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

[Jrb1979]

9 minutes ago, Hardhatharry said:

Italy over 31k now over 3000+ a day right now with over 300+ deaths a day. 

 

World closing in on 200k 

The scariest thing about it is how over here in Canada and the U.S. so many believe this is nothing. 

[Jauronimo]

19 hours ago, Foxx said:

i know your not implying you would prefer an echo chamber.

I hope you're not implying the sensible and reasonable discussion in this thread is an echo chamber without the participation of the same 5 morons saying "this isn't even as bad as the flu!" or "this is just hype driven by the media. Nothing to see here".  

[DC Tom]

13 hours ago, Hapless Bills Fan said:

 

"2009 H1N1 was first detected in the United States in April 2009. This virus was a unique combination of influenza virus genes never previously identified in either animals or people. The virus genes were a combination of genes most closely related to North American swine-lineage H1N1 and Eurasian lineage swine-origin H1N1 influenza viruses."

"While initial efforts were underway to develop a safe and effective vaccine to protect people against 2009 H1N1, work also was being done at CDC to help laboratories supporting health care professionals to more quickly identify the 2009 H1N1 virus in samples from patients. The real-time PCR test developed by CDC was cleared for use by diagnostic laboratories by FDA under an Emergency Use Authorization (EUA) on April 28, 2009, less than two weeks after identification of the new pandemic virus." (....)
From May 1 through September 1, 2009, more than 1,000 kits were shipped to 120 domestic and 250 international laboratories in 140 countries. (Each test kit contained reagents to test 1,000 clinical specimens).

-from CDC "The 2009 H1N1 Pandemic: Summary Highlights", tagged "CDC Novel H1N1 Flu" in browser bar. 

So yeah, no 6-12 month lead time.  Very quick response.  Test developed 2 weeks after ID of "new pandemic virus".  1,000,000 sample throughput over next 4 months.

Let's see, 2019-nCoV identified January 7.   First test kits available in China January 13.  Covid19 made "class B notifiable disease" Jan 20, and Wuhan shut down Jan 23.

Even if we didn't start to pay attention until January 20, the federal agencies I grew up to know and love (CDC, FDA, NIH) really shoulda been able to ship substantial kits under EUA by Feb 3rd.  Instead, at the end of February, testing was still limited to about 5 state labs and the CDC itself, and even those labs were struggling with false positives.
 

 

It's. A. Freakin'. RT-PCR. Test.  It's the same technology as the flu test that was initially used for H1N1, and MERS (a coronavirus) and SARS (also a coronavirus).  If we don't have pre-existing industrial infrastructure on which to base test manufacture for these kind of tests, damned good question why we've let it slide (we haven't).
 

 

I dunno about "magically under the sun", but you're factually incorrect about the H1N1 test development timeline, the existing manufacturing infrastructure for these types of tests, and the amount of time it should have taken the CDC to roll out a test.  If you really want to read about it you can go here or here.

 

What I expect is the same level of competence and short timeline for rolling out needed tests that the same organizations proudly achieved for earlier novel diseases.

 

 

Yeah, after weeks of people screaming "coronavirus isn't the flu," we'll just pretend it is the flu now, so you can be right.  Whatever.

Edited March 17, 2020 by DC Tom

[Hapless Bills Fan]

2 hours ago, BillsFanNC said:

 

Yes, but they didnt take them because regulations only allowed for them to use CDC validated tests, and the WHO tests hadn't been validated by CDC.

 

It took lifting those regulations to allow for testing on the scale that seems to be now necessary.

 

I think you should probably stop posting on this, because this demonstrates lack of understanding of the process of test design, the meaning of surveillance testing, the process of validating a clinical test etc and thus is not helping clarity here.

Validating a test that is fully developed and in use elsewhere is a standard process that should take a scientist who knows their ***** a small amount of time - weeks or even a week, if a team is assigned to the task, equipment is fully available (both of which could have been done).

The regulations that were partially lifted were a rather ponderous bureaucratic process that the current FDA had imposed to qualify tests developed OUTSIDE the FDA under "emergency use authorization".  Because their own test development was struggling, the CDC finally took the step of allowing state and university laboratories to validate and use their own tests and clearing some of the hurdles to validating them under EUA - but it's not entirely clear that they've lifted enough of them (see above)

The problem is if the validation requirements are unreasonable or pose an undue burden beyond the necessary science of "does this test detect what it should, does it not detect what it shouldn't, and what are the error estimates?"  Example: Alexander Greninger, an assistant professor in laboratory medicine at the University of Washington Medical Center, said after he submitted his COVID-19 test, which copies the CDC protocol, to the FDA, a reviewer asked him to prove that his test would not show a positive result for someone infected with the SARS coronavirus or the MERS coronavirus — an almost ridiculous challenge. The SARS virus, which appeared in November 2002, affected 26 countries, disappeared in mid-2003 and hasn’t been seen since. The MERS coronavirus primarily affects the Middle East, and the only two cases that have been recorded in the U.S., in 2014, were both imported.  There are labs that can create parts of a SARS virus, but the FDA’s recommended supplier of such materials said it would need one to two months to provide a sample, Greninger said. He spent two days on the phone making dozens of calls, scrambling to find a lab that would provide what he needed.

Greninger said the FDA was treating labs as if they were trying to make a commercially distributed product. “I think it makes sense to have this regulation,’’ he said, when “you’re going to sell 100,000 widgets across the U.S. That’s not who we are.”

 

https://www.propublica.org/article/how-south-korea-scaled-coronavirus-testing-while-the-us-fell-dangerously-behind
 

"Jeremy Konyndyk said he saw a devastating lack of urgency in the White House's approach to the pandemic. Konyndyk, who led the government’s response to international disasters as director of the Office of U.S. Foreign Disaster Assistance, said the government should have moved swiftly in the early weeks of 2020 when the virus overwhelmed the health care system in Wuhan with an avalanche of untreatable pneumonia cases, much like Korean officials did.

 

“We know that it was floating around in China undetected for some time before we realized they had it,” he said, “so we have to realize it’s a vulnerability here.”

Instead, he said, the CDC tried to create a more complicated test than the WHO’s that could tell the difference among coronaviruses. “It’s a neat idea if it works, but it smacks of letting the perfect be the enemy of the good,” said Konyndyk, now a senior policy fellow at the Center for Global Development, and a sharp critic of the government’s decision making regarding the virus.

(....) “My impression is that it was less a conscious decision that, ‘We don’t like the WHO test and we don’t want to do it,’ and more just, ‘We’re going to do our own test because that’s how we do it.’
 

“I don’t think they saw it as urgent. And this, too, is inexplicable to me. We kept hearing from the administration that it was a low risk to the U.S., and I think they sincerely believed that. And it was low risk in the sense that if you see a forest fire sweeping towards you, burning up every town in its wake, but it’s three towns away, then they’re right, at this moment you’re not at risk of being burned alive.

“But that doesn’t mean you’re at low risk. It’s insane to me that they weren’t thinking of it that way. They were thinking that somehow between those three towns away — and us — there was some sort of fire break that would magically prevent us from being burned alive.”

 

[Sundancer]

15 minutes ago, Hapless Bills Fan said:

 

This is my fervent prayer, but the lack of a more coordinated national response (eg asking governors to close restaurants and bars nationwide, so people are still out in bars partying for St Paddy's in some places) is worrisome from a mitigation standpoint.

 

 

The Imperial College London report suggests we will have waves of shutdowns and reopenings lasting 9-12 months.  

 

Some have suggested that Wuhan is back open for business, cases are under control, and it only took 5 weeks. That's not the case. The anti-body carrying population may now be OK but the rest are not and reopening for business opens the rest of the country to re-spread. China is not through this unless they have a perfectly functioning quarantine system, which is impossible. And we in the US are not China. 

 

My greatest concern after health and it's really close to health is the economy and what is about to happen. A large portion of the population currently has $0 in the bank or will soon. Not, "we have a credit line we can draw on" but $0. That's people and businesses. That is not workable. We cannot stay shutdown for long so my guess is that although we may flatten the curve a little, the pig in the python of cases to overwhelm the healthcare system is coming, and maybe in many waves. 

 

 

 

 

2 minutes ago, DC Tom said:

 

Yeah, after weeks of people screaming "coronavirus isn't the flu," we'll just pretend it is the flu now, so you can be right.  Whatever, moron.

 

Not exactly a convincing response. 

[Hapless Bills Fan]

4 minutes ago, DC Tom said:

 

Yeah, after weeks of people screaming "coronavirus isn't the flu," we'll just pretend it is the flu now, so you can be right.  Whatever, moron.

 

Tom, I am the person to whom you are responding, as I have stated up-thread I am a PhD biochemist with a decade of experience at a major med school and a decade in drug development at Big Pharma.  I have direct, relevant professional expertise here and a network of contacts with people of greater more relevant expertise.  I am far from a moron on this topic.

 

Nowhere up there did I say or imply I was pretending Covid-19 was the flu.  

 

The point is you are scientifically and factually mistaken in your contention that H1N1 tests had a year leadtime in development - they did not

 

You are scientifically and factually mistaken in your contention that more than a few weeks was necessary to develop a functional Covid-19 test - China and Korea did it in a few weeks.

 

You are scientifically and factually mistaken in your contention that the manufacturing infrastructure didn't exist - the Covid-19 test uses a standard and widely available technique used to test for many viruses, RT-PCR.  The wheel did not have to be re-invented here.

Respond carefully.  I am fully prepared to withstand more people wondering whether you've been murdered and take the fall if you continue in this vein.

 

 

 

 

[DC Tom]

1 minute ago, Hapless Bills Fan said:

 

Tom, I am the person to whom you are responding, I am a PhD biochemist with a decade of experience in drug development, and nowhere up there did I say or imply I was pretending Covid-19 was the flu. 

 

People will no doubt message me asking if you're dead and mourn, but I have no freakin' patience with failure to read carefully and respond thoughtfully here, nor with tossing insults around.

 

 

 

You did, when you said that the tests for COVID can be developed the same as the flu. 

 

We have an entire industry for producing flu tests and vaccines, and for surveillance of the flu.  We don't for coronavirus.  You cannot go directly from the lab setting to mass production of a coronavirus test like you can a flu test, because the production infrastructure does not exist for coronavirus, but does for the flu.  You cannot scale your lab work to mass production in two weeks.  

 

If you develop drugs, you should know that.  Testing stages aside, what does it take to take a drug from laboratory samples to mass production?

[BillsFanNC]

1 minute ago, Hapless Bills Fan said:

 

I think you should probably stop posting on this, because this demonstrates lack of understanding of the process of test design, the meaning of surveillance testing, the process of validating a clinical test etc and thus is not helping clarity here.

 

 

 

I dont have time now to respond to the rest of your post now, but I'll instead ask a question, what is your experience in developing tests for viral diagnostics? I've spent 20 years developing tests mostly for influenza dealing with the FDA and CDC along the way. So I wont stop posting on this as my understanding is just fine.

 

[teef]

1 hour ago, Gugny said:

 

Man, I am so sorry to hear this, Teef.

thanks man.  to add to injury the original statement of 2 weeks was a mistake.  it has to be three weeks.  i just won't be able to pay employees.   sure enough this was the year we build a new building and underwent aggressive expansion.  i can weather this for a bit, but if it drags on for months, i'm *****.

55 minutes ago, Jrb1979 said:

Sorry to hear that. I hope for you and your staff it is only 2 weeks. I pray that this ends quick and we can get to back to normal sooner rather then later. I'm a little scared for myself as I work in retail that sells groceries so I have to be around a lot of people daily. 

thanks so much.  just be vigilant and take care of yourself.  this is going to be a long month.

[Hapless Bills Fan]

42 minutes ago, OldTimeAFLGuy said:

 

…...from what I've read Hap, this seems to be your line of work.....and thanks for passing info along to TBD......would you surmise that there was/is a turf war between CDC and FDA?.....from a layperson's perspective, if a successful kit was available, wouldn't time be of the essence versus week(s) going by?...…I just had an admin person go for testing, but was declined because her symptoms were not significant enough....she just returned from Mexico and thinks she has a chest cold, similar to what her partner had prior to leaving....returning from international travel and being age 56 still could not qualify her for testing......

 

I don't really want to go there.  I don't know, and it really doesn't matter right now.  My guess would be it would be more from the top.  When the boss says "this is a priority, Make it Happen", you jump.  When the boss says "this is a low risk to us", it's business as usual.  But that's just a guess.

 

22 minutes ago, BillsFanNC said:

 

I dont have time now to respond to the rest of your post now, but I'll instead ask a question, what is your experience in developing tests for viral diagnostics? I've spent 20 years developing tests mostly for influenza dealing with the FDA and CDC along the way. So I wont stop posting on this as my understanding is just fine.

 

 

I am a biochemist who worked on process development including for viral therapeutic for a virus.  So I worked closely with scientist validating tests and have a network of friends in various places.  That's all I'll say.

 

I think it's telling that your posts gave me that impression; by all means, continue to share your expertise, but please do some research first and give sources, and please don't post nonsense like they couldn't use the WHO test because it wasn't validated by the CDC.  When the question is a public health emergency, not production for sale, the validation process should not pose that kind of a barrier.  If it does, it's a failure of the process (which it may have been).
 

20 minutes ago, teef said:

thanks man.  to add to injury the original statement of 2 weeks was a mistake.  it has to be three weeks.  i just won't be able to pay employees.   sure enough this was the year we build a new building and underwent aggressive expansion.  i can weather this for a bit, but if it drags on for months, i'm *****.

 

A lot of people in that  boat right now, teef.  We can only hope that our government, as with UK and others, will provide some relief that actually gets to the people who need it - all the servers and techs and everyone.

[OldTimeAFLGuy]

5 minutes ago, Hapless Bills Fan said:

 

I don't really want to go there.  I don't know, and it really doesn't matter right now.  My guess would be it would be more from the top.  When the boss says "this is a priority, Make it Happen", you jump.  When the boss says "this is a low risk to us", it's business as usual.  But that's just a guess.

 

...appreciate your perspective......rest assured, I was not trying to politicize it because it serves no purpose......agency turf wars will occur regardless of party in charge......I'm surprised they wouldn't test my employee even just returning from international travel......co-workers are now really on edge...…….

Edited March 17, 2020 by OldTimeAFLGuy

[Hapless Bills Fan]

47 minutes ago, DC Tom said:

You did, when you said that the tests for COVID can be developed the same as the flu. 

 

No, I did not say "it's just flu".  The Covid19 test uses a well-known laboratory technology.   Saying that the test technology being used for Covid 19 is similar to what was done for H1N1 back in 2009 (different from flu test used today)  is a different statement from saying of the disease "it's just flu".  A thoughtful, intelligent person really should be able to see the difference between the two statements.

 

Quote

We have an entire industry for producing flu tests and vaccines, and for surveillance of the flu.  We don't for coronavirus.  You cannot go directly from the lab setting to mass production of a coronavirus test like you can a flu test, because the production infrastructure does not exist for coronavirus, but does for the flu.  You cannot scale your lab work to mass production in two weeks. 

If you develop drugs, you should know that.  Testing stages aside, what does it take to take a drug from laboratory samples to mass production?

 

I think you don't understand what mass production entails when we're talking about RT-PCR tests.  We're talking about a series of little 1.8 ml eppendorf tubes.
 

A kit that will do 1000 tests wil fit in a box the size of a (medium) box of chocolates, and the reagents can be produced in a laboratory (they aren't of course, for clinical tests in wide production).  Many of the reagents are common to all PCR tests.  The primers, positive, and negative controls must be customized.  It requires specialized equipment to run, but the equipment to run RT-PCR is common to many laboratories.  (Robotic throughput maybe not so much)
 

How do you think China, Taiwan, and Korea mass-produced so many test kits and put them in play so quickly?  Did they have magic?  No.  They did it because Its.  Not.  That.  Hard.  It takes good decisions on test design, and prioritization/allocation of existing resources.  The ultimate disproof of your point is that other countries actually did this on a very short timeline.

 

Vaccines are a different question entirely, and vaccines were not the subject of the post.

 

Off topic, but no, I never developed drugs; I developed manufacturing processes for biomolecules and vaccines.  But again, the process of discovering and developing a drug is different from the process of developing a clinical test and was not the topic of discussion here.

 

Last point, the development of a clinical test for widespread use routine use against (say) a form of cancer, and the development of a test against an emerging disease, are or should be somewhat different processes.  You want an accurate test, but you also need to balance checking the test for every possible failure mode against getting the test out there as a public health tool.

 

[ChevyVanMiller]

Thank you @Hapless Bills Fanfor the insightful information you are providing here. It is comforting to have access to someone with your level of expertise.

 

I have a request: Seeing as this has sort of become the official Covid-19 thread I’m hoping you will consider changing the title to reflect that status.

 

Thanks again for your thoughts and insights. I know that I speak for many here when I say they are greatly appreciated.

[BillsFanNC]

1 hour ago, Hapless Bills Fan said:

 

 

 

Surveillance testing means you are able to screen a section of the population (test on a mass scale) not limit testing to people who are critically ill.  In the past, the CDC has developed and rolled out large numbers of novel tests for other potentially epidemic diseases quite quickly.

 

 

Surveillance for flu is not done on a mass scale.  If memory serves, they typically report about 2000 tests per week for surveillance purposes to drill down to influenza subtypes and lineages.  Again I'll respond more fully later when I have time.

[Hapless Bills Fan]

34 minutes ago, teef said:

thanks man.  to add to injury the original statement of 2 weeks was a mistake.  it has to be three weeks.  i just won't be able to pay employees.   sure enough this was the year we build a new building and underwent aggressive expansion.  i can weather this for a bit, but if it drags on for months, i'm *****.

thanks so much.  just be vigilant and take care of yourself.  this is going to be a long month.

 

I hope this helps:
https://www.washingtonpost.com/us-policy/2020/03/17/trump-coronavirus-stimulus-package/?fbclid=IwAR2KkREQqp2rxv0ZU_PVacOJcapUX18of9avRe0amrEt2Sep9doF_iHNKDc

 

[teef]

2 minutes ago, Hapless Bills Fan said:

 

I hope this helps:
https://www.washingtonpost.com/us-policy/2020/03/17/trump-coronavirus-stimulus-package/?fbclid=IwAR2KkREQqp2rxv0ZU_PVacOJcapUX18of9avRe0amrEt2Sep9doF_iHNKDc

 

this is great...thank you.

 

 

I was also told that anyone with a small business, (in this case under 500 employees) should go to https://www.sba.gov/  for info on help.  

[Hapless Bills Fan]

15 minutes ago, BillsFanNC said:

 

Surveillance for flu is not done on a mass scale.  If memory serves, they typically report about 2000 tests per week for surveillance purposes to drill down to influenza subtypes and lineages.  Again I'll respond more fully later when I have time.

 

Thanks for info on flu surveillance testing.  I believe in 2009 for H1N1, a more massive scale was done, but I'd have to go look it up to be sure.

Certainly 2000 tests per day in 5 cities is way more than got done for Covid19 (I think even, more than is being done now), right?  It would have helped, you must admit....

To my understanding, I believe surveillance testing in the public health sense means what public health officials decide it needs to mean.  In the case of flu, they know it's out there and spreading, so they're interested in subtypes and lineages to see how well it matches the year's vaccine and to pick up any strains that might be particularly problematic.   Here's a link to an article about Active Surveillance Testing for MRSA.

In the case of a novel disease such as Covid-10, public health officials are more interested in "where is it, and how widespread is it?".  Surveillance testing could mean testing everyone who returns from a country or set of countries, or everyone who reports a certain symptom (fever, say; or contact with an infected person).  Or it could mean random screening of a sample population, though I feel that would be of less use at present.

The distinction (again as I understand it) is that you're testing widely, not just limiting to people who traveled to specific countries AND report specific symptoms.

 

But I'd love to hear more about flu surveillance testing with regard to how it might or might not help here.

[BringBackFergy]

44 minutes ago, teef said:

thanks man.  to add to injury the original statement of 2 weeks was a mistake.  it has to be three weeks.  i just won't be able to pay employees.   sure enough this was the year we build a new building and underwent aggressive expansion.  i can weather this for a bit, but if it drags on for months, i'm *****.

thanks so much.  just be vigilant and take care of yourself.  this is going to be a long month.

Sorry to hear this teef. I'm in the same boat here as a small business owner (smaller scale)...only two employees. I'm giving them the option to come in and work with me here (cancel office appointments) via email with clients, other attys and banks...or go home. I think they would rather be here because it takes their minds off what is happening for a few hours each day.

 

Keep us posted and if there's anything we can do to help.

 

 

@Hapless Bills Fan Not sure if this has been asked, but do you know if this will be an annual vaccination we should all get? Will it be something infants should be vaccinated for like Chicken Pox, Mumps, etc or will this die off in the next year or so? I know these are very broad questions but didn't know if this thing will find its last host and disappear or if it will continually change and revisit us each Fall/Winter?

 

Also, this is a dumb question: Any risk of this virus affecting beef, pork, or even my stupid Yellow Lab? Is it unique to humans only and animals cannot spread the disease?

[Hapless Bills Fan]

22 minutes ago, BringBackFergy said:

Not sure if this has been asked, but do you know if this will be an annual vaccination we should all get? Will it be something infants should be vaccinated for like Chicken Pox, Mumps, etc or will this die off in the next year or so? I know these are very broad questions but didn't know if this thing will find its last host and disappear or if it will continually change and revisit us each Fall/Winter?

 

Also, this is a dumb question: Any risk of this virus affecting beef, pork, or even my stupid Yellow Lab? Is it unique to humans only and animals cannot spread the disease?

 

Good questions. 
Last first: Beef and pork not felt to be risks.  It is thought the virus may be carried in Pangolins.  Don't eat any Pangolin.  Sorry if this disrupts your planned dinner.  Personally, I had to educate myself about "WTF is a Pangolin?"

Your goofy Yellow lab is a bit less clear.  There was a report of the pet owned by a Covid-19 patient testing "weakly positive" for Covid-19.  The animal was not ill.  It may have picked up Covid-19 from its owner.  "The department said it does not have evidence that pets can be infected with the virus or can be a source of infection to people."  The CDC says this:
While this virus seems to have emerged from an animal source, it is now spreading from person-to-person in China. There is no reason to think that any animals including pets in the United States might be a source of infection with this new coronavirus. To date, CDC has not received any reports of pets or other animals becoming sick with COVID-19. At this time, there is no evidence that companion animals including pets can spread COVID-19. However, since animals can spread other diseases to people, it’s always a good idea to wash your hands after being around animals. For more information on the many benefits of pet ownership, as well as staying safe and healthy around animals including pets, livestock, and wildlife, visit CDC’s Healthy Pets, Healthy People website.

But that does bring up a point that was discussed on a dog group to which I belong: as a precaution, when out walking your dog, it might be wise to answer "no" to the perennial question "may I pet your dog?"  The "weakly positive" test plus the news that covid-19 may live some period of time on solid surfaces, suggests that potentially, an infected person loving on your dog with hands or especially face, might put virus on your dog's fur, which your dog could then bring home and transfer to family lovin' on the dog.  Remote risk, probably, but we're makin' our dog sad by restrictin' the pets she gets.

 

At this point, we don't have a vaccine (though we will, but it will probably take 12-18 months), nor do we have any detailed studies of how persistent immunity is, so deciding if it will be annual or permanent vaccine must wait.  Many people would like to know if this will die off and disappear or continually change and require the sort of annual "guessing game" of seasonal influenza!

 

 

 

[Gugny]

I can't be the only one who had no idea wtf a pangolin is … so ….