The biology of coronavirus COVID-19 - including research and treatments

BBC News - Oxford-AstraZeneca vaccine: Bogus reports, accidental finds - the story of the jab
https://www.bbc.co.uk/news/health-55308216

More recent article about the Oxford vaccine. Interesting that they now say it was a difference in techniques in how to measure the concentration that led to the weakened dosing. If I remember correctly initial news reports insinuated it was manufacturing issues at the contract manufacturer.

It's still not very clear to me what happened, but it seems Oxford group believed the doses were double strength, decided to give half a dose on that basis but actually the vaccine was the correct strength meaning patients received a half dose.

Anyone else figure it out?
 
Mij said:
Anyone else figure it out?
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Yes, there were measurement problems as you suggest.

But it's more complicated than that, the doses are not uniform. Some of the "half" doses in the UK isn't much less than some of the "full" doses in Brazil...

Hilda Bastian said:
The doses are measured by the number of altered viral particles they contain, and the developers decided that the standard dose would be 5 x 1010 viral particles. But for many of those arms in the UK trial—as well as everyone who got the vaccine in the Brazilian trial—publicly available trial information shows that the standard dose could be between 3.5 and 6.5 × 1010 viral particles. The lower end of that range isn’t far off from a half-dose.
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Snow Leopard said:
Yes, there were measurement problems as you suggest.

But it's more complicated than that, the doses are not uniform. Some of the "half" doses in the UK isn't much less than some of the "full" doses in Brazil...
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Thanks, but that implies it was just variation in the dosing. The article from BBC implies it was an intentional decision to dose at half strength based on the assumption the concentration was double what was required.
It's still not clear to me.
 
Having been through an early stage trial process myself this all seems very unsurprising. They were in the unusual situation of moving to proof of concept phase II/III within weeks of producing the first samples of vaccine. Uncertainty about exactly what dose level is best supported by your background studies would be very much expected. If there are also uncertainties about assaying for potency all the more so. I jiggled around full and half doses for a few months. Moreover, there isn't any sort of ethical or competence issue since for agents of this sort you normally assume you are reasonably well up on the flat part of the dose response curve so you are not expecting a doubling or halving of dose to make a lot of difference and with vaccines and biologics dose-related toxicity is not generally a big issue.

What I think is of note is that it looks as if there may be a rather weird dose response curve conceivably because a high first dose blocks efficacy of the booster by raising antibodies to the carrier. It may be that this is a fluke. On the other hand it wouldn't be too unexpected to find something like this when finessing dosage for this sort of technology.

I am a bit in two minds about this vaccine. On one hand I suspect it is actually pretty good, and will prevent almost all severe cases, especially if the dose is optimised. On the other hand the data so far are shaky in comparison to the other vaccines. Then again it looks as if it may be much more practical as an option for getting the UK population immunity up enough to terminate the epidemic. Maybe we should have the Oxford vaccine and then have one of the others if travelling abroad at a time when infection is still around worldwide.
 
Snow Leopard said:
Yes, there were measurement problems as you suggest.

But it's more complicated than that, the doses are not uniform. Some of the "half" doses in the UK isn't much less than some of the "full" doses in Brazil...
Click to expand...
Apologies, to quote a former co-worker --- let's look at the big picture here --- how will this affect me!

If the Oxford vaccine doesn't come through then the UK has access to a limited amount of the other 2 (RNA) vaccines:
  • 40 million Pfizer
  • 7 million Moderna
so that's enough to vaccinate 25% of the UK population ----
Grateful if you'd tell me I'm wrong!
 
FMMM1 said:
Apologies, to quote a former co-worker --- let's look at the big picture here --- how will this affect me!

If the Oxford vaccine doesn't come through then the UK has access to a limited amount of the other 2 (RNA) vaccines:
  • 40 million Pfizer
  • 7 million Moderna
so that's enough to vaccinate 25% of the UK population ----
Grateful if you'd tell me I'm wrong!
Click to expand...

We spend a lot of time on this forum asking questions. I think it's only fair to hold everyone to the same standard and not lower the standard just because its a covid vaccine.
Sure the Oxford vaccine should bring a lot of benefit to the UK and more people around the world but that doesn't mean we shouldn't get to the bottom of what happened.
 
Jonathan Edwards said:
Having been through an early stage trial process myself this all seems very unsurprising. They were in the unusual situation of moving to proof of concept phase II/III within weeks of producing the first samples of vaccine. Uncertainty about exactly what dose level is best supported by your background studies would be very much expected. If there are also uncertainties about assaying for potency all the more so.
Click to expand...
I can understand all that. But I don't think that was the issue here.
It seems to me like it was very simple, based on the most recent BBC article :
They measured the potency incorrectly.
They adjusted the dose based on the incorrect potency.

If that was all it was why didn't they just say that.
Instead the PR people got involved with the Science Media Centre and spun a story about manufacturing issues at the contract manufacturer. Which, if true would be a lot worse than the simple explanation above.

From the BBC article "The Oxford team bristle at any suggestion that there was a mistake, error, call it what you will."

I think this is the issue, it seems that to admit to making a mistake is just not done in some hallowed halls of academia/Science.
 
NIHR funds £5.5 million into new research projects to investigate long-term impacts of COVID-19
The NIHR has funded nine new research projects to help us to better manage current and future waves of the COVID-19 pandemic and investigate its long-term impact on society and the health and care system.

The projects, which total £5.5 million in funding, span a wide range of specialties and scientific disciplines and were funded at a rapid pace due to the urgency of the pandemic. Research ranges from digital devices to help improve tracking and tracing in care homes, to remote rehabilitation regimes for patients affected by Long-COVID and tools and support systems to help staff boost their wellbeing and performance during further stages of the pandemic.

Emerging evidence shows that the virus has had long-term impacts on both the physical and mental health of patients and the NHS workforce caring for them and rapid deep-rooted impacts on the services and organisation of the health and social care sector.
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https://www.nihr.ac.uk/news/nihr-fu...vestigate-long-term-impacts-of-covid-19/26390
 
BurnA said:
We spend a lot of time on this forum asking questions. I think it's only fair to hold everyone to the same standard and not lower the standard just because its a covid vaccine.
Sure the Oxford vaccine should bring a lot of benefit to the UK and more people around the world but that doesn't mean we shouldn't get to the bottom of what happened.
Click to expand...

I was not suggesting that we should approve the Oxford vaccine on the basis that we need to vaccinate the population and get back to "normal". I was simply concerned that we only have access to enough Pfizer/Moderna to vaccinate 25 million people (population 100 million ish).

I think @Jonathan Edwards made an excellent point that the Oxford vaccine might wipe out the virus in the UK --- good. However, I noticed that @Snow Leopard has pointed out that Australia only has 1 case of coronavirus so it's not in the same position as the UK etc.
 
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FMMM1 said:
I was not suggesting that we should approve the Oxford vaccine on the basis that we need to vaccinate the population and get back to "normal". I was simply concerned that we only have access to enough Pfizer/Moderna to vaccinate 2 million people (population 100 million ish).
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Actually my issue is not concerned so much about approval, or indeed efficacy, I am just trying to figure out what they did. They don't seem to be forthcoming with information.
 
BurnA said:
Actually my issue is not concerned so much about approval, or indeed efficacy, I am just trying to figure out what they did. They don't seem to be forthcoming with information.
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Good point, that is the key thing i.e. what they did & the results --- but there's commercial interest.
 
Andy said:
NIHR funds £5.5 million into new research projects to investigate long-term impacts of COVID-19

https://www.nihr.ac.uk/news/nihr-fu...vestigate-long-term-impacts-of-covid-19/26390
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The funding appears to include a GET and CBT long covid study:

Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN)

University Hospitals Coventry & Warwickshire NHS Trust

NIHR132046 - £1,191,977

Some COVID-19 patients continue to experience long-term symptoms, even after months of recovery including; shortness of breath, tiredness and anxiety. While ongoing symptoms may be improved upon through a combination of regular exercise and group support; because the NHS is struggling to meet growing demand, an alternative method of support is much needed. Researchers will assess the effectiveness of an eight-week programme which will offer online, home-based physical and mental health support to see if this can help patients while taking additional pressure off the NHS.
 
Andy said:
NIHR funds £5.5 million into new research projects to investigate long-term impacts of COVID-19

https://www.nihr.ac.uk/news/nihr-fu...vestigate-long-term-impacts-of-covid-19/26390
Click to expand...
I don't see a single project relevant to Long Covid here. There are worthy projects, they are just not related to the long-term consequences of COVID19. The ones that are "related" are two rehabilitation programs, the usual FINE/PACE crap. Otherwise it's on stress in health care workers or other things, again nothing to do with long-term impacts of COVID19.

So basically in a LC funding program they do not fund a single LC program. Typical.

Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN) £1,191,977

Work-related stress: the Impact of COVID-19 on Critical Care and Redeployed Nurses (CANDID) £184,567

Protecting older people living in care homes from COVID-19: challenges and solutions to implementing social distancing and isolation £237,058

Lessons from the frontline: The impact of redeployment during Covid-19 on nurse well-being, performance and retention £281,359

CONtact TrAcing in Care homes using digital Technology (CONTACT) - A pragmatic cluster randomised controlled trial, cost-effectiveness evaluation and theory-informed process evaluation £1,552, 387

Procalcitonin: Evaluation of Antibiotic use in COVID-19 Hospitalised patients. (PEACH) £731,858

The Resilience Hubs: An NHS Outreach, Screening and Support Navigation service model to support the mental health needs of key workers affected by the COVID-19 pandemic £474,380

Supported remote rehabilitation post Covid-19: development, deployment and evaluation of a digitally enabled rehabilitation programme £781,964

Prevention and treatment of persisting olfactory dysfunction after COVID-19 infection £34,011​

Do you see any research relevant to Long Covid here? Because I don't. It's basically a funding scheme for pet projects unrelated to LC.
 
Simon M said:
The funding appears to include a GET and CBT long covid study:

Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN)

University Hospitals Coventry & Warwickshire NHS Trust

NIHR132046 - £1,191,977

Some COVID-19 patients continue to experience long-term symptoms, even after months of recovery including; shortness of breath, tiredness and anxiety. While ongoing symptoms may be improved upon through a combination of regular exercise and group support; because the NHS is struggling to meet growing demand, an alternative method of support is much needed. Researchers will assess the effectiveness of an eight-week programme which will offer online, home-based physical and mental health support to see if this can help patients while taking additional pressure off the NHS.
Click to expand...
Yes, discussed in this thread, U.K. trial Rehabilitation exercise and psychological support after Covid 19 infection (REGAIN) Warwick University
 
FMMM1 said:
Apologies, to quote a former co-worker --- let's look at the big picture here --- how will this affect me!

If the Oxford vaccine doesn't come through then the UK has access to a limited amount of the other 2 (RNA) vaccines:
  • 40 million Pfizer
  • 7 million Moderna
so that's enough to vaccinate 25% of the UK population ----
Grateful if you'd tell me I'm wrong!
Click to expand...

Pfizer's COVID-19 vaccine appears to be in slightly less short supply than originally thought.

"Many hospitals have quickly discovered that the vials they were told contained a maximum of five doses actually contain six or in some cases even seven doses. the FDA is telling hospitals to go ahead and use the extra doses if they have them."

https://www.cbsnews.com/news/pfizer-covid-vaccine-vials-more-doses-expected/
 
What exactly is it (or could it be) about this virus that would make it more transmissible? That is, what's the biology?

I suddenly realise that I don't know what makes any virus more transmissible than another.
 
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