One point of clarification… at the time the vaccine studies were being carried out, the pandemic wasn’t exactly in full swing, and if I recall correctly there were doubts expressed that enough incident covid infections would occur in both control and intervention groups to reach a clear cut, timely answer.
New cases had dropped back significantly from the April surge, and restrictions and lockdowns meant far lower cases were being seen than was earlier forecast by the researchers. Things picked up as infections rose in the summer, but mainly in states that had rescinded restrictions more than others.
If you'r referring to the Phase 2/3 trials, the fact they were completed so quickly, with normal-sized cohorts was primarily due to the fact that control-group participants were becoming ill at a rate that drove end-point achievement. There were gaps in knowing how far to cycle PCR tests when infection was suspected, but that can be forgiven because we were still trying to sort through that test parameter for routine diagnosis.
Lockdowns did provide a significant reduction in cases but several states elected to foreshorten those. Some of the blame belongs to Deborah Birx who proposed a short period that Trump initially accepted, but then reversed course on. Overall, I still maintain that, had we maintained a national restriction on congregating, and maintained mandatory masking for an additional 6-8 weeks we might have had a bigger impact on spread than we did with the shorter lockdown.
Lockdowns are always unpopular because the United States, with its rugged individualist culture, doesn't favor actions that benefit the public at large, rather, preferring to preserve individual liberties, either enumerated or perceived. Public Health is at odds with that view, as the PH goal is maximizing protective benefit to the public at large. Birx understood this and on that basis, and based on what we thought we knew about the virus her recommendation was sound.
The increase in summer cases corresponds to the various relaxed stances in several states. We had a viral disease with an R(t) in excess of 2.0 even after its first devastating wave. I saw, and even calculated (based on local cases in Oklahoma at the time) an R(0) and R(t) of up to 8 and 4, respectively, in the April-May timeframe. Infection-derived immunity allows R(t) to drop (R(t) approx. 2.0-2.3) until we started seeing more variant activity, which initiated in the June-July timeframe (implied, based on a mini-surge but could also be aided by the reduction in congregate restrictions.
I note your prior affiliation to NHS. British numbers were a bit different from US numbers. I'm still not sure who was on the right track.
You wrote: "As someone with a loved one who does have PASC/Long-COVID, I sorta know it when I see it but many of her doctors were stymied as to whjat to call it or what to do. In other words, we’re still learning."
I'm curious what kind of treatment your loved one has received for long-COVID, and if they got COVID before their COVID vaccines or afterwards. I read the government spent millions studying long COVID, but came up with nothing regarding what to do about it. Are there groups of doctors sharing their long COVID treatments and learning from each other how to treat long COVID? When long COVID was first recognized, the only treatment offered in clinics I read about was just physical therapy.
Government spending on Long-COVID has taken a long time to develop and is in the form, now, of organized trials. There are independent research labs working with grants from various donors, or without external funding, looking at the issues as well. We are starting to see biochemical markers suggesting anomalies worthy of further investigation but the signals are still confusing. "Millions" on Long-COVID research is only a drop in the bucket. $5B would be a better start.
There are several networks of researchers, clinicians and basic science alike, who are collaborating. That doesn't mean every doc is hooked into a network or is reading the same things I am regarding the research and clinical findings. There are several groups trying new therapies, but so far nothing on a wide-spread basis that appears to be consistent across practices, nor really addresses the underlying condition and (possible) causes.
I was infected in late June 2020, almost certainly shopping for groceries, by a checker at the cash register who was manifesting influenza-like symptoms, and while he had a mask on, it was not being worn properly. I, too, was masked; I suspect his viral load was high, and I was in his presence too long. (That was the only foray out of the house in over 2 weeks; there was no other plausible infection vector, as the store was virtually empty, and all other patrons were wearing masks properly.) My wife started showing symptoms 4 days later, by which time, I was virtually over my symptoms, and merely had to deal with the residual fatigue. Since I was working from home already, I lost no time at work... until the next week when caring for her meant I couldn't go to the building to work on my supercomputer hardware. This was 6 months before vaccines were available.
Initially, we suspected the illness had caused significant lung scarring, and decreased lung capacity led to muscle mass loss. Physical therapy, as we do when patients are hospitalized and lose muscle mass, made sense from the view of, "We always do this", but COVID wasn't that cooperative: It wasn't LIKE other viral illnesses, something we were starting to learn about the time we were first infected. Our infections were a brief discussion point on my nightly chatroom visits with clinicians around the country. How I handled her at home was of significant interest, and actually helped guide some of our group-think since our old protocols weren't working too well.
I found this website which seems to be the center for government work on Long COVID, now also called PASC - post-acute sequelae of SARS-CoV-2: https://recovercovid.org
I read they got 1.5 billion in 2021. They just got another $515 million. So that's 2 billion being spent on this by the federal government. But so far no recommendations for doctors. I have seen some pages from RECOVER on trials of drugs specifically for certain effects of long COVID.
It looks like Long COIVD is a very difficult thing to treat. We don't see the independent doctors who have been treating long COVID claiming they have the ideal treatment and they are having great success with it. Maybe it needs different treatment for different individuals. The independent doctors are trying different things.
I never got COVID as far as I know, and I was being tested a lot ever since the tests became available. It was a requirement for my work. Maybe I was exposed to it, but did not get sick. I've read that pretty much everybody has been exposed by now.
Yes, COVID is nothing like the other cornaviruses which have been around for a pretty long time and infecting humans. Those other coronaviruses do not cause the kinds of problems COVID does.
I made a mistake. RECOVER got $1.15 billion in 2021, not 1.5 billion. What will be interesting to me is to see is if RECOVER studies points to aspects of the particular spike proteins of COVID as being a problem. COVID shots result in the body producing a very similar spike protein.
We keep hearing that the spike protein is reproduced. In fact, elements of the S1 protein are created by the mRNA introduced, but the entire S1 protein is not. Most notably, the receptor binding domain (RBD) has been the target of the mRNA vaccines. But even if it was reproduced in its entirety, the S1 protein is not the infectious element of the vaccine. Once the vaccine attaches, primarily through binding (RBD) to acetyl cholinesterase Inhibitor (2) binding sites on cells, the contents of the capsid, an RNA chain, are injected into the cell, enter the nucleus and "reprogram" cellular reproduction to produce additional replicable (live) virus.
Creating elements of, or even the entire S1 protein produce a "foreign" antigen that stimulates rapid production of IgG and IgM to attenuate and neutralize the virus when it is, in fact introduced in infection.
Current studies are demonstrating reservoirs of reproducible virus, random protein fragments, in patients with prolonged symptoms.
One very erudite and provocative article exquisitely describing Pfizer and Moderna’s modification of the antigenic spike protein for the mRNA vaccines to render them immunologically acceptable. This paper and the conclusions made by the authors from Oxford and Cambridge provide reasonable cause and data-driven reasons why an increasing percentage of the population has begun to question the risk/benefit of acquiescing to more booster vaccines. Perhaps many of those disinclined aren’t all alarmists or anti-vaxxers. Perhaps they are more well-versed than the average agent representative from the CDC, FDA or IDSA Fellow. These are critically important conclusions and I for one could never accept a for-profit Pharma’s opinion that the product they are promoting is, perhaps, 99.9% safe and that idiotypic antibodies aren’t an issue when altered antigenic proteins are introduced more than once in a pandemic scenario. It simply defies belief that everyone that declines is ignorant of the consequences of immune stimulation by foreign material. Oh, to be clear, my spouse and I are fully vaccinated and boosted. I simply choose to keep an open mind and also believe that treating the SARS-COV2 virus with a pure antiviral like Paxlovid within 5 days of symptoms does NOT address the virus’ downstream targets. My in-depth research and clinical experiences dealing with issues with the critical a7 neurotransmitter receptors has concluded that the virus has the overwhelming advantage of infecting and disseminating way before the infection manifests itself or the individual realizes he/she is a victim. An immune modulator that addresses the antigen-antibody cascade is a far better bet if I needed a durable therapy. Using a repurposed, efficacious, durable and safe drug that isn’t priced like a Pharma blockbuster makes it an even better choice. Those that have had no vaccine would do well to at least get a basic 2 shots given the significant jump in cases and the only monitoring left on the table, wastewater monitoring.
I'll look at that but I have to at least initially reject your theory that those disinclined toward boosters are better versed than those who've spent lifetimes studying infectious disease and virus-borne illness. Instead, I fall in the camp that has seen too many people get their science, such as it is, from web sites and social media dedicated to conspiracy theories and misrepresentation of significant published results. I've looked at your work before, and while I don't necessarily agree with all your findings, I believe you've been doing credible work and the recent findings regarding complement cascade activation and maintenance in long-COVID do support the concept that the virus is reproducing well before the humoral system can catch up.
I agree: Everyone should have, at least, the basic series of one of the mRNA or Novavax agents, but I remain a firm believer, until more evidence arises, that the boosters are beneficial, especially in the higher risk populations. And that the definition of high-risk is transitory.
Thank you for your thoughts and comments, Dr Creager. I do agree that many that reject vaccines/boosters are not more well-versed given the misinformation available from so many sources. However, for those with a science background and with an expanded knowledge of the immune consequences, their concerns have much validity imho. The article in Nature 4 January 2024 vol 625 pp 189-194 by the Cambridge, Oxford groups Mulroney, Pöyry et al describes such issues but in an highly technical format. Re-assuringly, the authors did conclude that no adverse outcomes have been reported (“recognized”) would be my word choice. RS) from mistranslation of ....mRNA COVID19 vaccines. Have a look. I found it fascinating.
Actually, "identified" is my choice, and I doubt, after reading the article and spending a little time revisiting the research, that any adverse effects of mistranslation WILL be identified.
And, yes, the article was indeed fascinating.
We come back to the degree of comprehension of truly obscure science topics by even very intelligent people. When they're forced to extrapolate, their conclusions have an increased likelihood of diverging from what true discipline experts would conclude. And if you're honest, how many of your medical school classmates could explain the complement activation sequence and subsequent cascade 20 years after graduation... unless they are clinical ID or immunology docs? (perhaps half the allergists?)
I am unprepared to see the development of overall successful mRNA vaccines for SARS-CoV-2 as a failure uintil I see concrete clinical evidence thereof. So far, I've seen little to that end, but more significant signal that the vaccines have saved lives with, statistically, very few adverse effects. But then, I've heard Denton Cooley say, "A 1% mortality rate sounds pretty good, but if you're the one, mortality is 100%". Thus, we do need to research, document and fully understand all the adverse events that can really (not simply "reasonably") be linked to the use of these vaccines. Myocarditis/pericarditis was one such example. Not yet fully understood, in fact, cases associated with vaccine administration were overall less severe than non-vaccine and non-COVID-infection cases, and mortality was extremely low. Duration of hospitalization was shorter than either comparison groups, and pressors were rarely required (statistically, essentially zero). On the other hand, myocarditis/pericarditis associated with active COVID-19 infection had higher mortality rates, durations and pressor requirements than myocarditis/pericarditis not associated with COVID-19 infection. In other words, there was benefit and reduced relative risk.
This single targeted adverse event does not speak to mistranslation directly but does imply the dangers of vaccination are grossly outweighed by the risks of failure to vaccinate.
I won't get into the discussion of excess mortality over the last 4 years, as that is rehashed repeatedly and frequently used to bludgeon real epidemiologists with misleading (or worse) statements regarding such events. Suffice it to say I have confidence that at least one Southern State with a Republican governor had orders that all statistics related to excess mortality were to be routed through the Governor's office to be checked and "corrected" prior to release. This isn't illegal, but it does represent misrepresentation of public health data and was designed to produce a particular narrative embraced and followed closely by vaccine and even COVID skeptics. We cannot afford to see this happen again under the guise of free expression: If someone makes a false statement, that statement must be called out and countered immediately rather than thinking it causes no harm.
Or not. Too much has been taken out of context. I was receiving more detailed information and fewer soundbites, but regardless, Fauci's comments and recommendations paralleled the work that Public Health professionals were facing, especially in the 2020-2022 timeframe. Information was coming rapidly, and communicating that information was problematical. Fauci was less affected, but not immune, to political appointees lacking training in medicine, virology or infectious disease rewriting material for release (this was especially prevalent at CDC, slightly less at FDA and HHS, but still unconscionable). There's been a lot of misinformation that's circulated about Fauci, his history, intent and goals. Now, having working in the field off and on since the first AIDS outbreak, seeing a lot of Fauci's work, and a LOT of his writings and recommendations over 50 years, and having spent my own time trying to communicate what we knew and didn't know in the rapidly changing landscape of COVID, again in the 2020-2022 timeframe I'm a lot more inclined to cut him some slack because I was also attacked for having provided the best interpretations of the latest information, changing my position as new material arose (and like Fauci, acknowledging the landscape was changing dramatically) and being attacked as inconsistent.
So, sites trying to discredit one of the folks who was better able to track and understand the nature of everything we learned on the fly, in the face of a novel virus, whose properties we didn't know (think airborne spread, aerosolized transmission, NOT transmitted by surface contact except in exceptional settings, the scarcity of masks initially due to hoarding, decimation of the Just In Time supply chain for critical elements that business executives imposed to increase profits (yes, also hospital and medical device executives), the decisions by large corporate interests to off-shore manufacturing for the same profit-based goals.
Understand that I've been very critical of CDC. I'm not happy with the current definitions and recommendations we see for testing, isolation when positive, nor for that matter, restricted treatment with Paxlovid (joint CDC and FDA issues. That said, I suspect some of the issues with definitions and recommendations are simply acknowledgement that misinformation and disinformation by sites such as the one you cite played a role in people discounting what the professionals have learned, and desperately tried to convey.
I've said before, and will again here: Robert Redfield was never the right appointee for Director of CDC. He'd been out of his depth in the Army working on HIV/AIDS, but fairly safe in terms of not doing harm. He was a known proponent of abstinence-based policies, which are known to not work for STI transmission... or pregnancy prevention. But like everyone one of us in Public Health, leading CDC was a dream retirement gig. He was demonstrably loyal to Trump until shortly before the 2020 election when Birx, Fauci and Hahn wore him down and he had to look at reality. Similarly, the Trump administration's plan to defund CDC caused a massive loss of senior scientific talent which contributed to both scientific (manufacturing) errors and messaging. Repairing this damage may be a decadal event.
Essentially, posting misinformation websites does nothing to contribute to this discussion.
Your masking plea as part of a multi layer approach for prevention was well stated Dr Creager. If you have followed some of my previous comments fbo viewers concerns and questions, you might have noted my focus on repurposed drugs and the issues surrounding the two most infamous therapies based upon Hydroxychloroquine and ivermectin. They are both dead in the water
A distillation of our four years of clinical experience and my personal efforts with clinical research has been distilled in the following articles you might find worthy of your time. A recent one focusing on PASC is still in review by the publisher, but it focuses on a credible therapy for and I think you will find it especially meaningful since you mentioned a loved one with this complication from SARS-Cov2 exposure.
Ref #1 Foster, M.R.B., Hijazi, A.A., Sullivan, R.C., Opoku, R. (2023). Hydroxyurea and pyridostigmine repurposed for treating
Covid-19 multi-systems dysfunctions. AIMS Medical Science. 10(2), 118-129.
I can tell you anecdotally that several people with PASC have had a remarkable response to 2 repurposed pharmaceuticals. The drugs have a long history of safety and utility for other purposes (by definition). The details of the pharmacodynamics of HU and rivastigmine are readily available.
Actually, I'm relatively well-read on the scientific literature regarding SARS-CoV-2, vaccines, therapeutics and mitigations. You are, of course, entitled to your own opinion. YOur comment suggests you disagree with most of the established science; I've tended to lean toward established lines of study and also worked early on with clinicians as we started sorting things out.
As for comments, based on the selection I made on publishing this I allowed comments and made them open to everyone. That you were able to comment supports this.
At the height of the pandemic I intentionally avoided ALL media references whenever possible so as to not be tainted by information that had been interpreted and scrubbed of data, nuance and sources. As a result, most of what I heard from Fauci, Walenski, Birx, Redfield, etc., was in more professional setting and forums. I did not, nor do I now cite popular press stories (I do use the NYTimes COVID data page as it's about the most comprehensive available now) as authoritative, but I am guilty of occasionally using a graphic I've found useful and accurate.
Wow..the person telling the author they do not know what they are talking about is a perfect example of the misinformed people the article describes. Biased much there dude?
There are several fallacies here. One is thinking we ever expected a sterilizing vaccine. The original requirements for any of the vaccines in development worldwide was a reduction of serious illness, hospitalizations and deaths by at least 50%. While this might not have made it to your news sources, it was, indeed, the published intent of Operation Warp Speed. However, efficacy of the mRNA vaccines was so unprecedentedly high. we believed there was a potential to outpace the virus if we saw sufficient numbers vaccinated. The misinformation and disinformation campaigns regarding the speed of development, suggestions that microchips or magnetic particles were incorporated, half-truths suggesting the Phase 2/3 endpoints were not met, etc., drove overall acceptance of vaccines well below the 85-95% uptake that could (and I stress COULD) have seen a marked reduction in infection had it happened quickly. As time has seen the random evolution of the virus, we've seen it change its genome to be able to evade antibodies to earlier vaccines, requiring the cellular immune system to become the primary means of fighting the virus, which requires time to adapt to the new antigenic invader. The previous humoral immunity, induced directly by vaccination, and which we have found to wane over time (and we had no way of knowing how long it would persist save time to study it) do provide some less significant antibody response already circulating; for JN.1 and JN.1.1.1, prior immunization with an XBB strain of vaccine, or for that matter, prior infection with XBB strains, does provide more protection than the initial vaccines which were based on the ancestral Wuhan strain. The statements you label as "Total lies" are nothing of the sort but do in some small manner reflect the issue of using newly developed vaccines in the face of a novel virus to which almost the entirety of the human race was immunologically naive.
Vaccines are not seen as "therapeutic". While they may produce an immediate antibody response, they serve to train the cellular immune system by exposing it to the antigen so it can catalog same, and respond much more quickly to a repeat exposure to the same, or very similar antigen.
I'm not quite sure which "thousands of studies" you might be referring to, but in point of fact, since January 2020, I've been following the research pretty solidly, including a number of rather questionable studies placed on preprint servers that never saw publication in peer reviewed journals. I've been careful to avoid and not parrot the news media (from any source) as I judged most of their expert sources to usually be specialized in something besides infectious disease, public health, virology, vacinology, epidemiology. Thus my understanding, and growing knowledge was powered by actually reading, critiquing and critically reviewing the various studies reported. Now, several, including studies of hydroxychloroquiine and azithromycin, appeared to show some benefit but were hampered by being poorly controlled metaanalyses, obervational studies without control, or outright fraud (e.g., Raoult et al., https://www.sciencedirect.com/science/article/pii/S1477893920302179). At last look, well over 350,000 articles have been either published or placed in open-access sites related to COVID-19, in terms of vaccines, therapeutics and care regimens. I make no claim to have done more than a sampling of these, but for authoritative sources, I prefer to see studies with large enrollments, randomized controlled trials, where the use of such is ethical and well-designed, and research untainted by industry funding. I've amassed thousands of published reports thereof since 2020 and have read them. I've also read a number of the studies that claimed to show something that's not well supported, but taken as truth by other researchers, what you refer to as "the other so claled misinformation side", and while I have found significant issues, the reason they are discounted is others also find significant issues and we call them into question. For the record, that is how science is done: If you have one study showing a particular result, and someone questions it, you have to demonstrate why they are incorrect. If someone uses your published materials and methods and cannot reproduce your work, it calls into question whether there was an error in either of the efforts, and the work will be reproduced again. IF it still fails to produce your result, then your hypothesis and findings are called into question.
I shall dismiss Musk's misinformation tantrums as the nonsense they've proven to be. His training is not, nor ever was in any of the pertinent fields, and therefore really doesn't matter. His rants fly in the face of established science, and make him less credible.
As for the GBD, the basic premise (illness-derived immunity will protect you better than the various layered non-pharmaceutical interventions plus vaccines, and their claim that Sweden proved them correct, nuance to the Swedish response once they realized they had the highest infection, hospitalization and mortality rates in Europe were strongly supported by their population's predisposition to support their government's recommendations. In other words, they implemented increased vaccination rates, masking in public, isolation when sick, use of monoclonal antibodies and antivirals, etc., without mandates because they were more orderly and inclined to follow such guidance. Based on especially the disinformation rantings of a variety of talking heads and certain networks overall, as well as too many people with little/no experience in appropriate disciplines pontificating on social media, I fear Americans are living in their own echo chambers.
Retruning briefly to the GBD, I can understand professionals having differences of opinion regarding a major scientific issue being investigated. I'm convinced, for instance, that Jay Bhattacharya was basing his views more on his economic studies than on his clinical interactions early in the pandemic with real clinical cases. Vinay Prasad's claims, and his unstinting demands for randomized trials for everything appear to be more petulance than I'd expect from someone who is a recognized expert in his field (oncology), but less well informed in virology. Neither seems to have engaged in patient care between February 2020through June 2021, at least for COVID patients.
I've been listening to a great number of people, in the form of their published research results, including those who I know outright are not saying something I already believe, because my knowledge is plastic and based in the scientific findings I see routinely.
One point of clarification… at the time the vaccine studies were being carried out, the pandemic wasn’t exactly in full swing, and if I recall correctly there were doubts expressed that enough incident covid infections would occur in both control and intervention groups to reach a clear cut, timely answer.
New cases had dropped back significantly from the April surge, and restrictions and lockdowns meant far lower cases were being seen than was earlier forecast by the researchers. Things picked up as infections rose in the summer, but mainly in states that had rescinded restrictions more than others.
If you'r referring to the Phase 2/3 trials, the fact they were completed so quickly, with normal-sized cohorts was primarily due to the fact that control-group participants were becoming ill at a rate that drove end-point achievement. There were gaps in knowing how far to cycle PCR tests when infection was suspected, but that can be forgiven because we were still trying to sort through that test parameter for routine diagnosis.
Lockdowns did provide a significant reduction in cases but several states elected to foreshorten those. Some of the blame belongs to Deborah Birx who proposed a short period that Trump initially accepted, but then reversed course on. Overall, I still maintain that, had we maintained a national restriction on congregating, and maintained mandatory masking for an additional 6-8 weeks we might have had a bigger impact on spread than we did with the shorter lockdown.
Lockdowns are always unpopular because the United States, with its rugged individualist culture, doesn't favor actions that benefit the public at large, rather, preferring to preserve individual liberties, either enumerated or perceived. Public Health is at odds with that view, as the PH goal is maximizing protective benefit to the public at large. Birx understood this and on that basis, and based on what we thought we knew about the virus her recommendation was sound.
The increase in summer cases corresponds to the various relaxed stances in several states. We had a viral disease with an R(t) in excess of 2.0 even after its first devastating wave. I saw, and even calculated (based on local cases in Oklahoma at the time) an R(0) and R(t) of up to 8 and 4, respectively, in the April-May timeframe. Infection-derived immunity allows R(t) to drop (R(t) approx. 2.0-2.3) until we started seeing more variant activity, which initiated in the June-July timeframe (implied, based on a mini-surge but could also be aided by the reduction in congregate restrictions.
I note your prior affiliation to NHS. British numbers were a bit different from US numbers. I'm still not sure who was on the right track.
Thanks for the details. 👍
You wrote: "As someone with a loved one who does have PASC/Long-COVID, I sorta know it when I see it but many of her doctors were stymied as to whjat to call it or what to do. In other words, we’re still learning."
I'm curious what kind of treatment your loved one has received for long-COVID, and if they got COVID before their COVID vaccines or afterwards. I read the government spent millions studying long COVID, but came up with nothing regarding what to do about it. Are there groups of doctors sharing their long COVID treatments and learning from each other how to treat long COVID? When long COVID was first recognized, the only treatment offered in clinics I read about was just physical therapy.
Government spending on Long-COVID has taken a long time to develop and is in the form, now, of organized trials. There are independent research labs working with grants from various donors, or without external funding, looking at the issues as well. We are starting to see biochemical markers suggesting anomalies worthy of further investigation but the signals are still confusing. "Millions" on Long-COVID research is only a drop in the bucket. $5B would be a better start.
There are several networks of researchers, clinicians and basic science alike, who are collaborating. That doesn't mean every doc is hooked into a network or is reading the same things I am regarding the research and clinical findings. There are several groups trying new therapies, but so far nothing on a wide-spread basis that appears to be consistent across practices, nor really addresses the underlying condition and (possible) causes.
I was infected in late June 2020, almost certainly shopping for groceries, by a checker at the cash register who was manifesting influenza-like symptoms, and while he had a mask on, it was not being worn properly. I, too, was masked; I suspect his viral load was high, and I was in his presence too long. (That was the only foray out of the house in over 2 weeks; there was no other plausible infection vector, as the store was virtually empty, and all other patrons were wearing masks properly.) My wife started showing symptoms 4 days later, by which time, I was virtually over my symptoms, and merely had to deal with the residual fatigue. Since I was working from home already, I lost no time at work... until the next week when caring for her meant I couldn't go to the building to work on my supercomputer hardware. This was 6 months before vaccines were available.
Initially, we suspected the illness had caused significant lung scarring, and decreased lung capacity led to muscle mass loss. Physical therapy, as we do when patients are hospitalized and lose muscle mass, made sense from the view of, "We always do this", but COVID wasn't that cooperative: It wasn't LIKE other viral illnesses, something we were starting to learn about the time we were first infected. Our infections were a brief discussion point on my nightly chatroom visits with clinicians around the country. How I handled her at home was of significant interest, and actually helped guide some of our group-think since our old protocols weren't working too well.
I found this website which seems to be the center for government work on Long COVID, now also called PASC - post-acute sequelae of SARS-CoV-2: https://recovercovid.org
I read they got 1.5 billion in 2021. They just got another $515 million. So that's 2 billion being spent on this by the federal government. But so far no recommendations for doctors. I have seen some pages from RECOVER on trials of drugs specifically for certain effects of long COVID.
It looks like Long COIVD is a very difficult thing to treat. We don't see the independent doctors who have been treating long COVID claiming they have the ideal treatment and they are having great success with it. Maybe it needs different treatment for different individuals. The independent doctors are trying different things.
I never got COVID as far as I know, and I was being tested a lot ever since the tests became available. It was a requirement for my work. Maybe I was exposed to it, but did not get sick. I've read that pretty much everybody has been exposed by now.
Yes, COVID is nothing like the other cornaviruses which have been around for a pretty long time and infecting humans. Those other coronaviruses do not cause the kinds of problems COVID does.
I made a mistake. RECOVER got $1.15 billion in 2021, not 1.5 billion. What will be interesting to me is to see is if RECOVER studies points to aspects of the particular spike proteins of COVID as being a problem. COVID shots result in the body producing a very similar spike protein.
We keep hearing that the spike protein is reproduced. In fact, elements of the S1 protein are created by the mRNA introduced, but the entire S1 protein is not. Most notably, the receptor binding domain (RBD) has been the target of the mRNA vaccines. But even if it was reproduced in its entirety, the S1 protein is not the infectious element of the vaccine. Once the vaccine attaches, primarily through binding (RBD) to acetyl cholinesterase Inhibitor (2) binding sites on cells, the contents of the capsid, an RNA chain, are injected into the cell, enter the nucleus and "reprogram" cellular reproduction to produce additional replicable (live) virus.
Creating elements of, or even the entire S1 protein produce a "foreign" antigen that stimulates rapid production of IgG and IgM to attenuate and neutralize the virus when it is, in fact introduced in infection.
Current studies are demonstrating reservoirs of reproducible virus, random protein fragments, in patients with prolonged symptoms.
https://www.nature.com/articles/s41586-023-06800-3.pdf
One very erudite and provocative article exquisitely describing Pfizer and Moderna’s modification of the antigenic spike protein for the mRNA vaccines to render them immunologically acceptable. This paper and the conclusions made by the authors from Oxford and Cambridge provide reasonable cause and data-driven reasons why an increasing percentage of the population has begun to question the risk/benefit of acquiescing to more booster vaccines. Perhaps many of those disinclined aren’t all alarmists or anti-vaxxers. Perhaps they are more well-versed than the average agent representative from the CDC, FDA or IDSA Fellow. These are critically important conclusions and I for one could never accept a for-profit Pharma’s opinion that the product they are promoting is, perhaps, 99.9% safe and that idiotypic antibodies aren’t an issue when altered antigenic proteins are introduced more than once in a pandemic scenario. It simply defies belief that everyone that declines is ignorant of the consequences of immune stimulation by foreign material. Oh, to be clear, my spouse and I are fully vaccinated and boosted. I simply choose to keep an open mind and also believe that treating the SARS-COV2 virus with a pure antiviral like Paxlovid within 5 days of symptoms does NOT address the virus’ downstream targets. My in-depth research and clinical experiences dealing with issues with the critical a7 neurotransmitter receptors has concluded that the virus has the overwhelming advantage of infecting and disseminating way before the infection manifests itself or the individual realizes he/she is a victim. An immune modulator that addresses the antigen-antibody cascade is a far better bet if I needed a durable therapy. Using a repurposed, efficacious, durable and safe drug that isn’t priced like a Pharma blockbuster makes it an even better choice. Those that have had no vaccine would do well to at least get a basic 2 shots given the significant jump in cases and the only monitoring left on the table, wastewater monitoring.
I'll look at that but I have to at least initially reject your theory that those disinclined toward boosters are better versed than those who've spent lifetimes studying infectious disease and virus-borne illness. Instead, I fall in the camp that has seen too many people get their science, such as it is, from web sites and social media dedicated to conspiracy theories and misrepresentation of significant published results. I've looked at your work before, and while I don't necessarily agree with all your findings, I believe you've been doing credible work and the recent findings regarding complement cascade activation and maintenance in long-COVID do support the concept that the virus is reproducing well before the humoral system can catch up.
I agree: Everyone should have, at least, the basic series of one of the mRNA or Novavax agents, but I remain a firm believer, until more evidence arises, that the boosters are beneficial, especially in the higher risk populations. And that the definition of high-risk is transitory.
Thank you for your thoughts and comments, Dr Creager. I do agree that many that reject vaccines/boosters are not more well-versed given the misinformation available from so many sources. However, for those with a science background and with an expanded knowledge of the immune consequences, their concerns have much validity imho. The article in Nature 4 January 2024 vol 625 pp 189-194 by the Cambridge, Oxford groups Mulroney, Pöyry et al describes such issues but in an highly technical format. Re-assuringly, the authors did conclude that no adverse outcomes have been reported (“recognized”) would be my word choice. RS) from mistranslation of ....mRNA COVID19 vaccines. Have a look. I found it fascinating.
Actually, "identified" is my choice, and I doubt, after reading the article and spending a little time revisiting the research, that any adverse effects of mistranslation WILL be identified.
And, yes, the article was indeed fascinating.
We come back to the degree of comprehension of truly obscure science topics by even very intelligent people. When they're forced to extrapolate, their conclusions have an increased likelihood of diverging from what true discipline experts would conclude. And if you're honest, how many of your medical school classmates could explain the complement activation sequence and subsequent cascade 20 years after graduation... unless they are clinical ID or immunology docs? (perhaps half the allergists?)
I am unprepared to see the development of overall successful mRNA vaccines for SARS-CoV-2 as a failure uintil I see concrete clinical evidence thereof. So far, I've seen little to that end, but more significant signal that the vaccines have saved lives with, statistically, very few adverse effects. But then, I've heard Denton Cooley say, "A 1% mortality rate sounds pretty good, but if you're the one, mortality is 100%". Thus, we do need to research, document and fully understand all the adverse events that can really (not simply "reasonably") be linked to the use of these vaccines. Myocarditis/pericarditis was one such example. Not yet fully understood, in fact, cases associated with vaccine administration were overall less severe than non-vaccine and non-COVID-infection cases, and mortality was extremely low. Duration of hospitalization was shorter than either comparison groups, and pressors were rarely required (statistically, essentially zero). On the other hand, myocarditis/pericarditis associated with active COVID-19 infection had higher mortality rates, durations and pressor requirements than myocarditis/pericarditis not associated with COVID-19 infection. In other words, there was benefit and reduced relative risk.
This single targeted adverse event does not speak to mistranslation directly but does imply the dangers of vaccination are grossly outweighed by the risks of failure to vaccinate.
I won't get into the discussion of excess mortality over the last 4 years, as that is rehashed repeatedly and frequently used to bludgeon real epidemiologists with misleading (or worse) statements regarding such events. Suffice it to say I have confidence that at least one Southern State with a Republican governor had orders that all statistics related to excess mortality were to be routed through the Governor's office to be checked and "corrected" prior to release. This isn't illegal, but it does represent misrepresentation of public health data and was designed to produce a particular narrative embraced and followed closely by vaccine and even COVID skeptics. We cannot afford to see this happen again under the guise of free expression: If someone makes a false statement, that statement must be called out and countered immediately rather than thinking it causes no harm.
The PDF doesn't download.
Of interest...
https://www.powerlineblog.com/archives/2024/01/whole-lotta-lyin-goin-on-3.php
Or not. Too much has been taken out of context. I was receiving more detailed information and fewer soundbites, but regardless, Fauci's comments and recommendations paralleled the work that Public Health professionals were facing, especially in the 2020-2022 timeframe. Information was coming rapidly, and communicating that information was problematical. Fauci was less affected, but not immune, to political appointees lacking training in medicine, virology or infectious disease rewriting material for release (this was especially prevalent at CDC, slightly less at FDA and HHS, but still unconscionable). There's been a lot of misinformation that's circulated about Fauci, his history, intent and goals. Now, having working in the field off and on since the first AIDS outbreak, seeing a lot of Fauci's work, and a LOT of his writings and recommendations over 50 years, and having spent my own time trying to communicate what we knew and didn't know in the rapidly changing landscape of COVID, again in the 2020-2022 timeframe I'm a lot more inclined to cut him some slack because I was also attacked for having provided the best interpretations of the latest information, changing my position as new material arose (and like Fauci, acknowledging the landscape was changing dramatically) and being attacked as inconsistent.
So, sites trying to discredit one of the folks who was better able to track and understand the nature of everything we learned on the fly, in the face of a novel virus, whose properties we didn't know (think airborne spread, aerosolized transmission, NOT transmitted by surface contact except in exceptional settings, the scarcity of masks initially due to hoarding, decimation of the Just In Time supply chain for critical elements that business executives imposed to increase profits (yes, also hospital and medical device executives), the decisions by large corporate interests to off-shore manufacturing for the same profit-based goals.
Understand that I've been very critical of CDC. I'm not happy with the current definitions and recommendations we see for testing, isolation when positive, nor for that matter, restricted treatment with Paxlovid (joint CDC and FDA issues. That said, I suspect some of the issues with definitions and recommendations are simply acknowledgement that misinformation and disinformation by sites such as the one you cite played a role in people discounting what the professionals have learned, and desperately tried to convey.
I've said before, and will again here: Robert Redfield was never the right appointee for Director of CDC. He'd been out of his depth in the Army working on HIV/AIDS, but fairly safe in terms of not doing harm. He was a known proponent of abstinence-based policies, which are known to not work for STI transmission... or pregnancy prevention. But like everyone one of us in Public Health, leading CDC was a dream retirement gig. He was demonstrably loyal to Trump until shortly before the 2020 election when Birx, Fauci and Hahn wore him down and he had to look at reality. Similarly, the Trump administration's plan to defund CDC caused a massive loss of senior scientific talent which contributed to both scientific (manufacturing) errors and messaging. Repairing this damage may be a decadal event.
Essentially, posting misinformation websites does nothing to contribute to this discussion.
..credible therapy for PASC (inexplicably truncated)
Your masking plea as part of a multi layer approach for prevention was well stated Dr Creager. If you have followed some of my previous comments fbo viewers concerns and questions, you might have noted my focus on repurposed drugs and the issues surrounding the two most infamous therapies based upon Hydroxychloroquine and ivermectin. They are both dead in the water
A distillation of our four years of clinical experience and my personal efforts with clinical research has been distilled in the following articles you might find worthy of your time. A recent one focusing on PASC is still in review by the publisher, but it focuses on a credible therapy for and I think you will find it especially meaningful since you mentioned a loved one with this complication from SARS-Cov2 exposure.
Ref #1 Foster, M.R.B., Hijazi, A.A., Sullivan, R.C., Opoku, R. (2023). Hydroxyurea and pyridostigmine repurposed for treating
Covid-19 multi-systems dysfunctions. AIMS Medical Science. 10(2), 118-129.
Ref #2 Moftah and Eswayah
https://www.sciencedirect.com/science/article/abs/pii/S0306987723000178
Repurposing of Hydroxyurea Against COVID-19: A Promising Immunomodulatory Role. - Abstract - Europe PMC
Ref #3 https://www.sciencedirect.com/science/article/pii/S0165572823002308
Ref #4: (preprint)
https://www.qeios.com/read/DTA98L
I can tell you anecdotally that several people with PASC have had a remarkable response to 2 repurposed pharmaceuticals. The drugs have a long history of safety and utility for other purposes (by definition). The details of the pharmacodynamics of HU and rivastigmine are readily available.
Actually, I'm relatively well-read on the scientific literature regarding SARS-CoV-2, vaccines, therapeutics and mitigations. You are, of course, entitled to your own opinion. YOur comment suggests you disagree with most of the established science; I've tended to lean toward established lines of study and also worked early on with clinicians as we started sorting things out.
As for comments, based on the selection I made on publishing this I allowed comments and made them open to everyone. That you were able to comment supports this.
At the height of the pandemic I intentionally avoided ALL media references whenever possible so as to not be tainted by information that had been interpreted and scrubbed of data, nuance and sources. As a result, most of what I heard from Fauci, Walenski, Birx, Redfield, etc., was in more professional setting and forums. I did not, nor do I now cite popular press stories (I do use the NYTimes COVID data page as it's about the most comprehensive available now) as authoritative, but I am guilty of occasionally using a graphic I've found useful and accurate.
Wow..the person telling the author they do not know what they are talking about is a perfect example of the misinformed people the article describes. Biased much there dude?
There are several fallacies here. One is thinking we ever expected a sterilizing vaccine. The original requirements for any of the vaccines in development worldwide was a reduction of serious illness, hospitalizations and deaths by at least 50%. While this might not have made it to your news sources, it was, indeed, the published intent of Operation Warp Speed. However, efficacy of the mRNA vaccines was so unprecedentedly high. we believed there was a potential to outpace the virus if we saw sufficient numbers vaccinated. The misinformation and disinformation campaigns regarding the speed of development, suggestions that microchips or magnetic particles were incorporated, half-truths suggesting the Phase 2/3 endpoints were not met, etc., drove overall acceptance of vaccines well below the 85-95% uptake that could (and I stress COULD) have seen a marked reduction in infection had it happened quickly. As time has seen the random evolution of the virus, we've seen it change its genome to be able to evade antibodies to earlier vaccines, requiring the cellular immune system to become the primary means of fighting the virus, which requires time to adapt to the new antigenic invader. The previous humoral immunity, induced directly by vaccination, and which we have found to wane over time (and we had no way of knowing how long it would persist save time to study it) do provide some less significant antibody response already circulating; for JN.1 and JN.1.1.1, prior immunization with an XBB strain of vaccine, or for that matter, prior infection with XBB strains, does provide more protection than the initial vaccines which were based on the ancestral Wuhan strain. The statements you label as "Total lies" are nothing of the sort but do in some small manner reflect the issue of using newly developed vaccines in the face of a novel virus to which almost the entirety of the human race was immunologically naive.
Vaccines are not seen as "therapeutic". While they may produce an immediate antibody response, they serve to train the cellular immune system by exposing it to the antigen so it can catalog same, and respond much more quickly to a repeat exposure to the same, or very similar antigen.
I'm not quite sure which "thousands of studies" you might be referring to, but in point of fact, since January 2020, I've been following the research pretty solidly, including a number of rather questionable studies placed on preprint servers that never saw publication in peer reviewed journals. I've been careful to avoid and not parrot the news media (from any source) as I judged most of their expert sources to usually be specialized in something besides infectious disease, public health, virology, vacinology, epidemiology. Thus my understanding, and growing knowledge was powered by actually reading, critiquing and critically reviewing the various studies reported. Now, several, including studies of hydroxychloroquiine and azithromycin, appeared to show some benefit but were hampered by being poorly controlled metaanalyses, obervational studies without control, or outright fraud (e.g., Raoult et al., https://www.sciencedirect.com/science/article/pii/S1477893920302179). At last look, well over 350,000 articles have been either published or placed in open-access sites related to COVID-19, in terms of vaccines, therapeutics and care regimens. I make no claim to have done more than a sampling of these, but for authoritative sources, I prefer to see studies with large enrollments, randomized controlled trials, where the use of such is ethical and well-designed, and research untainted by industry funding. I've amassed thousands of published reports thereof since 2020 and have read them. I've also read a number of the studies that claimed to show something that's not well supported, but taken as truth by other researchers, what you refer to as "the other so claled misinformation side", and while I have found significant issues, the reason they are discounted is others also find significant issues and we call them into question. For the record, that is how science is done: If you have one study showing a particular result, and someone questions it, you have to demonstrate why they are incorrect. If someone uses your published materials and methods and cannot reproduce your work, it calls into question whether there was an error in either of the efforts, and the work will be reproduced again. IF it still fails to produce your result, then your hypothesis and findings are called into question.
I shall dismiss Musk's misinformation tantrums as the nonsense they've proven to be. His training is not, nor ever was in any of the pertinent fields, and therefore really doesn't matter. His rants fly in the face of established science, and make him less credible.
As for the GBD, the basic premise (illness-derived immunity will protect you better than the various layered non-pharmaceutical interventions plus vaccines, and their claim that Sweden proved them correct, nuance to the Swedish response once they realized they had the highest infection, hospitalization and mortality rates in Europe were strongly supported by their population's predisposition to support their government's recommendations. In other words, they implemented increased vaccination rates, masking in public, isolation when sick, use of monoclonal antibodies and antivirals, etc., without mandates because they were more orderly and inclined to follow such guidance. Based on especially the disinformation rantings of a variety of talking heads and certain networks overall, as well as too many people with little/no experience in appropriate disciplines pontificating on social media, I fear Americans are living in their own echo chambers.
Retruning briefly to the GBD, I can understand professionals having differences of opinion regarding a major scientific issue being investigated. I'm convinced, for instance, that Jay Bhattacharya was basing his views more on his economic studies than on his clinical interactions early in the pandemic with real clinical cases. Vinay Prasad's claims, and his unstinting demands for randomized trials for everything appear to be more petulance than I'd expect from someone who is a recognized expert in his field (oncology), but less well informed in virology. Neither seems to have engaged in patient care between February 2020through June 2021, at least for COVID patients.
I've been listening to a great number of people, in the form of their published research results, including those who I know outright are not saying something I already believe, because my knowledge is plastic and based in the scientific findings I see routinely.
This conversation is ended.