Covid 19 Diaries, july 26, Day 132

Dear Diary,

For posterity I’m going to get down some of the theories, older and newer, about the origin, treatment, and future of corona virus that have circulated and continue to circulate in various media venues.

Early on there was hype about hydroxychlorquine, a drug used for autoimmune patients, being curative for corona. I’ll admit that I was excited about this one because I’ve taken that drug for years (with no side effects) and had some in the closet (albeit expired). This idea lingered for quite some time, and was made stickier by presidential proclamation that people should “give it a try”–a suggestion met with significant scorn by the medical community, as it caused a run on the drug (keeping it from lupus and RA patients who genuinely need it on a daily basis), and can have some nasty cardiac side effects, and has been proven ineffective by various randomized trials.

A number of different anti-virals have had their moment on the cat walk. People were excited about Remdevisvir, a drug originally created to combat Ebola. The randomized trials that have come out so far suggest that it might shorten the course of the disease, but today it’s not clear it effects mortality.

HIV drugs have been tried, with varying reports about their success.

There is a theory that blood type matters. In particular, people with type A are at higher risk for serious infection, and type O have a relatively lower risk. The idea is that genes that control blood type also affect immune function, and could potentially affect the receptor on cells to which the virus binds. (I wish I could ask my father about this one!!) But this is just a theory, and about every two weeks there is an article claiming that it’s true (and was also true for SARS-Cov1), and then an article saying it’s not true. Jury is still out on this one (or hung?)…time will tell.

There’s been some anxiety over quickly dropping antibody rates in people who’ve overcome the virus once. This became a drum beat for a while, which was slightly muffled by the further investigation of T cell derived immunity.  Part of the panic is that vaccines rely on the durability of antibodies to work…so if antibodies don’t stick around, what does that mean for the frequency and effectiveness of vaccines?

And there’s also the suggestion that some people may have a more mild reaction to the virus if they’ve had the type of common cold (also caused by a corona virus) that cross reacts with Covid-19–which essentially means that their lingering antibodies mistake Covid-19 for the common cold virus they defeated.

I’m sure there are more…and the lunatic fringe has cooked up many theories, none of which are entertaining during the pandemic, making it hard to see why we’d preserve them….

Until tomorrow

Covid 19 Diaries, July 24, Day 130

Dear Diary,

Today I listened to a talk between the editor of JAMA and the head of Scripps research, Eric Topol on my morning walk with the puppies. They (the doctors) had a long and comprehensive discussion about the covidtastrophe, with two big take aways.

My beloved monoclonal antibodies, the treatment I’m pacing around in my kitchen waiting on, are expected to be a significant game changer (Topol is like the 17th scientist I’ve heard say this), maybe in the fall? But, shit…they are expensive–which I didn’t realize. I imagine their expense will hamper their ability to be widely distributed? Or maybe Congress will subsidize them if they are really effective?

Rapid (and cheap!) testing is another thing on the horizon that will transform lockdown life. Topol talked about Covid tests that could be self administered at home (something comparable to a pregnancy test).  You buy them at your local pharmacy, test yourself and get results in under an hour.  Then you could leave home if you are negative and stay if you are positive. And we’d use some kind of honor system and trust that those who are out are negative? Not sure about that part…maybe you’d have to bring your dated positive results with you when you are out to gain admission into any business…

I’m ready for a breakthrough. The percent of covid tests in our county that are positive is 4%, up a little, down a little for the last 10 days…but I can’t tell how hard it is to get a test, or get results…so maybe the spread in the community is twice that? It’s hard to know if demand is based on symptoms at this point and what the unmet demand is…But I will say that the very small number of things I’m doing: going to the pharmacy, the doctor’s office, etc. still seem very vacant. I had a doctor’s appointment on Saturday and the receptionist and I were the only ones in the building (other than the doctor).

Consistent with that, the younger one’s dance class has been moved outside to a park.  I’m guessing that move was in response to parent feedback? Four percent isn’t very high, but we are all acting like it is high enough to reject a return to normalcy.

This pandemic has grown tiresome.

Until tomorrow.