Hi Reddit, AMA Complete as of 18:47

Comments: 523 • Responses: 77  • Date: 

muffinlemma280 karma

What is the endgame for covid-19? Will it just become an endemic childhood illness like other coronaviruses or will children be vaccinated? Do you think the virus will continue to mutate frequently like an influenza and require new vaccines periodically?

UniOfManchester397 karma

The virus is less similar to the cold causing coronaviruses and more closely resembles the virus causing SARs. It has changed slightly since it first emerged but we have no evidence to suggest it has become less virulent or that it has changed sufficiently to evade the immune response. As such vaccination is our best route most likely. We will have to continue to monitor it to see if this changes

HappyChestnutKing216 karma

Has anyone else commented on how Grainger and Cruickshank is like (Hermione) Granger and Crookshanks the cat???

UniOfManchester125 karma

Ha Ha

benmac1989174 karma

What can I say to people who are anti-vax or Vaccine-hesitant when they claim "but they've rushed the Vaccine through, it takes years normally and they've done it months" what's the scientific understanding needed to show that this hurried Vaccine is safe?

UniOfManchester410 karma

There are approx three different vaccines that have released interim phase three trial results currently. To create a vaccine you need some way of delivering the information on the disease to the body and we have lots of different tried and tested approaches for this. So you have the technology, then all you need is the information on the disease. The genetic sequence of the virus was analysed very early in the pandemic and so this enabled vaccine development to gets started. Lessons had also been learnt from sars which is very similar to the virus that causes COVID 19.
For all the vaccines on trial
Phase 1/2 of trials ran cocurrently- these assess safety and whether there is measurable immune responses. The Phase three trial had accelerated recruitment across countries because people interested and countries cooperated together. It can take years to recruit the numbers we have seen in the phase three trials that take in a varied population in order to see effectiveness, It can also take time to get the funds for all this. So the combination of established platforms and international coopertaion and funding has really fast tracked the vaccines without cutting corners around safety or efficacy. That is why we are in such a good place now for vaccine development.

UniOfManchester217 karma

The regulatory authorities will never pass a vaccine that is unsafe. Other than clean water, vaccines have saved more lives than any other medicine globally. It has gone quicker because everyone has worked together and focussed entirely on this virus. Also remember you are given the template for bits of the virus or a strain that cannot replicate in humans. The side effects of COVID are awful and certain, the side effects with the vaccine are, to date much milder.

nobody_u_kno152 karma

What are chances of getting the virus again, once recovered?

(I’m on day 10 of self isolation, after testing positive. Awaiting results of my 2nd test)

Edit: now tested negative

UniOfManchester253 karma

We have had some reports of apparent re-infections. For any such re-infection its important that it is verified in case of false positives OR false negatives. Fortunately the majority of reports (and they are rare) have shown that reinfection is usually milder or asymptomatic because the immune system is protecting from the virus. I wrote about it here:

https://theconversation.com/coronavirus-reinfection-cases-what-we-know-so-far-and-the-vital-missing-clues-147960

cheeruphumanity149 karma

What do we currently know about the effect of vitamin D3 supplementation to the infection risk and outcomes of infection?

UniOfManchester231 karma

The evidence for vitamin D is mixed but some evidence has previously suggested it can help reduce upper respiratory tract infections and it is an important vitamin for effective immune function so although unlikely to be cure it may well help support the immune response work well in COVID19

HappierWhenAsleep98 karma

Hello! Sorry if this may be a dumb question but genuinely curious, if the COVID strain evolves further in the future, will this affect the developed vaccine?

UniOfManchester247 karma

Not a dumb question. Most of the vaccines are targeting the spike protein, which is the protein the virus uses to enter cells. Although the virus doesn't appear to be mutating rapidly it's possible the spike could mutate. In fact the spike already mutated in mink in Denmark. One thing that's great about the Oxford vaccine and the mRNA vaccines is that they can quickly be edited to protect against a different form of the spike if necessary so a new form of the vaccine could be developed super fast rather than starting from scratch.

Yiping0759 karma

Hi Professor Hussell, Professor Cruickshank, Professor Grainger, I am Yiping, a PhD student in mathematics. I am interested in the models in immune system and I have several questions about immunity of COVID-19. 1. Is the inflammation(including cytokine storm) the main reason that leads to COVID-19 death? 2. What’s the cause of cytokine storm? Is this because innate immune cells keeps secreting those cytokines? 3. Is lymphopenia associated with cytokine storm? 4. How do our body regulate the pro-inflammation cytokine and anti-inflammation cytokine? If the immune cells secret anti-inflammation cytokine, does it mean it’s going to shut down our immune defences? Thank you in advance! Kind regards. Yiping

UniOfManchester70 karma

Answering each of your questions in turn:

  1. Is the inflammation(including cytokine storm) the main reason that leads to COVID-19 death?

We're still learning about what leads to death in COVID-19 although clearly severe lung inflammation is a major contributor in the vast majority of individuals. There is a lot of controversy around the role of cytokine storm in this lung pathology and some studies even suggest that the cytokine storm in COVID-19 is not as dominant as in other infections e.g. flu. What is clear is that blocking certain cytokines e.g. IL-6 antibody or giving drugs that suppress cytokines e.g. dexamethasone can improve outcome in patients with severe disease.

UniOfManchester52 karma

  1. What’s the cause of cytokine storm? Is this because innate immune cells keeps secreting those cytokines?

Again there is still work ongoing about the way the cytokine storm occurs. Some of the cytokines likely derive from the immune populations in the lung that have dysregulated cytokine production but also other organs such as the liver can become a major source of systemic cytokine in storm events.

UniOfManchester45 karma

  1. How do our body regulate the pro-inflammation cytokine and anti-inflammation cytokine? If the immune cells secret anti-inflammation cytokine, does it mean it’s going to shut down our immune defences? Thank you in advance! Kind regards. Yiping

There are multiple feedback loops between pro and anti-inflammatory cytokines that lead to an appropriately controlled inflammatory response. If your immune cells induce to weak an anti-inflammatory response then you end up with uncontrolled inflammation and too strong can lead to immune suppression. So the aim of the anti-inflammatory cytokines is to create a state where you can control the virus but limit damage to the organ e.g. the lung. If the anti-inflammatory cytokines become too great then this can shut down immune defence.

UniOfManchester36 karma

  1. Is lymphopenia associated with cytokine storm?

Certainly some of the factors produced during a storm event could directly affect lymphocyte survival leading to death and lymphopenia. Another explanation could be that the lymphocytes are getting recruited into the lung and other inflammed tissues and this is why they decrease in the blood.

admirable_antwat51 karma

When the lockdowns here in the US started to happen there was an issue with people taking ibuprofen and causing covid symptoms to be worst. Is there any evidence to support this? If so why would an anti-inflammatory make covid any worst than it already can be?

Thanks for the time, you guys are the real heroes here.

UniOfManchester116 karma

The concern about ibuprofen was based on a study that has since been debunked so its safe to take ibuprofen and other medication to reduce the fever and aches the virus can cause

intronert48 karma

Do you believe that the COVID-19 work will bring significant new understanding of the human immune system, or are all of the mechanisms seen simply well known already?

UniOfManchester83 karma

It will definitely bring new understanding. Some of the mechanisms of this disease have already been described in other infections but the huge number of people infected with the same infection at the same time gives us unprecedented opportunity to understand the variations in different peoples' immune response. This means we can learn a lot about the underlying differences in immunity that are associated with sex, ethnicity and comorbidities such as diabetes.

cicalino43 karma

One thing I haven't seen addressed concerns people who may have already had the covid virus but were never able to be tested.

Should they be vaccinated?

UniOfManchester65 karma

Thanks for your question - I've just written a blog on this for the conversation. essentially vaccinating people who previously had COVID is not a problem and may even boost the immune memory they previously developed. Also, we don't know fully how long immunity lasts following natural infection so I guess its a case of better safe than sorry.

UniOfManchester62 karma

This is something that there is more research going on into, but at the moment we don't understand how well you are protected from another infection with Coronavirus if you have already had it. We do know from the preliminary reports that the vaccines likely offer good protection so it's likely that even if people suspect they may have had the virus that they should also be vaccinated.

LittleCurie36 karma

How much were your names considered when hiring you, @J. Grainger & S. Cruickshank ?

I mean... You can't have similar sounding names to Harry Potter's Hermione "Granger" and her cat "Crookshanks" and tell us it had nothing to do with you working together!

UniOfManchester64 karma

Hadn't realised this before. Am hoping this isn't the main reason we were recruited.

direfrog34 karma

Good evening!

After getting the vaccine, will the immunity be sterilizing? I mean, if a vaccinated person is exposed to coronavirus, will they be:

- not infected at all (and not contagious),

- or infected a bit (and contagious) but with few or no symptoms as the immunity prevents the virus from doing real damage?

UniOfManchester43 karma

This is clearly still a major question to be answered. From the information we have so far from the vaccine trials it seems like both of these are possibilities. Ideally, we would want the vaccines to lead to protection rather than allowing the virus to grow but with limited damage. Protection would be better at preventing transmission to non-vaccinated individuals.

TnyBob33 karma

Thanks for the AMA. Is there much work in the way of immune system disorders and COVID? It seems like the effects of the disease, especially long term, are still being understood.

Also, there are some theories that certain immune function disorders are predicated by yet unknown viral infections. Can you speak to that?

Thank you for your time.

UniOfManchester43 karma

An interesting question. You are right to point out that immune system disorders can tell us a lot about COVID. The work is progressing but there is not much out there at the moment. For example, there is one study showing that rheumatoid arthritis patients taking certain immune modulators have an increased chance of severe disease and death. This specifically related to patients who were on therapies that deleted B cells. There was a pre-print on bioRXive from Kimme Hyrich that detailed this. I'm not aware of any other studies looking at immune cell defects. I think this research is in its infancy and/or those patients have been isolating and so their information hasn't appeared. Transplant patients and those on cancer therapies would also be interesting, but so far they have avoided infection

Dontbecruelbro30 karma

When are you guys going to take a vaccine shot?

UniOfManchester99 karma

As soon as it is available. I will be at the front of the queue

bunniswife30 karma

Has the vaccine maker included people with autoimmune disease in the vaccine study? I am wondering if the vaccine would cause my immune system to go haywire. For clarity, I have antiphospholipid antibody syndrome and am prone to clotting episodes.

UniOfManchester29 karma

I'm not sure whether people with autoimmune diseases have been included so far - I would anticipate not. However, remember the vaccine is either a genetic map of the dominant virus proteins, or a strain of virus that does not replicate in humans. It would be far better to have the vaccine than the infection, which is associated with increasing clotting problems. As the vaccines are being manufactured, the government will clearly define who and when will get vaccinated.

UniOfManchester23 karma

The full details of the studies haven't been published yet so I am unsure as to the precise groupings of individuals that were included in the phase 3 study. At this time, it's difficult for me to make any real comment on whether the vaccine could have implications for someone with your condition.

UniOfManchester28 karma

We are ready

mazgraz27 karma

Hiya- this might be quite a basic question, but what currently is the most recent understanding as to how long covid immunity lasts, and what might this mean for immunocompomised people who've contracted and recovered from covid? I'd like to illustrate this in part by explaining that I'm an young person on immunosuppressive medication, and I tested positive for covid 2 months ago. Before that point, I was basically shielding, but after having it and completely recovering from the very mild symptoms I experienced, the supposed immunity gave me a little bit more freedom again (e.g. going into supermarkets, or onto public transport- still completely within social distancing restrictions ofc). I'm obviously very interested in how long this immunity continues for as I'm unsure when I should start limiting any and all social interaction again- I know there are other immunocompromised people wondering the same thing.

UniOfManchester67 karma

We are still learning but evidence is growing that patients can have immunity for at least 6 months. Although antibody levels drop, studies have suggested that specialised white blood cells called T lymphocytes that recognise the virus survive and can kill the virus. It is likely that there will be B cells that survive too and these cells will make antibody again if needed

UniOfManchester39 karma

That is the million dollar question. Only analysing antibodies over time will tell. There is evidence that people who have very severe disease, their immune system gets exhausted and so they might not develop long lasting immunity. These studies haven't yet been repeated. For mild cases in the community it is more unclear. Vaccination could boost the immunity you got to the natural infection . Usually repeat infections are milder than the first. Good luck

ProfAndyCarp20 karma

Based on what (little) we know so far, would you be surprised if annual COVID immunizations were necessary? Why or why not?

UniOfManchester47 karma

We have flu vaccines every year. It seems that this coronavirus is slower to mutate. It will need epidemiologist to study the drift in the viral genome and then predict what might protect us from the next one. I think these viruses (if the last 3 pandemics are anything to go by) will keep emerging, but perhaps not as often as flu

tootie18 karma

What you can tell us about Hygiene Hypothesis? It's gained a lot of traction over the years that the increasingly sterilized lifestyle in first world countries has resulted in negative secondary effects on our immune systems. It sounds plausible, but is there any evidence of the long-term outcomes of living a "clean" life versus rolling in the mud with animals?

UniOfManchester33 karma

There is substantial evidence that certain infections may be beneficial to support healthy immune development. The best example of this is probably gastrointestinal worm infection that seems to have positive effects in limiting development of inflammatory diseases. There is a lot of epidemiological evidence but there are now a trials ongoing to establish whether administration of worms could be used to cure inflammatory diseases such as IBD.

fluorophoregreen11 karma

Why arent children affected to a similar degree compared to the seasonal flu?

UniOfManchester25 karma

Good question and one that is being actively explored. We do know children can get the infection and they can contribute to infection spread. Some evidence suggests that children may be protected partially because they get some many upper respiratory tract infections including those cause by other coronaviruses which causes a level of immunity. Research on the immune response in children has also suggested they have a more protective type of immune response that doesn't cause the nasty side effects that some adults suffer.

ProfAndyCarp9 karma

What are the most important gaps in our immunological knowledge of COVID-19? How quickly (or not) do you expect those gaps to be filled in?

UniOfManchester19 karma

The biggest gap is knowing how long immunity lasts for and we will only know this through continued longitudinal studies that requires significant funding. The issue of re-infection is also vague. Very few people so far have got reinfected, so hopefully if you survive the infection you will have some degree of protection.

We also dont know what drives Long covid symptoms of fatigue and fibrosis. The follow up on these patients is going to take time. Also, what happens if you get an unrelated infection?

Therefore - lots of questions remaining, but we do know an awful lot about the acute disease itself

Flashesfan759 karma

Is there ever going to be a cure for lupus?

UniOfManchester15 karma

Its a complex autoimmune disease and currently the best strategies are around treating the symptoms to reduce the inflammation and reduce or preventing further damage. We don't yet know why some people get autoimmune diseases like lupus so sadly without knowing that its hard to say how we can prevent it.

Lucky_Tie8 karma

Do you ever encounter people with anti-vaccination beliefs and if so how do you deal with them?

UniOfManchester41 karma

I have indeed. There have actually been quite a few studies on how best to approach anti-vax beliefs. This is a really nice piece here: https://www.theatlantic.com/ideas/archive/2020/03/how-talk-about-coronavirus/609118/

MTVChallengeFan8 karma

I know being obese is a big risk for being vulnerable to COVID-19(and many other things, really), but does this classification solely go by the Body Mass Index(BMI) Table, or are there other factors as well, such as where you store fat, Body Fat Percentage(BFP), etc.?

My BMI is a 34, which is classified as "obese", but I'm actually a tall guy with "dad-bod" belly(if that makes sense), and I'm 30 years old, and lift weights. I also do cardio six days a week, and can jog a mile without stopping. In other words, I'm overweight, but I'm not sure if I'm actually "obese". My BFP(just checked two months ago) is at 28 percent. Again, I need to lose weight(and I'm losing weight by as the days go on), but it just seems I'm more "Overweight", and not "Obese".

UniOfManchester16 karma

Multiple factors are used to class a person as obese and not just BMI. this is a really helpful explainer: https://www.nhs.uk/conditions/obesity/

UniOfManchester6 karma

You are likely right, but people haven't done the studies yet. You sound low risk with that healthy lifestyle

byproduct08 karma

Good morning. Thanks for doing this AMA.

I’m curious what you can say about research into who is most at risk. I’ve read that people with obesity are at greater risk, and also that people who get the most sick also seem to have have vitamin D deficiency. While that last doesn’t seem to be causal, it’s an easy fix. There are other factors too like age and other conditions like diabetes. Is there anything you’ve seen to date saying these are the biggest risk factors, so if you have A and B you’re at risk but if you do X or Y it offers some of those risks. I guess I’m trying to say it’s hard to know how to do the risk calculus. If we have to go out, which person is at lowest risk?

UniOfManchester22 karma

Thank you for your question. there are people at greater risk . Those who end up in ITU are usually old/frail and have underlying conditions such as diabetes, heart disease or hypertension. If younger people have these conditions they tend to fare a bit better because they are not so frail. Therefore the risk is quite clear. In the community however, it is less clear. Vitamin D and other self-help ideas haven't shown great benefit to date, but then healthy, young and fit have very mild symptoms

ConsciousnessWizard7 karma

Why don't pharmaceutical companies work together instead of against each other and keeping the intellectual property to themselves?

UniOfManchester39 karma

Sometimes it is good to have competition as it drives manufacturers to try and develop the best solution. We also need lots of vaccines as some may work better in specific populations than others. But I hear what you are saying. Companies do sometimes work together, but this is not visible

wildsupernova6 karma

Is the virus mutating?

UniOfManchester11 karma

data suggests the virus is relatively stable but this is being assessed constantly

LikeASleepTwitch6 karma

[deleted]

UniOfManchester40 karma

I understand your concerns, but remember, other than providing clean water, vaccines have had the greatest impact on disease than any other medicine. Vaccines got a very bad press without any robust data to support their findings. This person was subsequently struck off. If you look in your packet of paracetamol, there is an information sheet the provides hundreds of "possible" side effects. But somehow we get over this.

The "side effects" of the actual infection are known and dreadful. The side effects of a vaccine are minor and rare. I understand your point about children, but they are effective carriers of the virus and we need to drive it away, otherwise the elderly, who have poor immunity will always be at risk

Pepperspray245 karma

Someone told me that COVID is like HIV in that it attacks and breaks down your immune system and has lasting horrible side effects. Is any of that true? What side effects (if any) have been found after someone does recover from the virus itself?

UniOfManchester19 karma

Some groups of people seem to be very vulnerable to the virus and in some cases this can lead to their immune system over-reacting and causing damage which can be fatal. I wrote about some of this here:

https://theconversation.com/inflammation-the-key-factor-that-explains-vulnerability-to-severe-covid-144768

For some people who do not develop severe COVID they do get long lasting symptoms known as Long COVID. Research in Manchester is currently trying to investigate what happens in long COVID and why some people get this

JudyLyonz4 karma

Do you find that the virus is mutating to become less lethal but more contagious?

UniOfManchester6 karma

We have no evidence for this currently but we have seen some small shifts in the viral genome however this may not impact on immunity and the evidence so far did not suggest the small changes affected viral infectivity or lethality.

UniOfManchester6 karma

People are watching the change in the viral genetic material. THere is not enough data yet to say whether it is getting worse or better.

Northernfrog3 karma

After receiving the vaccine, can a person still spread COVID19?

UniOfManchester4 karma

Possibly, but their immune response will clear it more quickly and so there will be much less to spread, plus a vaccine is likely to prevent you getting symptoms and coughing over others

Globetrotbedhop3 karma

What is the likelihood of similar coronavirus outbreaks over the next fifty years? How do we prevent transmission of these viruses into humans?

UniOfManchester21 karma

sadly with climate change and factors such as deforestation there is even greater chance of viruses and infections spilling over from animals to humans. This is why the work of organisation such as WHO is so vital in monitoring and tracking new outbreaks and having well resourced researchers and experts ready to respond. Global cooperation is also very important. some interesting info here:

https://www.theatlantic.com/science/archive/2020/02/coronavirus-very-2020-epidemic/605941/

UniOfManchester15 karma

Well, we have had SARS, MERS and CoV-2 in the last 10 years. So I think it is highly likely, though the previous ones have not been nearly so devastating as this one. It is transmission we have to establish nd then either change social and culturable habits or eradicate the infection in the animal species

DeejOne3 karma

First off, keep up the good work guys!

Second, what simplified, scientific explanation can I give to skeptics (tinfoils) who beleive that Bill Gates wants to plant a chip in them or poison everyone? 😂

UniOfManchester7 karma

I've come across this a lot - i point out that it would be prohibitively expensive and impossible to manufacture. A vaccine this quick cant possible contain a microchip!

FinancialPercentage43 karma

I've heard people talk about the possibility that the Indian subcontinent or perhaps even the African continent will fare better when it comes to covid-19 compared to other places.

They've got various explanations for why that might be the case, but if you were to make an educated guess, which countries or continents do you think will have a higher or lower IFR than the worldwide average? And why?

UniOfManchester8 karma

This is a question that someone could write an essay on. Generally sections of the population that have multiple generations of the family living together, crowding and social habits involving lots of people transmit the virus faster than more spare households. The closer proximity the higher the dose, the more chance of severe disease. Thus in any population you need to consider whether they have these habits, but also how old, how healthy and also the extent of other diseases. Each country will have its own extent of disease,

making_sammiches3 karma

Thank you for taking the time today! Assuming that it will take a year for the vaccine to be distributed to the bulk of the world's population: how many years do you think we will be dealing with COVID-19 before we achieve herd immunity globally? As I understand it, we need a 90% vaccination rate to achieve herd immunity and many Western countries seem to be vaccine averse.

UniOfManchester10 karma

Really difficult to say as there are so many parameters at play. Clearly even if we don't achieve herd immunity then vaccination will reduce incidence of the infection as occurs for other infections such as measles or flu.

UniOfManchester6 karma

Very good question, and i wish we knew the answer. I think the percent for herd immunity may be a little lower at 65-70%. I think when the weather warms up again, the case load will drop, but unfortunately, it could be a while

Nepenthes_Rowaniae2 karma

Can I catch Covid from someone across the street from me?

Edit: This may seem like a joking question. But it absolutely is not. It something that I am seriously freaking out about.

UniOfManchester2 karma

It is very unlikely you can catch the virus from across the street. So dont worry and remember, if you get infected you are very likely to only have a mild disease.

ywalts2 karma

There been studies on how COVID 19 has lead to mental problem/ psychosis? (Not sure if right wording) e.g a woman in the uk after contracting COVID reported seeing monkeys/lions in her own home, Any chance you could elaborate on that?

UniOfManchester9 karma

There are strong links between the immune system and the brain. The inflammatory factors that are produced during an infection can have effects on mood for example and can lead to confusion in some individuals. In Coronavirus infection there has been suggestion that ACE2 (the receptor that Coronavirus uses to infect) may be expressed in the brain and so there could be some infection of the brain directly that could lead to these psychotic-type responses. So there are a number of potential reasons.

UniOfManchester5 karma

You are right that mental health problems have arisen. Some people think it is the cytokine storm that happens while you are affected, but it could also be caused by sedatives used in hospital and being intubated in ITU also causes problems. People will be depressed following such an awful experience. THey will also be very fatigued

ProfAndyCarp2 karma

This isn’t your area of expertise,‘I know, but do you wife a sense of how prepared or unprepared the world is for global COVID immunizations? How significant are the logistical issues? How long might we reasonably expect it to take for enough immunization to take place to effectively control COVID-19 infection?

UniOfManchester4 karma

The vaccines that we have heard about in the interim phase three results both use well established technologies which will help with vaccine roll out however the need for cold chain storage for one is problematic for getting it distributed especially in low resource countries as will the cost. There is much work being done to support global cooperation in vaccine roll out but it will be challenging and needs a high level of cooperation. Another huge logistical issue is vaccine hesitancy and the anti-vax movement. some good info here: https://royalsociety.org/-/media/policy/projects/set-c/set-c-vaccine-deployment.pdf;

sofluffylol2 karma

Do you think the cause of the virus is the proximity we have with animals? Is it in fact a zoonotic disease? And do you think the prevalence of these types of viruses will grow if we keep exploiting animals like we do?

UniOfManchester4 karma

It seems to be proximity and a moist environment that allows the droplet that contains the virus not to dry out.

Rodan-Lewarx2 karma

Hello.

Something that is bothering me is the excess for using hand sanitizer.

Is there any study about a long term risk of diseases due to the excess for using it?

for example skin cancer, reduced immunity, infecctions, etc

Thank you

UniOfManchester16 karma

Not that I am aware of. Your skin is pretty robust and has a strong barrier to protect it in the form of our epidermis. Sanitiser will potentially affect the microbes that normally live in your skin but your skin is pretty robust as is the skin microbiome. The biggest issue I have seen is with skin become overly dry from excess washing and good barrier cream can help there

ajgressss2 karma

This happened when I was just a little kid so I never experienced it myself, but what happened to the SARs outbreak in 2004?

Why is it that SARs just "disappeared" after two years without anyone having to take a vaccine, and what makes COVID-19 so different that a vaccine may have to become mandatory?

UniOfManchester7 karma

The previous coronavirus infections caused really bad disease but didnt transmit from person to person very well. The lower the number infected the quicker the virus is cleared. This current virus transmits efficiently, unfortunately!

intromission762 karma

If another similar Coronavirus were to emerge after having received a COVID19 vaccine, could that possibly result in the much debated ADE? Can someone explain to me how this vaccine doesn't carry that risk for those who take it? This would be my biggest concern with getting jabbed.

UniOfManchester6 karma

We haven't seen evidence of ADE in the phase I/II or III trials which is good news. Crucially results will continue to be monitored for many years after the trials start.

-JohnnyDanger-2 karma

How do I convince my friends from anti-science families to get a vaccine?

UniOfManchester8 karma

I find detailing what might happen to you if you get the actual virus helps. The side effects of COVID-19 is truly awful, whereas the side effects of vaccination are small and usually within hours. Education is key here

UniOfManchester7 karma

It can be really hard. The key factor is to try not to succumb to immediately telling someone they are wrong. Try instead to use a more open curious question to establish what misconceptions they may have and open up a dialogue. This is a really nice piece here:

https://www.theatlantic.com/ideas/archive/2020/03/how-talk-about-coronaviru

s/609118/

NexusReflexX1 karma

Have you seen any cases of someone getting the virus a second time? If so, how did these reoccurance cases differ from the first time an individual had the virus?

UniOfManchester2 karma

In our studies at The University of Manchester we have found a very very small number of individuals that had the virus a second time or had recurrence of the original infection. Effects if anything were less severe than on first occurrence. However, this is very small numbers. Worldwide there have been reports of individuals having both less severe disease and more severe disease the second time.

UniOfManchester2 karma

We have only seen a few cases and they are much milder. They happen generally in patients who have other underlying conditions. The patient we had was missing part of their immune system

tdogg19671 karma

Hello, is the Los Alamos National Laboratory in the U.S a partner of yours? If so how are you helping each other.?

UniOfManchester2 karma

They are not a partner of ours, but only because we have been too busy setting up networks across the UK. We have set up national connections well. This has meant we can have a unified approach and make sure we answer the important questions first. We are also receiving samples across the UK from clinical trials. I think such working styles are the future as we have moved very fast together that we wouldn't do individually.

mchandr41 karma

How does COVID affect babies that are less than a year old? Is it safe for a 4 month old to do international air travel... US to India?

UniOfManchester3 karma

Alas, we are not qualified to answer this. Very few babies have been affected by this virus. That does not mean they cant be though. I would ask advice from your GP

TheRebelliousSpire1 karma

What do you think about vaccine tourism? I fly to China and get a vaccine shot but on the plane i contract covid from the passenger beside me. Will the vaccine work in time?

UniOfManchester3 karma

Alas it takes up to a week or perhaps two to develop sufficient immunity from a vaccine. Plus you are likely to need a booster vaccination to be fully protected. So, you would be at risk on a plane next to a virus carrier

UniOfManchester2 karma

The timing of the vaccine shot or shots is critical. A vaccine cannot make someone immediately immune, it takes time for the immune system to get that information from the vaccine and start to generate the cells that can recognise the infection. Often a booster 2nd shot is required to really get the immune response going too so the best protection won't be until after both shots and maybe a few days after that.

TheRebelliousSpire1 karma

Do you think vaccine tourism is going to be a thing?

UniOfManchester3 karma

there has been some talk about vaccine passports, for such a thing to work there would need to be a mechanism to confirm vaccination and international cooperation to agree rules.

peachymaleachy1 karma

Is a vaccination a binary issue of either “effective” or “not effective” and if you are in the 5% or 10% (or whatever) for whom the vaccination does not work, you are as vulnerable to the disease as if you were never vaccinated? Or could someone who contracts the disease despite being vaccinated expect to experience milder symptoms (in particular, avoiding long Covid) than would otherwise have been the case?

UniOfManchester3 karma

A vaccine could provide complete immunity or it may provide partial protection and reduce the risk of severe disease by making infection less symptomatic or even asymptomatic. The data on the current vaccine frontrunners suggest the latter

UniOfManchester3 karma

This will vary person to person, but with an effective vaccination you are most likely to be assymptomatic. In the 5-10% where vaccination doesn't work they will actually be protected by the successful vaccinees around them, because they wont transmit the virus. Overall re-infections are much milder

That_free_life1 karma

Has there been any hard data gathered on covid and fertility, given ace2 receptors in the testes?

UniOfManchester3 karma

I haven't seen any data on this, just a news item in the sun. I guess it might be hard for the virus to reach the testes as it has mostly been found in the lungs and oral cavity

popposa1 karma

Is the virus constantly changing when it transfer from human to human or do the significant mutations only occur between animals and humans? If you have had the virus, do the antibodies recognize slightly mutated versions of the same virus?

How do mutations affect the viability of a vaccine, will the vaccine need to be changed over time?

UniOfManchester3 karma

It's clear that the virus can change when it transfers from human to human and there are slight mutations in the protein the virus uses to infect (spike protein) that are occurring. As you say in some animals significant mutation can occur and this is what happened in the Denmark mink. Because antibodies can be directed against different parts of the same protein it's possible that they will still recognise a mutated form but this would depend on the mutation.

If there are mutations then it might be necessary to vary the vaccine (as occurs with flu vaccine) but the advantage of the Oxford vaccine and the mRNA vaccines is that it would be very easy to modify them quickly to target mutated forms of the virus.

bukunothing1 karma

Is convalescent plasma really an effective treatment for COVID-19?

UniOfManchester4 karma

This is being assessed now in the UK in a large trial. Recovered patients should have protective antibodies in their plasma and the treatment would therefore aim to pass on some protection to lessen the effects of the virus. To assess how effective it is its critical that this is investigated in a large cohort of people

https://www.nhsbt.nhs.uk/how-you-can-help/convalescent-plasma-clinical-trial/

sake234561 karma

Do you think that young people with underlying medical conditions such as Diabetes, Psoriasis, Heart failure etc. show symptoms of Covid 19 or are they too asymptomatic like their perfectly healthy adult counterparts ?

UniOfManchester3 karma

The evidence to date has shown that certain conditions such as diabetes are a significant risk factor for COVID. https://theconversation.com/inflammation-the-key-factor-that-explains-vulnerability-to-severe-covid-144768

fromscratch4041 karma

Hey! thank you all for doing an AMA with your combined expertise!

”t-cell immunity” has been simplified and misunderstood many times during this year.

What is your current best understanding of the role it plays with sars-cov2?

Could it be that some people experience asymptomatic infection with viral shedding because this part of the immune system ”gets there first”?

UniOfManchester2 karma

Hello. It is strange that most people focus on antibody when most antibody relies on T cell to help them be produced. We found that as patients recovered in hospital their T cell response in the blood increased. With asymptomatic infection, either their T cell response is fast and clears the virus before symptoms appear or an even early part of immunity (the innate immune system) does the job itself without the need for later parts of immunity to come in. T cells in SARS-CoV-2 are helping other immune cells perform their function, and they can lyse virus infected cells.

Jpavlofsky1 karma

Is singing solo with a vocal instructor as high risk as singing in a large group or is it relatively safe? I’m a musical theatre actor who’s been in virtual voice lessons (in person over the summer) and I HATE working on Zoom because of the lag.

UniOfManchester2 karma

unfortunately the virus is spread by aerosol transmission of droplets and singing is better at this than talking. The more people in a room, the less ventilated it is, the duration of activity will all impact on how the virus can spread.

oopseyeforgot11 karma

Is there any relevance to Ige inhibitors like Xolair and susceptibility to Sars Cov-2 and Covid-19?

UniOfManchester2 karma

Interesting question. IgE is not usually involved in immunity to viruses, but rather allergies. If someone has nasal allergies then irritation of their nose could make it more susceptible to low doses of coronavirus. Also, patients with irritated nasal passages may sneeze more often and spread the virus more.

Draw-Wide1 karma

Vaccines may not always be 100% effective. For those who indeed catch Covid-19, will the effects be very mild? And avoid complications ESPECIALLY for heart patients with co-morbid symptoms. Asking for my parents

UniOfManchester2 karma

the current data form the vaccine frontrunners would indeed suggest that they will reduce severity and thus far are looking very promising so cause for optimism