Do we Cancel Everything? You still Travelling??

[SteveFx 258]

The UK Health Minister (newly recovered from coronavirus himself..)  said today that Germany started off with the world leader in diagnostics tests based there (Roche?) whereas the UK started with mainly small scientific/medical  labs.   

That was fine for the initial contact tracing phase  but when the volume started to build the UK  was forced to abandon mass testing and prioritise clinical testing - i.e is this newly arrived patient covid-19 or something else which might be treatable with antibiotics. 

We are now trying to expand testing to include health staff who have self isolated to get them back to work and are also trying to build large scale diagnostics labs.

That means that the current UK and GE figures for covid-19 cases are simply not comparable.  For the UK the figure is predominantly tests conducted at a hospital of very ill people being admitted whereas in Germany they  include a much greater proportion of people  who like our health minister get mild symptoms and never actually go to hospital.  

Now you cannot conclude very much - its possible that

a)  The UK has far more cases than Germany and the same proportion sadly die in both countries  ( i.e the UK is 2 weeks behind Italy and Germany is 4 days behind the UK)

b)   Germany has more cases than the UK even with the differences in testing but the scale and excellence of the German health system (best in the world) allows them provide  better nursing care and/or admit people a few days earlier which might help the outcome. 

Or the truth lies somewhere between a) and b)

Such things will only be knowable when antibody testing is available and its possible to look back and work out what % of the population were actually exposed and how the health services did.

What you can compare is the trends  and most European countries seem to be following fairly similar trajectories.

The FR figures may be  similar to the  UK or there may be other differences but it isn't necessarily true that the testing in GE is saving a great number of lives during a lockdown - there is no early treatment so if someone tests positive but doesn't need to be admitted to hospital the advice will be to remain at home which was what they were supposed to be doing anyway if they had any symptoms... 

[Alan_A 1,650]

10 hours ago, domkle said:

In France an enormous concern rises about what is happening in retirement homes. In one, not far from where I live, 19 dead over 120 residents. The gouvernement says that it cannot collate the figures from all over the country  (I'd rather not comment that, I would get quite nasty)...

How is it in your countries ?

It's the same.  There was the initial case cluster at the nursing home in Kirkland, Washington - made worse, apparently, by a series of missteps. 

There's another in my state.

I'm sure we'll be hearing about still more. There are good nursing homes that I'm sure are doing everything they can to limit exposure (I'm thinking of the one not far from me where I moved my father in the final stages of his Alzheimer's).  But overall the industry has been pretty shoddy for years - lots of places doing the bare minimum and trying to fly under the regulatory radar.  That, plus the age and condition of the patients, makes them time bombs.

It's not a good prospect.

 

[Alan_A 1,650]

8 hours ago, pete_auau said:

we  just  started  to  test  a  vaccine  on  some  ferrets

There's a small-scale safety trial in humans underway in Seattle.

But animal studies are the typical first stage.

Vaccines are powerful, dangerous things, and it's hard to predict how they're going to work. They can be ineffective, or they can be effective, and in either case they can still cause some hellacious side effects, including fatal ones.

So there's no choice but to go though all the steps. 

The same is true of drug trials in general.  I've seen some really promising drugs fail in the last stages of trial.  In late 1991, when I was doing the HIV work on behalf of Burroughs Wellcome, I was hired by another agency to do communications support for the launch of a new HIV antiviral from Boehringer Ingelheim that everyone had been waiting for for about three years.  Three weeks before I was supposed to start the job, I went to the FDA advisory panel meeting where Boehringer Ingelheim presented the final, Phase III trial results - which were that the drug had failed and they were withdrawing it.  Everybody was stunned - and on a purely selfish note, I was standing there wondering if I still had a job to report to (spoiler: I did, they hired me anyway and I helped launch a new HIV test a few months later).

Am telling that story just to illustrate what can happen on the way to a treatment.  Early reports are just that, and you can't skip steps.  You can accelerate them - the HIV activist community made a huge contribution to that, and basically changed the timeline for how drugs get reviewed and approved.  But you've still got to go in order.

This is official info on how the vaccine development process goes in the U.S,

I hope the ferrets do really well - seriously - we're all counting on them.

[Alan_A 1,650]

5 hours ago, martin-w said:

 

Just to say, nobody is infected with Covid 19.

The virus is calad SARS CoV 2.

The disease is calad COVID 19

And the virus is a type of corona virus.

 

Right.  Same as with HIV - that's the name of the virus (Human Immunodeficiency Virus), and AIDS (Acquired Immune Deficiency Syndrome) is the name for the symptomatic condition - all the infections that happen when HIV takes down the immune system.

The "D" in COVID stands for "disease" - it's COronaVIrusDisease-(20)19

 

[Alan_A 1,650]

The testing regime is so far behind in so many countries - and there are so many differences between countries in testing and classification - that it's pretty much impossible to get any useful information out of testing programs right now.  I've even seen suggestions that testing should be abandoned in favor of field surveillance - i.e. reports from doctors' offices, which is how seasonal flu is tracked.  That might give a better handle at least on who's symptomatic, though it'd just be a ballpark figure, and some of the reports of symptomatic people won't turn out to be COVID.

Crowdsourcing projects are another way to do this - but there you have to depend on people actually going to the site and reporting.  If enough do, you're in the ballpark, though not necessarily with great seats.

Testing is the only way to count confirmed cases.  Which means our confirmed case count has only partial value right now. It can show you trends - is the number increasing?  But it can't tell you how big the problem is.

We're going to have to find that out the hard way.
 

[Pastaiolo 1,688]

It's all the same in retirement homes guys. Sadly it is like that and there isn't much to do at this point. People visiting their older people, perhaps bringing kids too and there you have it, a perfect environment of people with weakened immunitary systems 😞

We are doing those checks in Italy too. Just in my region out of 5000 tests on elderly, around 500 are positive. The good thing is that they don't seem to be from the first wave of infections so they have still mild symptoms and hopefully can be healed properly. Plus my region is not Lombardy and we currently have less than half of the ICU beds occupied. Lombardy instead according to the same statistics is full, but patients are being distributed to other regions and in Germany too. 

[HiFlyer 9,363]

Worldwide coronavirus cases reach 1 million, doubling in a week as death toll tops 50,000

[Alan_A 1,650]

Here's a thin thread of hope - a preliminary report of five patients treated in China with antibody-rich plasma from recovered COVID patients.  Results were positive.

A trial in five patients isn't more than an anecdote, so - to my point above about drug development timelines - don't hang your hat on it. 

But it's something to keep an eye on among all the projects going on.

[Alan_A 1,650]

And about other urgent problems - here's why the toilet paper shortage isn't just the result of panic buying and hoarding.

Among the things that are going to have to be rethought when this is over, supply chains are somewhere on the list.

[pete_auau 1,163]

4 hours ago, Alan_A said:

There's a small-scale safety trial in humans underway in Seattle.

But animal studies are the typical first stage.

Vaccines are powerful, dangerous things, and it's hard to predict how they're going to work. They can be ineffective, or they can be effective, and in either case they can still cause some hellacious side effects, including fatal ones.

So there's no choice but to go though all the steps. 

The same is true of drug trials in general.  I've seen some really promising drugs fail in the last stages of trial.  In late 1991, when I was doing the HIV work on behalf of Burroughs Wellcome, I was hired by another agency to do communications support for the launch of a new HIV antiviral from Boehringer Ingelheim that everyone had been waiting for for about three years.  Three weeks before I was supposed to start the job, I went to the FDA advisory panel meeting where Boehringer Ingelheim presented the final, Phase III trial results - which were that the drug had failed and they were withdrawing it.  Everybody was stunned - and on a purely selfish note, I was standing there wondering if I still had a job to report to (spoiler: I did, they hired me anyway and I helped launch a new HIV test a few months later).

Am telling that story just to illustrate what can happen on the way to a treatment.  Early reports are just that, and you can't skip steps.  You can accelerate them - the HIV activist community made a huge contribution to that, and basically changed the timeline for how drugs get reviewed and approved.  But you've still got to go in order.

This is official info on how the vaccine development process goes in the U.S,

I hope the ferrets do really well - seriously - we're all counting on them.

Yea  I  read  that awhile  ago  about the  testing  in  seatle,  which  ever  country  that brings  out  the  vaccine  that is  safe  to use,   will  be  most  gratefull by  all other  countries  etc,  and  wonder  what  they  will  charge  for  the  vaccine?

[Alan_A 1,650]

3 minutes ago, pete_auau said:

wonder  what  they  will  charge  for  the  vaccine?

You'd hope it'd be affordable and widely available, along the lines recommended in this article.

It's happened before... sometimes.

Pharmas and governments are going to have to step up.

[G-RFRY 1,712]

10 hours ago, Biggles2010 said:

It fits with what I had heard previously about Germany classifying Corona deaths in a particular way. I don't know if this is accurate, but the story was that elderly patients with serious existing medical conditions and a poor prognosis who test positive for Corona and then die, would not necessarily be counted as a Corona death. Medically this would be perfectly sound logic because patients in those situations are actually dying from an accumulation and combination of factors, not simply from the Corona virus.

Germany has the largest testing facility in Europe and one of the worlds largest drug company`s, southern Europe has been pleading for help from the EU and it looks like they are on there own.

[HiFlyer 9,363]

Just in case anyone missed the madness:

Engineer intentionally derails speeding train at Port of Los Angeles near Navy hospital ship aiding virus crisis, feds say

 

Edited April 3, 2020 by HiFlyer

[Biggles2010 343]

12 hours ago, G-RFRY said:

Germany has the largest testing facility in Europe and one of the worlds largest drug company`s, southern Europe has been pleading for help from the EU and it looks like they are on there own.

The EU, as an organisation, has been notable by it's almost total absence throughout the Corona problem, until a couple of days ago. Now they have just woken up, but only because they are concerned about member countries doing their own thing and closing borders to protect their citizens.

[G-RFRY 1,712]

1 minute ago, Biggles2010 said:

The EU, as an organisation, has been notable by it's almost total absence throughout the Corona problem, until a couple of days ago. Now they have just woken up, but only because they are concerned about member countries doing their own thing and closing borders to protect their citizens.

Just woken up they have been burning the EU flag in ITALY for a couple of weeks, they and Spain asked for funds to help from the EU.