Re: 2019 Novel Coronavirus 医学信息链接
Posted: 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。
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。
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 。在这种时期随便得个啥病都是很恐怖的事情。
Fascinating. 九十年后杀个回马枪,好传奇的感觉。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).
谢谢推荐,RadioLab 很有趣的。幻儿 wrote: ↑2020-07-24 11:11RadioLab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
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?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.
嗯, 感觉就中国能根除,其他的地方都没戏了。Jun wrote: ↑2020-07-28 7:30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?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.
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。
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。
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。
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。以及,Jun居然也养猫了!!!都几岁了啊?
小E这个问题很好,可惜我没有很好的答案给你。
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。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]
好像不是mRNA? 我哪里看到是protein subunit, make senses to me...