Coronavirus

[AlanSubie4Life]

Maybe along the lines of this
The FDA's 'Wild West' COVID-19 antibody test rules did more harm than good, 60 Minutes finds

On March 16 ... "the Food and Drug Administration took the unprecedented step of allowing COVID antibody tests to flood the market without review."
...
But federal officials knew pretty quickly that this "'game-changer' that could get Americans back to work" wouldn't work, because many of the tests were seriously flawed, Anfonsi reported, citing a three-month investigation. They "continued to allow them to be sold anyway."
...
In late May, the FDA started pulling tests — 50 so far — "but by then it was too late," 60 Minutes reports. "The flawed antibody tests are still being used and the bad data collected from them is guiding critical decisions about when to reopen communities."
...
If you still want to get a serology test, Alfonsi said you should get checked two or three times using different tests to lower the risk of false positives...

Yeah, it's so dumb that Elon doesn't distinguish between these two things (PCR and AB). Clearly antibody tests have nothing to do with hospitalizations, but presumably he has wiggle room to say that's what he was talking about, later (even though that makes absolutely no sense). Weasel room might be a more appropriate term.

 

[AlanSubie4Life]

You can see here something suspicious happened in early May in AZ, apparently driving up the PCR false positive rate. Mutations?????

(Ignore the 36% for yesterday BTW - obviously it's from a small number of tests - the gray bars (tests per day) are monotonically headed upwards, with obvious weekend exceptions.)

 

[electracity]

A number of southern and western states (except florida) have all time high covid hospitalizations.

A really like medcram for hospital-ish oriented updates. He's a pulmonologist.

 

[NikolaACDC]

a few months in and still nobody in government is interested in or capable of securing supplies

‘The new gold’: demand for PPE soars again amid shortage as US cases rise

‘The new gold’: demand for PPE soars again amid shortage as US cases rise
Fragile supply chains and wary hospitals continue to push some workers to wear N95 masks and and gowns for up to a week
Demand and prices for personal protective equipment is soaring again across the US as coronavirus cases continue to rise in more than half of states.

 

[heltok]

China’s military has received the greenlight to use a COVID-19 vaccine candidate developed by its research unit and CanSino Biologics after clinical trials proved it was safe and showed some efficacy, the company said on Monday.

The Ad5-nCoV is one of China’s eight vaccine candidates approved for human trials at home and abroad for the respiratory disease caused by the new coronavirus. The shot also won approval for human testing in Canada.

China’s Central Military Commission approved the use of the vaccine by the military on June 25 for a period of one year, CanSino said in a filing. The vaccine candidate was developed jointly by CanSino and a research institute at the Academy of Military Science (AMS).


“The Ad5-nCoV is currently limited to military use only and its use cannot be expanded to a broader vaccination range without the approval of the Logistics Support Department,” CanSino said, referring to the Central Military Commission department which approved the military use of the vaccine.

CanSino declined to disclose whether the innoculation of the vaccine candidate is mandatory or optional, citing commercial secrets, in an email to Reuters.

The military approval follows China’s decision earlier this month to offer two other vaccine candidates to employees at state-owned firms travelling overseas.


The Phase 1 and 2 clinical trials of the CanSino’s vaccine candidate showed it has the potential to prevent diseases caused by the coronavirus, which has killed half a million people globally, but its commercial success cannot be guaranteed, the company said.

CanSino's COVID-19 vaccine candidate approved for military use in China

 

[Doggydogworld]

I'll post some of our central FL hospital data when I get them. It is very weird that we are seeing ridiculous new case increase but without increase hospitalization to match. Something definitely feels off.

That is weird. San Antonio hospitalizations grew almost 10x from June 6-28. ICU and Ventilator counts each grew 8-9x. Our daily confirmed cases is up more, maybe about 12x since end of May/early June. So the relationship isn't perfectly linear, but not that far off. From one of our county dashboards:

COVID patients occupy 802 of our 4713 total hospital beds. That's only 17% and we still have 1270 free beds. ICU is a different story, with 265 COVID patients out of I'd guess 450 beds. Add in non-COVID ICU patients and we must already be in overflow. I assume they've created COVID wards with quasi-ICU capability per their surge plan.

We obviously can't manage another 10x in 3 weeks ramp. Closing bars is the only real step we've taken to reverse the trend.

 

[electracity]

The decrease use of ventilators and the great increase in home pulse oximeters (at least among educated 50+ peeps) should change covid hospitalizations. WHO discouraging steroid use and some docs probably rushing patients onto ventilators probably killed a lot of people in April who would recover today.

We shall see in a couple of weeks if the death rate has really decreased. But considering the new cohort of hospitalized covid patients are apparently younger and treatment knowledge has increased the rate should improve.

One surprising aspect for me has been the relatively low infection rate of hospital personnel. I expected hospitals to be devastated by the disease. The apparently low covid infection rate in hospital personnel suggest good hygiene works.

 

[AlanSubie4Life]

The apparently low covid infection rate in hospital personnel suggest good hygiene works.

PPE works. From what I understand they have triple layers and double layers of PPE that take 5-10 minutes to put on, especially when doing anything risky. And of course P100 respirators, goggles/face shields, etc. They still get infected though.

I'm not 100% convinced that simple mask wearing & basic hygiene will completely eliminate transmission (though at a macro level there's little doubt in my mind that if everyone wore one and took the other common sense precautions, the pandemic would be over).

It's still very unclear to me how transmissible this virus is, but my assessment of it & concern for my personal health is actually increasing, not decreasing. Hence, I wear a face shield in any indoor environment in addition to an N95/KN95. I want to feel like I did everything I reasonably could.

It is continuing to spread without issues in summertime, so that suggests to me it is definitely more transmissible than flu (which we kind of already knew), and that makes it quite concerning.

I suspect it is partially airborne, and not just droplet borne. (To be clear, I have no idea.) And that makes me very concerned for my personal health.

 

[Kant.Ing]

https://www.nejm.org/doi/full/10.1056/NEJMp2015897

False negative could be even more harmful as the sense of security makes the spread more penetrable. This is why some countries currently are still against testing the public before the one-off tests are accurate enough.

 

[SMAlset]

View attachment 558055

This may be his worst take yet.
It's also not cool to encourage known C19 positive people to go out and possibly expose more people.

I can see him wanting his employees tested twice before sending them home for 14-day quarantine to be sure, but making the comment about the hospitalizations just doesn’t make sense, like I previously said because a positive doesn’t automatically get you hospital admittance.

 

[electracity]

PPE works. From what I understand they have triple layers and double layers of PPE that take 5-10 minutes to put on, especially when doing anything risky. And of course P100 respirators, goggles/face shields, etc. They still get infected though.

I'm not 100% convinced that simple mask wearing & basic hygiene will completely eliminate transmission (though at a macro level there's little doubt in my mind that if everyone wore one and took the other common sense precautions, the pandemic would be over).

It's still very unclear to me how transmissible this virus is, but my assessment of it & concern for my personal health is actually increasing, not decreasing. Hence, I wear a face shield in any indoor environment in addition to an N95/KN95. I want to feel like I did everything I reasonably could.

It is continuing to spread without issues in summertime, so that suggests to me it is definitely more transmissible than flu (which we kind of already knew), and that makes it quite concerning.

I suspect it is partially airborne, and not just droplet borne. (To be clear, I have no idea.) And that makes me very concerned for my personal health.

Another possibility is that ~80% of reasonably healthy people aren't at risk for significant covid. This is preprint, so still subject to review:
SARS-CoV-2 T-cell epitopes define heterologous and COVID-19-induced T-cell recognition

 

[AlanSubie4Life]

I can see him wanting his employees tested twice before sending them home for 14-day quarantine to be sure,

The thing is, aside from human-induced errors (contamination of samples or confusion of samples), false positives for a PCR test are very rare (with the currently selected test they do - in general I think if the test is designed to the incorrect target, it could somehow trigger off of an identical sequence from some other virus, though not sure the likelihood of that), from what I understand. So doing another test and pushing this lie (presumably from the Russians, but I have no idea) has a number of downsides:

1) Waste of a test.
2) Exposes testing personnel and anyone else involved in a trip to get tested to an active case of the virus, unnecessarily.
3) Encourages infected people to pretend they are not infected and behave as normal.

That's what I can think of for now; there are probably like 5 other reasons his tweet was incredibly reckless and damaging.

Here's the detail on how this works - it's not like no one has thought of this problem before!

"Primer and probe specificity can be increased by ensuring they do not share great sequence similarity with other viral RNA sequences. Choosing primers and probes that recognize highly specific genome domains of SARS-CoV-2, such as the N domain, can help to increase specificity. Most laboratories have also assessed test specificity by checking for cross-reactivity with a panel of respiratory viruses, such as influenza A (H1N1), influenza A (H1N3), influenza B, rhinovirus, and other human coronaviruses. Ideally, cross-reactivity should be tested on RNA derived from patient samples. To be deemed adequately specific, the test should not read positive for any virus other than SARS-CoV-2."

https://www.centerforhealthsecurity.org/resources/COVID-19/COVID-19-fact-sheets/200410-RT-PCR.pdf

 

[AlanSubie4Life]

Another possibility is that ~80% of reasonably healthy people aren't at risk for significant covid. This is preprint, so still subject to review:
SARS-CoV-2 T-cell epitopes define heterologous and COVID-19-induced T-cell recognition

I'm not sure I follow. It's clearly plenty damaging as it is, even if there is some cross-reactivity in the population. Hospitals were overwhelmed, right? And IFR in the initial surge appears to have been at least 0.6%. Am I missing something here?

It's not like only the people who were vulnerable got sick the first time, and now we're exposing the rest of the population - that would be obvious from the serology - people who are infected who have cross-reactivity will develop SARS-CoV-2 specific antibodies (sounds like about 90% based on the paper).

"To determine if these T-cells indeed mediate heterologous immunity and whether this explains the relatively small proportion of severely ill or, even in general, infected patients during this pandemic32,33, a dedicated study using e.g. a matched case control, or retrospective cohort design applying our cross-reactive SARS-CoV-2 T-cell epitopes would be required."

"Confirmation of this observation in a larger SARS cohort including hospitalized patients is warranted and requires single epitope-based methods to determine T-cell epitope recognition rates as enabled by our SARS-CoV-2 T-cell epitopes."

 

[SageBrush]

Another possibility is that ~80% of reasonably healthy people aren't at risk for significant covid. This is preprint, so still subject to review:
SARS-CoV-2 T-cell epitopes define heterologous and COVID-19-induced T-cell recognition

This smells right, but it cannot be most of the story given the extremely strong risk factor age represents.
A person keeps their TCR repertoire through life

 

[electracity]

This smells right, but it cannot be most of the story given the extremely strong risk factor age represents.
A person keeps their TCR repertoire through life

Olders people's immune system still need to mount a response, right? I'm not in medicine, but I assume "immunity" has to be an active response in the presence of communicable disease.

An interesting related fact (IIRC) is that both the Diamond Princess passengers and that US aircraft carrier crew had about a 20% infection rate.

 

[Daniel in SD]

Olders people's immune system still need to mount a response, right? I'm not in medicine, but I assume "immunity" has to be an active response in the presence of communicable disease.

An interesting related fact (IIRC) is that both the Diamond Princess passengers and that US aircraft carrier crew had about a 20% infection rate.

People do start to notice when everyone is getting sick! That creates a lot of pressure to disembark and stop the outbreak.
The key to getting higher rates is to have people somewhere where they can't escape.
For example:
78% of the entire Marion prison population in Ohio tested positive for COVID-19.
92% of prisoners tested at Parnell prison in Michigan have antibodies (Almost everyone at one Michigan prison tests positive for COVID-19 antibodies)

Or you can be one of the first hotspots when no one knew what was going on. An Austrian ski town recently had 42% of the population test positive for antibodies (Over 42 percent in Austria’s Ischgl have coronavirus antibodies, study finds)

 

[SageBrush]

I'm not in medicine

Which is why I pointed out the obvious to anybody in medicine

 

[AlanSubie4Life]

and that US aircraft carrier crew had about a 20% infection rate.

More like 60% probably (though that was not a truly random sample, the number is not far off).

SARS-CoV-2 Infections and Serologic Responses from a Sample ...

 

[Singuy]

All right, new data out for our hospital network in Central FL. Make those "new hospitalization numbers" very fishy. We will be getting an update daily now so we will see.


June 25 COVID-19 Patient Update

• Total Positive Inpatients: 112
• Rule-out Inpatients Pending: 108
• Ventilated Patients: 2 Positive COVID-19 and 1 Rule-out COVID-19

June 29th COVID-19 Patient Update

• Total Positive Inpatients: 172
• Total Positive in ICUs: 24
• Rule-out Inpatients Pending: 144
• Ventilated Patients: 6 Positive COVID-19 and 1 Rule-out COVID-19

 

[SageBrush]

Covid-19 Surge Begins Reaching Older, More Vulnerable Floridians
Bloomberg - Are you a robot?

Who wudda thunk ?