Covid-19 discussion and humor thread [Was: CDC says don't touch your face to avoid Covid19...Vets to the rescue!

[BuffaloBillsGospel]

10 hours ago, Hapless Bills Fan said:

In honor of @BuffaloBillsGospel and @TheBrownBear

Wishing you health and a quick recovery!

 

 

 

 

 

Thanks brother and not going to lie, since I wrote that I had mild symptoms I was on a rollercoaster of different waves to the virus, I hope I'm at the end of it because it feels like someone kicked my in the kidneys, my back, arms and legs. I can see why so many have succumb to this virus. It's like the flu on crack, I wish this upon nobody, not even Jets fans.

[Hapless Bills Fan]

20 hours ago, Hapless Bills Fan said:

 

I really appreciate you coming back here and giving your source, @spartacus, so I wanted to wait until I had a minute to give a careful reply.

 

the TL;DR summary:

1) more than one thing can be true at once

2) the FDA is, sadly, doing a piss-poor job of regulating covid-19 tests.  I looked it up: their actual standard is 5 positive and 5 negative tests. 

3) that said, this article is NOT a very well written article, and IMO fits the profile of "alarmist journalism".  The author misunderstands a couple things, and states a very unreasonable assumption. 

 

First, to frame the discussion a little bit: we need to understand that fundamentally, many of the diagnostic (virus-detecting) tests filing for EUA from various hospital and university labs, are the same test.  They are often using the same primers and the same amplification conditions as the CDC-designed test.  They may be using a different polymerase, or a different machine, or some other minor change.  So they're required to file EUA basically to show "hey, it works for us, too".  Under that circumstance, it's not intrinsically unreasonable to set a low bar and just have labs show "I got this" rather than having them do a whole dog-n-pony show. 

 

But IMO, having started out setting an unreasonable and unrealistic high bar (for example, initially the FDA demanded that any lab developing a test show it wouldn't react to MERS and SARS, highly-contagious diseases that the CDC refused to send samples of to test developers - for good reason!!!!), after they were justly criticized for that the FDA dropped the bar onto the floor and went too far in the other direction.  5 positive and 5 negative tests is just way too low.

That said, while I didn't look at every single filing (and that seems to be an outdated list somehow, tests that I know have sought and received EUA aren't on there), I looked at a bunch, and most of these test developers have done considerably more than the minimum. (I don't think the author looked at them all, nor understood them, frankly).

 

About the "contrived samples": the author implies this as a negative.  In the context of filing, it's simply a technical term saying they altered samples in one of several ways, rather than working 100% with current clinical samples.  Maybe we can lure @BillsFanNC or one of the guys who has developed diagnostics to talk about this, but there are good and valid reasons to do this during test development. 

1) you are developing the test in a lab that doesn't meet the safety standards to work with live, infectious human pathogens - so you do your development work and initial tests in a safer way, by using frozen negative patient swabs and spiking them with viral RNA

2) you want to focus on the limit of detection so that you ensure you have a good test.  For a clinical sample, the viral titer is unknown - you can obtain a more challenging sample set if you work with spiked samples where you spike with RNA just over your LOD.

3) if you work with actual clinical samples for all your development, you're actually just replicating the good and bad work of existing clinical tests.  There is benefit in working de novo with samples that you have high confidence are actually negative (they date before the virus emerged) and that you know are positive (because you spiked them).

 

So some test developers used contrived samples, then verified using a limited number of FDA-required actual clinical samples.  As a development strategy, this has merit, but the article makes it sound sketchy.

 

Ordinarily, yes, clinical tests undergo a long development period and extensive clinical trials.  But that's clearly (IMO) an unrealistic expectation during a pandemic.  For one thing, everyone is dipping out of the same limited pot of reagents.  If test developers have to run thousand-sample clinical trials depleting the supply of reagents, that's not a good thing.  For another, time is of the essence here.

Now let's get to the part that really bothers me: "Mayo Clinic researchers warned Thursday that inaccurate test results may drive a “second wave” of infections involving people who spread the virus after a test falsely indicates they don’t have it."

 

This really has nothing to do with new tests on the market!!!!!  First off, this is true of any of the covid-19 tests, including the CDC test!  People who get tested need to understand that the best tests in the world have a false negative rate.  It may have nothing to do with the test itself.  Maybe the swab didn't get deep enough or swab  well enough.  Maybe it was stored improperly.  Maybe the person in question was early enough in their infection that they didn't have enough virus in their throat.  Maybe the virus had moved on, and was living in their lungs or intestine.  Frankly, it's a failure of the medical profession, of public health, and of journalism if we don't ram home the message that a negative test ONLY MEANS YOU WERE NEGATIVE AT THAT TIME.  If you have symptoms or known exposure, you MUST continue to take precautions.   Distance.  Wear a mask.

 

And finally, even if the test is a true negative, you may be infected tomorrow.

 

That's why the whole thing about mask-wearing is so important.

 

Edit: and to your point, @spartacus, the FDA is apparently finally moving to investigate the Abbott ID Now covid-19 test after two different study groups reported it had an unacceptably high number of false negatives

 

First, back in April, Cleveland Clinic compared 5 different covid-19 tests and reported that the Abbott ID Now system had an unacceptable rate of false negatives (15%)

https://www.npr.org/sections/health-shots/2020/04/21/838794281/study-raises-questions-about-false-negatives-from-quick-covid-19-test
https://www.sfgate.com/coronavirus/article/which-COVID-19-tests-are-accurate-antibody-swab-15250911.php

Another system with unacceptable false negatives was the Diasorin Simplexa (20% false negatives).

 

The company pushed back, saying the test was intended to be used with swabs pushed into the machine immediately, not stored in viral storage media.

The Cleveland study guys reasonably responded "then share your data showing this".

 

Now another group in NYC is saying the Abbott ID now can miss up to half the infections another test catches:

https://www.latimes.com/science/story/2020-05-15/fda-probes-accuracy-issue-with-abbotts-rapid-coronavirus-test

Actual preprint:

https://www.biorxiv.org/content/10.1101/2020.05.11.089896v1.full.pdf

They say it misses on 30% of tests if the samples are stored in media, but even more when the samples are stored dry

 

This is the system used for daily tests of White House staff and visitors.  I expect Abbott will push back and say "the swabs can't be stored, they need to be read immediately" but in that case, they need to provide careful data around what "immediately" means - wait to swab until the machine is available, then run to the machine and shove the swab in?  5 minutes?  15 minutes?

 

 

[K-9]

8 minutes ago, Hapless Bills Fan said:

 

Edit: and to your point, @spartacus, the FDA is apparently finally moving to investigate the Abbott ID Now covid-19 test after two different study groups reported it had an unacceptably high number of false negatives

 

First, back in April, Cleveland Clinic compared 5 different covid-19 tests and reported that the Abbott ID Now system had an unacceptable rate of false negatives (15%)

https://www.npr.org/sections/health-shots/2020/04/21/838794281/study-raises-questions-about-false-negatives-from-quick-covid-19-test
https://www.sfgate.com/coronavirus/article/which-COVID-19-tests-are-accurate-antibody-swab-15250911.php

Another system with unacceptable false negatives was the Diasorin Simplexa (20% false negatives).

 

The company pushed back, saying the test was intended to be used with swabs pushed into the machine immediately, not stored in viral storage media.

The Cleveland study guys reasonably responded "then share your data showing this".

 

Now another group in NYC is saying the Abbott ID now can miss up to half the infections another test catches:

https://www.latimes.com/science/story/2020-05-15/fda-probes-accuracy-issue-with-abbotts-rapid-coronavirus-test

Actual preprint:

https://www.biorxiv.org/content/10.1101/2020.05.11.089896v1.full.pdf

They say it misses on 30% of tests if the samples are stored in media, but even more when the samples are stored dry

 

This is the system used for daily tests of White House staff and visitors.  I expect Abbott will push back and say "the swabs can't be stored, they need to be read immediately" but in that case, they need to provide careful data around what "immediately" means - wait to swab until the machine is available, then run to the machine and shove the swab in?  5 minutes?  15 minutes?

 

 

“If we didn’t do any testing we would have very few cases.”

 

That quote alone tells me that some people would think a high number of false negatives is advantageous. Again, very concerning. 
 

[BillsFan4]

1 hour ago, BuffaloBillsGospel said:

 

 

Thanks brother and not going to lie, since I wrote that I had mild symptoms I was on a rollercoaster of different waves to the virus, I hope I'm at the end of it because it feels like someone kicked my in the kidneys, my back, arms and legs. I can see why so many have succumb to this virus. It's like the flu on crack, I wish this upon nobody, not even Jets fans.

Came across this and thought it might be useful for you and @TheBrownBear

 

https://rehabmed.weill.cornell.edu/sites/default/files/post_covid_rehab_-_patient_guide_0.pdf

Recovering from COVID-19: A Patient Guide

 

its the recovery guide given out at NY Presbyterian hospital in NYC. It’s been one of the hardest hit hospitals.

 

If you don’t have an incentive spirometer you may want to order one (they should be cheap or at least they used to be), or call and ask your doctor or local hospital for one. They should give you one without issue I’d think. But even if you can’t get one they still show a number of different breathing exercises to do and they link to a bunch more videos at the bottom. Id also think about getting a pulse oximeter as Hapless recommended to monitor your oxygen levels.

 

 

 

Here’s s couple more breathing exercises from the American lung association that I’ve seen recommended for Covid 19 recovery.

 

https://www.lung.org/lung-health-diseases/wellness/breathing-exercises

 

Ive read and been told it’s important to fight this virus setting into your lungs.

 

This video demonstrates similar techniques to link from the ALA.

 

 

 

 

Best wishes to both Roth of you for a speedy recovery!

[BillsFan4]

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31140-5/fulltext

”Reviving the US CDC”

 

Wow, the lancet ain’t playing around... (and they’re THE gold standard of medical journals).

Edited May 16, 2020 by BillsFan4

[Buffalo Bills Fan]

38 minutes ago, BillsFan4 said:

Came across this and thought it might be useful for you and @TheBrownBear

 

https://rehabmed.weill.cornell.edu/sites/default/files/post_covid_rehab_-_patient_guide_0.pdf

Recovering from COVID-19: A Patient Guide

 

its the recovery guide given out at NY Presbyterian hospital in NYC. It’s been one of the hardest hit hospitals.

 

If you don’t have an incentive spirometer you may want to order one (they should be cheap or at least they used to be), or call and ask your doctor or local hospital for one. They should give you one without issue I’d think. But even if you can’t get one they still show a number of different breathing exercises to do and they link to a bunch more videos at the bottom. Id also think about getting a pulse oximeter as Hapless recommended to monitor your oxygen levels.

 

 

 

Here’s s couple more breathing exercises from the American lung association that I’ve seen recommended for Covid 19 recovery.

 

https://www.lung.org/lung-health-diseases/wellness/breathing-exercises

 

Ive read and been told it’s important to fight this virus setting into your lungs.

 

This video demonstrates similar techniques to link from the ALA.

 

 

 

 

Best wishes to both Roth of you for a speedy recovery!

 

Classy post.

Wishing you both as well speedy recovery. 

[Hapless Bills Fan]

3 hours ago, K-9 said:

“If we didn’t do any testing we would have very few cases.”

 

The "logic" of that just boggles my mind.
 

I guess if we didn't do any pregnancy testing, we'd have fewer births?

 

The cases are there whether or not we test.

 

The testing just finds them

[Hapless Bills Fan]

3 hours ago, BuffaloBillsGospel said:

 

 

Thanks brother and not going to lie, since I wrote that I had mild symptoms I was on a rollercoaster of different waves to the virus, I hope I'm at the end of it because it feels like someone kicked my in the kidneys, my back, arms and legs. I can see why so many have succumb to this virus. It's like the flu on crack, I wish this upon nobody, not even Jets fans.

 

Hang in there!  I second @BillsFan4 recommendation for the breathing exercises/incentive spirometer.  I have personally kicked the butt of post surgical pneumonia by being a PITA until the nurses brought me a spirometer and then using the heck out of it. 

 

I won't lie, it isn't any fun but it beats the alternative.  The human body functions best while moving, but if you can't move due to surgery or "flu on crack", the spirometer and breathing exercises do a lot to compensate.

 

Be especially alert if you start to feel better, and then develop new symptoms or feel worse again.  There are a lot of case studies which seem to follow this pattern.  It can signal that the virus is provoking an auto-immune response, a "cytokine storm".  We aren't doctors here, but there's a cheap blood test, "ferritin", that can be used to check.  This article gets pretty technical pretty quickly but the start of it describes:
https://www.physiciansweekly.com/cytokine-storm-the-sudden-crash-in-patients-with-covid-19/

Oxygen levels falling is another watch-out, and apparently many covid-19 patients are not aware of this, because their CO2 levels don't rise so they don't feel short of breath.

 

Pulse oximeter.  Buy one if you can.  If you get your Dr to prescribe, health insurance MAY cover. 

 

 

[BillsFan4]

 

Definitely not “just an average flu” (if there’s anyone left who actually still believes it is...).

Edited May 16, 2020 by BillsFan4

[JohnC]

6 hours ago, BuffaloBillsGospel said:

 

 

Thanks brother and not going to lie, since I wrote that I had mild symptoms I was on a rollercoaster of different waves to the virus, I hope I'm at the end of it because it feels like someone kicked my in the kidneys, my back, arms and legs. I can see why so many have succumb to this virus. It's like the flu on crack, I wish this upon nobody, not even Jets fans.

Wishing you and the @BrownBear the best and a full recovery. 

Edited May 16, 2020 by JohnC

[Bad Things]

4 hours ago, BillsFan4 said:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31140-5/fulltext

”Reviving the US CDC”

 

Wow, the lancet ain’t playing around... (and they’re THE gold standard of medical journals).

This was on our national news last night.

 

What a damning article. 

However, it should come as no surprise to anyone watching the daily WH briefings.

https://www.stuff.co.nz/world/americas/300014088/coronavirus-medical-journal-lancet-blasts-trumps-incoherent-covid19-response

 

[The Dean]

On 5/14/2020 at 10:51 PM, BUFFALOKIE said:

THAT IS ALL,

 

 

 

 

Yup, nothing like getting scientific/medical advice from a comedian!  Let's all drive in any lane we want and at any speed!  (" I know it's a one-way street, officer. I was only going one way!") Screw using my lights at night, I can see where I'm going! Facists aren't going to tell me what to do! Who cares if I endanger others. Not MY problem!

 

BTW, did anyone check out Amy Schumer Learns to Cook on the Food Network?  Probably not for everyone, but I actually thought it was funny and very appropriate for our current situation. A more or less "honest" look at what it like to be stuck inside.

 

 

[JohnC]

8 hours ago, K-9 said:

“If we didn’t do any testing we would have very few cases.”

 

That quote alone tells me that some people would think a high number of false negatives is advantageous. Again, very concerning. 
 

You are being too kind. The highlighted statement is simply a dumb comment. It is on the level of the Clorox comment. It's like saying if you are not tested for sugar you are not diabetic although the disease is ravaging you. It is a stupendously foolish statement.

 

When the virus was becoming apparent in the US the president argued against allowing a coronavirus ravaged cruise ship to dock on the west coast because he didn't want the infected numbers to increase the count that he was dismissing. Eventually the ship was allowed to belatedly dock after the virus was allowed to run rampant longer on the ship. When humanity and compassion are not part of the considerations when making decisions regarding public health then you end up with soulless decisions.  

[JaCrispy]

https://twitter.com/KarluskaP/status/1261817503724064769?s=20

[Saxum]

6 hours ago, BillsFan4 said:

 

Definitely not “just an average flu” (if there’s anyone left who actually still believes it is...).

 

I do not think you should pick on the mentally handicapped who still think so.

 

It reminds me of a time when I took my daughter shopping as a young girl.

We were walking to supermarket in parking lot and a large expensive Lexus SUV pulled into handicapped spot barely missing us.  Out came a young healthy mother who picked up her young (7-9 year old) daughter and walked to supermarket without even an apology.  My daughter asked "Why is that woman parking in handicapped spot?"  I told her "Mentally handicapped people do not understand that they need to use handicapped permits. Hopefully someone will call a police officer to explain to her." My daughter said "Oh.".   The lady who was 10 steps ahead of me turned her head around and looked at us with venom in her eyes.  When we left supermarket there was a police officer putting ticket on car.  I had nothing to do with call.

[The Dean]

1 hour ago, Limeaid said:

 

I do not think you should pick on the mentally handicapped who still think so.

 

It reminds me of a time when I took my daughter shopping as a young girl.

We were walking to supermarket in parking lot and a large expensive Lexus SUV pulled into handicapped spot barely missing us.  Out came a young healthy mother who picked up her young (7-9 year old) daughter and walked to supermarket without even an apology.  My daughter asked "Why is that woman parking in handicapped spot?"  I told her "Mentally handicapped people do not understand that they need to use handicapped permits. Hopefully someone will call a police officer to explain to her." My daughter said "Oh.".   The lady who was 10 steps ahead of me turned her head around and looked at us with venom in her eyes.  When we left supermarket there was a police officer putting ticket on car.  I had nothing to do with call.

 

 

Instant Karma

[Hapless Bills Fan]

2 hours ago, Limeaid said:

I do not think you should pick on the mentally handicapped who still think so.

 

A problem is that we just lack a clear and coherent message from leadership.

 

That leaves people who actually are not mentally handicapped, vulnerable to the latest memes and sound bites.  When you don't look under the hood, "100,000 Americans died from H3N2 flu in 1968 and we held Woodstock, only 80,000 Americans have died from covid-19 so why are we shutting the country down?" sounds superficially reasonable.

 

Little details like 100,000 was the death toll through the entire flu season and AFTER being adjusted for excess mortality, while we're already approaching 90,000 and it's only been 2.5 months from covid-19 (as the graph @BillsFan4 posted above shows - 1968 H3N2 was similar to 1957-58 H2N2 flu pandemic); the difference in morbidity - covid-19 has the ability to fill hospitals and swamp the medical system wherever it's allowed to flow unchecked - and of course, that Woodstock was, in fact, NOT held during flu season or a flu outbreak, but the following summer, during the warm-weather "lull" in flu season.

 

Yeah, I know it would be nice for people to do their own legwork, but the problem really is a disconnect between information that is put out, and reality.

 

 

There's also the CDC Morbidity and Mortality Report preliminary data from NYC (click figure to embiggen).  When we look back at previous years, we can see there is excess mortality (the black line) this year.  When we look at people who called their doctor or went to hospital with covid-19 relevant symptoms, but weren't tested and were sent home to self-monitor (happened a lot in NYC as hospitals filled up), we get the light blue marks (probable covid-19 deaths). 

 

Point being, in the height of an epidemic surge with hospitals overwhelmed, it can be very hard to sort out causes of death.  There is similar data being collected and assessed in Italy and Spain (and probably China) right now.   It's data like these that have public health figures such as Dr Fauci saying that he feels the covid-19 deaths are almost certainly being under-counted at present.

 

 

https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm?s_cid=mm6919e5_w

[BillsFan4]

https://www.usatoday.com/story/news/factcheck/2020/05/12/fact-check-did-woodstock-take-place-middle-pandemic/3094481001/

 

I see this story about the 1968 flu pandemic and Woodstock making its rounds on social media. 

 

Here is some context. (no, it was nothing like this coronavirus pandemic)

[K-9]

14 minutes ago, BillsFan4 said:

https://www.usatoday.com/story/news/factcheck/2020/05/12/fact-check-did-woodstock-take-place-middle-pandemic/3094481001/

 

I see this story about the 1968 flu pandemic and Woodstock making its rounds on social media. 

 

Here is some context. (no, it was nothing like this coronavirus pandemic)

I’ve seen these arguments about the Honk Kong flu used to support criticisms of the measures taken to today vs. the SARS-CoV-2  virus. They are COMPLETELY invalid. On EVERY point. 

[Hapless Bills Fan]

 

OK, which one of our Wise Guy lawyers is this?