2019 Novel Coronavirus 医学信息链接

入得谷来,祸福自求。
Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-07-23 1:29

问得好!我也奇怪,比尔盖兹招谁惹谁了。为啥就没人造warren buffet 类似的谣言。 可能是因为比尔盖兹基金会长年在第三世界帮助治流行病吧。
Nevertheless, she persisted.

笑嘻嘻
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 笑嘻嘻 » 2020-07-23 2:21

哦,对,他乌鸦嘴来着。他早几年就在tek talk说了美国完全没有应付大型流行病的准备。他居然敢不说美国是最强的,美国是最棒的。(他是不是还夸过中国防疫?)
云浆未饮结成冰

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-23 9:38

大家不知道听说过没有 QAnon 这个组织,在网上受众很广大。阴谋论在美国文化里由来已久,但是这些年越来越疯狂,川普自从参加 Birthers 运动开始就跟他们无缝对接。狐狸台自从正式变成党台之后,经常跟他们互通款曲,吞咽彼此的呕吐。

谣言越来越汹涌的年代,大概就是快亡国的迹象?
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-07-23 9:53

Jun wrote:
2020-07-23 9:38
大家不知道听说过没有 QAnon 这个组织,在网上受众很广大。阴谋论在美国文化里由来已久,但是这些年越来越疯狂,川普自从参加 Birthers 运动开始就跟他们无缝对接。狐狸台自从正式变成党台之后,经常跟他们互通款曲,吞咽彼此的呕吐。

谣言越来越汹涌的年代,大概就是快亡国的迹象?
前段时间不知哪里听了一耳朵,阴谋论的源头就是incompetence, government 造谣散布阴谋论就是为了掩盖他们的incompetence.
一个人的性格决定他的命运。

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-07-23 10:00

tiffany wrote:
2020-07-22 14:30
我怨念一下儿,我就怕医生写论文,脑子里装的都是啥啊
有些MD/phD 还是非常强的,绝大部分只做临床的医生理论水平不行,更别说“编故事/写论文”啦。 我总觉得医学院的训练不太会强调科学思考,所以很多医生的辩证思维能力是团谜。。。 again, 术业有专攻, 医生做好医生的事儿就行了,各司其职。
一个人的性格决定他的命运。

vivi
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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-07-23 10:15

不好意思,我是真糊涂了一下。也有点惊讶美国这么多人了。比一下加拿大人好少啊。
又没头脑又不高兴

Elysees
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Elysees » 2020-07-23 15:47

等等,你们到底哪里找来的3.8亿? Census上的数据是330 milion啊,3.3亿啊
https://www.census.gov/popclock/
Jun wrote:
2020-07-22 8:41
Elysees wrote:
2020-07-21 18:30
这段时间,全民囤货的时候,我不由自主想起了Educated里面Tara的爸爸和妈妈,我难以自控的想,她爸爸这个时候会跟她说I told you so么?她跟父母因为这个机会和解了么?
他们家的问题不是 abuse 么?外界条件(例如瘟疫)只能制造个机会,除非当事人想和解否则是不行的。

我说这个是因为Tara的父亲长期以来一直认为会有apocalypse,Tara在书里多少把这个作为她父亲一种偏执,可是现在看,好像囤积食物什么也不算特别难以理解。她父亲说不定会以此为由头跟她说,i was right all the time etc. 她父母认为她关于abuse的指控是delusional的,希望她能坚持吧。
What annoys me is,在我看到的她的所有采访里,她一再说,it's not that my parent don't love me, they love me very much, just in their own way。我老觉得她在等待父母与她和解,哎。
我自横刀向天笑,笑完我就去睡觉。

Elysees
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Elysees » 2020-07-23 15:51

我这些天看唐顿庄园(十分落后),看到里面提到了1918年的西班牙大流感,查了一下,那场Pandemic大概算起始于1918年秋天,到1920年初就基本褪去了。当时也没有全球疫苗研究也没有现在日以继夜的医学投入,基本上就是靠命,这么着也不过一年半而已,瘟疫就自己退去了。现代医学总得有点儿进步吧,今年2月开始,咱怎么也得在今年就把这事儿清算了吧,不然岂不是还不如1918年放任自流的结果。

另外,Jun的检验结果有了吗?
我自横刀向天笑,笑完我就去睡觉。

tiffany
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Re: 2019 Novel Coronavirus 医学信息链接

Post by tiffany » 2020-07-23 16:13

那是一年半啊。而且当时人口流动跟人口密度跟现在不能比...
有酒有酒 闲饮东窗

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-23 17:05

Elysees wrote:
2020-07-23 15:51
我这些天看唐顿庄园(十分落后),看到里面提到了1918年的西班牙大流感,查了一下,那场Pandemic大概算起始于1918年秋天,到1920年初就基本褪去了。当时也没有全球疫苗研究也没有现在日以继夜的医学投入,基本上就是靠命,这么着也不过一年半而已,瘟疫就自己退去了。现代医学总得有点儿进步吧,今年2月开始,咱怎么也得在今年就把这事儿清算了吧,不然岂不是还不如1918年放任自流的结果。

另外,Jun的检验结果有了吗?
没,星期二中午测的,到今天才两天。考虑到美国的检验盒又又又紧缺了 ... 估计这星期能收到结果就不错了。不过我从昨天开始就活蹦乱跳了,家属也毫无症状。是星期一半夜突然开始腹痛腹泻和发低烧,之前上午我还去游泳哪,根本毫无预感。当时虽然害怕是 COVID,但也十分怀疑是 Salmonella,因为做晚饭时又切又捏一块猪肉和几块鸡肉。星期二一早去看附近的 urgent care,等着做 COVID-19 检验的人在门外大热天的排长队,吓得我赶紧溜了,本来没感染也会被感染上啊!幸好平时的 primary care office 有 telemedicine service,迅速约到医生 video 了一下,他给我开了个单子让我去 drive through 的检验站。医生认为是 viral gastroenteritis 即 stomach flu,我去查了一下最常见的 norovirus,一切症状吻合,直接追踪到星期天下午吃的半打生蚝 :speechless002: 。在这种时期随便得个啥病都是很恐怖的事情。

本地县政府开的 drive-through 还是很方便的,不必下车,都在户外搞定,几乎不用排队。在视频上我还问了医生要不要跟家属隔离,虽然我早已知道答案——要传早传了,还等到出现症状乎?等检验结果还要一星期,有毛用处哦 ... 我们县是深蓝县,政府还算有点良心,开了一处免费给穷人(无保险)检验门诊;有保险的群众去另一处,虽然是明晃晃的阶级隔离也算不错了。在很多地方尤其是红州就别想了,有保险还不一定能及时测试呢。美国的公共卫生从头烂到脚,现在的状况说是天谴或上帝的惩罚也不为过。

1918年大流感到底是怎么消失的,这个问题一直被研究了很久,我记得去年或前年还看过文章,结论是还没找出原因来 ... 神秘的病毒,甚至现在都知道是 H1N1 strain 了,但具体情况还是不明白,也不明白为什么死亡的大多数是年轻人。

一个 pathogen 能不能被消灭,主要因素之一是有没有 animal reservoir,如果能在动物和人类身上跳来跳去就很难彻底消灭。天花是唯一被人为消灭的 pathogen,就是因为接种了足够多的人就能达到。根据 recreated 1918年 H1N1 influenza A 品种,貌似它从鸟类(禽类?)跳到人身上之后就不能回去了,所以就 ... 消失了?Maybe. 但是 Ebola 就很难彻底消灭,因为继续存在于猴子身上。SARS-CoV-2 如果能继续存在于猫狗身上,我估计也很难根除。

------

更正:1918年的 influenza A 病毒也没消失,而是 ... 跳到猪身上了。参见下面的论文:

https://mbio.asm.org/content/3/5/e00201-12
Although the pandemic influenza viruses of 1957, 1968, and 2009 are all descended, via different pathways, from the 1918 virus, only the 2009 pandemic virus expresses an antigenically similar hemagglutinin (HA) (11). All influenza A viruses (IAV), including the 1918 virus, possess a segmented single-stranded RNA genome and can evolve by the accumulation of selected mutations (“antigenic drift”) or through the exchange of gene segments by reassortment with other influenza viruses (“antigenic shift”). Sequencing the 1918 virus provided the basis for the subsequent understanding that the key 2009 virus HA gene, after having apparently been transmitted from humans to pigs in or about 1918, had been maintained in pigs over the past 90 years or so as a separate lineage from the 1918 human pandemic H1N1 virus (11), a lineage that has long been recognized as the “classical” swine H1N1 influenza virus. When the 2009 pandemic virus emerged in humans with a swine H1 HA gene descended from, and still closely related antigenically to, the 1918 pandemic virus, extensive cross-protection between the 2009 and 1918 pandemic viruses was demonstrated in experimental animals (12–16). Interestingly, 1918 virus-specific B cell clones could also still be recovered from very elderly survivors 90 years after their exposure to that virus but before their exposure to the 2009 pandemic virus (17).
Fascinating. 九十年后杀个回马枪,好传奇的感觉。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

幻儿
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 幻儿 » 2020-07-24 11:11

RadioLab最近有一期讲1918大流感的,很有意思!推荐!叫Dispatches from 1918.
其中也说到这个H1N1一直没死,继续以各种方式流传。最后还请了Dr. Fauci问他会不会新冠也如此。欲知详情,请自己去听,哈哈。
https://www.npr.org/podcasts/452538884/radiolab

唐唐的郁金香
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 唐唐的郁金香 » 2020-07-24 11:37

推荐Spillover: Animal Infections and the Next Human Pandemic by David Quammen,专讲各种从动物跳到人类的疾病,相当好看。按照1918年流感的标准,covid-19还算不上the NBO (Next Big One) :worthy:
Ultimately, happiness comes down to choosing between the discomfort of becoming aware of your mental afflictions and the discomfort of being ruled by them. -- Yongey Mingyur Rinpoche

vivi
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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-07-24 12:29

我发现好几本自传体的书都是这个路数,Angela’s Ashes, Glass Castle, Hillbilly Elegy, Educated, 极度不靠谱的父母(mental illness)和杂草一样坚强生长的孩子。

我打错了,是328.2M in 2019.
又没头脑又不高兴

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-24 14:15

幻儿 wrote:
2020-07-24 11:11
RadioLab最近有一期讲1918大流感的,很有意思!推荐!叫Dispatches from 1918.
其中也说到这个H1N1一直没死,继续以各种方式流传。最后还请了Dr. Fauci问他会不会新冠也如此。欲知详情,请自己去听,哈哈。
https://www.npr.org/podcasts/452538884/radiolab
谢谢推荐,RadioLab 很有趣的。

---------

有兴趣学习或复习免疫学的同学们可以看看油管上的小课堂,我随手就找到一段(差点写一支)入门动画:
Immune and Adaptive Immunity Explained

如果看完了还不过瘾可以看看更详细的课堂,例如下面一个画图狂的讲课(需要一定理论基础):
Adaptive Immunity

还有这一课也蛮重要的,即一个人(或哺乳动物)体内的 B cell receptors (也就是戳在细胞膜中间的抗体)可以认出各种各样的外来 antigens,只要不是自己“人”(细胞或碎片)就都能拼积木般认出,并触发免疫反应。打个比方,虽然此生从未打过照面,我却早已准备好了与你相逢的那一天。大学免疫课内容大部分都还给老师了,就这段印象最深。
Antibody (BCR) and TCR Diversity
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-25 7:52

一直在追本州感染数据的人越来越感到疑惑不解,NoVA 地区的感染数量从六月九日到七月25日都没有显著增长,而 NoVA 之外的农村最近一直狂涨,这是为什么呢?是不是试剂盒短缺带来的 delay 效应呢?城市什么时候会被农村带过去呢?

去看了下纽约市的数据,很类似,从六月初到现在完全没有第二波的迹象。

我又开始怀疑 herd immunity 了,也许之前说的70%免疫是不对的,也许不需要这么高的比例,毕竟这个数据是从其它类型的流行病推算的,但是这个病毒也许有性质差异,也或许无症状感染被极大低估了(抗体抽查也测不准)。I don't think we understand this at all.
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-07-25 11:31

谢谢推荐,动画很好看易懂,小绿跟着津津有味的看了两遍还接着youtube 底下其它推荐的免疫系统小动画,现在假装抗体冲过来黏在我们身上(所以我们是病菌?)
我很希望群体免疫是真的,但也许至少时间问题?西班牙和法国都有第二波高峰的迹象,我很怒的想你们开夜总会干什么?不过年轻人们都憋坏了吧,还有那么多英国德国年轻游客就是去疯狂派对的
Nevertheless, she persisted.

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-27 15:31

今天 NoVA 的感染数据上去了,所以可以肯定大部分原因是检验结果太慢了,前两个星期被 delay 了。

而我自己的检验结果一星期后还没出!诊所今天打电话去 Quest Diagnostics 去问了也没用。啧啧,这速度,还隔离个P啊。考虑到家里的另一个人和两只喵都毫无症状,让我不付出代价就轻松获得抗病免疫力的希望也是十分的渺茫 ...

难怪 CDC 最近把解除隔离的标准从两次检验阴性改成了症状消失后十天自动解除隔离。检验个毛啊,还两次!等到结果出来黄花菜都凉了。

Pfizer/BioNTech 和 Moderna 都开始做三期临床了,现在。我看到说巴尔的摩就有 study site.
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-07-28 3:21

那他们怎么筛出已经得过病不能参加试验的人?你去报个名没准还快点。
Nevertheless, she persisted.

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-07-28 6:53

https://www.broadinstitute.org/blog/sur ... o-reported

"Between April 9th and June 9th, 2020, the Broad Institute’s COVID-19 diagnostic laboratory worked in partnership with the Massachusetts Department of Public Health to test 32,299 residents and staff from 366 skilled nursing facilities, nursing homes, and assisted living facilities across the state, regardless of whether these individuals showed any symptoms.

In addition to forming a critical part of the state’s effort to combat the spread of disease among vulnerable populations, this effort generated a large dataset worth exploring — nearly 33,000 tests, all processed at a single lab using the same standards, connected to data about the presence of symptoms and demographics.

We are sharing our initial findings in a preprint study, which has not yet been peer-reviewed. We see two key takeaways:

First, surveillance testing (regular testing of asymptomatic people) can effectively detect potential outbreaks among individuals without symptoms, especially in vulnerable populations. Even among nursing home residents at high risk of severe disease, we found that the majority of patients harboring SARS-CoV-2 had no symptoms at the time they tested positive. This underscores the importance of active surveillance and the limitations of symptom-based screening alone.

Second, the viral load distributions among those with and without symptoms at the time of testing are similar. This raises the possibility that the risk of transmission may also be similar, regardless of symptoms — underscoring the importance of regular surveillance tests, especially for at-risk populations. (Important note: Although this study looked at viral load, we did not directly study how infectious any of these individuals are, nor did we distinguish viable from non-viable virus.)

In the nursing homes we tested, approximately 12 percent of residents and nearly four percent of staff showed no symptoms but nevertheless tested positive. Without surveillance testing, they might have continued to move normally among these vulnerable groups — even though their viral loads were the same as the patients and staff who reported symptoms.

WHAT WE DID
At the Broad Institute Clinical Research Sequencing Platform, we extract RNA from nasopharyngeal swabs and look for the presence of SARS-CoV-2 using reverse-transcriptase polymerase chain reaction (rRT-PCR). Our high-throughput facility runs 24 hours a day and typically can return results to the ordering physician within 24 hours.

For this study, we performed a retrospective analysis comparing nasopharyngeal viral loads (as measured by RT-PCR cycle threshold (Ct) levels) in residents and staff with or without symptoms. We examined viral load, as indicated by Ct values, in different cohorts and by reported symptomatology.

For each person tested, the facility reported symptoms at the time samples were collected, as well as basic demographic information to facilitate reporting to the MA Department of Public Health. For people who reported symptoms, we do not know exactly what the symptoms were, only that they were symptomatic.

WHAT WE FOUND
We found that 12.6 percent of nursing home residents and 3.7 percent of nursing home staff who did not report symptoms tested positive for SARS-CoV-2, compared to 53.7 percent of symptomatic residents and 17.7 percent of symptomatic staff. Of the individuals who tested positive, 71.1 percent of residents and 92.7 percent of staff did not have symptoms at the time of testing.

We also found that viral loads among infected people varied by as much as 250 million-fold, but the distribution of viral load was similar between the populations with and without symptoms at the time of testing. Because we tested so many people, we were able to find statistically significant differences in some comparisons. But in all of the sub-categories of people examined (age, race, ethnicity, gender, resident/staff), there was no substantial difference in viral load distributions between people with symptoms and those without.
一个人的性格决定他的命运。

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-28 7:30

Of the individuals who tested positive, 71.1 percent of residents and 92.7 percent of staff did not have symptoms at the time of testing.
这个结果分不开 asymptomatic 和 presymptomatic 的人。但是根据之前别的研究,PCR positive 但是无症状的人,大部分一直也没啥症状。所以可以推测大部分 ... 大概 ... 真的不会发出来 ... 吧?

另一个 CDC 在加州 LTC 做的 surveillance 也是发现40%的人 PCR positive 但是没症状。注意40%大概是最低限度,因为 PCR 也只能赶上一定程度的 active shedding,但如果是两三个星期之前的无症状感染,这时去测 PCR 也查不出,所以实际上无症状比例更高,再说这还是在 LTC 里面,都是些有基础症的老年人。

https://wwwnc.cdc.gov/eid/article/26/10/20-2694_article

我觉得这种情况下就不要做什么根除 SARS-CoV-2 的梦了,那么多无症状传播是不可能根除的,它已经打败了人类了。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-07-28 7:36

Jun wrote:
2020-07-28 7:30
Of the individuals who tested positive, 71.1 percent of residents and 92.7 percent of staff did not have symptoms at the time of testing.
这个结果分不开 asymptomatic 和 presymptomatic 的人。但是根据之前别的研究,PCR positive 但是无症状的人,大部分一直也没啥症状。所以可以推测大部分 ... 大概 ... 真的不会发出来 ... 吧?

另一个 CDC 在加州 LTC 做的 surveillance 也是发现40%的人 PCR positive 但是没症状。注意40%大概是最低限度,因为 PCR 也只能赶上一定程度的 active shedding,但如果是两三个星期之前的无症状感染,这时去测 PCR 也查不出,所以实际上无症状比例更高。

https://wwwnc.cdc.gov/eid/article/26/10/20-2694_article

我觉得这种情况下就不要做什么根除 SARS-CoV-2 的梦了,那么多无症状传播是不可能根除的,它已经打败了人类了。
嗯, 感觉就中国能根除,其他的地方都没戏了。
学校可以开学了,各种室内室外活动都可以搞起来了,我已经被家里的两神兽搞的奄奄一息了。 现在州里又说要“先”推迟两周秋季开学。。。
一个人的性格决定他的命运。

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-28 7:56

可以考虑投资给研究治疗药的公司,尤其是 immune modulators 那种药 ... 估计以后的关注点就是治疗而不是预防了。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-07-28 8:13

Jun wrote:
2020-07-28 7:56
可以考虑投资给研究治疗药的公司,尤其是 immune modulators 那种药 ... 估计以后的关注点就是治疗而不是预防了。
治疗药好多公司都在投入,各种各样的,immune modulators 我个人不是很看好,不过最近发现很多I/O 的抗体药在做这方面的新用途研究 (有几个是中国公司的抗体,直接在美国做临床,无他,中国已经很难招募到病人了),但是要知道抗癌的话,延长点生存期就好了, 抗新冠, 需要治愈或者非常有效的逆转,估计难。
小分子的抗病毒药不少在研, 热钱很多,很多是private owned 小公司, 都是大的基金和corporate investor 在砸钱,所以Merck 虽然下场晚,我觉得他们整个strategy 是对的, 就是Jun 说的,这个病毒已经打败人类,跟我们长期共存了。。。
一个人的性格决定他的命运。

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-28 8:16

lucoco wrote:
2020-07-28 8:13
小分子的抗病毒药不少在研, 热钱很多,很多是private owned 小公司, 都是大的基金和corporate investor 在砸钱,
不知道有多少在搞 angiotensin receptor blockers。理论上好像很有希望似的 ... :gromit_thought:
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-07-28 8:41

所以以后每年打疫苗就来针二合一(新冠/流感)就可以了嘛? :mrgreen:
Nevertheless, she persisted.

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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-07-28 13:04

全世界等一个疫苗的日子。。。
又没头脑又不高兴

Elysees
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Elysees » 2020-07-28 13:10

Jun wrote:
2020-07-27 15:31

而我自己的检验结果一星期后还没出!诊所今天打电话去 Quest Diagnostics 去问了也没用。啧啧,这速度,还隔离个P啊。考虑到家里的另一个人和两只喵都毫无症状,让我不付出代价就轻松获得抗病免疫力的希望也是十分的渺茫 ...

我又有问题,美国这个检测盒跟中国的有什么不同么?为什么需要那么长的时间,中国现在是城市如果有相当病例就全市开始检验,成千上万的人几天就测完了(这个是不是过激另外讨论哈),为什么北美的反而会慢这么多。
我很久不看数字了,因为感觉数字已经没有什么实际意义,并没有下降的趋势。刚刚查了一下,加州佛州都超过了纽约州的数字,看起来现在有海滩的州还是更危险。我在加州的朋友说,还不如疫情一开始做第一呢,那时人们还更警惕,现在大家都不愿意待在家里了,即使是第一也没人在意。

以及,Jun居然也养猫了!!!都几岁了啊?
我自横刀向天笑,笑完我就去睡觉。

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-28 13:28

Elysees wrote:
2020-07-28 13:10
我又有问题,美国这个检测盒跟中国的有什么不同么?为什么需要那么长的时间,中国现在是城市如果有相当病例就全市开始检验,成千上万的人几天就测完了(这个是不是过激另外讨论哈),为什么北美的反而会慢这么多。
这边也是成千上万地测啊,过去几天 Virginia 每天报的检验数都是一万到两万个 PCR tests,除了周末报得少点。这是因为需要检测的人数实在太多了,VA算好的,FL 和 CA 需要检验的人更多。实际上上周二我去本县 drive-through 的时候,并没有排队。

今天早上接到电话了,不出所料是 negative。所以还是不能放纵自己到处乱跑。
以及,Jun居然也养猫了!!!都几岁了啊?
一直都在养啊。家属本来就养喵,原先的两只寿终正寝后(第一只灰猫是肾衰竭,不知算不算寿终正寝),我们又领养了两只,芒果和美姬,现在已经七岁和十一岁了。有空发张照片上来。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Elysees
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Elysees » 2020-07-29 15:51

7岁和11岁可都算高龄了吧,想想小踢如果到了那岁数,我们家儿子们都已经离家了。
今天看到新闻说美国有二十几个州沙门氏菌爆发,其中就有维州,我立即想到了Jun。
最近这段时间我惯例每天用酒精喷雾清理家里,一边喷一边想,这样好么?以前宁宝过敏很厉害的时候我读过的一些文献就说,人应该能与一定程度的细菌病毒共存,大量使用消毒液杀菌液其实对免疫系统并没有好处,反而会让免疫系统变得脆弱。我以前很少用肥皂洗手,除非真的很脏,现在一天用肥皂洗七八次。安宁出去玩经常也是水洗洗手冲掉灰尘就开始吃东西。这次过后,人们恐怕会变本加厉的对周边和自己消毒杀菌,长远来说,恐怕,只会让免疫更脆弱吧。
我自横刀向天笑,笑完我就去睡觉。

tiffany
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Re: 2019 Novel Coronavirus 医学信息链接

Post by tiffany » 2020-07-29 17:38

这个,也不至于吧,毕竟咱们在人间世行走,碰到无数多致病因素。目前似乎也没有因为外源致病因素减少而导致整体免疫系统蜕化的报道。
有酒有酒 闲饮东窗

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Re: 2019 Novel Coronavirus 医学信息链接

Post by 笑嘻嘻 » 2020-07-29 17:39

啊!我从小喜欢洗手,手上有点油渍的感觉就要洗手,做饭拿了生肉,洗!然后把刚刚放了生肉解冻的盘子放进洗碗机,再洗一次。历来天天用肥皂洗手不止7、8次。好像听起来怪有毛病似的。不过现在也并没有增加次数。
云浆未饮结成冰

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-30 7:21

Elysees wrote:
2020-07-29 15:51
最近这段时间我惯例每天用酒精喷雾清理家里,一边喷一边想,这样好么?以前宁宝过敏很厉害的时候我读过的一些文献就说,人应该能与一定程度的细菌病毒共存,大量使用消毒液杀菌液其实对免疫系统并没有好处,反而会让免疫系统变得脆弱。我以前很少用肥皂洗手,除非真的很脏,现在一天用肥皂洗七八次。安宁出去玩经常也是水洗洗手冲掉灰尘就开始吃东西。这次过后,人们恐怕会变本加厉的对周边和自己消毒杀菌,长远来说,恐怕,只会让免疫更脆弱吧。
小E这个问题很好,可惜我没有很好的答案给你。

免疫学内部这些年有个理论越来越上涨,但是到现在尚未得到彻底的证实,就是 The Hygiene Hypothesis. (如果全面证实就改成 The Hygiene Theory 了。)我只能说我认识的免疫学家表示,多半是真的 ...

https://en.wikipedia.org/wiki/Hygiene_hypothesis
In medicine, the hygiene hypothesis states that early childhood exposure to particular microorganisms (such as the gut flora and helminth parasites) protects against allergic diseases by contributing to the development of the immune system.[1][2] In particular, a lack of exposure is thought to lead to defects in the establishment of immune tolerance.[1] The time period for exposure begins in utero and ends at school age.[3]
一个例子是环境越干净的国家,自免疫病发病率越高,例如全国都很干净的芬兰就是一型糖尿病和celiac disease的高发区。

原因是什么呢?现在的理论是儿童早期如果没有接触到大量的外来病原体的话,免疫系统会相对“糊涂”,分不清“我”和“它”的差别,从攻击外来物种很容易就演变为攻击自己的器官。当然这是最简单粗暴的解释,而免疫系统跟神经系统一样,从来就不存在简单这回事。这个现象也不是少洗手就能改过来的。

另外有一个跟 autoimmune disease 不相关的事情是人体的表面一直有各种各样的健康细菌存在,这个表面也包括肠道和阴道。这些健康细菌能通过生存竞争把有害细菌给挤掉。所以过度使用广谱抗菌素和杀菌的肥皂有可能伤害到这些细菌群,人工选择抗药性强的危险细菌类。在家里没事儿不用老用 antibacterial 肥皂洗手。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

dropby
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Re: 2019 Novel Coronavirus 医学信息链接

Post by dropby » 2020-07-30 12:17

懒妈大汗地说,懒也有懒的好处,哈哈哈。欢乐小时候我就连奶瓶都是几个月才扔进开水锅煮一煮的,衣服都是和我们的一起洗。我家从来就没买过任何灭菌清洁剂。

唐唐的郁金香
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 唐唐的郁金香 » 2020-07-30 14:41

所以“不干不净,吃了不得病” :mrgreen: 。实际上我有轻度洁癖,特别是在厨房和厕所。不过,我从来都只用普通肥皂洗手。

常常户外运动,登山、野泳,做农活当园丁,养宠物,都有好处。
Ultimately, happiness comes down to choosing between the discomfort of becoming aware of your mental afflictions and the discomfort of being ruled by them. -- Yongey Mingyur Rinpoche

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-30 21:52

就算这个理论是真的,也只适用于小时候的 exposure,大一点就没用了。有过研究表明在农村长大的小孩子患自免疫病的几率比较低。但是, exposure 的另一面是被感染的风险,所以也很难说孰好孰坏。

人生在世60%-70%是基因决定,20%-30%是运气决定,剩下0-10%大概 ... 是个人奋斗? :-P
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

笑嘻嘻
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 笑嘻嘻 » 2020-07-30 23:24

我小学的时候学校组织看宣传片,主要内容是饭前便后要洗手。农场的传染病,寄生虫很多可以被洗手解决。不需要消毒洗手液,就普通洗手。
云浆未饮结成冰

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-07-31 3:14

农村卫生条件不好,孩子们免疫系统有点不太那啥的早就挂了。。。等不及长大得免疫系统疾病。
Nevertheless, she persisted.

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-31 4:56

关于寄生虫,有个理论认为现在急速增长的 allergies 的原因是本来对付寄生虫的免疫系统因为接触不到病原体而糊涂了。貌似跟 eosinophils 和 IgE 有关,但是我很不了解,在学校里根本都没教寄生虫感染。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-07-31 6:59

美国政府又给Sanofi /GSK下了个大单。英国政府也下单了。Sanofi的疫苗技术好像跟牛津疫苗的基因矩阵和moderna 的 mRNA都不一样?谁给科普一下?
美国的新感染人数总算停止攀升了
Last edited by Knowing on 2020-07-31 12:05, edited 1 time in total.
Nevertheless, she persisted.

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-07-31 8:03

好像他们还没公布疫苗技术。可能还在筛选中。不过 Sanofi 的疫苗技术很成熟。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

tiffany
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Re: 2019 Novel Coronavirus 医学信息链接

Post by tiffany » 2020-07-31 8:44

Knowing wrote:
2020-07-31 6:59
美国政府又给Sanofi /GSK下了个大单。英国政府也下单了。Sanofi的疫苗技术好像跟牛津疫苗的基因矩阵和moderna 的MRNA都不一样?谁给科普一下?
美国的新感染人数总算停止攀升了
mRNA
有酒有酒 闲饮东窗

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-07-31 9:14

tiffany wrote:
2020-07-31 8:44
Knowing wrote:
2020-07-31 6:59
美国政府又给Sanofi /GSK下了个大单。英国政府也下单了。Sanofi的疫苗技术好像跟牛津疫苗的基因矩阵和moderna 的MRNA都不一样?谁给科普一下?
美国的新感染人数总算停止攀升了
mRNA
好像不是mRNA? 我哪里看到是protein subunit, make senses to me...
"PARIS and LONDON – July 29, 2020 – Sanofi and GSK have reached an agreement, subject to final contract, with the UK government for the supply of up to 60 million doses of a COVID-19 vaccine. The vaccine candidate, developed by Sanofi in partnership with GSK, is based on the recombinant protein-based technology used by Sanofi to produce an influenza vaccine, and GSK’s established pandemic adjuvant technology."

mRNA 现在有报道的是Moderna, BioNTech/pfizer, CureVac. 中国有两三家。
protein based 的 GSK/Sanofi 这款是新闻,一直没听他们有动静,一下子来了个大的。不过技术平台很成熟, 能够guarantee delivery at commerical scale.
对了, 强生 的AAV based vaccine 刚刚公布了动物数据非常好,也上了临床。 业界比较看好, 他们的优势也会在大规模量产上。
一个人的性格决定他的命运。

tiffany
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Re: 2019 Novel Coronavirus 医学信息链接

Post by tiffany » 2020-07-31 10:19

:mrgreen: :mrgreen: 不是,小K写 MRNA,我 OCD 发作,一定要改成 mRNA :mrgreen: :mrgreen:
有酒有酒 闲饮东窗

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-07-31 11:10

tiffany wrote:
2020-07-31 10:19
:mrgreen: :mrgreen: 不是,小K写 MRNA,我 OCD 发作,一定要改成 mRNA :mrgreen: :mrgreen:
:super:
一个人的性格决定他的命运。

豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-07-31 15:03

MRNA 是股票代码。 你俩都是OCD。
却将万字平戎策 换得东家种树书

vivi
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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-07-31 15:23

要是有一个所有在研发的疫苗和药物总结就好了。
又没头脑又不高兴

tiffany
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Re: 2019 Novel Coronavirus 医学信息链接

Post by tiffany » 2020-07-31 16:26

疫苗有,我给你翻翻
有酒有酒 闲饮东窗

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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-07-31 21:13

tiffany wrote:
2020-07-31 16:26
疫苗有,我给你翻翻
:rabbit001:

我有一个小白问题。我知道几个research都说HCQ对新冠没用,但是有人说那是因为你没加Zing。这个Zing有啥作用?是对新冠有特效吗?
又没头脑又不高兴

豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-07-31 21:43

zinc 锌
却将万字平戎策 换得东家种树书

vivi
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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-07-31 21:58

哦 对,打错了。 :oops:
又没头脑又不高兴

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