Monday, December 28, 2020

Hay que parar la transmision lo antes posible para evitar que aprezcan mas mutaciones

  Hay que parar la transmision lo antes posible para evitar que aprezcan mas mutaciones

Los virus mutan, hay mas de 4000 variantes detectadas, la mejor forma de parar esto es evitar el contagio! Sean responsables y cuídense (usen tapaboca, mantengan distancia, respeten, coman sano, mediten, bailen, sonrían, ayuden, aprendan cosas nuevas, hagan ejercicio...) somos una gota en el océano, pero se necesita solo una gota para rebalsar un vaso lleno!




Thursday, September 10, 2020

What happened to the AstraZeneca/Oxford COVID vaccine?

In the middle of the pandemic turmoil and a lot of pressure from the government and financial lobbies, AstraZeneca followed the clinical trial guidelines and paused their COVID vaccine AZD1222 trial. This phase III trial aimed to enroll up to 50,000 participants globally.

They had reported numerous low to mild adverse events during the first phases of the study, such as headaches and fever, however in this case a severe adverse event was a red flag that put the enterprise on hold. The latest information indicates that one female UK volunteer in the phase III trial suffered from transverse myelitis. Transverse myelitis is an inflammation of the spinal cord that damages the insulating material covering nerves (called myelin), interrupting the communication within the body. Some symptoms include pain, muscle weakness, paralysis, sensory problems, bladder and bowel dysfunction. Infections and immune system disorders that attack the body's tissues can cause myelitis. The woman who suffered transverse myelitis seems to be recovering and was reported that will be leaving the hospital.

However, this unexplained illness triggered a standard review process, leading to the voluntary pause of vaccination across all trials to allow an independent committee to review the safety data of this event in the UK Phase III trial.

The important thing to remember is that clinical trials take years to complete as they need to be done int the right way in order to produce safe and effective treatments, and that is not the end of it, because the treatment/therapy also has to be approved by each regional regulatory entity and this process is long and exhaustive.

In fact, there is at least a 50% failure rate for every phase of a trial, and only 13.8% of phase I clinical trials get approved.

Constant monitoring of clinical trials is a routine activity and it is a good signal that only one adverse event was picked up fast and the reaction was proper.

One of the reasons is that pharma companies know that vaccines that people can't trust are not worthy as you need people to actually get the vaccine, so having the public trust is essential.

Even if this vaccine doesn't prove to be safe and/or effective, almost 200 other candidates, with diverse modes of action are eager to jump to the leading candidate role that AZD1222 was holding so far.

Multiple pharma companies signed an agreement to honor the clinical trial process and don't "rush the science" to ensure the development of safe and effective vaccines.

To learn more about the AZD1222 vaccines click here




References

https://www.statnews.com/2020/09/09/astrazeneca-covid19-vaccine-trial-hold-patient-report/


https://www.fiercebiotech.com/biotech/astrazeneca-s-covid-19-vaccine-hold-sparks-reassessment-race?mkt_tok=eyJpIjoiTkdGbU9EVTRNbUptWVROaiIsInQiOiIrVkc4QlNEdFwvNFl4VFlvamtaXC9WT1JBTzU1ZkU4Y2ZwbWszUEtoZm9SSUh1bnVPQ1wvRWRFZE5mbm5hcVppY21uZ1c0RkpcLzRBenRCNkhzek5taHQ4UktybEdvNkozbkxTUHVxWDFuaUkrU2JZSFk2NjBubXNpTGRLWGlKUUZSMU4ifQ%3D%3D&mrkid=644691

Tuesday, July 21, 2020

What you need to know about the promising Oxford-AstraZeneca COVID-19 vaccine

I would like to share here the positive results from one of the promising SARS-COVID-2 vaccines labelled AZD1222, and explain more about the clinical trial process.

Currently, more than 140 vaccines for COVID-19 are in pre-clinical and clinical development, which means that they are being tested in non-human subjects (cells, mice, rats, ferrets, rhesus macaques, etc). 10 vaccines are being tested in humans for safety and dosages (this means in healthy subjects), 8 vaccines are in phase II, which involves testing the safety in expanded studies. Only 3 vaccines are starting phase III, meaning large scale efficacy tests. In this phase, the vaccine is tested in thousands of people separating the volunteers in 2 groups: one will receive the actual vaccine and the other - the placebo one to determine if the vaccine protects against the coronavirus. The last step can be a phase IV trial with an even bigger and diverse group of volunteers and a review of the results by the local regulatory entity which will evaluate if the vaccine is approved or not for use in that region. Notice that each country has its own regulatory organization and some medicines are approved for use in the USA but not in Europe. Fortunately, there are a lot of different types of vaccines and you CAN NOT put them all in the same bag!

These vaccines use a different type of virus that wouldn’t affect humans in a negative way (called a vector) to deliver coronavirus genes into cells and trigger an immune response.

The British-Swedish company AstraZeneca and the University of Oxford are working on a viral vector vaccine using a chimpanzee adenovirus that will expose the coronavirus’ S protein on its surface in order to trigger an immune system response in the people that will be vaccinated. The vaccine is in Phase II/III trial in the UK and Phase III trials in Brazil and South Africa, and it might be ready by 2021. “AstraZeneca” claimed their total manufacturing capacity stands at two billion doses. This vaccine uses a different type of virus that wouldn’t affect humans in a negative way (called a vector) to deliver coronavirus genes into cells and trigger an immune response.  

They reported last Monday the "encouraging" results from the trial that included 1,077 participants from 18 to 55 years old (who had not previously tested positive for the coronavirus). The participant's gender was fairly well distributed, but they were mostly white. The study was single-blind, meaning patients did not know whether they received the coronavirus vaccine or the control (a meningitis vaccine).

They reported that around 70% of the participants suffered adverse events such as pain, feeling feverish, chills, muscle ache, headache, and malaise, which were reduced by the use of paracetamol, and there were no serious adverse events related to the vaccine. The T-cell immune responses peaked on day 14 and the antibody response rose by day 28. Neutralising antibody responses against SARS-CoV-2 were detected in 91% of participants. After a second vaccine application, called boost, this number rose to 100%. After a booster dose, all participants had neutralising activity. 

Just a friendly reminder: we should be grateful for the existence of vaccines that have helped prevent the spread of terrible diseases, such as tuberculosis and polio. Both brought huge suffering in multiple countries around the world and were controlled thanks to the implementation of vaccines! 

 I encourage you to check on the links below and learn more about the different vaccines and the research behind them. Be aware of your own cognitive bias, for example, stop citing the inexistent connection between autism and vaccines, that research has now been thoroughly debunked, the Lancet journal issued a retraction on Wakefield’s paper, and he lost his medical licence.

Let me leave you with this great advice from the WHO about how to respond to vaccine deniers:

“Vaccine-preventable diseases can be very severe, and still cause millions of deaths per year around the world. Even with the best available care in the world, vaccine-preventable diseases can cause permanent disability and even death. Prevention is by far the best intervention.”

 “There are no equally safe and effective alternatives to vaccinations.”

 “The scientific evidence is clear: vaccination is the most effective health intervention for prevention of many serious diseases.”

 “We as an institution/agency are aiming to sustain the health of every individual member of the public. We are sorry that you have lost trust in our effort, but we hope to regain it.”

 “The scientific evidence is clear; vaccination is a safe way to prevent many serious diseases. Any theoretical risk to the individual and society is far outweighed by the risks to one and all of not doing so.“

 

 

References:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31604-4/fulltext

https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html

https://www.statnews.com/2020/03/11/researchers-rush-to-start-moderna-coronavirus-vaccine-trial-without-usual-animal-testing/

https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker

https://www.youtube.com/watch?v=-dYWZMx-Lfs

https://www.who.int/immunization/sage/meetings/2016/october/8_Best-practice-guidance-respond-vocal-vaccine-deniers-public.pdf


Thursday, July 9, 2020

The good news about WFH: your long commute was killing you slowly...

How is your long commute killing you slowly?

 Legend says that Greek messenger Pheidippidies run 42.195 km (26.219 miles) from Marathon to Athens to report the victory over Persia in the Battle of Marathon, and then suddenly died. Since those times, circa 490 BC, the commute to work has changed a lot, it might look as it has improved from that tragic myth, however more and more research is pointing out that the modern long commute is indeed killing us. If you live in a big city, probably you commute around 30 min to 1 hour each way to work every day, if you are lucky you walk or bike, if not you have to suffer horrendous traffic, or crowded and unreliable public transportation, and all this stress affects your health.

Knott and collaborators, from the University of Cambridge, analyzed the “mental wellbeing” of 5.474 British commuters, aged 40-75, with a follow-up of 4,65 years. They reported that depression-asymptomatic commuters who transitioned from inactive to active commuting reported less severe depression symptoms than those who remained inactive, and a similar relationship was evident among commuters with pre-existing symptoms. Moreover, longer commutes were associated with worse depressive symptoms. “Shifting from exclusive car use towards more active commuting may help prevent and attenuate depressive symptoms in working adults”. (1)

 

Another study done in the UK by Flint and collaborators showed that individuals who transitioned from car commuting to active or public transportation had a decrease in body mass index (BMI) of -0.30 kg/m2, contrariwise, individuals who transitioned from active commuting to car had a BMI increase of 0.32 kg/m2. The take-home message is that increased levels of physical activity as part of the commute to work could reduce obesity among middle-aged adults. (2) Already in 2013, Laverty and collaborators reported that, in the UK, using public transport, walking, or cycling to work was associated with a lower likelihood of being overweight. Walking or cycling was associated with a lower likelihood of having diabetes, and walking was associated with a lower likelihood of having hypertension than private transport. (3)

In the USA, one out of every six commuters travels more than 45 min each way every weekday, and this long voyage makes people lonelier (4). Back in 2009, as part of the Gallup-Healthways Well-Being Index study, 173,581 employed adults were interviewed by the phone, and they reported that one in three employees with a commute of more than 90 minutes have had a neck or back condition that has caused recurrent pain; among those with commutes of 10 minutes or less, the figure drops to roughly one in four. Longer commuters are more likely to say they have been diagnosed with high cholesterol and are more likely to have a BMI that classifies them as obese. Their results point to a connection between commuting and emotional well-being. Among employees who take more than 90 minutes getting from home to work, 40% experienced worry for much of the previous day, significantly higher than the 28% among those with negligible commutes of 10 minutes or less. Conversely, workers with extremely long commutes were less likely to have experienced enjoyment for much of the previous day or that they felt well rested that day. (5) Behavioral economists Kahneman and Krueger tracked the emotional states of women in Texas during their daily activities and they found that respondents' ratio of positive to negative emotions was particularly low during the time spent commuting.

In Sweden, using longitudinal individual data from 1985 to 2008, Sandow and collaborators, modeled mortality through propensity score matching and Kaplan–Meyer estimates of survival among long-distance commuters, more than 50 km (31 miles) one way. The results indicate that women who have experienced long-distance commuting face a significantly higher mortality risk compared with women with short commutes to work. This seems to be driven by variations in income and education: for women with long-distance commuting experience, substantially lower survival rates are found among those with low education and low income. Surprisingly, for men mortality risks do not seem to be associated with long-distance commuting. Sandow findings suggest that men and women are subject to different mechanisms regarding the nexus between commuting and mortality. (6) In another study by Dr. Sandow in Sweden they stated the alarming connection of commuting and divorce rates: if one spouse commutes longer than 45 minutes that couple is 40% more likely to get divorced (7).

 

 

One solution is to work from home, as Tim Ferris, the author of the four hours work week, showed working from home can improve your productivity and increase efficiency by, for starters, not wasting time traveling. I used to work at a company where we were allowed to 20% of remote work time and this really improved the work life. More companies are adding this successful work practice because it enhances the employees’ happiness. The WHO set a minimum of 10.000 steps per day to keep your heart healthy, you can reach this goal by walking to work some days. If you can’t change the type and duration of your commute, you can always make it more productive, reading, playing a game or listening to an audio book or music that will make it “me time”.

 

 

 

 

 

References:

 

1- Knott CS, Panter J, Foley L, Ogilvie D. Changes in the mode of travel to work and the severity of depressive symptoms: a longitudinal analysis of UK Biobank. Prev Med. 2018 Mar 28;112:61-69. doi: 10.1016/j.ypmed.2018.03.018.

2- Flint E, Webb E, Cummins S. Change in commute mode and body-mass index: prospective, longitudinal evidence from UK Biobank. Lancet Public Health. 2016 Dec;1(2):e46-e55. doi: 10.1016/S2468-2667(16)30006-8.

3. Laverty AA, Mindell JS, Webb EA, Millett C. Active travel to work and cardiovascular risk factors in the United Kingdom. Am J Prev Med. 2013;45:282–288.

4 -https://www.newyorker.com/magazine/2007/04/16/

5-http://news.gallup.com/poll/142142/wellbeing-lower-among-workers-long-commutes.aspx

6- Sandow, Erika; Westerlund, Olle; Lindgren, Urban

Is your commute killing you?: On the mortality risks of long-distance commuting

Environment and planning A, Pion 2014, Vol. 46, (6) : 1496-1516

7-Erika Sandow. Volume: 51 issue: 3, page(s): 526-543 2014

https://doi.org/10.1177/0042098013498280

Wednesday, July 8, 2020

How can you boost your immune system? With super vitamin D

Surely you have heard about how important vitamin D is for the correct function of your body is. But do you know why and how much you should get per day or how to improve the intake? And the recently reported connection with Coronavirus infection outcomes?

Vitamin D is important to keep functional healthy muscles and bones (it has a role in the regulation of the calcium and phosphate balance), it also supports the production of antimicrobial peptides in the respiratory tract, reducing negative outcomes from viral or bacterial infections. Additionally, vitamin D helps to reduce the inflammatory response to infection with SARS-CoV-2. Vitamin D interacts with angiotensin-converting enzyme 2 (ACE2), which is the receptor in the human cells that interacts with SARS-CoV-2 and allows its entry into the cell. While SARS-CoV-2 downregulates the expression of ACE2, vitamin D promotes the expression of this gene.

For respiratory tract infections (like the type that coronaviruses cause), it has been reported vitamin D supplementation protected against acute respiratory tract infections and that patients with very low serum 25-hydroxyvitamin D concentrations (a marker of vitamin D status) gained the most benefit. These results were published in a meta-analysis done with data from 25 clinical trials, including 11.321 participants. 

A recent article published in The Lancet analyzed how the relative vitamin D status can influence COVID-19 outcomes. The study emphasizes the importance of Vitamin D supplementation for older people as they are at high risk of poor outcomes from COVID-19 and of vitamin D deficiency. In a cross-sectional analysis across Europe, COVID-19 mortality was associated with vitamin D status in different populations, in addition to very strong circumstantial evidence that highlights this connection. Some countries seem to be exceptions to this “correspondence”: Spain, Italy and the Nordic countries.

Vitamin D deficiency is common worldwide. In the US, more than 42% of the population is vitamin D deficient, and this rate rises to 82% in black people and 70% in Hispanics. One of the concerns is that the main source of Vitamin D is the exposure to the sun, which is reduced in wintertime and even more in some regions and vitamin D intake can be reduced in people with darker skin pigmentation and/or medical conditions. Dr. Holick, an eminence in Vitamin D research, recommends 10 minutes of sun exposure per day without sunscreen follow with sunscreen application because you do not want to increase your risk of getting skin cancer (melanoma). I strongly recommend you to watch the lecture “The D-Lightful Vitamin D for Health” by Michael F. Holick. The best source of Vitamin D is sunlight with 10.000 to 20.000 IU (international units) of Vitamin D being produced in 30 minutes with whole-body exposure to sunlight, and the “excess” is stored in your fat. The good news is that you will never produce too much, the bad news is that you can take too much vitamin D if you take an overdose of supplements and this can cause serious intoxication. Some foods high in vitamin D include salmon, tuna fish, sardines, mackerel, trout, mushrooms, eggs, cod and fortified milk, cereals and juice. The Endocrinology practice guidelines recommend different Vitamin D daily intakes depending on your age group:

0-1 years old 400-1000 IU

1-18 years old 600-1000 IU

Over 18 years old 1500-2000 IU

 Importantly, if you are obese you will need 2 to 3 times more! Now, you had probably run to your vitamin cabinet and checked the label in the supplement bottle, and it might say “Vitamin D 5 ug” (micrograms), meaning only 200 IU… side note, the recommendation in the US is 400-800 IU per day.

 

The professional advice is to measure your vitamin D blood levels and consult a doctor about the best way to get and maintain the optimal level of Vitamin D.

 


References

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30183-2/fulltext

https://tilda.tcd.ie/

https://www.youtube.com/watch?v=-zK8LgVx2G8

https://www.youtube.com/watch?v=EP81YMvs4yI


Thursday, July 2, 2020

Why learning about vaccines is important? more than just to make an educated decision… it saves lives!

Understanding the role of vaccines is important, hence this question really resonates with me. First of all, because it can save your life and the life of friends and family. Let me put in my personal hero words: “Vaccines are one of humanity’s most incredible accomplishments and they’ve saved millions of lives,” John Oliver (see the link to his show below).

Secondly, your understanding will allow you to make an educated decision about which type of vaccines you may get, for example, if you are allergic to eggs you should get the flu vaccine that has been produced in mammalian cells (cell culture-based) instead of the one produced in chicken eggs, and you would communicate this to your care provider.

I could continue explaining why having different types of vaccines and knowing more about their modus operandi is a fantastic idea; however here, I would like to explain some thoughts on why some people might think the opposite. Once upon a time (28 February 1998), there was a doctor called Andrew Wakefield, and 12 other medical doctors; they published in a prestigious scientific journal The Lancet, an article entitled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children”. In the article, they reported a study of 12 children with gastrointestinal disease and regressive developmental disorder. They claimed to have identified an associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated with possible environmental triggers. Their conclusions drew an association between the MMR (measles, mumps, and rubella) vaccine and autism. The article was retracted on 2 February 2010, in part, thanks to the fantastic work of the journalist Brian Deer, who discovered research fraud, unethical treatment of children, and Wakefield’s conflict of interest through his involvement with a lawsuit against the manufacturers of MMR vaccine. Other concerns about the study came from the parents of children involved in the study: one claimed that part of the data in the paper was not true, another parent claimed that “the data clearly appeared to be distorted”. Some subjects appeared to be “cherry-picked” to participate in the study, for instance, a boy who lived 5000 miles from the hospital had been flown to London and admitted to Wakefield’s project. Furthermore, there were multiple discrepancies (inconsistent data between the article and the actual medical records). For example, only one of the patients had “regressive autism” although the existence of this condition and the gastrointestinal disease was the bedrock of Wakefield’s allegations. Some conditions that were suffered by the children were also suffered by siblings that were not included in the study. There was another key issue: there were no controls (for example unvaccinated children) as this was just a case report, a big red flag in any medical study!

 

The study claimed that all 12 children were previously normal, but five had documented pre-existing developmental concerns. In the article, some children were reported to have experienced first behavioural symptoms within days of MMR, but medical records documented these as starting some months after vaccination. In nine cases, unremarkable histopathology results were changed, after a medical school’s “research review”, to “non-specific colitis”. The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations, all giving time to onset of problems in months, helped to create the appearance of a 14-day temporal link. Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation.

Why would Wakefield commit such terrible fraud and put people's lives at risk? It is thought to be for MONEY. He was recruited to support a now failed lawsuit against vaccine manufacturers and was paid £435,643 for being part of the lawsuit. BTW, after the fraud was uncovered Wakefield’s medical license has revoked.

On the other hand, multiple studies since then have shown that there is NO link between mental illnesses and vaccination. In 2002, a Danish study provided strong evidence against the hypothesis that MMR vaccination causes autism. They studied 537,303 children that had received the MMR vaccine. They reported no association between the age at the time of vaccination, the time since vaccination, nor the date of vaccination and the development of the autistic spectrum disorder (ASD). More recently in 2019, given the risks of a disease outbreak that the anti-vaxxer movements generated in the general population, the research team investigated another 657,461 children born in Denmark, comparing MMR-vaccinated with MMR-unvaccinated children. This study yielded a fully adjusted autism hazard ratio of 0.93, meaning no association between MMR vaccination and autism. In addition, no increased risk for autism after MMR vaccination was consistently observed in subgroups of children defined according to sibling history of autism, autism risk factors, other childhood vaccinations, or during specified periods after vaccination.

Since then there has been a call from researchers around the world to stop “wasting” time and resources trying to find a link between vaccines and autism, because these resources could be used to investigate other diseases and find treatments for them.

Despite claims of many unfounded vaccine damages, vaccines may have a protective effect from unintended diseases. In adults, a study including 4,000 people over age 65 found that people with previous exposure to vaccines for diphtheria, tetanus, polio, and the flu had a decreased risk for Alzheimer's disease. Another study in nearly 12,000 people with chronic kidney disease found that flu-vaccinated people had a 30-40% lower risk of dementia than the unvaccinated control, and showed that people who got their flu shots more regularly had a greater benefit in lowering their risk for dementia. There has been also no evidence that getting the flu shot worsens cognitive decline in people with Alzheimer's disease. However, individuals with dementia who contract the flu are at 1.5-time increased risk for flu-related mortality. These studies suggest that getting an annual flu shot may be one factor in maintaining a healthy lifestyle associated with promoting lifelong brain health.

It is heart-breaking to witness the antivax movement evolve in the last few years and take innocent victims due to misinformation and fraudulent conspiracy theories. Please help to educate everybody about vaccination programs and the important role that each member of the society plays in the wellbeing of the whole community. We are in this together, and only united we can defeat infectious diseases.

For more information about the development of anti COVID-2 vaccines:

https://sciencetechreviews.blogspot.com/2020/06/why-vaccines-are-important-and.html

 

 


 

  

References:

Vaccines: Last Week Tonight with John Oliver: https://www.youtube.com/watch?v=7VG_s2PCH_c

https://www.acpjournals.org/doi/10.7326/M18-2101

https://www.nejm.org/doi/10.1056/NEJMoa021134?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov

https://www.bmj.com/content/342/bmj.c7452

https://www.bmj.com/content/342/bmj.c5347

https://www.thetimes.co.uk/article/mmr-doctor-given-legal-aid-thousands-00ftl80msbs



Saturday, June 27, 2020

Why vaccines are important? And especially for COVID-19!

I would prefer to be writing about the fantastic ways to improve and boost your immune system backed up by scientific evidence, but I can’t because I feel the duty to explain the importance of “vaccines education”. 

First, let me clarify that there are a lot of different types of vaccines and you CAN NOT put them all in the same bag! I will explain 5 of the most promising SARS-COVID-2 vaccines further below. 

Second, a bit of a history lesson: we should be grateful for the existence of vaccines that have helped prevent the spread of terrible diseases, such as tuberculosis and polio. Both brought huge suffering in multiple countries around the world and were controlled thanks to the implementation of vaccines! 

Third, look at the current situation when people refuse to vaccinate: we have an outbreak that puts others in danger. “Why?”, you ask. Because viruses need a host or reservoir to continue existing and non-vaccinated people can be that reservoir. Therefore, don’t do to others what you don’t want done to you: to infect you with a disease!

Currently, more than 125 vaccines for COVID-19 are in pre-clinical development, which means that they are being tested in non-human subjects (cells, mice, rats, ferrets, rhesus macaques, etc). 10 vaccines are being tested in humans for safety and dosages (this means in healthy subjects), 8 vaccines are in phase II, which involves testing the safety in expanded studies. Only 3 vaccines are starting phase III, meaning large scale efficacy tests. In this phase, the vaccine is tested in thousands of people separating the volunteers in 2 groups: one will receive the actual vaccine and the other - the placebo one to determine if the vaccine protects against the coronavirus. The last step can be a phase IV trial with an even bigger and diverse group of volunteers and a review of the results by the local regulatory entity which will evaluate if the vaccine is approved or not for use in that region. Notice that each country has its own regulatory organization and some medicines are approved for use in the USA but not in Europe.

Types of vaccines:

Attenuated or inactivated virus vaccine

These vaccines use a weakened or inactivated version of the coronavirus to trigger an immune response. The Chinese companies “Sinopharm” and “Sinovac” are starting to test their attenuated and inactivated vaccines for phase III internationally.  “CoronaVac”, the Sinovac’ vaccine, has shown promising results in Phase I/II of the trials: 743 volunteers reported no severe adverse effects and produced an immune response. Sinovac is building a facility to manufacture up to 100 million doses annually.

Attenuated bacteria vaccine

This vaccine contains live bacteria that have been weakened or attenuated. One such vaccine is the Bacillus Calmette-Guerin (BCG) vaccine which was developed in the early 1900s as a protection against tuberculosis.

After a study reported a relationship between Covid-19 outcomes and the BCG vaccination status, a Research Institute in Australia started conducting a Phase III trial, and several other trials are underway to understand if this vaccine partly protects against the coronavirus.

Viral Vector Vaccines

These vaccines use a different type of virus that wouldn’t affect humans in a negative way (called a vector) to deliver coronavirus genes into cells and trigger an immune response.

The British-Swedish company “AstraZeneca” and the University of Oxford are working on a viral vector vaccine using a chimpanzee adenovirus that will expose the coronavirus’ S protein on its surface in order to trigger an immune system response in the people that will be vaccinated. The vaccine is in Phase II/III trial in the UK and Phase III trials in Brazil and South Africa, and it might be ready by 2021. “AstraZeneca” claimed their total manufacturing capacity stands at two billion doses.

Vaccines with viral genomic material

These vaccines use one or more of the coronavirus’ own genes to trigger an immune response. USA based company “Moderna” uses the viral messenger RNA to produce only the viral proteins in the cells that will trigger an immune response. The company tested this vaccine in 8 volunteers with positive results, and they are moving to phase III in July. The trial was dosing volunteers in Phase I with 3 different amounts of mRNA species, and after testing the immunogenicity (whether or not these doses produce antibodies) they reported that by day 15 after the first injection, the volunteers generated antibodies.

The German company “BioNTech” is collaborating with “Pfizer” and “Fosun Pharma” to develop their mRNA vaccine. They started the Phase I trial in May, “Pfizer” hopes to have a few million doses for emergency use in 2021 if all goes well in the trials.

Another interesting one, the Imperial College London is collaborating with “Morningside Ventures” to develop a “self-amplifying” RNA vaccine, which boosts the production of a viral protein that stimulates the immune system, and they began Phase I/II trials in June.

 

Protein-Based Vaccines

These vaccines use a coronavirus protein or a protein fragment to trigger an immune response.

One such vaccine is worked on by the USA company “Novavax” which started a Phase I/II trial on a vaccine made up of particles carrying fragments of coronavirus proteins.

 

The list goes on and I encourage you to check on the links below and learn more about the different vaccines and the research behind them. Be aware of your own cognitive bias, for example, stop citing the inexistent connection between autism and vaccines, that research has now been thoroughly debunked, the Lancet journal issued a retraction on Wakefield’s paper, and he lost his medical licence.

Let me leave you with this great advice from the WHO about how to respond to vaccine deniers:

“Vaccine-preventable diseases can be very severe, and still cause millions of deaths per year around the world. Even with the best available care in the world, vaccine-preventable diseases can cause permanent disability and even death. Prevention is by far the best intervention.”

 “There are no equally safe and effective alternatives to vaccinations.”

 “The scientific evidence is clear: vaccination is the most effective health intervention for prevention of many serious diseases.”

 “We as an institution/agency are aiming to sustain the health of every individual member of the public. We are sorry that you have lost trust in our effort, but we hope to regain it.”

 “The scientific evidence is clear; vaccination is a safe way to prevent many serious diseases. Any theoretical risk to the individual and society is far outweighed by the risks to one and all of not doing so.“

 

References:

https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html

https://www.statnews.com/2020/03/11/researchers-rush-to-start-moderna-coronavirus-vaccine-trial-without-usual-animal-testing/

https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker

https://www.youtube.com/watch?v=-dYWZMx-Lfs

https://www.who.int/immunization/sage/meetings/2016/october/8_Best-practice-guidance-respond-vocal-vaccine-deniers-public.pdf



Tuesday, April 28, 2020

Ways to boost your immune system

Boosting your immune system is a great strategy in general, but especially during a pandemic. I have been researching a lot about real options to properly activate the immune system, in a way that does not over-activate it, hint to all my allergic pals suffering the spring haze fever!
In this quest for healthy protocols, I found forest bathing. Back in 2007, a group of American and Japanese scientists studied the effect of forest bathing on the human immune system. Particularly they measured some cells involved in the protection of the body, such as natural killers (NK); measuring the number of NK cells, and perforin, granzymes and granulysin-expression in peripheral blood lymphocytes (PBL) during a visit to forest fields. The study involved 12 healthy male adults who experienced a three-day/two-night trip and walks in three different forest fields. As a control, they took the same measurements on a working day without visiting any forest. Almost all the subjects (11/12) showed higher NK activity after the trip (about 50% increased) compared with before. The forest bathing significantly increased the numbers of NK, perforin, granulysin, and granzymes AlB-expressing cells. They concluded that their findings indicate that a forest bathing trip can increase NK activity and that this effect is at least partially mediated by increasing the number of NK cells and by the induction of intracellular anti-cancer proteins.
Moreover, they followed up with an investigation of how long the increased NK activity lasts and compared the effect of a forest bathing trip on NK activity with a trip to places in a city without forests. Blood and urine were sampled from the 12 subjects that participate in the study and also phytoncide concentrations in forest and city air were measured. They reported that: “the forest bathing trip significantly increased NK activity and the numbers of NK, perforin, granulysin, and granzyme AlB-expressing cells and significantly decreased the concentration of adrenaline in the urine. The increased NK activity lasted for more than 7 days after the trip. In contrast, a city tourist visit did not increase NK activity, numbers of NK cells, nor the expression of selected intracellular anti-cancer proteins, and did not decrease the concentration of adrenaline in the urine. Phytoncides, such as alpha-pinene and beta-pinene were detected in the forest air, but almost not in the city air. These findings indicate that a forest bathing trip increased NK activity, the number of NK cells, and levels of intracellular anti-cancer proteins, and that this effect lasted at least 7~ays after the trip. Phytoncides released from trees and decreased stress hormone may partially contribute to the increased NK activity.”
In 2009 they investigated the effect of essential oils from trees on human immune function in twelve healthy male subjects, who stayed at an urban hotel for 3 nights. Aromatic volatile substances (phytoncides) were produced by vaporizing Chamaecyparis obtusa (hinoki cypress) stem oil with a humidifier in the hotel room during the night stay. Blood samples were taken on the last day and urine samples were analysed every day during the stay. NK activity, the percentages of NK and T cells, and granulysin, perforin, granzyme AlB-expressing lymphocytes in blood, and the concentrations of adrenaline and noradrenaline in urine were measured. Similar control measurements were made before the stay on a normal working day. The concentrations of phytoncides in the hotel room air were measured. Phytoncide exposure significantly increased NK activity and the percentages of NK, perforin, granulysin, and granzyme AlB-expressing cells, and significantly decreased the percentage of T cells, and the concentrations of adrenaline and noradrenaline in urine. Phytoncides, such as a-pinene and ~-pinene, were detected in the hotel room air. These findings indicated that phytoncide exposure and decreased stress hormone levels may partially contribute to increased NK activity.
These results are very encouraging, but the reduced number of participants puts a question mark on the results. Fortunately, there are no known adverse events (besides the allergies that I mentioned before) for a nice stroll in a park or forest, so why not just go for a walk and take a deep breath hoping that will boost our immune system, or at least that the placebo effect will do the job!

References:



Bluebells in London

Friday, April 17, 2020

14 Facts That Will Make You More Aware About COVID-19

by Jesica Levingston Mac Leod, PhD.

After reading and listening to a lot of COVID-19' hoaxes that friends have shared with me over the last few weeks, which broke my little virologist heart, I realized that it is not their fault believing fake information, but ours, as scientists for not correctly educating the public on this topics. Therefore, I hope this post helps to clarify and to educate the public about COVID-19.
First, let me tell you what a virus is, and what it is not... They are not bacteria, they are obligate intracellular parasites, as they need to infect a cell to reproduce. A virus requires the cellular machinery in order to reproduce, therefore, if you leave a viral particle isolated it won't multiply, and at some point depending on the type of membrane that covers/protects the genetic material, it will "die". Viruses are made of genetic material (in this case RNA ribonucleic acid), lipids (a type of fats that helps to keep the membrane structure) and proteins, some binding the RNA, protecting it, some for replication and regulation of the hosts' immune system and some in the viral membrane. The viral particles are quite sensitive to the environment, soap can destabilize/destroy the external membrane of the virus and therefore "kill it". I use quotation marks because there is a huge philosophical dilemma about calling viruses "living entities" or not and if you can kill them but destroying their structure. Contrary, bacteria can reproduce by themselves as they have the whole machinery to function independently of eucaryotic cells (human cells are eukaryotic cells) and have a way more sophisticated metabolism than the viruses

1-Can kids catch COVID-19?
Yes, people of all ages can be infected by COVID-19. A Chinese retrospective study showed that COVID-19 occurred in children, causing moderate-to-severe respiratory illness.

2-What do we know about the COVID-19 structure?
The whole virus has been sequenced, given that scientists have worked 24/7 to get this done, so we have the Wuhan seafood market pneumonia virus isolate Wuhan-Hu-1 complete genome is now available to compare with other viruses and follow up on anti-viral research. Similar viruses, members of the coronavirus family have been studied by virologists since approx 1970s.

3-What can you do to avoid being infected by COVID-19?
Limit interaction with other people, avoid crowded places and gatherings.
wash your hands, at least 20 seconds of old school soap and water washing are enough, hand sanitizer is good too, just be aware that it contains alcohol that can dry the skin
Avoid touching your face, yes the virus can enter through holes other than your mouth and/or nose
- Use a mask if you are sick or taking care of a sick person (mostly for the placebo effect)
- If you have a deficit of vitamins, a multivitamin pill might help (again mostly for the placebo effect)
Clean and disinfect regularly touched objects and surfaces using your regular cleaning products to reduce the risk of passing the infection on to other people.
- Be kind and have compassion: treat others as you would like to be treated, and take care of yourself as you would for a person you love.

4-What are the symptoms?

This is a tricky one because of the wide spectrum of symptoms recorded so far... most of the patients start with cold-like symptoms (fever, dry cough and difficulty breathing) and then it goes to a more intense phase of joint and muscle pain, sore throat, sneezing, congestion, and even pneumonia. The virus infects the lower respiratory tract and causes severe pneumonia (approx 10% of cases) and mortality in 3-5% of cases, mainly among the elderly and/or people affected by other diseases. One article that analyzed thousands of patients' records, reported that the main clinical symptoms of COVID-19 patients were fever (88.5%), cough (68.6%), myalgia or fatigue (35.8%), expectoration (28.2%), dyspnea (21.9%). Minor symptoms include headache or dizziness: (12.1%) diarrhea (4.8%), nausea, and vomiting (3.9%).

5-What does testing mean?
The main test consists of detecting the viral genetic material using a very sensitive technique called reverse transcription-polymerase chain reaction (RT-PCR). They will take a nasal and/or mouth swap to collect some fluid that is then sent to the laboratory and it takes approx. 4 h to get a result. An Argentinian group developed a faster test based on CRISPR, it takes only 60 min to get a result, but it still under development.

6-How long does COVID survive on surfaces?
According to the latest research, still under review. it depends on the surface: the viable virus was detected up to three hours in the air, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.

7-How long is the incubation period?
Guess what? it depends on your immune system and viral charge you got... generally around 4-6 days. A review of the Chinese clinical data reported an average incubation period of COVID‐19 is around 6.4 days, ranges from 0‐24 days. So travel restrictions to and from high-risk areas and/or 14 days quarantine of travelers coming from high-risk areas are recommended to prevent possible importation of COVID-19. This is why it is so important to stay home even if you don't have symptoms, at least for 14 days after you were in contact with a COVID-19 patient.

8-Is there a vaccine?
Not yet, and other vaccines don't work because the COVID-19 proteins won't be recognised by the antibodies that your body generated based on previous vaccines. The development of a safe and approved vaccine will take at least 2 more years.

9-Is there a treatment?
There are no specific treatments to date, but again, it depends on the severity of the symptoms and if by the "treatment" you mean just keeping the patient hydrated... Overall, no, there are no antivirals available yet and no, a big NO to antibiotic usage as they do not work, they only work for bacteria, and as we stated before viruses are not bacteria. Some vitamins, like Vitamin A have been shown to be important to maintain a healthy immune system in animal models, BTW, the Asian population has a general deficit of Vitamin A due to their diet. Importantly, you can get these vitamins from fruits and vegetables, and it seems they only work if you have a constant intake before you get infected.
Several drugs such as chloroquine, arbidol, remdesivir, and favipiravir are currently undergoing clinical studies to test their efficacy and safety in the treatment of COVID-19 in China.

10-Can you take ibuprofen?
The consensus is yes, you can. Some false claims were published in social media about ibuprofen. However, until we have more information about the effects of non-steroidal anti-inflammatory (NSAIDs), like ibuprofen, some authorities recommend taking paracetamol to deal with fever and pain. Paracetamol must be taken strictly according to the recommended dose because too much of it can damage the liver. If you are already taking ibuprofen or another  (NSAID) on the advice of a doctor, do not stop taking it without checking first.
https://sciencetechreviews.blogspot.com/2020/03/should-you-take-ibuprofen-if-you-have_18.html

11-How to boost your immune system for real?
A healthy lifestyle!
Sleep at least 7 h every night
Eat healthy (a plant-based low-calorie diet is ideal... but you know, life is too short eat dessert first)
- Exercise (from a walk to HIIT or dancing, get your heart rate up)
Drink plenty of water (the 2 liters per day is under debate, but aim for 1.5 liters at least)
Avoid stress, I know easy to say difficult to do. Breathing exercises and meditation can help.
- Be aware that viruses and bacteria are everywhere, including inside of you, and not all are bad.

12-Can you be re-infected?
We don't know. Probably not, based on previous knowledge on coronaviruses behavior, if the virus doesn't increase its mutation rate. There is one report of a potential re-infection in China and another one in Japan.

13- What wouldn't work?

Probiotics intake during the infection, they showed very low activity.
Vitamin C intake during the infection, it is not a shield!
The 10 secs breathing test, is not a real thing!
Ensuring your mouth and throat are moist and humidity myth... eh, nope. Although drinking water is always recommended, this claim is false. While staying hydrated by drinking water is important for overall health, it does not prevent coronavirus infection.
- Gargling with salt and won't work, because the highest viral load was found in nasal swabs.
Cold weather and snow CANNOT kill COVID.
- Taking a hot bath does not prevent the COVID infection.
- There is no evidence from the current outbreak that eating garlic has protected people from the new coronavirus. Though, it is a healthy food that may have some antimicrobial properties

- Antibiotics are for bacteria, not viruses!
-So far, it can't be transmitted by cooked food

14-Is COVID-19 airborne?

Initially, COVID-19 was considered not airborne, because it can't be transmitted just by air but it needs large respiratory droplets. However, preliminary research (as it hasn't been peer-reviewed yet) reported the detection of COVID-19 up to 3 hours after aerosolization and can infect cells throughout that time period.

Please be kind and show compassion to others at all times! Big kudos to the scientist, doctors, nurses, and volunteers working 24/7 to treat patients, produce vaccines, tests, and treatments ASAP. Please help the ones in need and in risk groups during the lockdown. To paraphrase Brandon Sanderson: "the original plan for this article was to be short. It ends up being quite long. Ah well. That just happens sometimes. (Particularly when you are me)"

If you have any questions please post them in the comments and I will try to answer them ASAP.
Some ideas about what do to at home: read (you can get free books from the library, amazon, google and other websites), take an online course, learn a new language, cook, play board games and/or video games, workout, call your friends and family, meditate, try an online tour...




An electron microscope image of a coronavirus. Photograph: AP

Thanks Dr. Ilse Daehn for the edits.

Recommended links:
https://youtu.be/E3URhJx0NSw
https://sciencetechreviews.blogspot.com/2018/04/chasing-one-drug-to-rule-them-all.html
https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Avril, Tom. “Coronavirus has shut down schools and events. Here’s why that helps, short- and long-term.” Philadelphia Inquirer. 8 Mar 2020.

“Coronavirus COVID-19 Global Cases.” Center for Systems Science and Engineering, Johns Hopkins University. Accessed 27 Jan 2020.

“Coronavirus disease 2019 (COVID-19) | Situation Report – 51.” World Health Organization. 11 Mar 2020.

Johnson, Krys. Assistant professor of epidemiology and biostatistics, Temple University. Email to FactCheck.org. 12 Mar 2020.

“Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19).” World Health Organization. 20 Feb 2020.

“Steps to Prevent Illness.” U.S. Centers for Disease Control and Prevention. Accessed 12 Mar 2020.

Weinberg, Abigail. “There’s a Facebook Coronavirus Post Going Viral Claiming to be From Stanford. Don’t Believe It.” Mother Jones. 11 Mar 2020.

“WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020.” World Health Organization. 11 Mar 2020.
“WHO Director-General’s opening remarks at the Mission briefing on COVID-19 – 12 March 2020.” World Health Organization. 12 Mar 2020.
World Health Organization Western Pacific (@WHOWPRO). “Q: Does drinking water alleviates a sore throat, does this also protect against 2019-nCoV infection? A: While staying hydrated by drinking water is important for overall health, it does not prevent coronavirus infection.” http://bit.ly/COVID19Mythbusters… #COVID19 #KnowtheFacts.” Twitter. 26 Feb 2020.