PlagueWatch 2020-23 - Coronavirus

[sagegrouse]

Not the ones with the little metal handles I hope!

Mine said "Microwave Safe" on top.

[swood1000]

Finally somebody has given an informed estimate as to when we’ll be able to turn the corner on this thing.

Former Food and Drug Administration Commissioner Scott Gottlieb headed a team that put out a Road Map to Reopening which described when it would be appropriate to move from Phase 1, where we are now. The goal of Phase I is:

• Slowing the transmission of SARS-CoV-2 across the United States by reducing the effective reproduction number of infections,
• Increasing testing capacity to accommodate the ability to test everyone with symptoms and their close contacts, and
• Ensuring the health care system has the capacity to safely treat both COVID-19 patients and others requiring care.

They describe the following conditions in order to move to Phase II:

• A sustained reduction in cases for at least 14 days,
• Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care,
• The state is able to test all people with COVID-19 symptoms, and
• The state is able to conduct active monitoring of confirmed cases and their contacts.

The goals of Phase II are to:

• Lift strict physical distancing measures in a concerted and careful fashion,
• Allow the vast majority of businesses and schools to open, and
• Continue to control SARS-CoV-2 transmission so we do not revert back to Phase I.

In Phase II, the majority of schools, universities, and businesses can reopen. Teleworking should continue where convenient; social gatherings should continue to be limited to fewer than 50 people wherever possible. Other local restrictions should be considered, such as those that limit people from congregating in close proximity.

[LegoBatman]

Convalescent serum had been mentioned previously in the thread. Houston Methodist has been given the go ahead by the FDA for the procedure. I believe the local news mentioned they had been granted approval to treat 2 patients.

https://finance.yahoo.com/news/fda-a...150200582.html

[BD80]

Finally somebody has given an informed estimate as to when we’ll be able to turn the corner on this thing.

Former Food and Drug Administration Commissioner Scott Gottlieb headed a team that put out a Road Map to Reopening which described when it would be appropriate to move from Phase 1, where we are now. The goal of Phase I is:

• Slowing the transmission of SARS-CoV-2 across the United States by reducing the effective reproduction number of infections,
• Increasing testing capacity to accommodate the ability to test everyone with symptoms and their close contacts, and
• Ensuring the health care system has the capacity to safely treat both COVID-19 patients and others requiring care.

They describe the following conditions in order to move to Phase II:

• A sustained reduction in cases for at least 14 days,
• Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care,
• The state is able to test all people with COVID-19 symptoms, and
• The state is able to conduct active monitoring of confirmed cases and their contacts.

The goals of Phase II are to:

• Lift strict physical distancing measures in a concerted and careful fashion,
• Allow the vast majority of businesses and schools to open, and
• Continue to control SARS-CoV-2 transmission so we do not revert back to Phase I.

In Phase II, the majority of schools, universities, and businesses can reopen. Teleworking should continue where convenient; social gatherings should continue to be limited to fewer than 50 people wherever possible. Other local restrictions should be considered, such as those that limit people from congregating in close proximity.

This is WAY too reasonable and well thought out. It has absolutely no chance in today's political climate. I can envision the arguments about how the standards benefit one state, region, party, or demographic over another.

[AustinDevil]

Convalescent serum had been mentioned previously in the thread. Houston Methodist has been given the go ahead by the FDA for the procedure. I believe the local news mentioned they had been granted approval to treat 2 patients.

https://finance.yahoo.com/news/fda-a...150200582.html

Good news; I really hope this helps!

[Dr. Rosenrosen]

Where is NC? Not that I think we are doing a good job on testing.

I calculate NC at roughly 18 tests per 10K people. That’s based on Herald-Sun stating nearly 19,000 tests have been performed in NC and taking the population as 10.38M. That puts NC pretty much right in the middle in terms of rate of testing.

[swood1000]

...Governor Northam continues to request Federal assistance in testing efforts. Virginia does not have enough test kits, swabs and PPE. With the large number of Federal workers in Virginia, especially in Northern Virginia, it makes sense to stand up Federal testing center(s) to assist the state.

They need to get some of those toaster-sized test machines from Abbot Labs that were just authorized by the FDA.




Apparently they can deliver positive results in as little as five minutes and negative results in 13 minutes. There are currently about 18,000 of these machines in the U.S. and Abbott expects to ramp up manufacturing to deliver 50,000 tests per day.

[Rich]

Finally somebody has given an informed estimate as to when we’ll be able to turn the corner on this thing.

Former Food and Drug Administration Commissioner Scott Gottlieb headed a team that put out a Road Map to Reopening which described when it would be appropriate to move from Phase 1, where we are now. The goal of Phase I is:

• Slowing the transmission of SARS-CoV-2 across the United States by reducing the effective reproduction number of infections,
• Increasing testing capacity to accommodate the ability to test everyone with symptoms and their close contacts, and
• Ensuring the health care system has the capacity to safely treat both COVID-19 patients and others requiring care.

They describe the following conditions in order to move to Phase II:

• A sustained reduction in cases for at least 14 days,
• Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care,
• The state is able to test all people with COVID-19 symptoms, and
• The state is able to conduct active monitoring of confirmed cases and their contacts.

The goals of Phase II are to:

• Lift strict physical distancing measures in a concerted and careful fashion,
• Allow the vast majority of businesses and schools to open, and
• Continue to control SARS-CoV-2 transmission so we do not revert back to Phase I.

In Phase II, the majority of schools, universities, and businesses can reopen. Teleworking should continue where convenient; social gatherings should continue to be limited to fewer than 50 people wherever possible. Other local restrictions should be considered, such as those that limit people from congregating in close proximity.

This is WAY too reasonable and well thought out. It has absolutely no chance in today's political climate. I can envision the arguments about how the standards benefit one state, region, party, or demographic over another.

Right, let's either go with this ^ or pick a random date out of the air

[Dr. Rosenrosen]

They need to get some of those toaster-sized test machines from Abbot Labs that were just authorized by the FDA.




Apparently they can deliver positive results in as little as five minutes and negative results in 13 minutes. There are currently about 18,000 of these machines in the U.S. and Abbott expects to ramp up manufacturing to deliver 50,000 tests per day.

I read about this last week. But it’s frustrating to keep hearing about all these incremental and new testing capabilities but with no understanding of how, when and where all of this is being deployed around the country.

[budwom]

I think the idea of buying restaurant gift cards is that you're making a small, emergency loan to the restaurant. And, yes, they may default.

-jk

Indeed...it's a good idea not because it's a good investment, but rather because it's a good thing to do.

by the way: in checking in with friends in NYC, I've found that several of them have had the virus (they are quite certain) and lots of their friends have as well, yet almost none of them have been tested, because they didn't get to the point where they required hospitalization...the point being there's a whole lot of it down there, and having enough beds and respirators is likely to become a real issue very very soon...hard to see how they bend that curve.

[Mtn.Devil.91.92.01.10.15]

They need to get some of those toaster-sized test machines from Abbot Labs that were just authorized by the FDA.




Apparently they can deliver positive results in as little as five minutes and negative results in 13 minutes. There are currently about 18,000 of these machines in the U.S. and Abbott expects to ramp up manufacturing to deliver 50,000 tests per day.

Well then, take the extra eight minutes and make them all negative results! Crisis over!

[budwom]

I read about this last week. But it’s frustrating to keep hearing about all these incremental and new testing capabilities but with no understanding of how, when and where all of this is being deployed around the country.

yeah, there's been a guy on the news talking about ramping up his company's ventilator production, but the numbers are really small...like a few thousand this month, 3k the next, does not appear to be sufficient for the near term crisis...

[Dr. Rosenrosen]

yeah, there's been a guy on the news talking about ramping up his company's ventilator production, but the numbers are really small...like a few thousand this month, 3k the next, does not appear to be sufficient for the near term crisis...

Hoping that someone somewhere is coordinating all these efforts but I’m not holding my breath. Sounds more like governors making one-off efforts to purchase what they need if they can get it. I hope that’s wrong.

[swood1000]

I read through the entire paper that your article references. Interestingly, but not surprisingly, the part that the media chose to highlight was barely on the radar in the actual paper. The paper was about spread on cruise ships. I found some of the numbers actually fairly reassuring; despite being stuck together on fairly close quarters, about 80% of the passengers did not get infected. Spread among passengers was largely halted once they began limiting their contact aboard the ship, whereas spread among the crew (who had to continue to work) peaked AFTER contact/movement of passengers was limited.

The part about finding viral RNA on surfaces 17 days later was a single line in the article, and was attributed to "personal communication" (that's science speak for unpublished and unreviewed). It should be noted that coronavirus RNA is not infectious unless it is contained within the virus and its envelope. When an enveloped RNA virus dessicates, the virus becomes no longer communicable.

It is somewhat surprising that even RNA would survive that long, given the fact that there are RNAses everywhere (RNA is notorious for breaking down very quickly). It pays to remember, however, that RT-PCR testing done for coronavirus RNA only looks at two segments of the genome that together are about 100 nucleotides in length, and also that PCR logarithmically expands existing RNA. It is possible (and, in fact, in my opinion, likely) that not only was there no communicable viral material on those surfaces but also that there wasn't even any INTACT viral RNA on the surface; if small segments had not yet been broken down by environmental RNAses, PCR could still come back as positive. I have no way of knowing for sure, but I would be willing to bet that no infectious virus was in those cabins after 17 days. From a virologic standpoint, it's almost impossible to believe otherwise. Finally, testing was also done before any cleaning whatsoever was performed.





For those who don't know what PCR testing is or how it works, I'll give you a short primer (pun intended). If you already understand PCR testing, feel free to skip this part.

For simplicities' sake, let's look at the most common testing, PCR of DNA. (PCR stands for Polymerase Chain Reaction, by the way.)

Say you are looking for herpes simplex virus DNA in a sample taken from a skin lesion. You put the sample into a buffer, along with primers that match up to the DNA of virus, along with a soup of nucleotides and DNA polymerase (the polymerase is an enzyme that catalyzes the reproduction of DNA; the nucleotides are the building blocks of DNA). Then you put the sample into a machine. What the machine does is heat up the sample to a point at which the herpes DNA strands denature (essentially separate into two strands), at which point the sample begins to cool. As it cools, the polymerases in the "soup" start taking the nucleotides in the soup and matching them up to the separated strands. Thus, one strand of DNA becomes two, each new strand containing half of the old DNA and the other half the newly synthesized DNA. The sample is cooled down enough to make the entire process complete, then it is reheated again, which then separates the two strands, then it is cooled again, and the polymerases turn those two strands into FOUR. This process continues over and over again for multiple cycles, thus amplifying the sample many, many times over in logarithmic fashion. Sometimes they are cycled up to 30 or 40 times, turning even a single piece of DNA potentially into BILLIONS of pieces of DNA.

The main problem with PCR testing is false positives, precisely because amplification is so immense. Say, for example, that the person who had the skin lesion doesn't really have herpes infection, but the person who loads the PCR machine has occasional cold sores. If he/she is not wearing a mask when they load the sample, it would be simple for a tiny amount of herpes virus DNA to be accidentally inoculated into the sample (herpes DNA can be shed even when the person is not experiencing active cold sores).

Anyway, sorry for the long explanation. Many of you probably already knew all this. I certainly don't want to "talk down" to anybody. Some things I think people might want to know they really might not care about. It's hard to know, also, when I am oversimplifying things, or, conversely, going over people's heads. I apologize to anybody who feels like I am doing either of those things. I'm trying to walk the line between the two, but sometimes it's hard to know where that line is.

Apparently, the Abbott machines use isothermal nucleic acid amplification technology instead of PCR, and so do not require the time-consuming series of alternating temperature cycles. Does this mean that PCR is becoming old technology?

[Ggallagher]

For the more senior members of the board, you'll remember that back in the day we could have just built a tester at home and gotten this straightened out much more quickly.

Heathkit.jpg

But times have changed.

OK, back to the important stuff - hope somebody can crank out these new kits post haste.

[aimo]

For the more senior members of the board, you'll remember that back in the day we could have just built a tester at home and gotten this straightened out much more quickly.

Heathkit.jpg

But times have changed.

OK, back to the important stuff - hope somebody can crank out these new kits post haste.

Well, I didn't think of myself as "more senior", but now I do. My dad and his friend built our first color TV from Heathkit.

[BD80]

For the more senior members of the board, you'll remember that back in the day we could have just built a tester at home and gotten this straightened out much more quickly.

Heathkit.jpg

But times have changed.

OK, back to the important stuff - hope somebody can crank out these new kits post haste.

There is no "L" in "Heathkit!"


FWIW: I was building my Dynakit pre-amplifier the night I won the tickets to the limited preview of "Star Wars" in May of 1977. I feel like I could build a few Covid tests kits at home now.

I've got time.

[Bob Green]

Governor Northam has issued a “Stay at Home” order for Virginia:

https://www.wavy.com/news/health/cor...-for-virginia/

[swood1000]

Apparently, when flu deaths in a year are listed, the number given is the number of deaths over and above what one would expect to happen in that year (at least in the UK). This is because quite a few of these people would have died anyway of old age or of other health conditions. So a way exists to estimate these “excess deaths” from flu. However, with Covid-19 this reduction is not made and we are given the gross death number. Consequently the number of deaths attributed to Covid-19 is inflated.

In Great Britain, 600,000 people die each year. Neil Ferguson, the Imperial College London scientist whose recent research on Covid-19 received much press, now is expecting 20,000 deaths or fewer, and says that half to two thirds of those people would have died anyway before the end of the year “because these are people at the end of their lives or who have underlying conditions.”

One British statistician says that if the number can be kept to 20,000 by stringent suppression measures there may end up being a minimal impact on overall mortality for 2020 (although background mortality could increase due to pressures on the health services).

All-cause mortality in England and Wales in 2020 compared to prior years is below (the Office for National Statistics only lists 2020 up to March 13).

[Channing]

Has anyone called Elizabeth Holmes and asked her to produce a test?