COVID-19 (Con’t 2)

[Peter Wilcox]

It looks like we can buy point-of-care 15 minute antibody tests from China - the paramedics in Coral Springs Florida have them and are using them (though maybe not entirely appropriately.) Nothing about it I can find except that I saw it on the news last night: https://www.nbcnews.com/nightly-news...ls-81664069703

Nightly News
Paramedics under pressure with record level emergency calls

Paramedics in Florida are now getting more and more calls for potential coronavirus cases. In Coral Springs, many paramedics took “quick-read” blood tests to check for antibodies to see if they have an inexplicable immunity and can take more calls.April 5, 2020

Anybody know anything about this? Obviously not FDA approved, but it would be nice if we could buy these for local use, and if the FDA could get on the stick and ramp this up.

[srick]

Originally Posted by Peter Wilcox

It looks like we can buy point-of-care 15 minute antibody tests from China - the paramedics in Coral Springs Florida have them and are using them (though maybe not entirely appropriately.) Nothing about it I can find except that I saw it on the news last night: https://www.nbcnews.com/nightly-news...ls-81664069703

Nightly News
Paramedics under pressure with record level emergency calls

Paramedics in Florida are now getting more and more calls for potential coronavirus cases. In Coral Springs, many paramedics took “quick-read” blood tests to check for antibodies to see if they have an inexplicable immunity and can take more calls.April 5, 2020

Anybody know anything about this? Obviously not FDA approved, but it would be nice if we could buy these for local use, and if the FDA could get on the stick and ramp this up.

Form the news I have heard (PBS Newshour), there has been a high incidence of failure of tests coming from China.

Abbott Labs does have a 5-10 minute test which it is producing in large numbers right now (needs an automated processor). Supplies are disappearing as quickly as the units are produced.

[HodgdonExtreme]

Originally Posted by srick

This article from the NYT today noted https://www.nytimes.com/2020/04/05/u...ndercount.html The True Death Rate of the Virus is Probably Much Higher.

There are a few take-homes in this article:

1. When multiple contributors to death are present, the virus may be over-represented or under represented
2. If the deceased had not been tested, you have no good basis to determine cause of death
3. Similarly, if everyone is not tested, corona virus like symptoms that go away may or may not counted in the disease statistics
4. Definitions and procedures for reporting vary widely across states, counties and countries

1. If there are multiple contributors, human(s) must decide how to attribute it. For this to skew the mortality rate artificially downwards, there would need to be some bias driving it. What would this bias be?
2. I've not seen statistics (if they even exist), but I suspect VERY FEW people in USA are dying of a double-pneumonia respiratory failure - and NOT being tested to see if they had the plague. Regardless, for this to skew the mortality rate - there would need to be a VERY SIGNIFICANT number of these untested respiratory deaths occurring. That doesn't pass my "sniff test".
3. People that get and recover from the plague (having not been tested) serve to drive the mortality rate DOWN, not up. This effect could be somewhat cancelled out by people that get and DIE of plague having not been tested. However, I think that is far more rare than those that get infected and recover at home untested.
4. While definitions and procedures do indeed vary - for the mortality rate to be reported erroneously low, one or both of these two things must be happening: More people are dying than we know, Or fewer people are infected than we know. The former is possible to some extent - the latter is not. Personally, I do not believe the former could be happening to a large enough extent to skew the mortality rate to any statistically significant extent.

I welcome your reply.

[buddyhu]

There is very little point in arguing what the “real” death rate is. As with most aspects of this pandemic, too little is known, and everything is in motion. What we do know is that good hygiene and social distancing are good steps to take.

And we know that everyone has their own characteristic response to fear: some will feel it, some will amplify it, some will deny it, some will transform it into another emotion (depression or anger, most commonly). This is on display with virtually every post related to Covid19.

[robj144]

Shipping to a lab and waiting for the results I don't think is a problem. It's "decentralized" testing in mass quantities that needs to be done by the millions because and labs can't deal with that quick enough. Hence, you need mobile "testing kits" which take time to make.

[robj144]

I keep on saying this, but the actual morality rate doesn't matter. It's the absolute number of people dying you want to minimize. It doesn't really matter what the mortality rate is now. You don't want the number of dead doubling every few days like it has been.

[KevWind]

Fortunately most (certainly not all) of those who make public policy are listening to actual infectious disease experts , who do understand that death rate alone is not , and absolutely should not be, the primary concern or primary reason to institute policy .

[Blueser100]

Originally Posted by RedJoker

I work in an R&D lab but not anything bio related. I keep hearing everyone say we need more testing but what does that really mean? As far as I can tell, it's a nasal swap that then gets sent to the lab for 'testing.' But that can mean a bunch of different things, obviously.



Maybe my question is really, what is the testing bottle-neck? Is it technicians? Is it analyzers? Is it reagents? Is it some other facility requirement? Is there a time requirement that is inherent to the test?



I'm just trying to cure my ignorance but I don't think it's as straightforward as many seem to think it is. Thanks!

What we need is antibody testing. Researchers are working on it. If we knew who has coronavirus antibodies, we might glean more info on who is immune and therefore presumed safe from contracting it again.

[AX17609]

When making public health policy, you look at total deaths. When assessing personal risk you look at death rate.

[Cypress Knee]

In an article on page A6 of the April 6 San Diego Tribune, and Italian official stated that they did not know exactly how many deaths could be attributed to the Corona virus, but they did know that number of deceased was four times greater than was average for that time of the year.

[Peter Wilcox]

This is from over 2 weeks ago, by a Caltech virologist: https://www.caltech.edu/about/news/t...about-covid-19

"What are the tests we need to detect coronavirus infection?

Everybody's talking about testing and that's actually referring to PCR [polymerase chain reaction] testing, looking for viral RNA to determine whether a person is infected. But there's still no talk of antibody testing to determine which people have had it and are immune, and that is another crucial tool we need to combat this epidemic. Many research labs throughout the country—I'm sure at Caltech too—could be running antibody tests right now to survey the population and tell us what the real penetrance of this pathogen is in our communities. We are, on a research basis, embarking on that to understand the degree of infection in New York City and outside of New York City.

How long before the U.S. sees test availability similar to what South Korea has implemented?

The PCR testing, which is the one that's approved, is now ramping up very, very rapidly in state and local labs as well as in academic medical centers and in the commercial sector. Their production will grow tremendously. Roche has a machine that will run 1,000 samples at a time. If you go to a commercial lab, they take a swab, they package it, they quite often send it to another facility somewhere else. The turnaround time is typically 72 hours. In that period, it's very, very hard to manage patients and their contacts. It's a nightmare for the healthcare worker.

We need point-of-care tests. Those kinds of tests are available for HIV and for many other diseases; you use a finger stick, drop the blood on a small device, and have a readout in 15 minutes. These tests measure antibody response to the virus and are extremely useful. Yet we don't have a single test licensed in the U.S. In China, in South Korea, and in Europe, those tests are used. The manufacturer for this rapid test is producing a million a day. It's there. But in the name of protecting the public, the FDA has moved very, very slowly. That delay, in my view, has caused more harm than good.

Can you elaborate on point-of-care testing?

It's almost like a home pregnancy test or home HIV test. These tests have been around for a long time. The test that I'm specifically referring to, coming out of China, South Korea, and approved in Europe, is an antibody test. You put a drop of blood on a plastic slide, add another drop of the buffer that comes with the test, and you let it sit for 15 minutes. Then, you look at the bands. You're negative if you have just one band, or you're positive if you have more than one band. The test also tells you type of antibody. There's a type of antibody called IgG [immunoglobulin G] and another type called IgM [immunoglobulin M]. Typically, when a person is infected, the IgM response is earlier and the IgG response is later. The two bands indicate the course of the infection.

This kind of test is available all over the world for HIV. The technology is there, the tests are there. But they're not FDA approved. While I think they are fairly close to being approved, we have let several weeks go by and to me that's tragic."

So now it's been over a month, and no FDA approved point-of-care antibody tests. Makes me wonder who's benefiting from the delays.

[Neil K Walk]

Anybody for some potentially good news?

https://www.upmc.com/coronavirus/vac...il-5_Apr-20_e1

[DCCougar]

Originally Posted by Neil K Walk

Anybody for some potentially good news?
https://www.upmc.com/coronavirus/vac...il-5_Apr-20_e1

That would be good. Really good.

[robj144]

Originally Posted by Neil K Walk

Anybody for some potentially good news?

https://www.upmc.com/coronavirus/vac...il-5_Apr-20_e1

That's great, but getting it through testing and production will take a fair amount of time.

[rokdog49]

Originally Posted by Mr. Jelly

https://www.arcgis.com/apps/opsdashb...23467b48e9ecf6

Thank you.
I’ve seen varying numbers from other reputable sources. I’m really not into these stats. Whatever the real numbers are, we really don’t know for sure and for me any death percentage is bad.