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Medicine

A New Theory Asks: Could a Mask Be a Crude 'Vaccine'? (nytimes.com) 147

A reader shares a report from The New York Times: As the world awaits the arrival of a safe and effective coronavirus vaccine, a team of researchers has come forward with a provocative new theory: that masks might help to crudely immunize some people against the virus. The unproven idea, described in a commentary published Tuesday in the New England Journal of Medicine, is inspired by the age-old concept of variolation, the deliberate exposure to a pathogen to generate a protective immune response. First tried against smallpox, the risky practice eventually fell out of favor, but paved the way for the rise of modern vaccines.

Masked exposures are no substitute for a bona fide vaccine. But data from animals infected with the coronavirus, as well as insights gleaned from other diseases, suggest that masks, by cutting down on the number of viruses that encounter a person's airway, might reduce the wearer's chances of getting sick. And if a small number of pathogens still slip through, the researchers argue, these might prompt the body to produce immune cells that can remember the virus and stick around to fight it off again. "You can have this virus but be asymptomatic," said Dr. Monica Gandhi, an infectious disease physician at the University of California, San Francisco, and one of the commentary's authors. "So if you can drive up rates of asymptomatic infection with masks, maybe that becomes a way to variolate the population."

That does not mean people should don a mask to intentionally inoculate themselves with the virus. "This is not the recommendation at all," Dr. Gandhi said. "Neither are pox parties," she added, referring to social gatherings that mingle the healthy and the sick. The theory cannot be directly proven without clinical trials that compare the outcomes of people who are masked in the presence of the coronavirus with those who are unmasked -- an unethical experimental setup. And while outside experts were intrigued by the theory, they were reluctant to embrace it without more data, and advised careful interpretation.

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A New Theory Asks: Could a Mask Be a Crude 'Vaccine'?

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  • by RightwingNutjob ( 1302813 ) on Tuesday September 08, 2020 @10:49PM (#60486780)
    where in this case, science means making an testable claim as an after-the-fact attempt at an explanation or justification.

    Any honest science and any honest science journalism about covid will begin and end with the words "insufficient information available to date" for about another 9 months at the very least.
    • by klipclop ( 6724090 ) on Tuesday September 08, 2020 @10:52PM (#60486786)
      This isn't science. It's just shitty news organizations and wannabe journalists taking early studies and trying to had it off as facts.
    • "insufficient information available to date" for about another 9 months at the very least.

      A cautious attitude is justified for an ivory tower academic debate.

      It is not reasonable when we need to be making hard policy decisions far sooner than 9 months from now.

    • by AmiMoJo ( 196126 )

      There is a lot of research into the effectiveness of masks at preventing the spread of respiratory diseases already. However there is no practical way to prove it on a large scale to the standard you require - we can't set up a closed city environment and have people live in it for a year to see if they get sick, and then an identical control one where they don't wear masks.

      It's like the old parachute debate. Do they work? Maybe... But you won't get many volunteers for the double blind study.

      • Re: (Score:2, Funny)

        by Bearhouse ( 1034238 )

        Hear the one about the new Chinese automatic parachute?
        Opens on impact...

        • by gweihir ( 88907 )

          Hear the one about the new Chinese automatic parachute?
          Opens on impact...

          I vote one of theses and a free mandatory trial for all anti-vaxxers and anti-maskers. I think we should keep the flat-earthers though, they serve an useful purpose in reminding everybody how disconnected from reality seemingly intelligent and educated people actually can become.

      • by gweihir ( 88907 )

        And that is exactly the problem. Because things need to be done under extreme time-pressure, a lot of information that would otherwise have been available is not. And because things are done under public scrutiny where reporting has to be "dramatic" and present absolute "facts" (or the deranged masses will stop listening and hence stop generating ad revenue), completely normal scientific steps like generating ideas and formulating hypotheses get misreported dramatically.

        The public will need to get it throug

      • ... we can't set up a closed city environment and have people live in it for a year to see if they get sick, and then an identical control one where they don't wear masks.

        I imagine North Korea might have something to say about that ...

    • Not Science.. (Score:3, Insightful)

      by thesupraman ( 179040 )

      This is based on what they teach 3rd graders a 'vaccine' is..

      A vaccine however is NOT actually 'a little big of the virus'. It is a very specifically engineered group of similar but weak viruses that trigger antibody generation but not the actual disease.

      So the answer is quite simple. NO.
      And that NO answer is also somewhat obvious, because if 'a small bit of the virus' worked, then the people working on the vaccines would have just perhaps though of that by now???

      This is what we refer to as 'Quackery'
      It is

      • I guess it's not so much vaccination as just allowing a gentler version of "herd immunity". As I understand there's some evidence that lower viral load correlates with more minor symptoms and lower mortality and transmissibility. So in effect, if everyone eventually gets infected while wearing masks, it's likely that their viral loads would be lower and they'd surive with fewer complications while developing an immunity.

        I'm not necesserily saying this is a good idea to go with but seems like it's not comple

      • by AvitarX ( 172628 )
        So your only complaint is that they used vaccine instead of inoculation?
      • by dak664 ( 1992350 )

        It is also more than bits of the virus...it is the adjuvants that boost the immune response to those bits.
        Odd that big pharma is silent on promoting a general enhanced immunity, yet rely on that mechanism for their single-dose products (or better yet, once a year).

      • by gweihir ( 88907 )

        What are you on about? This is an effect that possibly plays a role, but it is not even called "vaccination". Seriously.

      • A young person today might well think it's impossible to build a computer without first buying a motherboard. "You can't make a computer with Veroboard! This is what we refer to as 'Quackery'", they might say.

        Certainly, you can't build a PHONE that actually communicate with someone else without a SOC, and certainly not with discreet components. If that worked, "then the people working on the phones would have just perhaps though of that by now???", they might say.

        Some of us here on Slashdot are old enough

      • Infectious dose [statnews.com]

        Infectious respiratory diseases spread when a healthy person comes in contact with virus particles expelled by someone who is sick — usually through a cough or sneeze. The amount of particles a person is exposed to can affect how likely they are to become infected and, once infected, how severe the symptoms become.

        The amount of virus necessary to make a person sick is called the infectious dose. Viruses with low infectious doses are especially contagious in populations without significant immunity

        ...

        A high infectious dose may lead to a higher viral load, which can impact the severity of Covid-19 symptoms.

        Viral load is a measure of virus particles. It is the amount of virus present once a person has been infected and the virus has had time to replicate in their cells. With most viruses, higher viral loads are associated with worse outcomes.

        Please, please, PLEASE Google "infectious dose" before you spread any more false rumours.

      • Which is presumably why "vaccine" is in quotes, and variolation is mentioned a little further down. Modern vaccines often don't involve any kind of live virus, instead using inert protein fragments designed to trigger a compatible immune response. Initially though vaccines were an intentional infection with a much milder related virus - cow pox protected you against small pox, and the technique spread from there.

        Before vaccination was invented though, variolation [wikipedia.org] was in fact used used effectively to prote

    • I hate that the author seems to not understand the difference between vaccination and inoculation. Exposing yourself to a live virus in order to gain resistance or immunity is inoculation. Like when we were given a cow pox needle scratch in boot camp.

      One current theory as to why some people suffer only mild to no symptoms from nCoV-19 is that that person had already been exposed to another coronavirus in the past. Coronavirus has been around for a little while, but not a huge number of people contracted it.

      • by nasch ( 598556 )

        So when a highly contagious version evolves, people who have never dealt with a coronavirus, now have a relatively stonger one to deal with.

        The common cold is a coronavirus, so there probably aren't a whole lot of those people.

        • by e3m4n ( 947977 )

          uhh no... the 'common cold' is actually a few virus and you may have never had coronavirus. the virus associated with the common cold are:

          Rhinovirus
          Adenovirus
          Coronavirus
          RSV and parainfluenza

          the rhinovirus (from the Greek rhis "nose", gen rhinos "of the nose", and the Latin vrus) is the most common viral infectious agent in humans and is the predominant cause of the common cold. Rhinovirus infection proliferates in temperatures of 33–35 C (91–95 F), the temperatures found in the nose.

          as of last

  • by Penguinoflight ( 517245 ) on Tuesday September 08, 2020 @11:28PM (#60486868) Journal

    Telling healthy people to go about their day would cause a small amount of particle spread too. But wouldn't you guess, the best accidental advice was to follow the government's second recommendation that everyone wears masks all the time.

    Here's the other question though, if it "just so happens" that the virus particles going through and around the cloth masks aren't making people sick, doesn't that mean that the more usual recommendation of droplet precaution is accurate, as opposed to the airborne precaution we've all been told?
    The practical concern here would be that infected persons who are asymptomatic (incubation phase) and are breathing virus particles but not sneezing on others will be hitting them with "immunity" doses of the virus without overloading.

    • Here's the other question though, if it "just so happens" that the virus particles going through and around the cloth masks aren't making people sick, doesn't that mean that the more usual recommendation of droplet precaution is accurate, as opposed to the airborne precaution we've all been told?

      Mu.

      It's not possible to know what meaning of "airborne" you're using here. Are you using it as a layman, or as an epidemiologist would use it? Because there is no evidence that Covid is airborne in the latter sense. But droplets currently suspended in air can transmit it.

      Ask your question in a precise and complete manner.

      • Might I ask what "Mu" means in this context? I've seen it around a few times now, but can't find any explanation.

      • I know the difference between airborne and droplet precautions as are used in healthcare facilities. There are different mask requirements for example. The n95 that everyone talks about is required for airborne but not droplet precautions for example.

        As you mentioned, there's no evidence that covid is airborne, yet that's been how it's treated regardless.

    • by nasch ( 598556 )

      The practical concern here would be that infected persons who are asymptomatic (incubation phase) and are breathing virus particles but not sneezing on others

      If you're suggesting that breathing emits bare virus particles not encapsulated in droplets, and only sneezing spreads droplets, I believe that is not correct. Or if it is I would like to see a source.

  • Wondering if this is an area we've overblown?

    It seems like a lot of the cases come from exposure to breathing...given that a certain quantity of virus is required for infection (this amount isn't known, but exposure to 'one' virus won't likely result in infection, but dozens, hundreds or thousands may be the threshold), and it appears it's mainly airborne and comes from actually being around someone (and presumably inhaling COVID-19), I'm wondering if the handwashing is really required?

    Put another way: is t

    • To what extent are we not seeing substantial fomite transmission because most people are washing and sanitizing their hands more?

      • The way I see it is we'd see a lot more 'mystery' transmissions - if you touched something someone infected touched, you'd have a hard time identifying that event if also infected.

        It seems most reported cases are from known direct contact, but given how much external 'stuff' we're in contact with, if fomite transmission was high, wouldn't some sectors (say, mail carriers, couriers, grocery clerks) have HUGE transmission rates, given their exposure to a wide variety of potentially exposed items?

        And if there

    • by hey! ( 33014 )

      I don't think there are any definitively documented cases of fomite (via touching contaminated objects) transmission of COVID-19, but you wouldn't necessarily expect any. To prove fomite transmission you'd need a set of circumstances that enable you to absolutely rule out other forms of transmission like droplet or aerosol.

      There is circumstantial evidence that people may have been infected through fecally contaminated objects, e.g. on cruise ships, but again this isn't hard proof.

      Fomite and aerosol transmi

    • From what I've heard it does seem as though inhalation is the primary infection route - but if you've got virii on your hands and touch your face, or eat a bag of chips, that'll still do the trick. Once the virus is in your mouth or nose, your lungs are just a short hop away, a brief layover at the border isn't going to make a big difference.

  • by rsilvergun ( 571051 ) on Wednesday September 09, 2020 @12:12AM (#60486924)
    we already have mountains of people looking for excuses to forcefully reopen the economy before it's safe. Please do not give them excuses to risk getting and then spreading the virus. This nonsense will quickly become Covid Parties with masks.

    The editors should delete this story to avoid spreading dangerous misinformation...
    • by niftydude ( 1745144 ) on Wednesday September 09, 2020 @01:15AM (#60487022)
      You may recall Betteridge's Law: ""Any headline that ends in a question mark can be answered by the word no."

      I propose a corollary: "If the headline of an article posted by BeauHD ends in a question mark, the article will be so full of dangerous misinformation it should be deleted immediately."

      We can name it the Slashdot special corollary.
    • The problem is people are *already* doing that.

      And if this can convince a subset of teeth grinding weirdos that no the Government isnt trying to beam Autism into their brain using 5G chemtrail microchips embedded in masks and that yes you should absolutely be wearing them, thats still a net positive.

    • What makes you think it will ever be "safe?" Or that it ever was?

  • No? (Score:5, Insightful)

    by forgottenusername ( 1495209 ) on Wednesday September 09, 2020 @01:06AM (#60487008)

    Most vaccinations are made with dead (inactived) viruses or in some cases very weakened (live attenuated) ones that trigger the immune response without causing an actual widespread infection. The dead ones trigger a response so it might seem like you're sick, but you can't possibly get a viral infection from dead viruses. In rare cases the response can be strong for some people.

    It is possible to actually get a widespread viral infection from the weakened virus type vaccination but it's also quite rare.

    Source; https://www.vaccines.gov/basic... [vaccines.gov]

    Also, common sense. Getting deliberately exposed to covid19 is just dumb. This article is is embarrassing - the authors are chock full of caveats and the study is full of logic issues. People are getting severe symptoms or dying with low viral loads ffs. People are getting sick or dying with high viral load, low viral load, there's really nothing definitive. So don't unnecessarily expose yourself or others to it. NYT clickbait.

    Given that this is a coronavirus, I'd be expecting an inactivated style vaccination with boosters.

    • The science is not quite settled on effects of viral dose / load, but by all means don't let that stop you from pulling info directly from your pooper.
    • by shilly ( 142940 )

      If you have actual evidence that viral load doesn't affect disease course for covid-19, do feel free to share. Meanwhile, the article itself says: "With viral infections in which host immune responses play a predominant role in viral pathogenesis, such as SARS-CoV-2, high doses of viral inoculum can overwhelm and dysregulate innate immune defenses, increasing the severity of disease. Indeed, down-regulating immunopathology is one mechanism by which dexamethasone improves outcomes in severe Covid-19 infectio

      • All that says that more is statistically worse, it doesn't say that less won't kill you. And it can, even if it's less likely. You'd have to be a dumbass to take the above information and use it as validation for this idea.

        • by shilly ( 142940 )

          I was responding to this specific quote from the PP: "People are getting sick or dying with high viral load, low viral load, *there's really nothing definitive.*" [my emphasis]

          Viral load affects disease course -- statistically, on average, etc etc -- of course, low viral loads will still harm some, but the lower the better. No-one, including the paper authors, is suggesting that low viral load itself guarantees safety or even variolation.

  • You have to decide for yourself if you want to be a part of our society. I am not going to ask anyone to wear a mask when they are out in the middle of nowhere, but this "it's my right to infect everyone" crap has to stop.
  • The argument being that the virus enters the body ion lower quantity so that the immune system can respond to the infection better while the body develops immunity.

    The problem is this. If the virus does not invade in sufficient quantity to begin reproducing, then you will not develop an immunity. If the virus begins reproducing, then in initial stages it will grow exponentially. Which means in a very short period of time the virus is up to the levels that you would have had ithoput wearing a mask. It bu

    • Re: (Score:2, Informative)

      by gnasher719 ( 869701 )
      What you say about how the virus "works" is logical. That doesn't mean it is right. It is entirely possible that a lower initial virus load will end up affecting you less.

      Your last sentence is nonsense. "These doctors" admit that wearing a mask isn't 100% preventing any infection, but that isn't needed. We only need to prevent enough infections to keep the disease from growing exponentially. And they work, just not perfect.
    • by gweihir ( 88907 )

      Unfortunately for you, there is precedent for this "idea". The article also does very clearly state that this is a possible effect at work, not a recommendation to do this in any way. It even says that doing this intentionally is a very risky practice and hence fell out of use. Hence the stupid one here is you.

    • Variolation works in one of two ways. Either you inject with some less harsh version of the virus, but close enough so that once you develop an immunity to the softer virus you also develop an immunity to the stronger virus. The second way is to introduce a sample of the vaccine that is mostly inert ie mostly only fragments of the virus not the whole virus.

      Though:
      - death of a substantial fraction of the virus while it's in transit (possibly for days) from the source case to the inoculee, making it a

  • Sure, insight dives science and makes us what to find out how stuff works. But it often turns out that insight is dead wrong and things don't work the way we though they did. Therefore insight is not science - anymore than grape juice is wine. Call me when the trials are done.
  • Masks in a pandemic like this one delay infection. That's the whole point of them. This enables medical care [fill in USA healthcare joke of choice here] to treat those truly sick without being overwelmed. The long haul is the population eventually adapting that the effects of the pathogen losing their edge in terms of wrecking serious havoc in a relatively short period of time. It's natural immunization that eventually turns into herd-immunization and that's a good thing.

    • what point do you stop wearing masks though?

      The original lockdowns were to delay the effects to summer so the healthcare systems could cope. Only we kept lockdown going over summer and are now into "personalised lockdowns" using masks.

      I assume Thanksgiving and Christmas (but not Ramadan or Eid, in the UK gatherings of more than 6 are not allowed from Monday. But mosques are exempt. Bizarre huh) will be cancelled to stop mass revelry and maybe in April 2021 we can all start to go about out business to spread

      • by gweihir ( 88907 )

        what point do you stop wearing masks though?

        You stop when one of the following happens:
        1. An effective vaccine becomes available and you have been vaccinated and the time for that to become effective has passed
        2. Medical treatment has advanced to a point where it is easy to do and prevents most negative outcomes, including longer-term damage
        3. The infection rates become low enough to not justify the effort. In this case you remain prepared to start using masks again
        4. You find out you are reliably immune and have that independently confirmed by scien

        • 1. vaccine trials are being stopped due to unforseen illnesses. Astrazenica yesterday stopped one. I doubt we'll see a vaccine for a long time.

          2. Slashdot had a story about Oak Ridge National Supercomputer that had crunched through genetic data and out that vitamin D mitigates a lot of the effects, as do several pre-existing medicines.

          3. Cases are high currently because we are testing people, but hospitalisations are very low, and deaths are at almost zero.

          4. herd immunity will only be determined by 3 above

          • by tsqr ( 808554 )

            deaths are at almost zero

            I don't know what the current daily COVID-19 death toll is, but less than a month ago it was around 1000/day. [umn.edu] Personally, I think that's quite a bit more than zero.

          • by gweihir ( 88907 )

            So I think the pandemic is all but over

            Please, nobody listen to this deranged freak.

  • by gnasher719 ( 869701 ) on Wednesday September 09, 2020 @06:44AM (#60487484)
    There have been claims that how severely you suffer from a Covid infection depends strongly on the initial virus load that you received. And both social distancing and wearing a mask make the initial virus load smaller, even if you get infected.

    In the UK, the numbers of infected people are going up badly again, while the number of deaths are going up a lot less. Theories why this is happening are that the newly infected today are more often irreponsible young people (and older ones are more careful), but also that because of the lower initial virus load infections have a less bad outcome.

    Whether that all is true, I can't say obviously. And if it's true, I wouldn't call it a "vaccine".
    • by gweihir ( 88907 )

      And if it's true, I wouldn't call it a "vaccine".

      It is called "variolation", not vaccination and for good reasons. The story states this, but the title is indeed wrong.

    • It is probably just that the very susceptible people in the UK are already dead and cannot die a second time.
    • > There have been claims that how severely you suffer from a Covid infection depends strongly on the initial virus load

      Yes. And pretty much everyone should be wearing a mask anyway. What they are saying is, a small amount of the virus getting through may be a good thing. And since we know a mask isn't 100% effective, then we can add some hopeful thoughts in to make us feel better about it. Either way, we are in the same boat.

      There are numerous things that affect the severity.

      1) Age.
      2) Your sex.
      3) Your bl

    • There have been claims that how severely you suffer from a Covid infection depends strongly on the initial virus load that you received.

      "The dose makes the poison." [wikipedia.org] However, that usually applies to chemicals, not biologics. Also, the therapeutic index [wikipedia.org] is likely poor. The difference between a therapeutic dose and a deadly one is likely small.

  • do they actually have a print version anymore or have they gone just web site.
    Considering the bias and slant of everything NYT who reads or cares anymore.
  • Like plague (with its bubonic, pneumonic, and septicemic forms), smallpox outcomes were strongly affected by the infection route.

    If you got it "naturally" - probably by inhalation or possibly orally - it was widely disseminated in your body by the time your immune system got going against it. Result: High chance of death, extensive and disfiguring scarring if you survive.

    If you got it by having a bit of virus-containing matter inserted into your skin, your immune system got started on it while it was stil

    • If you got it by having a bit of virus-containing matter inserted into your skin, your immune system got started on it while it was still confined to that location:

      I've wondered for months if this would work with COVID-19. But not enough to try it, or mention it to others. (But if you're going to INSIST on exposing yourself by attending a COVID party, you might want to try it this way first - say by maksing and goving, poking yourself with snot or spit from a victim, then band-aid covering the inoculation

  • Next question.
  • There is exactly zero evidence to support this "theory". There is no data that even suggests that the fewer viral particles one receives the less damaging the infection will be. That study has never been done because you would need to deliberately infect a very large group of people.

    When you receive even a single viral particle that manages to evades your innate immune system and the mucosal IgA line of defenses, the result will be a single infected cell. But that cell then produces many more, thousands, o

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