COVID19 update, August 12, 2020: Stanford study of immunity dysfunction in severe COVID19; lockdown critic Scott Atlas MD joins White House COVID19 task force; Russian “public beta” vaccine; misc. updates

(1) “A Stanford study shows that in severely ill COVID-19 patients, “first-responder” immune cells, which should react immediately to signs of viruses or bacteria in the body, instead respond sluggishly[…] That difference may stem from how our evolutionarily ancient innate immune system responds to SARS-CoV-2, the virus that causes the disease. Found in all creatures from fruit flies to humans, the innate immune system rapidly senses viruses and other pathogens. As soon as it does, it launches an immediate though somewhat indiscriminate attack on them. It also mobilizes more precisely targeted, but slower-to-get-moving, “sharpshooter” cells belonging to a different branch of the body’s pathogen-defense forces, the adaptive immune system.

“These findings reveal how the immune system goes awry during coronavirus infections, leading to severe disease, and point to potential therapeutic targets,” said Bali Pulendran, PhD, professor of pathology and of microbiology and immunology and the senior author of the study” according to a press release in popular language about an article that just was published in SCIENCE. http://doi.org/10.1126/science.abc6261

Back to the press release: “

The findings suggest that in cases of severe COVID-19, bacterial products ordinarily present only in places such as the gut, lungs and throat may make their way into the bloodstream, kick-starting enhanced inflammation that is conveyed to all points via the circulatory system.

But the study also revealed, paradoxically, that the worse the case of COVID-19, the less effective certain cells of the innate immune system were in responding to the disease. Instead of being aroused by material from viruses and bacteria, these normally vigilant cells remained functionally sluggish. 

 If high blood levels of inflammation-promoting molecules set COVID-19 patients apart from those with milder cases, but blood cells are not producing these molecules, where do they come from? Pulendran believes they originate in tissues somewhere in the body — most likely patients’ lungs, the site of infection.

“One of the great mysteries of COVID-19 infections has been that some people develop severe disease, while others seem to recover quickly,” Pulendran said. “Now we have some insights into why that happens.”

(2) Scott Atlas MD of Stanford, an outspoken critic of lockdown measures, joins the White House coronavirus task force. Unlike the writer, I wouldn’t count on Anthony Fauci being “out”, but some counterbalance is clearly needed. Israel’s current “corona czar”, Roni Gamzu MD, is likewise no fan of lockdowns. I supported ours during the first wave, but it is increasingly looking to me like we just set ourselves up for a bigger second wave.

(3) Miscellaneous updates:

* Dr. John Campbell discussed the Russian “Sputnik V” vaccine, which is apparently getting beta-tested in production.

That’s aggravating enough when Microsoft does this sort of thing with a Windows release: here it’s downright worrisome.

The principle on which the vaccine is based, as Dr. Campbell explains, seems plausible: splice a COVID spike protein into an innocuous adenovirus and administer that, in order to induce a T cell response.  But lots of drug candidates that seem perfectly sound on paper/in the lab/on the supercomputer have a way of falling flat when applied to actual humans.

* (via The Spectator “evening blend”: [I wish their editor would learn how to properly permalink scientific papers])  An advance article in the Journal of Infectious Diseases considers mouth wash as a post-exposure prophylactic. https://doi.org/10.1093/infdis/jiaa471  The abstract:

The ongoing SARS-CoV-2 pandemic creates a significant threat to global health. Recent studies suggested the significance of throat and salivary glands as major sites of virus replication and transmission during early COVID-19 thus advocating application of oral antiseptics. However, the antiviral efficacy of oral rinsing solutions against SARS-CoV-2 has not been examined. Here, we evaluated the virucidal activity of different available oral rinses against SARS-CoV-2 under conditions mimicking nasopharyngeal secretions. Several formulations with significant SARS-CoV-2 inactivating properties in vitrosupport the idea that oral rinsing might reduce the viral load of saliva and could thus lower the transmission of SARS-CoV-2.

Whether sloshing with Listerine or an equivalent right after you suspect you’ve breathed in an expletive-load of coronavirus will stop you from getting the disease seems dubious to me, but there is increasing evidence that a reduced viral load increases your “rapid response” immune system’s chances of getting rid of it before it can do much harm. And mouthwash is definitely in the realm of “if it doesn’t help, neither will it hurt”.

* Israel deletes quirky COVID-19 ad after China offended. “May they be healthy” as the Hebrew equivalent of “bless their hearts” goes.

(4) (h/t: Erik Wingren) Personal fitness trackers (in this case, the Whoop) can play a role as early warning systems for COVID19 illness — in this case, respiration rate going up without concomitant signs of running, climbing,… https://www.whoop.com/thelocker/predict-covid-19-risk/

In combination with oximetry, this would be even more useful: as I understand it, Apple Watch would have this built-in already (as well as continuous glucose monitoring) if it weren’t for FDA approval issues. At any rate, a finger oximeter costs as little as $20-$30 on Amazon (search link for information only) and yields both oxygen saturation levels and pulse rate within a fraction of a minute. 

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