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And the CDC said that is an undercount. They believe people are testing positive at home and not reporting.

I have proof that what I had a month ago was COVID, but I don't show up in the statistics because I didn't take a test. I didn't think I had it until I started reading that Omicron doesn't affect the chest very often and the most common symptom is headache and fever, which is all I had until my mouth broke out in canker sores. So my case doesn't show up in any case counts, though if somebody is tracking how many people test positive for antibodies, I probably show up there.

Plus people testing negative multiple times before finally testing positive, how many people get a false negative and just accept it because of mild symptoms? One example, girlfriend gets sick, has multiple negative quick tests plus a negative PCR but finally gets a positive PCR test:


I've read that Omicron starts in the throat and can sit there for a couple of days before being detectable in the nose.
 
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Well thanks to the internet archive (wayback machine) the thread the one person complained about and one moderator deleted (even though 40 or so people voted), did get archived very early during the voting period. We lost the final votes (I think I left the poll open for two or three weeks after the archive date). I don't understand why one complaint can derail dozens of peoples participation but that's TMC moderation for you.

Hopefully the cat won't come in this thread and complain to get it deleted also.


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847,921 - 354,316 = 493,605 for 2021 so the next to highest bracket was the correct answer.
 
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Right. and so isn’t it funny that someone asks about early treatment that is lacking in the US treatment protocols. hilarious 🤣🤣
Your several post on this are confusing. There are 1000s of people in dozens of countries working on the coronavirus from every angle (antiviral treatments [ala. Paxlovid, etc], variations of monoclonal antibody treatment, antiviral oral pills, etc, etc.). If there were legitimate early treatments that were scientifically proven to be true with a very high rate of success every country would know and the gov bodies and scientific communities in each would have documented them.
 
Right. and so isn’t it funny that someone asks about early treatment that is lacking in the US treatment protocols. hilarious 🤣🤣
It definitely makes sense to get treated early as I said, it is well known in the US that that is appropriate. The best early treatment is vaccination and boosting, however. Unless you are immunocompromised or very frail you have very little to worry about in that case. Unpleasant? Maybe.

I definitely don’t plan to get it if I can avoid it.

Funny: I just thought the idea that we don’t have early treatment regimens in the US is a little funny. Doctors are doing their best for their patients in the US and the best protocol is very well researched, and research continues every day. I don’t understand the idea that somehow there is a miraculous protocol out there we are missing. I am certain there are early treatments that would be better - but no one knows about them, and I mean worldwide.
 
It definitely makes sense to get treated early as I said, it is well known in the US that that is appropriate. The best early treatment is vaccination and boosting, however. Unless you are immunocompromised or very frail you have very little to worry about in that case. Unpleasant? Maybe.

I definitely don’t plan to get it if I can avoid it.

Funny: I just thought the idea that we don’t have early treatment regimens in the US is a little funny. Doctors are doing their best for their patients in the US and the best protocol is very well researched, and research continues every day. I don’t understand the idea that somehow there is a miraculous protocol out there we are missing. I am certain there are early treatments that would be better - but no one knows about them, and I mean worldwide.
Let’s distinguish three things:

1. Prophylaxis
2. Early out-patient at home treatment
3. hospitalized in-patient treatment

For #1, of course, vaccination with booster is the best prophylaxis, as well as masks etc.

And for #3 there is good research and evolving treatment for hospitalized in-patient people with already serious symptoms.

but #2, early treatment, that is, therapies indicated merely based on a positive test and mild symptoms (and especially risk factors), but BEFORE serious symptoms and BEFORE you are admitted to the hospital seems limited in the US, but not in other countries as given in the example above.

In the US as an out-patient it seems that at best you only get monoclonal antibodies and only if your symptoms have already gotten bad and even then your area may not have them or they may be rationed for the well-deserving smokers and other high risk people already showing serious symptoms.

The anecdote above re the treatment in India and what has also been reported in other countries, is much more liberal treatment of out patient people early in the disease stage and before hospitalization.

This document does seem to be the closest thing to a US version of the India protocol document with lots of suggestions for early treatment, but unfortunatey, notwithstanding the hundreds of footnotes in the document, it is written by the docotors of the type on the Rogan show.
So going deep into the footnotes and related pubmed searches would be necessary to see where they might have something good to offer. But I just wish there could be more authoritative version of something like this for early and home treatment that could put a dent in the rising hospital admissions if those people got something helpful earlier in the disease stage.

 
And the CDC said that is an undercount. They believe people are testing positive at home and not reporting.

I don't think there is any question there is a huge undercount. I have 3 family members that tested positive last week on home rapid tests and I can't imagine they reported it to anyone aside from their employers. They are just isolating at home with mild symptoms as they are all under 40 and vaccinated. It is unbelievable to me how contagious this variant seems to be.

I am even laying low a bit the next couple weeks which I haven't done for a long time. I am not so much worried about catching it at some point, i just don't want to catch it now when 50 million other people have it at the same time... just on the off chance I needed some kind of care (though I shouldn't with 3 vax shots and a previous infection).
 
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Deltacron may be the newest flavor
There is skepticism of this report among some other researchers who think this may be a false report due to contamination during a lab sequencing run.
 
Deltacron may be the newest flavor
There is skepticism of this report among some other researchers who think this may be a false report due to contamination during a lab sequencing run.

Re: contamination: Threads with various details and references

Source: Vaccine Research & Development person

Source: Virologist
 
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Looks like NIH shares more info than CDC. Annoyingly have to click on a different pages but this is their collection of latest research in a somewhat readable format.


Would be pleased to see others post anything remotely useful on early treatments.
 
Looks like NIH shares more info than CDC. Annoyingly have to click on a different pages but this is their collection of latest research in a somewhat readable format.


Would be pleased to see others post anything remotely useful on early treatments.
Buried on this site is this which is closest thing i’ve found to what I was seeking. I wonder how many providers are doing any of this on an outpatient basis beyond the monoclonal antibody Sotrovimab when they have it available.


Recommendations​

For nonhospitalized patients with mild to moderate COVID-19 who are at high risk of disease progression,7 the Panel recommends using 1 of the following therapeutics (listed in order of preference):

  • Nirmatrelvir 300 mg with ritonavir 100 mg (Paxlovid) orally twice daily for 5 days, initiated as soon as possible and within 5 days of symptom onset in those aged ≥12 years and weighing ≥40 kg (AIIa).
    • Ritonavir-boosted nirmatrelvir (Paxlovid) has significant and complex drug-drug interactions, primarily due to the ritonavir component of the combination.
    • Before prescribing ritonavir-boosted nirmatrelvir (Paxlovid), clinicians should carefully review the patient’s concomitant medications, including over-the-counter medications and herbal supplements, to evaluate potential drug-drug interactions. See the Panel’s statement on the drug-drug interactions for ritonavir-boosted nirmatrelvir (Paxlovid) for details.
  • Sotrovimab 500 mg as a single IV infusion, administered as soon as possible and within 10 days of symptom onset in those aged ≥12 years and weighing ≥40 kg who live in areas with a high prevalence of the Omicron VOC (AIIa).
    • If the Delta VOC still represents a significant proportion of infections in the region and other options are not available or are contraindicated, patients can be offered bamlanivimab plus etesevimab or casirivimab plus imdevimab, with the understanding that this treatment would be ineffective if they are infected with the Omicron VOC.
    • Sotrovimab should be administered in a setting where severe hypersensitivity reactions, such as anaphylaxis, can be managed. Patients should be monitored during the infusion and observed for at least 1 hour after infusion.
  • Remdesivir 200 mg IV on Day 1, followed by remdesivir 100 mg IV daily on Days 2 and 3, initiated as soon as possible and within 7 days of symptom onset in those aged ≥12 years and weighing ≥40 kg (BIIa).
    • Because remdesivir requires IV infusion for 3 consecutive days, there may be logistical constraints to administering remdesivir in many settings.
    • Remdesivir is currently approved by the FDA for use in hospitalized individuals, and outpatient treatment would be an off-label indication.
    • Remdesivir should be administered in a setting where severe hypersensitivity reactions, such as anaphylaxis, can be managed. Patients should be monitored during the infusion and observed for at least 1 hour after infusion.
  • Molnupiravir 800 mg orally twice daily for 5 days, initiated as soon as possible and within 5 days of symptom onset in those aged ≥18 years ONLY when none of the above options can be used (CIIa).
    • The FDA EUA states that molnupiravir is not recommended for use in pregnant patients due to concerns about the instances of fetal toxicity observed during animal studies. However, when other therapies are not available, pregnant people with COVID-19 who are at high risk of progressing to severe disease may reasonably choose molnupiravir therapy after being fully informed of the risks, particularly those who are beyond the time of embryogenesis (i.e., >10 weeks’ gestation). The prescribing clinician should document that a discussion of the risks and benefits occurred and that the patient chose this therapy.
    • There are no data on the use of molnupiravir in patients who have received COVID-19 vaccines, and the risk-to-benefit ratio is likely to be less favorable because of the lower efficacy of this drug.
 
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I wouldn't call that "mild" anymore, even if it takes a lot of cases to get there.

I think the better term to use is “more mild” or “milder.” There’s no evidence that this is a mild disease, and some believe it is more virulent than the original strain (I am not sure - I think it is inherently less virulent than that, but we have very limited data).

It now seems reasonable to me to expect that we will reach an overall total of 1 million COVID deaths in the US, at some point this year.
By April. (Counted deaths…probably pretty close to 1 million already.)

In keeping with all the projections it seems. Just delayed. And it looks like those projections were actually a little optimistic!
 
Buried on this site is this which is closest thing i’ve found to what I was seeking. I wonder how many providers are doing any of this on an outpatient basis beyond the monoclonal antibody Sotrovimab when they have it available.

The only one of these practically currently available (except maybe the last?) is remdesivir which is a three-day IV infusion. And you probably don’t want the last one (not clear it should have been approved)!

These are all extremely well known treatments.

Anyway, this list appears somewhat inconsistent with the type of treatment I thought you were looking for.

Definitely the mAb has to be reserved for patients that are more likely to need it at this point. My understanding is that you’re pretty unlikely to get it due to lack of supply.
 
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Here’s my biggest question right now: what fraction of the susceptible population will get omicron? I ask for my own selfish reasons - I’m looking for herd immunity for me and relatives without having to get omicron. If it blasts through 90% of susceptible I should be good.

A side question is: What fraction of the population can’t get it? I’ve heard quite a few stories of boosted or double vaccinated people definitely exposed who did not get it. Are these people robustly immune for a decent period (in some people little waning occurs), or with repeated exposure could they get it? There’s lack of clarity on this and I’m not sure whether even immunologists really know.
 
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Update from Trevor, regarding the amount of undercounting. He thinks only a modest increase in undercounting (some people think it is 10x the case count but he thinks closer to 4x to 5x) using UK studies as a proxy for the US situation. In the end, it seems like about 5-10% of the US population is currently dealing with an Omicron infection (note this is not a daily number - about 1% of the population is being infected each day). Good times (not a surprise to anyone though, I don't think - everyone saw this coming 5 weeks ago, and chose to take their chances, or not, depending on the person).

I wonder if in future we'll see travel bans? I'm not sure how much value there is in a one-week delay, or whatever it bought us. In some respects it might have been better to get things really rocking before the holidays. Guess it depends on the desired burn-through strategy.

 
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Mildly interesting tweet by a UCSF doc describing the thought process of responding to a family member’s experience with (mild/moderate) Covid in today’s time.

Goes through the treatments & options mentioned just a few posts above, generally nothing is recommended in this case. And suggests adding a tonsil/throat swab to the rapid-test nasal swab (break the rules/instructions on the test!), for those who might be doing rapid tests.

I wonder (in the case of limited rapid tests, and doing tests once a day), whether it's worthwhile using a fresh q-tip to do the swabbing, with a few more drops of liquid, and re-use the prior test kit, just to see if it works. If it tests positive, you know you're positive. If not, you use another test (required; can't use the old test to check negative status). No idea whether that would actually work and how long the lateral flow/antibodies are actually active, and how well the saturated strip would laterally flow. Obviously there is no data on this, but I think for checking for positive results it seems like worth a shot. If it never works, there's really zero cost. (I think there's zero added chance of a false positive.)

Obviously we'd never know if it works if no one tries. Is someone turns a negative test positive then we'd have a crappy method of stretching test supplies.

Even more interesting would just be using multiple tests in parallel with a bunch of people, then after the first "flow," in the case of one positive test, move the positive swab to another card and see whether it can generate a response there. That would suggest at a single sitting you could potentially combine samples. Again, no idea, just pondering ways to try to conserve tests. Obviously you could use multiple swabs and then manually combine the samples to the single test swab (very likely with reduced sensitivity), before using a single test, in a household, for example.
 
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Anyway, this list appears somewhat inconsistent with the type of treatment I thought you were looking for.

So sorry for the confusion. When I said,

#2, early treatment, that is, therapies indicated merely based on a positive test and mild symptoms (and especially risk factors), but BEFORE serious symptoms and BEFORE you are admitted to the hospital

. . . I should have been more clear (at least for those needing certain accommodations) that I meant, what the NIH describes, as

Recommendations For nonhospitalized patients with mild to moderate COVID-19 who are at high risk of disease progression

smh


Meanwhile, for those also interested (whether to save lives and avoid disability, or simply to be amused) by out-patient early treatment recommendations for those with mild symptoms, more info is in the first two columns here and also in a recent update re Molnupiravir that hasn't yet made it into the "Summary Table" chart.

 
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