COVID-19 - Facts and Information Only Topic

[Stank_Nasty]

I've stayed away from most covid talks because i feel like it just gets too judgey from either side. But i'm gonna go ahead and post a link to an article about a study done in my own county of Erie, PA. Why this hasnt gotten more hype i dont know. i think maybe because it doesnt support the medias fear based narrative. It could also be that the formulas used arent peer reviewed and its relatively uncharted territory so maybe people just arent confident in the results of the data.

 

Anyways.... This is a sewage study done in one of 400 different cities. The bio company apparently created a formula to estimate active covid cases through testing the sewage before it gets cleansed. I'll preface these staggering numbers by saying that at the date of this article 3 weeks ago there was less than 1000 CONFIRMED cases in Erie county, PA since march and 7 or 8 deaths at the time of this article. With that being said, this article estimates over 30,000 active cases from just mid june to early july. this isnt even accounting for anything before june. 

 

If you plug the deaths into those estimates is drops the fatality rate to a staggeringly low %. Like less than .0003.... heck even if their numbers are 75% off it still drops the death rate an extremely low number of .001

 

I'm not saying this study is any sort of "end all be all", but it blows my mind it hasnt gotten more coverage. if these numbers are even remotely close it would seem to change the views on things quite a bit. I'm just tossing it out there. Do with it what you will.

 

https://www.msn.com/en-us/health/medical/erie-county-s-covid-19-sewage-numbers-drop-again/ar-BB16v2dJ

 

[EDIT: I find the potential of monitoring sewage as an "early warning system" for covid-19 spikes to be intriguing.

You can find a link to one of the first studies pubished on the technique posted here on May 5:

The Achilles heel of trying to translate this back to "number of patients actually infected" is that our data on the viral genome titer in infected people is limited.  When it comes to viral genome titer in poop, it's even more limited.  The chances are very good that titer varies  A LOT depending on a bunch of factors, including how sick the infected person is.  So using viral genome titer from sewage to back-calculate number of infections seemed very squishy to me back in May, and it hasn't gotten much less squishy (see what I did there?) in the last 2 months.]

 

[Richard Noggin]

9 hours ago, Stank_Nasty said:

I've stayed away from most covid talks because i feel like it just gets too judgey from either side. But i'm gonna go ahead and post a link to an article about a study done in my own county of Erie, PA. Why this hasnt gotten more hype i dont know. i think maybe because it doesnt support the medias fear based narrative. It could also be that the formulas used arent peer reviewed and its relatively uncharted territory so maybe people just arent confident in the results of the data.

 

Anyways.... This is a sewage study done in one of 400 different cities. The bio company apparently created a formula to estimate active covid cases through testing the sewage before it gets cleansed. I'll preface these staggering numbers by saying that at the date of this article 3 weeks ago there was less than 1000 CONFIRMED cases in Erie county, PA since march and 7 or 8 deaths at the time of this article. With that being said, this article estimates over 30,000 active cases from just mid june to early july. this isnt even accounting for anything before june. 

 

If you plug the deaths into those estimates is drops the fatality rate to a staggeringly low %. Like less than .0003.... heck even if their numbers are 75% off it still drops the death rate an extremely low number of .001

 

I'm not saying this study is any sort of "end all be all", but it blows my mind it hasnt gotten more coverage. if these numbers are even remotely close it would seem to change the views on things quite a bit. I'm just tossing it out there. Do with it what you will.

 

https://www.msn.com/en-us/health/medical/erie-county-s-covid-19-sewage-numbers-drop-again/ar-BB16v2dJ

Can you help me understand where your 2nd and 3rd paragraphs are coming from? After looking over the link provided, I'm not seeing any of the specific numbers or conclusions you're sharing in those two paragraphs. 

 

After you help me see the origins of your data (and thank you for doing so), could you do me one more favor? Can you help us all better understand or contextualize how useful/accurate sewage studies are in tracking Covid cases (and more specifically Covid death rates, which you cite in your post but I don't see cited anywhere in the article linked)? Thank you. 

 

I can be a bit careless in the wee hours of the morning, so I appreciate the help in verifying the stats you've cited in your post.

[Buddo]

12 hours ago, Stank_Nasty said:

I've stayed away from most covid talks because i feel like it just gets too judgey from either side. But i'm gonna go ahead and post a link to an article about a study done in my own county of Erie, PA. Why this hasnt gotten more hype i dont know. i think maybe because it doesnt support the medias fear based narrative. It could also be that the formulas used arent peer reviewed and its relatively uncharted territory so maybe people just arent confident in the results of the data.

 

Anyways.... This is a sewage study done in one of 400 different cities. The bio company apparently created a formula to estimate active covid cases through testing the sewage before it gets cleansed. I'll preface these staggering numbers by saying that at the date of this article 3 weeks ago there was less than 1000 CONFIRMED cases in Erie county, PA since march and 7 or 8 deaths at the time of this article. With that being said, this article estimates over 30,000 active cases from just mid june to early july. this isnt even accounting for anything before june. 

 

If you plug the deaths into those estimates is drops the fatality rate to a staggeringly low %. Like less than .0003.... heck even if their numbers are 75% off it still drops the death rate an extremely low number of .001

 

I'm not saying this study is any sort of "end all be all", but it blows my mind it hasnt gotten more coverage. if these numbers are even remotely close it would seem to change the views on things quite a bit. I'm just tossing it out there. Do with it what you will.

 

https://www.msn.com/en-us/health/medical/erie-county-s-covid-19-sewage-numbers-drop-again/ar-BB16v2dJ

 

https://www.bbc.co.uk/news/uk-wales-52544247

 

It can be a useful tool in finding 'spikes' and also perhaps giving some advance warning, but to think it can accurately say how many cases there are, is something of a stretch, imho.

Maybe over time, with far more extensive testing in communities, they can get a closer sense of how many cases there are, (in relation to the waste) but until they can actually correlate that sort of thing, I'd be very wary of taking the estimates as gospel.

 

Undoubtedly they can tell you if overall if it's on the rise or fall for a given area, but I don't think they can be particularly more accurate than that currently, simply because there isn't enough testing done of all of a community, to verify any algorithm etc. that they can come up with.

[Stank_Nasty]

5 hours ago, Richard Noggin said:

Can you help me understand where your 2nd and 3rd paragraphs are coming from? After looking over the link provided, I'm not seeing any of the specific numbers or conclusions you're sharing in those two paragraphs. 

 

After you help me see the origins of your data (and thank you for doing so), could you do me one more favor? Can you help us all better understand or contextualize how useful/accurate sewage studies are in tracking Covid cases (and more specifically Covid death rates, which you cite in your post but I don't see cited anywhere in the article linked)? Thank you. 

 

I can be a bit careless in the wee hours of the morning, so I appreciate the help in verifying the stats you've cited in your post.

The confirmed cases and deaths i cite in the 2nd paragraph are from my own knowledge of the situation. As a gym owner in the area I’ve paid very close attention to what’s going on. The adjusted fatality rates I speak of are me doing the math. It’s the confirmed deaths, at the time, put up against the estimated total cases from the article. 
 

As far as how useful or accurate the data is I cannot say. I’m no scientist. And in my post I sort of hint that maybe it’s not an accepted or reliable practice right now. So that might be why it’s gained no traction. But if those numbers are even 25%-50% correct it completely drops the floor out of the fatality rate and hospitalization rate on a local level anyways. 

3 hours ago, Buddo said:

 

https://www.bbc.co.uk/news/uk-wales-52544247

 

It can be a useful tool in finding 'spikes' and also perhaps giving some advance warning, but to think it can accurately say how many cases there are, is something of a stretch, imho.

Maybe over time, with far more extensive testing in communities, they can get a closer sense of how many cases there are, (in relation to the waste) but until they can actually correlate that sort of thing, I'd be very wary of taking the estimates as gospel.

 

Undoubtedly they can tell you if overall if it's on the rise or fall for a given area, but I don't think they can be particularly more accurate than that currently, simply because there isn't enough testing done of all of a community, to verify any algorithm etc. that they can come up with.

I’m not taking it as gospel. I’m just tossing it out there. I continue to be mindful of my surroundings and situation. And as a gym owner in the area my sanitation protocol is STRINGENT.  But like I said in my original post, if these numbers are even 25% correct it still literally drops the floor out of the fatality and hospital rates. 
 

The infectious disease specialist, Howard Nadworny, that they are interviewing in the article is a colleague and close friend of a nursing professor that I personally train. My client has told me that she and him have had some in depth talks over the study and he’s quite an advocate and very confident in the data.  For whatever that’s worth ?‍♂️....  I would hope my county isn’t paying for a study that’s only 25% accurate. That would be silly right? 
 

like i said. I continue to do what I need to do to keep my family, strangers i come in contact with and my 300 gym members safe but I think it should be obvious that the case counts are much higher than we hear and in turn the fatality rate is much less. I also get that there are more risks than just death. 

Edited July 31, 2020 by Stank_Nasty

[BillsFan4]

15 hours ago, Stank_Nasty said:

I've stayed away from most covid talks because i feel like it just gets too judgey from either side. But i'm gonna go ahead and post a link to an article about a study done in my own county of Erie, PA. Why this hasnt gotten more hype i dont know. i think maybe because it doesnt support the medias fear based narrative. It could also be that the formulas used arent peer reviewed and its relatively uncharted territory so maybe people just arent confident in the results of the data.

 

Anyways.... This is a sewage study done in one of 400 different cities. The bio company apparently created a formula to estimate active covid cases through testing the sewage before it gets cleansed. I'll preface these staggering numbers by saying that at the date of this article 3 weeks ago there was less than 1000 CONFIRMED cases in Erie county, PA since march and 7 or 8 deaths at the time of this article. With that being said, this article estimates over 30,000 active cases from just mid june to early july. this isnt even accounting for anything before june. 

 

If you plug the deaths into those estimates is drops the fatality rate to a staggeringly low %. Like less than .0003.... heck even if their numbers are 75% off it still drops the death rate an extremely low number of .001

 

I'm not saying this study is any sort of "end all be all", but it blows my mind it hasnt gotten more coverage. if these numbers are even remotely close it would seem to change the views on things quite a bit. I'm just tossing it out there. Do with it what you will.

 

https://www.msn.com/en-us/health/medical/erie-county-s-covid-19-sewage-numbers-drop-again/ar-BB16v2dJ

how so?
 

We know for a fact that this virus is plenty deadly, no matter what the mortality rate ends up being. This virus has killed 150,000 people in just over 4 months. and that’s with the (half-assed) preventative measures we’ve taken. I can’t even imagine how much worse it would have been if we just stayed open and did nothing. 

 

No average flu we’ve ever seen has killed 150,000 Americans in 4+ months. Our worst flu season in the last decade saw 30 to 60,000 deaths over the entire flu season (8-9 months). Covid has killed at least 2-4 x that amount in half the time (or less) and we haven’t even hit flu season yet this year. Covid is going to finish among the top 5 causes of death in the United States this year, and actually, probably top 3. For a whole month it was the #1 killer in the US. 
 

leading causes of death in the US, for comparison:

https://www.healthline.com/health/leading-causes-of-death
 

 

The mortality rate also doesn’t change the fact that this virus spreads fast and can quickly start to overwhelm our healthcare systems if left to spread unchecked (as we’ve seen over and over again here and around the world). 
 

We are also finding out that there could be longer term health effects, like damage to the heart and lungs. See the study that Hapless posted in the other covid thread that examined 100 “mild cases” (people who weren’t hospitalized) and found 78% with heart damage (in many people with no previous health issues).

[HappyDays]

 

This is concerning with schools set to reopen in the fall.

20 hours ago, Hapless Bills Fan said:

Here's the study referenced above:  https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm?s_cid=mm6931e1_w

 

A total of 597 Georgia residents attended camp A.

Median camper age was 12 years (range = 6–19 years), and 53% (182 of 346) were female.

The median age of staff members and trainees was 17 years (range = 14–59 years), and 59% (148 of 251) were female.

Test results were available for 344 (58%) attendees; among these, 260 (76%) were positive.

The overall attack rate was 44% (260 of 597), 51% among those aged 6–10 years, 44% among those aged 11–17 years, and 33% among those aged 18–21 years (Table).

Attack rates increased with increasing length of time spent at the camp, with staff members having the highest attack rate (56%). During June 21–27, occupancy of the 31 cabins averaged 15 persons per cabin (range = 1–26); median cabin attack rate was 50% (range = 22%–70%) among 28 cabins that had one or more cases.

Among 136 cases with available symptom data, 36 (26%) patients reported no symptoms; among 100 (74%) who reported symptoms, those most commonly reported were subjective or documented fever (65%), headache (61%), and sore throat (46%).

 

Staffers were required to wear cloth masks.  Campers were not required to wear cloth masks.  Campers had to provide documentation of a negative RT-PCR test taken <12 days before arriving and were assigned to "pods": "Camp attendees were cohorted by cabin and engaged in a variety of indoor and outdoor activities, including daily vigorous singing and cheering."

A 51% attack rate in age 6-10 is astoundingly high.  A widespread contact tracing study in S. Korea during mitigation measures reported an attack rate of ~12% inside the home, with the highest attack rate occurring in children age 10-19 (~18%) and a low attack rate in younger children.  But evidently when children are grouped together all day, the attack rate is much higher.

One does wonder if the attack rate would be lower had the Georgia CDC had access to test data on all campers, but even if it decreased by 50% it would still be a yike!ingly high 25%.

[Richard Noggin]

16 hours ago, Stank_Nasty said:

The confirmed cases and deaths i cite in the 2nd paragraph are from my own knowledge of the situation. As a gym owner in the area I’ve paid very close attention to what’s going on. The adjusted fatality rates I speak of are me doing the math. It’s the confirmed deaths, at the time, put up against the estimated total cases from the article. 
 

As far as how useful or accurate the data is I cannot say. I’m no scientist. And in my post I sort of hint that maybe it’s not an accepted or reliable practice right now. So that might be why it’s gained no traction. But if those numbers are even 25%-50% correct it completely drops the floor out of the fatality rate and hospitalization rate on a local level anyways. 

 

Thanks for clarifying. That was gracious of you, and transparent.

 

I'm going to have to shrug my shoulders at Covid levels in waste water as an indicator of anything, because I've not yet seen a single scientific source point to that metric as meaningful (or at all). Seems like we can't responsibly glean anything from that data without some kind of expert support for doing so. And as for the numbers you've come up with on your own, it's difficult for anyone else to find significance in them without transparent evidence and methodology. I appreciate your efforts, but it isn't apparent how accurate or meaningful that effort is without support. 

[DefenseWins]

https://www.nytimes.com/2020/07/31/health/coronavirus-children-camp.html

 

 

 

 

 

 

Edited August 1, 2020 by DefenseWins

[Punching Bag]

https://www.nytimes.com/news-event/coronavirus?action=click&pgtype=Article&state=default&module=styln_key_updates&variant=2_variant&region=body&context=what_you_need_to_know

Key developments you may have missed.

Updated weekday evenings

• Sanofi and GlaxoSmithKline will receive $2.1 billion to supply the U.S. government with 100 million doses of an experimental coronavirus vaccine — the largest such deal to date.
• Dr. Anthony Fauci said the U.S. would most likely have a safe and effective coronavirus vaccine by the end of 2020 or early in 2021.
  
  [Edit:  this is just one of several deals brokered by the "Operation Warp Speed" project.  An earlier deal offered Pfizer/BioNTec $1.95 billion.   Novavax, a struggling small company in Maryland, has received $1.6 billion. 
  
  There's a not-quite-up-to-date and not-very-transparent summary here.]
  
  [And edit again: part of the deals being offered to these companies specifies that the vaccine will be provided at no or low cost}

[Punching Bag]

https://www.yahoo.com/news/column-gop-plan-cant-sue-172938487.html

 

It would absolve employers of responsibility for taking any but the most minimal steps to make their workplaces safe. It would preempt tough state workplace safety laws (not that there are very many of them).

 

And while shutting the courthouse door to workers, it would allow employers to sue workers for demanding safer conditions.

 

This is the provision that McConnell has described as his "red line" in negotiations over the next coronavirus relief bill, meaning that he intends to demand that it be incorporated in anything passed on Capitol Hill and sent to President Trump for his signature. The provision would be retroactive to last Dec. 1 and remain in effect at least until Oct. 1, 2024.

 

The proposal would supersede such federal worker safeguards as the Occupational Safety and Health Act of 1970, the Fair Labor Standards Act of 1938, the Americans with Disabilities Act of 1990 and the Genetic Information Nondiscrimination Act of 2008, among oth

------------------

[Edit: I think this belongs here as it's being proposed as legislation related to covid-19, so folks with opinions either way have a need to be informed and weigh in pro or con with their elected representatives and senators. 

 

Gentle reminder that there are several places for discussion and that this post may be linked for the purpose by clicking on the posting date and time in the upper L corner- but if you wish to discuss or debate this: Somewhere else, Not here.  Thanks.]

 

[Hapless Bills Fan]

More vaccine stuff.

 

Pfizer and BioNTech pick a hoss.  For those who don't know, Pfizer and BioNTech have been simultaneously advancing 4 different vaccine candidates, two into the clinic.  This choice comes as somewhat of a surprise as all the stuff Pfizer has published to date has been on a different vaccine candidate, but the assertion is this choice beat the other out. Since their published candidate data looked very good indeed, that's good news.

• Companies advance nucleoside-modified messenger RNA (modRNA) candidate BNT162b2, which encodes an optimized SARS-CoV-2 full-length spike glycoprotein, at a 30µg dose level in a 2 dose regimen into Phase 2/3 Study
• Candidate and dose level selection informed by preclinical and clinical data obtained in Phase 1/2 studies conducted in the U.S. (C4591001) and Germany (BNT162-01) 
• The Phase 2/3 study protocol follows all the U.S. Food and Drug Administration (FDA) guidance on clinical trial design for COVID-19 vaccine studies.
• Phase 2/3 study of up to 30,000 participants aged 18 – 85 years started in the U.S. and expected to include approximately 120 sites globally  
• Trial regions to include areas with significant expected SARS-CoV-2 transmission to assess whether investigational vaccine candidate, BNT162b2, is effective in preventing COVID-19
• Assuming clinical success, Pfizer and BioNTech on track to seek regulatory review as early as October 2020 and, if regulatory authorization or approval is obtained, plan to supply up to 100 million doses by the end of 2020 and approximately 1.3 billion doses by the end of 2021

 

Pharma Blogger Derek Lowe has some commentary about it: It comes down to the antigen(s) being coded for. The b1 candidate, the one we’ve been hearing about, codes for the coronavirus Spike protein’s receptor-binding domain (RBD), and this was constructed as a trimer, three RBDs attached to a “foldon” protein core. Meanwhile, the b2 candidate codes for what they say is an “optimized full-length Spike” protein instead, not just the receptor-binding domain. Pfizer’s press release says that both the b1 and b2 candidates “induced favorable viral antigen specific CD4+ and CD8+T cell responses, high levels of neutralizing antibody in various animal species, and beneficial protective effects in a primate SARS-CoV-2 challenge model“. But they made the choice for the b2 variety partly because it seemed to be better tolerated on injection, and also because it led to a wider variety of T-cell responses. These include both CD4+ and CD8+ T-cells, and these were raised not only to recognize the RBD region, but also other regions of the Spike protein that weren’t contained at all in the b1 candidate. And they’re quite right – that could well be beneficial, and the better tolerability is a bonus. The release says that the neutralizing antibody response was similar between the two candidates.

Note that people expecting a vaccine in November can keep expecting.  There may be completion of a Phase III clinical trial, but that will be followed by regulatory review and hopefully, authorization or approval, with vaccine available "by the end of 2020" which probably means January 2021.

 

 

 

 

 

[Buddo]

https://www.bbc.co.uk/news/uk-53632043
 

New test for Covid19  that supposedly gives results in about 90 minutes. Could be an important step forward for any track  and trace Systems to become more worthwhile. Doesn’t say who has come up with it, and no data given about accuracy as yet, but you would think that at least positives would get further testing to be certain.

Obviously, false negatives are still a major concern, but speedier testing simply has to be achieved to nail this thing on the head.
 

Just now, Hapless Bills Fan said:

 

As far as I can tell, what's "new" about this is it's a combined test for covid-19 and flu, which many US companies are coming out with.  It's a 'point of care' test using a proprietary machine sold by the company, similar to the Abbott IDNow test that I believe the White House still uses.

We have no shortage of different tests that give 90 minute results.  Here is an upcoming (August) publication comparing 4 different tests that are already in use have good accuracy, comparable to the CDC assay.  Two of them take a total time of <2 hrs (90 minute run time).

The problem with testing is not the test time per se - even the CDC test officially takes only 3 hrs. 

 

The problem is overall throughput - is the equipment widely available at POC sites? how about the reagants?  if the test will be sent to a lab, how are they situated a far as equipment and reagants?  Tests get taken at a clinic or test site and sent to a designated laboratory working with that clinic or site, even if that laboratory is swamped or running low on reagants.

 

There is no logistical oversight and coordination to share "surge" load.  The FDA is open to authorizing pooled testing strategies, but only for "surveillance" and this may be too late with % positives in many areas outrunning the threshold at which it makes sense.

 

I don't think another proprietary machine for a POC test will be an important step forward, unless it somehow manages to truly become more widespread and available.

 

We could solve the testing bottlenecks with the tests we have now given appropriate logistics, coordination and use of pooled testing strategies that allow individual samples to be identified.

[Buddo]

https://www.bbc.co.uk/news/science-environment-53635692

 

This is an 'update' as regards the UKs attempts, to try and get information from sewage, as to how much Covid19 there is in an area. Seems there are 44 'sites' where this will take place. The hope is that detailed analysis will be able to give more advance warning of where outbreaks are about to occur.

[Hapless Bills Fan]

In case any of you or yours are impacted by "Cuomo's List", the Rochester D&C has a site tracking daily tests and calculating the # positives/100,000k population

 

http://rochester.nydatabases.com/database/ny-quarantine-order-daily-covid-19-cases-100k-residents?fbclid=IwAR0gfzqYRC_gyY6-oDV0CeWhClXdP6OTsHKXlHnRQEmT8gLjjJgrGmufcUA

 

Rhode Island is about to get a "lump of coal" in its stocking from CT, NY, and NJ

Colorado, Delaware, and DC may come off the list.

 

 

[Hapless Bills Fan]

Dilemma of a school superintendent.  Don't envy his job:

 

https://www.washingtonpost.com/nation/2020/08/01/schools-reopening-coronavirus-arizona-superintendent/?arc404=true

 

He does a pretty good job outlining his dilemma I think:

"The governor has told us we have to open our schools to students on August 17th, or else we miss out on five percent of our funding. I run a high-needs district in middle-of-nowhere Arizona. We’re 90 percent Hispanic and more than 90 percent free-and-reduced lunch. These kids need every dollar we can get. But covid is spreading all over this area and hitting my staff, and now it feels like there’s a gun to my head. I already lost one teacher [died, infected 2 other teachers while teaching summer school in a room with 2 other teachers who were masked, distanced, used separate computers etc] to this virus. Do I risk opening back up even if it’s going to cost us more lives? Or do we run school remotely and end up depriving these kids?" "I dream about going back to normal. I’d love to be open. These kids are hurting right now. I don’t need a politician to tell me that."

 

"More than a quarter of our students live with grandparents. These kids could very easily catch this virus, spread it and bring it back home. It’s not safe. There’s no way it can be safe.

If you think anything else, I’m sorry, but it’s a fantasy. Kids will get sick, or worse. Family members will die. Teachers will die."

 

And that's basically the bottom line.  The kids can catch covid-19 and transmit covid-19.  The S. Korea contact tracing data shows that unambiguously; so do the Georgia summer camp data.  The kids will almost certainly be all right - either no symptoms, or very few symptoms. 

 

The teachers, coaches, aides, bus drivers, custodians, and worse grandparents and other elders who live with or have frequent contact with them....that may be another matter.

 

We could likely mitigate - masks, "airplane arms", pods, "go teams" of experts helping schools assess HVAC.  But school districts just may not have the resources, and where was the push to help them out - back in May?

 

[Hapless Bills Fan]

Two new studies suggest that young children with mild symptoms may not only spread the covid-19 virus, but may possibly spread it more efficiently than adults.

 

Popular article on the topic from Forbes:

"The Chicago study examines the concentration of the SARS-CoV-2 in the nasopharynx, or the upper region of the throat that connects to the nasal passages, of children and adults. According to the results, children 5 years and younger who develop mild to moderate Covid-19 symptoms have 10 to 100 times as much SARS-CoV-2 in the nasopharynx as older children and adults. 

Whenever these young children cough, sneeze, or shout, they expel virus-laden droplets from the nasopharynx into the air. If they have as much as one hundred times the amount of virus in their throat and nasal passages as adults, it only makes sense that they would spread the virus more efficiently. The study also shows that children from the ages of 5 to 17, also with mild to moderate Covid-19 symptoms, have the same amount of virus in the nasopharynx as adults age 18 and above.
The authors conclude it is likely that young children, while not as prone to suffering from Covid-19 infection, still drive its spread—just as they do with several other respiratory diseases."

 

"The second manuscript reports the results of an extensive contact tracing study conducted in Trento, an autonomous region in Northern Italy. Despite a total lockdown that began in March with the closure of schools, universities, and all businesses except grocery stores, pharmacies, and newsstands, for more than a month the number of cases rose exponentially.  The researchers found that although young children had a somewhat lower risk of infection than adults and were less likely to become ill, children age 14 and younger transmit the virus more efficiently to other children and adults than adults themselves. Their risk of transmitting Covid-19 was 22.4 percent—more than twice that of adults aged 30 to 49, whose rate of contagiousness was about 11 percent. “Although childhood contacts were less likely to become cases,” they wrote, “children were more likely to infect household members.”

This is consistent with a recently published contact tracing study from S. Korea during lockdown which included very few young children as index cases - but which found that children age 10-18 as index case had an attack rate of 18.6%, 1.5x the overall attack rate of 11.8%
https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article

Oh, and this from Israel:
https://www.nytimes.com/2020/08/04/world/middleeast/coronavirus-israel-schools-reopen.html?smid=tw-share

 

 

[CountDorkula]

From the office of the state treasurer twitter account. 
 

Remdesivir manufacturer, Gilead, just set the price for the COVID-19 treatment: between $2,300 and $3,100 per patient. @icer_review estimates the treatment costs approx. $1 per vital to produce. $1.

[Edit: this is probably a more balanced take on the subject, though I'm looking for a more solid source.  The current mfr cost is the tip of the iceberg to the actual cost of producing a drug, by the way.  https://www.fastcompany.com/90537165/the-covid-19-drug-remdesivir-costs-as-much-as-3120-per-patient-but-the-government-could-change-that?partner=rss}]

AND Gilead weighs in (Thanks @Limeaid)

 

1 hour ago, Limeaid said:

 

https://www.gilead.com/news-and-press/company-statements/gilead-sciences-statement-on-state-attorneys-general-letter-on-remdesivir

 

[Nervous Guy]

14 hours ago, CountDorkula said:

From the office of the state treasurer twitter account. 
 

Remdesivir manufacturer, Gilead, just set the price for the COVID-19 treatment: between $2,300 and $3,100 per patient. @icer_review estimates the treatment costs approx. $1 per vital to produce. $1.

[Edit: this is probably a more balanced take on the subject, though I'm looking for a more solid source.  The current mfr cost is the tip of the iceberg to the actual cost of producing a drug, by the way.  https://www.fastcompany.com/90537165/the-covid-19-drug-remdesivir-costs-as-much-as-3120-per-patient-but-the-government-could-change-that?partner=rss}]

AND Gilead weighs in (Thanks @Limeaid)

 

 

It's not exactly a new tactic from this company..."Gilead made headlines in 2013 when its first HCV drug, sofosbuvir (brand name Sovaldi), went on the market at a cost of $1,000 per pill, or $84,000 for a full 12-week course of treatment (see here and here). In 2014, Gilead introduced its second HCV drug, Harvoni — which combines sofosbuvir with ledipasvir — at a price of $1,125 per pill, or $94,500 for a full course of treatment. According to ATF, the actual cost of making a 12-week course of sofosbuvir is estimated at $100 to $1,400."

 

https://www.citizen.org/news/outrage-of-the-month-a-price-gouging-tax-dodging-drug-company/

[CountDorkula]

Possible great news for vaccines and affordability, outside of America.

 

https://timesofindia.indiatimes.com/business/india-business/serum-institute-to-produce-up-to-100-million-covid-19-vaccine-doses-for-india-other-countries/articleshow/77413870.cms

 

The company has set an affordable ceiling price of $3

 

[Astrazeneca, one of the companies involved, has brokered or is brokering deals around the world including in the US.   They have pledged not to profit from the vaccine, should it be successful

https://abcnews.go.com/Business/wireStory/astrazeneca-profit-covid-19-vaccine-pandemic-72080936
AstraZeneca has struck a number of deals around the world to supply the experimental COVID-19 vaccine, which has shown promise in early testing. The Anglo-Swedish company recently completed agreements with the United States, Britain, the European Union, the Coalition for Epidemic Preparedness Innovations, a public-private-charitable partnership based in Norway, and Gavi, the Vaccine Alliance, another public-private partnership headquartered in Geneva.

It has also reached a licensing agreement with Serum Institute of India to supply low-and-middle-income countries and agreements with R-Pharm in Russia and SK Biopharmaceuticals Co., Ltd in the Republic of Korea “to manufacture and export for other global markets."

“We want to cover the whole world,'' Soriot said, “so everyone can get access to this vaccine.'' 

 

For those following vaccine progress, this is the Oxford University vaccine ChAdOx1 nCoV-19 or AZD1222, which uses a Chimpanzee Adenovirus as the delivery truck for SARS-CoV2 spike protein - more stuff on it up thread.  It has had promising results published recently in Lancet; the concern is whether older adults who may have anti-human adenovirus immunity would find it less effective. 

Here is a summary of various vaccine programs being funded by US BARDA under "Operation Warpspeed" https://medicalcountermeasures.gov/app/barda/coronavirus/COVID19.aspx?filter=vaccine ]

 

[Hapless Bills Fan]

More vaccine stuff.  This "wired" article is perhaps a wee bit exaggerative, at least to my understanding of "pretty bad".  But I think it makes a valid and necessary point that one needs to look carefully at the details of the adverse events, what they are, and exactly how prevalent they are.

 

https://www.wired.com/story/covid-19-vaccines-with-minor-side-effects-could-still-be-pretty-bad/?itm_campaign=BottomRelatedStories_Sections_4&itm_content=footer-recirc

 

For a vaccine developer, there's a balance - to work, a vaccine has to induce an immune response, and immune responses result in minor ill effects - soreness at the vaccine site, a headache or a low-grade fever for a day.  Modern acellular vaccines can have lower side effects, but sometimes turn out to be less effective at inducing a persistent immune response (example: Tdap)

 

From the point of  view of acceptance in the general public, if we're going to be asking people who may experience no or mild symptoms from covid-19 disease to be vaccinated for the benefit of the large number of Americans who have hypertension, diabetes, other cardiac problems, or are just plain old.....I think it's very important to be up-front about what the side effects are.

[Hapless Bills Fan]

It had been rightly pointed out in this group that we really don't know what we're putting on our faces and how well it works to block droplet transmission.

 

Well - Now we do, thanks to these folks who built a low-cost test device with a laser, a box, and a cell phone to assess how well different masks did at blocking particles.

Note: they are blocking particles the mask wearer EMITS, not particles the mask wearer breathes IN (I would expect the N95 to kick butt and take names there)

 

https://advances.sciencemag.org/content/early/2020/08/07/sciadv.abd3083?fbclid=IwAR2nZmIlAggEMgJjLUISYaU05YRQA-iwqOkgTZ0Bl5GdHN-tOT4gIgDvjfs

 

1) Fleece neck gaiter literally worse than nothing

2) Bandana pretty bad, cotton knit mask a little bit better

3) N95 and surgical mask the best, but pretty well everything else blocked at least 80% of the particles emitted by the mask wearer

 

 

 

[SlimShady'sSpaceForce]

@Hapless Bills Fan

 

https://www.yahoo.com/news/why-does-covid-19-strike-110000273.html

 

I tried to find the direct link to the Miami Herald but quickly gave up. 

 

Why does COVID-19 strike some and not others? Fauci sees an answer in new study

 

The discovery, which found potential signs of immunity in people who had previously been exposed to other types of coronavirus, could also expand the hunt for a long-lasting COVID-19 vaccine.

 

Fauci and other scientists said the study published in Science this month held promising findings for understanding why some individuals exposed to COVID-19 for the first time have a modest reaction to the virus.

 

The study found that the immune systems of roughly half of its subjects appeared to remember past exposure to other, prevalent coronaviruses, including variants of the common cold, equipping them to respond more quickly to a COVID-19 infection once it appeared.

 

[Edit: Thanks for looking.  This work builds on and expand observations in a paper published in Nature, linked above.  Here’s a link to this study's paper.

Key Quote . We demonstrate a range of pre-existing memory CD4⁺ T cells that are cross-reactive with comparable affinity to SARS-CoV-2 and the common cold coronaviruses HCoV-OC43, HCoV-229E, HCoV-NL63, or HCoV-HKU1. Thus, variegated T cell memory to coronaviruses that cause the common cold may underlie at least some of the extensive heterogeneity observed in COVID-19 disease.

 

For an explanation of immune function that may put this in context, check out this article published in the Atlantic and linked in the discussion thread.]

[Hapless Bills Fan]

press release about successful results in RLF-100 clinical trial.
NeuroRx, Inc. and Relief Therapeutics Holdings AG (SIX:RLF, OTC:RLFTF) “Relief” today announced that RLF-100 (aviptadil) showed rapid recovery from respiratory failure in the most critically ill patients with COVID-19. At the same time, independent researchers have reported that aviptadil blocked replication of the SARS coronavirus in human lung cells and monocytes.

RLF-100 has been granted Fast Track designation by FDA and is being developed as a Material Threat Medical Countermeasure in cooperation with the National Institutes of Health and other federal agencies. Further research will be conducted.

 

They appear to have not published the trial results yet, but it appears to be legit.  Drug is also known as aviptadil.  It is being made available by the FDA under an "Expanded Access Program", which is a program to make investigational drugs that are not yet approved but have had positive clinical trial results available to critically ill patients.

Here's a preprint about it

 

What is this avaptadil or RLF-100 drug?  It's a form of Vasoactive Intestinal Peptide or VIP. 

Here's their blurb on how it may protect the specific lung cells attacked by Sars-Cov2 virus during severe covid-19 disease, which produce the surfactant that protects the surface of the lungs:

https://www.neurorxpharma.com/our-services/curious-about-how-rlf-100-works/

 

"The clinical findings may be based on evidence that VIP inhibits the replication of the SARS-CoV-2 virus in human lung cells and immune cells (monocytes). The work was reported by Brazilian researchers working in a level-4 biocontainment laboratory.³ The same researchers reported a case-control study in which patients who survived being on ventilators for COVID-19 had significantly higher levels of VIP in their blood than those who died of respiratory failure."

 

Very hopeful that some combination of VIP, remdesivir, and dexamethasone will decrease death rates and shorten recovery times from covid-19

 

16 hours ago, Buddo said:

Is this a new product, or something that has been around for a while?

 

It's been around since the late 90's as a potential treatment for Erectile Dysfunction.  But it had to be injected, which made it a poor competitor for viagra, and it had some safety concerns which are probably not a concern for a life-threatening condition such as a covid-19 patient on a ventilator, so it was never pushed to approval as a drug.  It has been through a clinical trial as a treatment for ARDS.

https://www.dailymail.co.uk/news/article-8599731/Erectile-dysfunction-drug-aviptadil-beat-Covid-19-experts-believe.html

(this article has a list of potential treatments undergoing current study at the end)
https://seekingalpha.com/article/4367483-relief-therapeutics-discovers-promising-covidminus-19-killer

(investment article but with a good explanation of the clinical problem and how RLF-100 might work)

 

Reasonably balanced perspective:

https://www.medpagetoday.com/infectiousdisease/covid19/87990

Just to clarify - RLF-100 is a treatment that has shown promise in the lab and in treatment of a handful of patients, but the clinical trials are getting started.  So it may pan out, it may not.  But another drug that could help the recovery of seriously ill patients (in addition to dexamethasone) would be helpful.

 

[HappyDays]

On 8/12/2020 at 10:06 AM, Hapless Bills Fan said:

CDC Excess Death data.  Note that cause of death data can take weeks or months to be transmitted and recorded.  Also I'm not sure how to interpret this, but I think it's saying this excludes NYC?

 

https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

 

 

 

Related:

 

 

[Hapless Bills Fan]

Thanks @Nervous Guy for pointing this out.

 

UCF group found Llama nanobodies (which function like antibodies but are much smaller) that block the region of the covid-19 spike protein needed for infection.

Nanobodies tend to be very much more stable than antibodies.

 

Research article

https://www.biorxiv.org/content/10.1101/2020.08.08.238469v1

They hope to develop a room-temperature stable covid-19 preventative that can be inhaled.    Would be cool if it works and does not cause side effects, but I think it's not as far along as UCF in-house publication about their concept makes it seem:

https://www.ucsf.edu/news/2020/08/418241/aeronabs-promise-powerful-inhalable-protection-against-covid-19

 

 

[Mike in Horseheads]

FDA has approved a saliva based test that was funded by the NBA and NBAPA. 

 

The test, known as SalivaDirect, is designed for widespread public screening. The cost per sample could be as low as about $4, though the cost to consumers will likely be higher than that -- perhaps around $15 or $20 in some cases, according to expert sources.

 

https://www.espn.com/nba/story/_/id/29667299/fda-allowing-saliva-based-test-funded-nba

[Edit: some more info on this

General article on saliva testing https://www.the-scientist.com/news-opinion/saliva-tests-how-they-work-and-what-they-bring-to-covid-19-67720
Test U of Illinois plans to use https://www.biorxiv.org/content/10.1101/2020.06.18.159434v1.full.pdf

Yale/NBA developed test https://www.medrxiv.org/content/10.1101/2020.08.03.20167791v1

Note that the Yale and the U of Illinois test skip a step in the standard Covid-19 test - RNA extraction - but are still RT-PCR based tests]

 

 

 

 

[Mr Info]

This may be of interest to some.

‘COVID-19 vaccine development and a potential nanomaterial path forward.’
 

Published in peer-reviewed Nature Nanotechnology in July. Department of NanoEngineering, University of California San Diego, La Jolla, CA.

Contains some good vaccine background summary and you do not have to be a research scientist to comprehend the gist of it.

 

https://www.nature.com/articles/s41565-020-0737-y

 

[Edit: it's a good article but note that it was:

• Received25 April 2020

• Accepted22 June 2020

• Published15 July 2020

thus the information about where different vaccines are currently in clinical trials is out of date.  Thanks!]

[Hapless Bills Fan]

Slightly different covid-19 test technology.

 

https://www.technologynetworks.com/diagnostics/news/new-test-can-diagnose-covid-19-in-20-minutes-338629?fbclid=IwAR0DbtgIJyOlVWBcI0WwH-_zbHU4vSfHRwd_ZjU-P2sWNFtMGtPQ2KQSExo

 

 

 

Here's a general article about the LAMP technology (Loop Mediated Isothermal Amplification).

Unlike PCR, which requires cycles at different temperatures, LAMP only requires one temperature.

 

Here's the paper on the test itself. (That's a preprint, it's being published in the journal Medical Microbiology now) Despite the headlines, the N1-STOP-LAMP covid-19 test is less sensitive - only 87% of the positives the RT-PCR test detects.  But it's faster, less labor intensive, and less expensive.

[shoshin]

Economist video interview with Bill Gates. 

 

Highlights:

 

- Change of US admin won't affect Covid outcome.  

- Says the next admin (Trump or Biden) will face the challenge of getting Americans to take the vaccine quickly and get rid of the virus. I see this too. Lots of people just won’t take it, and this thing will be prolonged.

- He is not worried that the vaccines will fail in Phase 3 tests. Says of the 6 candidates, several will work. Fully optimistic about it. There are the left and right anti-vaxxers, but also a new group of people who are afraid of “new vaccines.”

- 4 candidates are very cheap ($2-3/dose) and should make it to developing world, but may not get there quickly because the US isn't leading to help those countries like it has in the past. 

- Phase 3 testing should be done by Q4. 

- timeframe to herd immunity (30% in his view) counting people who have had it + cross-immunity to other coronaviruses + vaccines: In the US, he says sometime 2021 we will be largely over it. 2022 rest of the world.

- key thing is that this has to work well with elderly. Phase I candidates seem to be doing well with older folks (notes that flu vaccines sometimes work poorly for elderly)

- is amazed about the conspiracy stuff...could not have predicted so many people could adopt this conspiracy mindset

 

Edited August 18, 2020 by shoshin

[Hapless Bills Fan]

This is important.  More evidence that T-cell response, including memory T-cells, is provoked in covid-19 patients who have no or weak anti-covid-19 antibodies

Paper from group at Karolinska Institit in Sweden, accepted in Cell (very good journal):

https://www.cell.com/cell/pdf/S0092-8674(20)31008-4.pdf?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867420310084%3Fshowall%3Dtrue

 

More readable Commentary on the article

https://www.technologynetworks.com/immunology/news/sars-cov-2-immunity-likely-to-be-higher-than-antibody-testing-has-shown-336861?fbclid=IwAR0qnz37qV_NAH9pVFCcbNd_JNWCLblh4v1CCGqDo9JIbN8RjavFwremsoI

 

TL;DR: Importantly, SARS-CoV-2-specific T cells were detectable in antibody-seronegative exposed family members and convalescent individuals with a history of asymptomatic and mild COVID-19. Our collective dataset shows that SARS-CoV-2 elicits robust, broad and highly functional memory T cell responses, suggesting that natural exposure or infection may prevent recurrent episodes of severe COVID-19

Point of this cartoon-like summary figure (supported by a *****-ton of data only an immunologist could love) is that they found "memory-type" T-cell response specific to covid-19 in people who were exposed or had mild disease, and didn't have strong or persistent antibody response.

 

[DefenseWins]

https://profootballtalk.nbcsports.com/2020/08/20/georgia-state-quarterback-out-for-season-with-covid-related-heart-ailment/

 

So much for the young being invincible as far as Covid is concerned...

[Hapless Bills Fan]

Ok, this one has me scratching my head.

 

CDC travel guidelines have changed.  They have dropped the recommendation to quarantine for 14 days when you return from travel:

You may have been exposed to COVID-19 on your travels. You may feel well and not have any symptoms, but you can be contagious without symptoms and spread the virus to others. You and your travel companions (including children) pose a risk to your family, friends, and community for 14 days after you were exposed to the virus. Regardless of where you traveled or what you did during your trip, take these actions to protect others from getting sick after you return:

• When around others, stay at least 6 feet (about 2 arms’ length) from other people who are not from your household. It is important to do this everywhere, both indoors and outdoors.
• Wear a mask to keep your nose and mouth covered when you are outside of your home.
• Wash your hands often or use hand sanitizer (with at least 60% alcohol).
• Watch your health and look for symptoms of COVID-19. Take your temperature if you feel sick.

Follow state, territorial, tribal and local recommendations or requirements after travel.

They still note that "you and your travel companions including children pose a risk to your family friends and community for 14 days"

 

In a number of studies, the "attack rate" (% of close contacts of an infected person who become ill themselves) range from 12% within the home to 40% (I think most of these are upthread, but I'll loop back and reference tomorrow).  The within-home attack rate may be  5x-20x higher than outside-home.

Given this, and the fact that the CDC notes returning travelers pose a risk to those close to them for 14 days, the focus on "outside the home" and "other people who are not from your household" while removing the advice to quarantine, is puzzling to understand. 

 

The revision is from last week and has received relatively little press coverage.  I could not find any interviews giving a scientific rationale for the change.

Gentle reminder that if you're moved to discuss or expostulate, please copy the link to this post and discuss in discussion thread.

 

 

 

[Hapless Bills Fan]

This is a practical (and obviously for football fans, applicable) experiment with 2000 people in Leipsig, Germany

 

https://wgntv.com/news/coronavirus/thousands-crowd-into-indoor-concert-in-german-experiment-on-how-to-return-to-normal/

 

Researchers in the German city of Leipzig staged a 2,000-person experimental indoor concert on Saturday to better understand how Covid-19 spreads at big, busy events, and how to prevent it.   At the gig, which featured a live performance from musician Tim Bendzko, fans were given respiratory face masks, fluorescent hand gel and electronic “contact trackers” — small transmitters that determine the contact rates and contact distances of the individual experiment participants.  Using data from the contact trackers, scientists from The University of Halle will monitor the number “critical contacts” had by each participant during specific times and locations, while the residue left by fluorescent hand gel will identify frequently touched surfaces. Researchers hope to use the data to find ways to bring big events back safely.
(....)

Gekle told CNN that due to a low prevalence of the virus in the states of Saxony and Lower Saxony, participating in the study was low risk for volunteers, who underwent coronavirus testing 48 hours before participation, and were wearing masks during the show. “It’s safer than flying to Majorca,” he said.

 

[Hapless Bills Fan]

Convalescent Plasma EUA. 

First, some perspective: giving patients convalescent plasma, is an old faithful, tried-and-true step taken by the medical community when there are no or few effective treatments for a novel disease.  It's been used for SARS, MERS, Ebola etc.  It seldom has severe side effects, and with other diseases, it has been found helpful.  But it's not "a historic breakthrough" or "a major therapeutic breakthrough".  For one thing, there unfortunately isn't great evidence to support its efficacy (see below).  For another, it was being used in China pretty early on in the epidemic - if we want to claim "historic breakthrough", Well Then.....

FDA memorandum issuing Emergency Use Authorization for convalescent plasma.

Scroll down a bit to get to the meat where they summarize evidence for effectiveness.

 

Some key points:

The actual randomized, controlled clinical trial evidence is very scant:

-true randomized, controlled studies only in Wuhan China and Netherlands, and they didn't show great effect

-three prospective studies where control patients were not transfused)

-4 retrospective matched cohort studies (they look at people who were treated with convalescent plasma and try to match their characteristics with untreated patients - unfortunately this is a very tricky business and the cohorts often differ in significant ways, muddying the waters)

-By "earlier in the course of the disease" they mean "seriously ill people who are or who should be hospitalized, but are not yet intubated and on ventilators"  they don't mean "Line up to get your CCP infusion right after your positive covid-19 results come back you ambulatory 94% O2sat Scum!"

 

Key quote from the Summary of Effectiveness:

Considering the totality of the scientific evidence summarized above, I agree that current data support the conclusion that CCP to treat hospitalized patients with COVID-19 meets the “may be effective” criteria for issuance of an EUA. Adequate and well-controlled randomized trials remain nonetheless necessary for a definitive demonstration of CCP efficacy and to determine the optimal product attributes and the appropriate patient populations for its use. Current evidence suggests that benefit is most likely in patients treated early in the course of the disease (e.g., prior to intubation).

In addition, as outlined in the data reviewed above from different studies, there is a potential benefit of CCP in intubated and non-intubated patients. Considering the absence of a control population in the EAP and that data from randomized trials remain limited, the lack of benefit observed in intubated patients in this study is currently insufficient to exclude potential benefit in this population. Therefore, bearing in mind the safety profile observed to date, inclusion of intubated and non-intubated patients under the EUA appears appropriate at this time.

 

The bottom line is the EUA was granted because there's enough evidence that it might be of benefit.   But the evidence that it works is not as definitive as one would like.

 

The press conference announcing the approval was highly misleading about what's known for the effects.  Pharma Blogger Derek Lowe has some rather trenchant commentary in his blog****.  Lowe knows his stuff and unfortunately, I see his points.

 

(...) The problem is that we still haven’t generated any controlled clinical data on how useful it is. The Mayo-led data that were talked about during yesterday’s press conference had no control group, making that key question impossible to really answer. This shows the perverse danger of being too free with emergency use. If you just turn everyone loose on a bunch of therapies, they will be used under all sorts of conditions and the chances of getting a useful read on any of them go down. Look at our current situation: we have data on over 35,000 patients who have received convalescent plasma, but we still don’t have a good comparison to not receiving it. It shouldn’t have happened this way.
 

I know that there was a figure of 35% being helped/saved by the plasma treatment being used at yesterday’s press conference, but unfortunately, that’s just plain wrong. FDA Commissioner Hahn used the phrase “35% improvement in survival”, but that merely makes him look like a fool (and like someone trying to keep his boss smiling) to anyone who’s capable of reading the actual paper, which is another nasty side effect of this whole affair. See this for more, and this: since the data do not have a control comparison group, we can make no firm statements about the benefit of the treatment, and the 35% number is a misunderstanding of what data we have. Sad but true.

Some background data:
The Mayo Clinic paper Hahn was apparently quoting:

https://www.medrxiv.org/content/10.1101/2020.08.12.20169359v1.full.pdf

 

There appear to be significant differences between the low-titer and high-titer arm, with the low-titer arm being significantly 1) older 2) sicker.

 

 

 

 

 

I hate writing this stuff because I know it looks so negative. 

Given the current state of treatment for covid-19, would I want convalescent plasma if someone I loved or if I myself were hospitalized with low oxygen levels?  Yes.  Yes, I would. 

Do I think it's as effective a treatment as that "35% decrease in mortality" soundbite makes it sound?  No - not based on the data we have to date.  I'm afraid that's stat mangling, and pretty misleading, and I understand the reaction of Lowe and Gaffney. 

Edit: and now Hahn himself has acknowledged as much:

 

**** and when I say "trenchant commentary", I mean I can not recall this level of critique and pungent language from Lowe, in all the years I've been reading him.  He has nothing at all against convalescent plasma - and everything against how it was hyped in the press conference.

[BillsFan4]

https://www.cnn.com/2020/08/25/health/covid-19-superspreading-boston-study/index.html
‘Covid-19 superspreading event in Boston may have led to 20,000 cases, researcher says‘
 

They’re talking about the BioGen conference at the end of February in Boston and how it could have caused 20k total cases since then and led to sustained community transmission in numerous places in MA. It also mentions that some of the event participants took covid back with them to numerous different states and a couple countries.

Link to the paper (it’s not peer reviewed yet): 

https://www.medrxiv.org/content/10.1101/2020.08.23.20178236v1.full.pdf+html

 

its an interesting read. They also looked at a breakout at a skilled nursing facility. There were multiple introductions of covid into the facility but 1 specific one led to roughly 90% of the cases at the facility.

[Hapless Bills Fan]

How pooled testing could be used to test the entire US:

https://news.cornell.edu/stories/2020/06/group-testing-could-screen-entire-us-research-suggests
 

White paper about it:
https://docs.google.com/document/d/1hw5K5V7XOug_r6CQ0UYt25szQxXFPmZmFhK15ZpH5U0/edit?ts=5e934170

 

The lead author is one of the modelers and developers of the very test-intensive plan Cornell University crafted to reopen campus.  They are planning to test 50,000 people a week (~30,000 people, some once a week and some twice a week or more) or 5,000-7,000 people per day.  The viral RNA is extracted from individual samples then 10 samples are pooled, so they're running only 700 tests per day.  The tests are being run in-house at Cornell's vet school, basically 8 - 96 well test plates per day - which is pretty much what a clinical virology lab at a good teaching hospital can handle.  We'll see how that works....So far the prevalence is very low.

 

BTW if you want to see an example of how increased testing does not lead to increased covid-19 diagnosis, check out Tompkins County at the NY Forward site

Cornell started testing arriving off-campus students in mid-July (first bump-up).  Then testing ramped up again, to >1000 samples/day, mid-August.  Tompkins County is running 0.1% positives. 

 

 

 

[Buddo]

https://www.marketwatch.com/amp/story/moderna-and-pfizers-covid-19-vaccine-candidates-require-ultra-low-temperatures-raising-questions-about-storage-distribution-2020-08-27

 

Someone posted this in the PPP thread, but I think it deserves to go here. The articles gives storage conditions for a few of the touted vaccines, and it's not pretty reading, as they need to be stored at very low temps. Means that there are a lot less places that will be able to successfully store, and hence administer, these potential vaccines. Doesn't apply to all of them, but it could well be an issue 'down the line'.

 

[Here's another article about it.  This is pretty typical for mRNA vaccines by themselves.  I don't think it's as big a deal as that paper makes out for the US.   For example, the Pfizer vaccine can be refrigerated for 24-48 hrs.  Vaccines can also be sent to community clinics in dry ice/styrofoam - the Pfizer drug substance for the vaccines got shipped off to filter and fill that way.   So vaccine for clinics at community centers can be sent there on dry ice then stored in the fridge for a 2 day vaccination clinic. It does make the supply chain more challenging, no doubt.  -94F is a -70C deep freeze, which is standard equipment at most hospitals.
https://www.fiercepharma.com/manufacturing/pfizer-moderna-s-covid-19-shot-rollouts-could-be-ice-as-analysts-question-cold  ]

[Hapless Bills Fan]

A propos of talk in the Discussion thread about the recent change in CDC recommendations to not test asymptomatic people with known covid-19 exposure, this study from CDC's MMWR (morbidity and mortality weekly report) seems relevant.

 

https://www.cdc.gov/mmwr/volumes/69/wr/mm6935e1.htm

 

TL;DR: a Maine summer camp introduced policies that prevented the sort of infection spread observed in Georgia, Arkansas, and MO summer camps.

Campers came from all over the country, including states and areas with active covid-19 outbreaks.

 

Here's what worked:

1) Asked campers and staff to quarantine 10-14 days and if possible, get tested before arrival.  4 asymptomatic infections were identified and delayed their trip to camp

2) Set up small "pods" or groups and asked campers to stay within them for 2 weeks after arrival

3) Tested 4-9 days after arrival (2-3 day turn around) - 3 asymptomatic infections were identified and isolated and their contacts were quarantined

 

These measures were employed in addition to use of face coverings, daily symptom checks, and isolating/testing campers with symptoms.

No further infections were identified during the 44-62 days camp was in session.

Non-pharmacological interventions can work to contain covid-19 without massive shutdowns. 

But they need to be applied consistently and in keeping with known epidemiological "best practice"

 

 

This summary figure courtesy "your local immunologist" Facebook account:

[Hapless Bills Fan]

I suspect this will be pretty good.  Open to the public - lectures available at any time, no need to crowd onto the server at 11:30 ET Tuesday.

 

https://biology.mit.edu/undergraduate/current-students/subject-offerings/covid-19-sars-cov-2-and-the-pandemic/?fbclid=IwAR2Spo0At8EoptV9fAD3gDrtOAqIzFceX6MF1WgFB08EO6mYmJ0LxGTWcwY

 

New Subject Offering: “COVID-19, SARS-CoV-2 and the Pandemic”

In Fall 2020, all MIT students and the general public are welcome to join Professors Richard Young and Facundo Batista as they discuss the science of the pandemic during this new class. Special guest speakers include: Anthony Fauci, David Baltimore, Britt Glaunsinger, Bruce Walker, Eric Lander, Michel Nussenzweig, Akiko Iwasaki, Arlene Sharpe, Kizzmekia Corbett, and others. The class will run from September 1, 2020 through December 8, 2020 and begin each Tuesday at 11:30 a.m. ET. See the syllabus for lecture details.

 

The class is open to all MIT students, as well as any eligible cross-registered students. The live stream will be available to the public, but only registered students may ask questions during the Q&A. To view the live stream, click on this link and type in the password: mit-covid. Miss a class? You’ll be able to view a video of the lecture on this page.

 

 

[Hapless Bills Fan]

Time to "Bite the Snake" on this 6% or whatever it is according to "Q"

 

This Forbes article does a pretty good job of explaining what the CDC data actually mean:

https://www.forbes.com/sites/brucelee/2020/08/31/twitter-removes-claim-about-cdc-and-covid-19-coronavirus-deaths-that-trump-retweeted/#1f0bc6993178
[A lot of the tweets quoted have apparently been deleted, but I haven't found anything better for the explanations that remain]

 

Edit: OK, here's a blog by a KC Hospice and Palliative Care doctor who writes a lot of death certificates and can explain how it works:

https://drbartlettpear.com/2020/08/30/covid-19-series-entry-11/?fbclid=IwAR2ljMe3hLMr2GMG8DbfYcFhTgHvT0OfbVhsQ9a9VCvzH2mXufzgML8VroE

"you’ve probably figured out that a death certificate with ONLY the diagnosis of Sars-CoV-19 doesn’t even make sense. Jennifer didn’t go from perfectly healthy to dead from Covid-19 without SOMETHING HAPPENING in the interim. When people die from Covid-19, they die because the virus has caused something to go very wrong in their body. I would go so far as to argue that the doctors completing the death certificates on those 6% without any other factors listed were either 1) in a hurry, 2) lazy or 3) didn’t understand how to fill out a death certificate in the first place. I would be embarrassed to submit such a half-assed death certificate, personally!  

If you look at Chart #3 from the CDC (here’s the link again – you’re welcome), you will see that the conditions listed are a mishmash of both chronic and acute illnesses. Things like ARDS, pneumonia, respiratory arrest and cardiac arrest are all acute illnesses most likely CAUSED by Covid-19. Other conditions like chronic lower respiratory disease, hypertension, diabetes and Alzheimer’s are all more chronic conditions that could have been exacerbated by Covid-19 or predisposed to a poor outcome. I’ll let you peruse the chart for yourself.

 

OK, Original CDC Data:

https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm?fbclid=IwAR2-muRM3tB3uBdbTrmKwH1NdaBx6PpZo2kxotNwkUXlnbZXCwSRP2OmqsI#Comorbidities

 

Summary: having multiple causes of death, or pre-existing conditions, listed does not mean "you didn't die of covid-19". 

Said before, bears saying again: Hypertension (45%), heart disease (7.5%), diabetes (10%) , obesity (42%), and overweight taken together are conditions that affect a huge number of Americans.  It's not quite additive because many have more than one of these conditions, but it's very close to half of all Americans have a pre-existing condition linked to increased risk of serious disease from covid-19.