foolish. Got it.
I think you’re so far left you’re actually right on this. (Politically speaking.)
No. Not "science". "the science". As if it's the final word, requiring us to not think any further.
Anyway, good for you for ignoring the meat of my post.
Smedley said:
Oh please. So referring to the guidance of the Centers for Disease Control and Prevention as science is foolish. Got it.
I think you’re so far left you’re actually right on this. (Politically speaking.)
Do you not see the grey area established by the “vaccinated individuals” guidance and the established non-compliance with mask wearing by many people, mostly those on the right?
Smedley said:
Well presumably the CDC, and then separately NJ, are following science. No?
Is MOL science > CDC and NJ science?
Science wasn't the issue in my post. It was the rights of employees actually running a business to feel safe in their workplace. Since this country isn't going to ask people to prove they have "stars on thars" and it is well-documented that people have been flouting masking requirements I lean towards the safety of the workers. I believe they have a right to protect themselves in a private business setting that unvaccinated people are potentially contaminating.
Heynj said:
Trader Joe’s in Florham Park no longer requiring masks, as the local store has decided not to override the chain’s national non-mandate. Probably Millburn, too.
that's not legally possible....some gyms did that and then had to back track because they can't over ride Murphy's mask mandate
Smedley said:
Well presumably the CDC, and then separately NJ, are following science. No?
Is MOL science > CDC and NJ science?
an honor system isn't science. That's the issue.
It should not be that difficult for you to comprehend our objection.
jmitw said:
that's not legally possible....some gyms did that and then had to back track because they can't over ride Murphy's mask mandate
Governor Murphy has announced that the indoor mask-wearing mandate is being removed shortly.
jimmurphy said:
Smedley said:
Oh please. So referring to the guidance of the Centers for Disease Control and Prevention as science is foolish. Got it.
I think you’re so far left you’re actually right on this. (Politically speaking.)
Do you not see the grey area established by the “vaccinated individuals” guidance and the established non-compliance with mask wearing by many people, mostly those on the right?
I don't even think it's a gray area. There are two different, though related, issues.
CDC said "the science" says that vaccinated individuals can forego the mask.
It said nothing about whether there should be mask requirements in public spaces. In fact, it actually says that people should follow local and business requirements.
There are couple of a people who post on MOL that I'd suspect might be unvaccinated and will go maskless in public indoor spaces.
The notion that people will honestly follow the guidelines after all we've seen this past year is sheer insanity. I guess those of us who are vaccinated should just say **** those people if they infect each other.
Unfortunately they will almost certainly infect a few unfortunate folks among the vaccinated.
But "freedom!"
joan_crystal said:
jmitw said:
that's not legally possible....some gyms did that and then had to back track because they can't over ride Murphy's mask mandate
Governor Murphy has announced that the indoor mask-wearing mandate is being removed shortly.
but it's not yet...sop stores have to require masks for now....might not be legal until next friday
the statement i was responding to was that the stores ARE CURRENTLY not requiring masks (the way it is written)
"no longer requiring masks"
We need to differentiate between "hard" sciences such as chemistry and physics where the same reactions will always cause the same result. Public Health is based upon science but it has a much more human behavior aspect. These are sometimes called best practices. For example, we know that keeping potato salad cold will result in reducing the chance of bacterial growth that can make people sick. But if the potato salad was poorly made with lots of bacterial contamination, then refrigeration may not stop people from becoming sick after eating it. The same for wearing masks. It is not a 100% guarantee, but it is "science" that this practice reduces infections. Thus, there is always room for questions.
One lesson from this pandemic has been that social science is much harder than biological science. Rally the body to respond effectively to an infectious disease? We can do that! Rally the body politic? Results have been mixed.
PVW said:
One lesson from this pandemic has been that social science is much harder than biological science. Rally the body to respond effectively to an infectious disease? We can do that! Rally the body politic? Results have been mixed.
when a third or more of our fellow Americans believe "freedom" means doing whatever they please, risking spread of a serious disease to their neighbors, I think we know we are really screwed as a country.
in a few short years a significant segment of the country got on the expressway from "**** Your Feelings" all the way to "**** You."
ml1 said:
PVW said:
One lesson from this pandemic has been that social science is much harder than biological science. Rally the body to respond effectively to an infectious disease? We can do that! Rally the body politic? Results have been mixed.
when a third or more of our fellow Americans believe "freedom" means doing whatever they please, risking spread of a serious disease to their neighbors, I think we know we are really screwed as a country.
in a few short years a significant segment of the country got on the expressway from "**** Your Feelings" all the way to "**** You."
I was down the shore today and I saw a crazy thing - a tricked-out open Jeep with a big car flag on the whole rear top. The car flag said (in huge capital letters) “ f___ Biden”, and (in smaller letters), “and f___ you for voting for him.” Driver was some squat meathead guy in his 30s.
Really demented to be so crazed that that’s your statement to the world.
Featured Events
-
Go "Back to the '70s" with The Maplewood Glee Club and Special Guests from CHS
May 19, 2024 at 4:00pm
Rentals
Advertisement
Thought this was a fun and helpful exercise:
Your Friend Doesn’t Want the Vaccine. What Do You Say?
It's an interactive article showing different communications strategies -- what works and doesn't, and why.