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Any ideas on NYC's declining rates of hospitalizations?

By Rin follow Rin   2020 Oct 31, 1:39pm 327 views   7 comments   watch   nsfw   quote   share    


Is there a feasible scientific explanation for the following news? ...

https://gothamist.com/news/despite-rising-covid-cases-ny-hospitalizations-have-yet-spike

Excerpt: "Coronavirus cases have been climbing steadily over the past month in New York, but while local public health leaders are watching carefully, they say so far it’s a good sign that relatively few people are getting sick enough to go to the hospital.
“Same as last week, no real changes,” texted one front-line doctor at Maimonides Medical Center, in Borough Park, which has had one of the highest rates of positive COVID-19 tests in the state and is in Brooklyn’s designated red zone.
Jason Molinet, a spokesman for Northwell Health, the state’s largest hospital network, said they have 113 people hospitalized with COVID-19 across 19 of its hospitals. “Our peak in October was 135, and September we were under 100 the whole time – that’s compared with 3,500 COVID patients at the peak last spring.
Statewide, there are only around 1,000 patients in the hospital, which is fewer than in less populous states, like Wisconsin, Pennsylvania, and Michigan. "


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When one looks at the actual coronavirus itself in PubMed, its mutagenicity appears to be rather high ...

https://pubmed.ncbi.nlm.nih.gov/21593585/

Excerpt: " demonstrate 15- to 20-fold increases in mutation rates, up to 18 times greater than those tolerated for fidelity mutants of other RNA viruses. Thus nsp14-ExoN is essential for replication fidelity, and likely serves either as a direct mediator or regulator of a more complex RNA proofreading machine, a process previously unprecedented in RNA virus biology."

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Ok, so has anyone studied the late winter/early spring 2020 Covid-19 outbreak in NYC and compared it, with the current strain out there in the Big Apple?
What I'm trying to propose goes on the lines of ... is there some herd immunity in New York and the reason why so many new cases in NYC do not have the associated spikes in hospitalizations is that it's a newer strain and that that person already has some prior immunity from the spring incarnation making it less likely for the now, immuno-enchanced patient to go the full monty to being on a respirator in a week or two?

Does anyone know?

Is anyone doing any research on this?

We all know the mass PCR testing is shotgun and thus, lacks the specificity needed to make delineations but I'm hoping some virologists have better assays, at least in the lab, to tell what's going on, on a smaller subset?
1   rocketjoe79   ignore (1)   2020 Oct 31, 2:54pm     ↓ dislike (0)   quote   flag      

It's because Cuomo killed most of the susceptible old folks early on by sending them to nursing homes - where they could infect other at-risk old folks.
2   mell   ignore (6)   2020 Oct 31, 3:38pm     ↓ dislike (0)   quote   flag      

It's likely herd immunity plus adaptation by the virus.
3   Rin   ignore (8)   2020 Oct 31, 3:48pm     ↓ dislike (0)   quote   flag      

mell says
It's likely herd immunity plus adaptation by the virus.


Which would mean that the spring time infection rate did reach some critical mass.

So where are the great virologists and their assays to study this phenomena?

This is quite possibly, the most anti-Manhattan project in modern times. It's like we have no scientists, just shills for corporate BigPharma.

And don't forget the 'I Believe In Science!' crowd!
4   just_passing_through   ignore (7)   2020 Oct 31, 4:28pm     ↓ dislike (0)   quote   flag      

Rin says
We all know the mass PCR testing is shotgun and thus, lacks the specificity needed to make delineations but I'm hoping some virologists have better assays, at least in the lab, to tell what's going on, on a smaller subset?


To get the info you're looking for the tech you'd use is NGS and the specific type of analysis you'd use after sequencing the genome would probably be metagenomics but perhaps RNA Seq or a novel hybrid of both.

PCR can be damn specific though:

https://cancerres.aacrjournals.org/content/75/15_Supplement/5238

They use LNA's and BNA bases which stiffens the oligo backbone allowing differentiation of nearly identical DNA fragments which dissociate and anneal at nearly identical temperatures. They called this ASCC or allele specific cycling conditions.

They were trying to fish out (quite successfully) trans-renal cancer DNA fragments from bladder. People said it couldn't be done. These are like 50-75 base pair fragments often with damage. Also 99.9999 was wild type dna which isn't what they were after. So for instance:

acatgacaGagcaca Wild Type (anneals at 45.2°C)
acatgacaAagcaca Cancer Mutant (anneals at 45.0°C)

So for each cycle you heat up the sample and double strand become single strand only for the cancer version because you never let it get to 45.2. Then as you cool enzymes attached to the single strand and rip copies of the originals. Do that 35 times and you enrich the mutant making it detectable (by ddPCR or NGS)

All of the other 'liquid biopsy' companies use blood not urine and DNA only lasts a few hours in the blood. So they can't quantitate like these folks can. For some reason they found the fragments making it to the bladder were more protected. Pretty amazing group.

It's just a 'right tool for the job/question' sort of thing. Neither is inherently better than the other.

Then there's droplet digital PCR as well.

You may find the answer to your question here:

https://nextstrain.org/sars-cov-2/

I'm off work for the weekend. :D
5   Rin   ignore (8)   2020 Oct 31, 5:33pm     ↓ dislike (0)   quote   flag      

just_adhom_preaching says
So for each cycle you heat up the sample and double strand become single strand only for the cancer version because you never let it get to 45.2.


That's a rather tight temperature spread. I've only heard of one place, MeCour, which does that for analytical labs.
6   just_passing_through   ignore (7)   2020 Oct 31, 10:24pm     ↓ dislike (0)   quote   flag      

I made those number up. Planned to say that but didn't. It's been so long I worked in a lab there's no way I could tell you a typical temp differential. I've interacted with that group though and it was about that tight from what I was told. Might have been some other base temp. Paper is 5 years old.

Super tight though I've met these people. I've seen data as well and it has to be similarly tight, relatively speaking.

Here's an example of how far off I am on the temp example:

PCR Step Temperature °C Duration
Denature template
94 °C
1 min
Anneal primers
55 °C
2 min
Extension
72 °C
3 min

https://www.sigmaaldrich.com/technical-documents/protocols/biology/standard-pcr.html

Standard! hahaha...

I'm literally 'In the cloud' these days with respect to this.

True Story!
7   theoakman   ignore (0)   2020 Nov 1, 5:36am     ↓ dislike (0)   quote   flag      

The CEO of Holy Name Hospital in Teaneck NJ was on a few weeks ago. This is a hospital that is running, I believe, more clinical trials than any other hospital. He said most of the infections were incidental, asymptomatic. They only reason they detected them was because they were required to test prior to surgery. The amount of people in critical care was tiny. He also said, nobody is coming in with the viral loads that we saw in March/April.

From my perspective, this is classic viral attenuation and evolution in action. All viruses will mutate over time and they mutate to not only become more infectious, but also less deadly. Those two things enhance the likelihood that the virus will survive and continue to transmit. A virus that kills its host will have a harder time propagating. The virus was knocking off doctors in their 30s in China initially. In NYC, it was knocking off doctors in their 50s. Now, it doesn't appear to be knocking off really anyone. I'd like to see what happens over the next month or two now that we are in fall and cases are rising pretty much everywhere.


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