COVID-19 - Facts and Information Only Topic

[SlimShady'sSpaceForce]

I know this was talked about 

 

https://www.washingtonpost.com/world/2020/04/24/coronavirus-latest-news/

 

The Food and Drug Administration Friday morning warned that malaria medicines touted by the president for coronavirus should only be used in hospitals or clinical trials because of dangerous side effects.

[SlimShady'sSpaceForce]

Coronavirus live updates: U.S. passes 50,000 deaths

https://www.yahoo.com/news/coronavirus-covid-19-live-updates-april-24-2020-104503217.html

https://sports.yahoo.com/us-coronavirus-virus-death-toll-151834675.html

[Hapless Bills Fan]

https://www.nytimes.com/2020/04/24/us/politics/trump-inject-disinfectant-bleach-coronavirus.html

But although companies and doctors have warned about such chemicals for years, officials around the country on Friday were fielding calls and questions about disinfectants and Covid-19. By the afternoon, Maryland’s hotline had received more than 100 calls on the subject, Mike Ricci, the spokesman for Gov. Larry Hogan, said on Twitter.

The calls prompted a response from the Maryland Emergency Management Agency: “Under no circumstances should any disinfectant product be administered into the body through injection, ingestion or any other route.”

https://www.rb.com/media/news/2020/april/improper-use-of-disinfectants/

Improper use of Disinfectants

Due to recent speculation and social media activity, RB (the makers of Lysol and Dettol) has been asked whether internal administration of disinfectants may be appropriate for investigation or use as a treatment for coronavirus (SARS-CoV-2).

As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route).  As with all products, our disinfectant and hygiene products should only be used as intended and in line with usage guidelines. Please read the label and safety information.

We have a responsibility in providing consumers with access to accurate, up-to-date information as advised by leading public health experts. For this and other myth-busting facts, please visit Covid-19facts.com.

For more information on our response to COVID-19, visit this link: Coronavirus information

https://www.thecloroxcompany.com/covid-19/learn-about-covid-19/clorox-statement-on-the-proper-use-of-disinfecting-products/

Clorox Statement on the Proper Use of Disinfecting Products

Bleach and other disinfectants are not suitable for consumption or injection under any circumstances. People should always read the label for proper usage instructions.

Disinfecting surfaces with bleach and other disinfecting products is one of the ways to help stop the spread of COVID-19, according to the Centers for Disease Control and Prevention.

Our products are safe when used properly. It’s critical that everyone understands the facts in order to keep themselves safe and healthy, which is why we continue to educate people about how to use disinfectants safely and effectively against COVID-19.

 

[Hapless Bills Fan]

Study from Yale on testing saliva samples vs nasopharangeal swabs.  They present evidence that the saliva testing may be more sensitive than NP swabs:

 

https://www.medrxiv.org/content/10.1101/2020.04.16.20067835v1#disqus_thread

 

When we compared SARS-CoV-2 detection from patient-matched nasopharyngeal and saliva samples, we found that saliva yielded greater detection sensitivity and consistency throughout the course of infection. Furthermore, we report less variability in self-sample collection of saliva. Taken together, our findings demonstrate that saliva is a viable and more sensitive alternative to nasopharyngeal swabs and could enable at-home self-administered sample collection for accurate large-scale SARS-CoV-2 testing.

 

Again, this is big if true because it totally takes away the need for specialized swabs and for PPE changes among test sample collectors - it is totally possible to give someone a sample container for saliva in a minimal contact manner and retrieve it the same way.  At times in the NYC outbreak, lack of NP swabs and PPE for sample collectors limited testing capacity.
 

 

 

[Hapless Bills Fan]

Two studies out looking at expression levels of the two proteins SARS-CoV2 uses to infect cells.

Both broadly agree on what cell types the virus is targeting.

 

https://www.technologynetworks.com/genomics/news/goblet-cells-may-play-a-significant-role-in-enabling-covid-19-infections-333911?fbclid=IwAR2yFnl7x7PUvQWG2QBvS61O5AkRM06gYQ5f3VOG81Mn5SfudfnnOSbUnPQ

 

The study revealed that two types of cells in the nasal passage --goblet and ciliated cells -- most highly expressed ACE2 and TMPRSS2. In addition, it found that ACE2 also is expressed in AT2 cells in the lungs. (....) In addition, researchers found expression of ACE2 in absorptive enterocytes within the gut, which could help explain why many COVID-19 patients have GI symptoms.

(they found expression elsewhere too, these were just cells expressing high levels of both proteins)

[Doc Brown]

Just wanted to put this tweet out there to give you an idea of how much the testing capacity has improved in a week.  Sadly, the deaths are still pretty high.

 

 

Edited April 26, 2020 by Doc Brown

[Hapless Bills Fan]

The Abbott rapid test may have a 15% false negative rate when tested against known positive samples. 

(Abbott says it's how the swabs were stored.  Lab medicine who did the study says "then prove it")

 

In use, clinicians are raising concerns that as many as 30% of their tests on patients who clinically have covid-19 may be false negatives.

 

https://medcitynews.com/2020/04/report-pathologist-says-abbotts-rapid-covid-19-test-produces-15-false-negative-rate/

 

OK so a couple people have PM'd me asking about this - does it mean it's a bad test and we need a better test?  Based on what I know of RT-PCR, it's actually a very sensitive test, one of the most sensitive, and the CDC-based test uses 3 sets of primers which should make it more sensitive.

My guess, based on prior experience of people in the medical field, is that the false negatives have more to do with
1) How the swab is taken - it has to really make it all the way back.  It's uncomfortable, even painful.  If the patient is given the swab and asked to do it him or herself (I have heard this happens), No Way.  I really hope saliva testing proves out, because it's just so much easier.
2) How the swab is stored and for how long, before testing.  Some places run out of viral storage medium, then the swab sits dry and the normal rate of degradation of virus on a surface applies

3) Where the patient is in the infection cycle.  If it's too early, not enough virus to detect.  If it's too late and they're recovering, their immune system may have taken care of those bad boys and not enough virus to detect.  If the virus isn't in the throat but has moved on to the lungs or GI system, ditto.

[Hapless Bills Fan]

https://weather.com/health/coronavirus/news/2020-04-26-coronavirus-found-on-pollution-particles

https://www.theguardian.com/environment/2020/apr/24/coronavirus-detected-particles-air-pollution

 

Coronavirus has been detected on particles of air pollution by scientists investigating whether this could enable it to be carried over longer distances and increase the number of people infected.
 

The work is preliminary and it is not yet known if the virus remains viable on pollution particles and in sufficient quantity to cause disease.
 

The Italian scientists used standard techniques to collect outdoor air pollution samples at one urban and one industrial site in Bergamo province and identified a gene highly specific to Covid-19 in multiple samples. The detection was confirmed by blind testing at an independent laboratory.
(....)
A statistical analysis by Setti’s team suggests higher levels of particle pollution could explain higher rates of infection in parts of northern Italy before a lockdown was imposed, an idea supported by another preliminary analysis. The region is one of the most polluted in Europe.

The preprint of the actual article: https://www.medrxiv.org/content/10.1101/2020.04.15.20065995v2
 

[Bear in mind this was found in an area with both high degree of pollution, AND high prevalence of covid-19 infection, and that it is testing for covid-19 genes, not live virus]

 

[ChevyVanMiller]

I thought this was the best piece I’ve read concerning the virus and properly reopening the economy.

 

https://www.forbes.com/sites/robertpearl/2020/04/21/3-coronavirus-facts/?fbclid=IwAR1MOx_u3E6JbDTY4BANFw_TUjC3u_UHpiuZizLLB01ZysCddbmg_SfJDls#2c22d4d04721
 

Just now, Hapless Bills Fan said:

 

Overall good read.  A few points:

1) Masks.  I doubt it's coincidence that the countries having the best success containing coronavirus are countries where people are wearing masks in public.  Not just servers in restaurants - EVERYONE.  Step out the front door, put on a mask.  If you're on an isolated forest path or trout stream, take it off, sure, but be ready to put it back on.  And not a freakin' tshirt, thong or scarf, either, a mask.  Make it a national priority to get one for everyone. 

Mask doesn't mean you're a weenie cowering in fear, it means you're a chivalrous Knight, showing concern for those weaker than yourself.

2) Too vague about protecting the vulnerable.  it's not enough to provide food, housing and safe transport.  Many elderly need far more care, and far more intimate, care.  Those who care for them MUST be tested regularly, and MUST be provided with not only PPE, but with medical care and with paid time off to quarantine.  Nursing homes and small hospitals were specifically exempted from the legislation passed requiring this.

3) The importance of saliva-based testing.  Emerging data showing it is as good as NP swab.  This MUST be verified and adopted.  The impact on PPE and testing supplies is huge.

4) In addition to health care workers and those caring for the vulnerable, testing needs to focus on industries where public contact is high (first responders, grocery stores, etc) and where quarters are unavoidably close (restaurant kitchens, meat packing plants, shipping warehouses)

 

5) It's not that the number of cases has gone beyond #testtraceisolate.  Part of the original point of social distancing was to bring cases back down to where test-trace-isolate could work.  However, it's become clear that the national leadership necessary to mobilize the country and implement a workable #testtraceisolate plan is going to be AWOL.  I could be wrong, but I don't think individual states acting individually can pull this off.

 

 

[SlimShady'sSpaceForce]

https://halosil.com/products/the-halo-disinfection-system/

 

HaloFogger® STD

 

The HaloFogger delivers complete surface disinfection throughout any room with the press of a button, delivering a precise amount of disinfectant solution to eliminate pathogens in a myriad of complex spaces found in healthcare, long-term care, and life sciences facilities, as well as in daycares, schools, athletic facilities and more.

 

Seems to be a method to kill virus'

 

 

late edit

$10 K per unit

[looks like it's essentially a hydrogen peroxide vaporizer with silver added.  probably works well.  hydrogen peroxide vapor is kind of the "gold standard" for disinfection]

[Hapless Bills Fan]

Independent review of antibody tests the FDA has allowed on the market without approval. 

 

Bottom line: most of them don't work very well and have unacceptable "false positive" rates.

 

Article about it: https://www.nytimes.com/2020/04/24/health/coronavirus-antibody-tests.html?utm_source=pocket-newtab

Group doing the work https://covidtestingproject.org/

Preprint manuscript: https://www.dropbox.com/s/cd1628cau09288a/SARS-CoV-2_Serology_Manuscript.pdf?dl=0

 

Each test was evaluated with the same set of blood samples: from 80 people known to be infected with the coronavirus, at different points after infection; 108 samples donated before the pandemic; and 52 samples from people who were positive for other viral infections but had tested negative for SARS-CoV-2.

Tests made by Sure Biotech and Wondfo Biotech, along with an in-house Elisa test, produced the fewest false positives.
 

A test made by Bioperfectus detected antibodies in 100 percent of the infected samples, but only after three weeks of infection. None of the tests did better than 80 percent until that time period, which was longer than expected, Dr. Hsu said. [Edit: IOW, until 3 weeks post-infection, there was at least 20% false-negative rate]   The lesson is that the tests are less likely to produce false negatives the longer ago the initial infection occurred, he said.
 

The tests were particularly variable when looking for a transient antibody that comes up soon after infection, called IgM, and more consistent in identifying a subsequent antibody, called IgG, that may signal longer-term immunity.

[plenzmd1]

 

18 minutes ago, Hapless Bills Fan said:

A bit more detail here, but can't find actual trial results yet.  It's certainly not amazing, but anything that might provide a treatment that shortens the course of hospitalization and keeps people out of ICU would be a huge help:

https://www.reuters.com/article/us-health-coronavirus-gilead-remdesivir-idUSKBN22B1T9

[Justin C]

https://www.newsweek.com/south-korea-experts-say-recovered-coronavirus-patients-retested-positive-because-dead-virus-parts-1500998

Quote

 

Health experts in South Korea are addressing the nation's growing incidence of former coronavirus patients who have retested positive for the disease after having previously recovered. According to Korea Centers for Disease Control and Prevention, figures published Wednesday indicated that 292 people countrywide had tested positive for the respiratory illness since initially contracting it and later testing negative, suggesting conceivable recovery from infection. However, discussing the upward trend in positive retests during a recent news conference, officials from KCDC's clinical committee for emerging disease control said the pattern does not necessarily reflect a reoccurrence of active infection.

 

Committee head Oh Myoung-don instead attributed positive test results following recovery to "dead," or inactive, virus components still present in patients' cells, multiple outlets based in South Korea reported on Wednesday.

 

"RNA fragments still can exist in a cell even if the virus is inactivated," Oh said during the conference, according to government-funded media organization Yonhap News Agency. "It is more likely that those who tested positive again picked up virus RNA that has already been inactivated," he continued, going on to explain that the coronavirus' biological interactions with human DNA strands show its lack of ability to "create chronic infections."

 

Still, concerns over South Korea's growing number of positive retests have circulated throughout April, as the number of second-time diagnoses among "recovered" individuals has steadily risen. Less than two weeks ago, KCDC reported that 163 patients had tested positive for the virus again following recovery and subsequent discharge from isolation. At the time, repeat diagnoses accounted for slightly more than 2 percent of the country's recovered population. On Wednesday, approximately 2.7 percent of previously recovered adults had tested positive for the coronavirus a second time, as well as 3.4 percent of children.

KCDC shared preliminary findings of an investigation into the retests on April 17, saying the average time between a recovered coronavirus patient's discharge and positive test result was roughly 13.5 days, with an overall range of one to 35 days. Of 137 cases studied, KCDC reported that 61 patients showed mild symptoms, 72 were asymptomatic and four were still being explored. The disease control center also said there were no secondary infections identified in any successive cases.

 

By Sunday, South Korea had confirmed 263 cases of positive test results in formerly recovered coronavirus patients, and KCDC said its investigation remained ongoing.

"Contact tracing on these re-positive cases is also underway to identify possibility of secondary infection," its April 26 report read. "No new case has yet been confirmed that resulted from exposure to the re-positive cases (during the period in which they were re-positive). The contacts are still under monitoring."

 

As of Wednesday morning, 10,761 coronavirus cases and 246 resulting deaths had been confirmed across South Korea, according to Johns Hopkins University's tracker. Reports from its Department of Health as well as KCDC show less than 15 people have tested positive for the first time each day since April 19.

 

 

I'd say that's good news.

[Edit: additional article on the topic https://time.com/5810454/coronavirus-immunity-reinfection/]
 

[Hapless Bills Fan]

https://www.npr.org/sections/health-shots/2020/04/29/848034963/antiviral-drug-remdesivir-shows-promise-for-treating-coronavirus-in-nih-study
 

Preliminary results of a major study of the antiviral drug remdesivir show it can help hospitalized patients with COVID-19 recover faster. Dr. Anthony Fauci hailed the findings, released Wednesday, as "quite good news."

Randomized, double-blind study of 1000 hospitalized patients in multiple countries: NIH released the results after an analysis by the data safety monitoring board overseeing the trial.

 

The preliminary results showed that patients who received remdesivir recovered 31% faster — the median time to recovery was 11 days rather than 15 days. The results also suggest a slightly lower mortality rate for the group receiving remdesivir, but until the complete data are analyzed, it's not certain if that effect is significant.  The study defined "recovery" as being well enough to be discharged from the hospital or returning to normal activity.

 

Fauci said that new studies will examine combining remdesivir with other drugs, such as an anti-inflammatory drug, to see how those compare with using remdesivir alone.

 

Actual trial results or preprint not yet available, and some are a bit nonplussed by this; they want to know what adverse events were seen before treatment begins.

 

https://www.nytimes.com/2020/04/29/health/gilead-remdesivir-coronavirus.html

 

A "senior administration official" says the FDA will issue emergency use approval for Remdesivir.

Note of caution: a smaller study from China published in the Lancet today showed no effect of Remdesivir, but did show significant adverse events:

Between Feb 6, 2020, and March 12, 2020, 237 patients were enrolled and randomly assigned to a treatment group (158 to remdesivir and 79 to placebo); one patient in the placebo group who withdrew after randomisation was not included in the ITT population. Remdesivir use was not associated with a difference in time to clinical improvement (hazard ratio 1·23 [95% CI 0·87–1·75]).

but in this study

Patients were permitted concomitant use of lopinavir–ritonavir, interferons, and corticosteroids. and

Remdesivir was stopped early because of adverse events in 18 (12%) patients versus four (5%) patients who stopped placebo early.
It's a smaller study and possible concurrent use of kaletra (lopinavir-ritonavir) as well as interferons and corticosteriods could have confounded any effects vs. placebo.

 

 

[Hapless Bills Fan]

A possible strategy to increase test throughput of asymptomatic people by combining samples:

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30362-5.pdf

 

The authors say they were able to combine up to 30 samples in a single RT-PCR test with acceptable sensitivity.  The idea is if you're testing a whole building of people, you bin them into pools and then only run individual tests if the pool sample is positive.  Hmmm.....in theory, could be a savings on limiting reagents. 

 

It still requires individual RNA extraction for each sample, which may be the limiting step in many places.

Israel and India are apparently also looking at this strategy:
https://www.newswise.com/coronavirus/pooling-method-for-accelerated-testing-of-covid-19/?article_id=728381

https://www.hindustantimes.com/india-news/india-takes-cue-from-israel-to-use-pooling-method-to-test-samples-for-covid-19/story-IFriWFUaLKR8euVT5WpQTM.html

Edit: these guys took it one step further and developed a pooling strategy to increase throughput 8 times, while still identifying individual positive samples.  The pooling itself takes significant time ("<5 hrs" with an automated robotic liquid handler).  But if reagents for running the tests are what is limiting, might be a good trade-off.

 

[Hapless Bills Fan]

How contact tracing works in Australia using a Google or Apple phone and bluetooth:

https://www.theguardian.com/australia-news/2020/apr/30/covid-safe-app-faq-review-how-to-download-australian-government-covidsafe-tracing-download-install-ios-app-store-iphone-phone-number-google-play-android-australia-coronavirus-tracking

 

There is a plan apparently to develop something similar in this country, but ?it is supposed to be developed individually by all 50 states with cooperation from Apple and Google? (sounds inefficient and likely to take longer):
https://www.cbsnews.com/news/on-the-trail-of-covid-19-contact-tracing-the-virus/?fbclid=IwAR1OygrDHh7QMHTkCwCrbVeSaum6bQZWwvHyYRrBN9GqO8KzpJmDIkhMfq0

A friend of mine who is employed at Google gave me some explanation of how this works (quoted by permission):
"So, the general idea is that you don't share any personal data -- only the random codes that you transmit via bluetooth. In the current plan, your phone only uploads even those impersonal codes to the state department of health if you get COVID-19 and you agree. The protocol itself doesn't track your location, so you only upload to your home state database. But, they perhaps might ask you what states you've been in lately, and share your group of codes to other states that you've been in.

Then, your app periodically downloads your state database, and compares the list of codes in the database to the codes it received via bluetooth. Presumably, you could download the database from another state if you've been there recently.

So, to handle the case of a truck driver who gets COVID, the home-state health department doesn't need to share anything more than "Here's a list of codes for an infected person who was in your state on Tuesday, May 23."

And to handle the case of the truck driver who's worried about picking up COVID on the road, he/she tells their app to grab Missouri, ... Colorado, ... California databases, and then it just works. The requests could be done as anonymously as any web page is. And, even if someone notices you, all they can deduce is that you were probably in Colorado on May 19.

This would all work fine with a national database, but the size of the database might be a little bit large. The database size is (14 days) * (16 bytes for each person's daily key) * (Total number of people who get COVID in the region per day) = 14 * 16 * 20,000 = 4 megabytes.

Actually, that's not especially huge. So, you could just have a national list, and it's all simple.  And, the download could be a bit clever. You tell the database 'I last downloaded yesterday evening at 22:32:05, just give me changes since then." and that'll cut the size of the download by 90% or so."

For those who say, "I don't have a smartphone, what about me?" your contact tracing would have to be done manually.  The suggestion is that you keep a written log of each day, where you went at what time, and known individuals you encountered so that you could protect their health and society's ability to stay open, by choosing to provide your log to public health, should you be tested positive.  But if an app can do automated contact tracing on, say, 30% of the population, it would help decrease manual contact tracing to a more manageable quantity.

[meazza]

https://www.cps.ca/en/documents/position/update-on-covid-19-epidemiology-and-impact-on-medical-care-in-children-april-2020

[ExiledInIllinois]

NOT sure if this was posted.  It has to have been updated during the previous weeks.  The floor part as vector is wild:

 

https://www.worldometers.info/coronavirus/transmission/

 

70% in ICU:

 

Floor

"The rate of positivity was relatively high for floor swab samples (ICU 7/10, 70%; GW 2/13, 15.4%), perhaps because of gravity and air flow causing most virus droplets to float to the ground.

In addition, as medical staff walk around the ward, the virus can be tracked all over the floor, as indicated by the 100% rate of positivity from the floor in the pharmacy, where there were no patients.

Furthermore, half of the samples from the soles of the ICU medical staff shoes tested positive. Therefore, the soles of medical staff shoes might function as carriers. The 3 weak positive results from the floor of dressing room 4 might also arise from these carriers. We highly recommend that persons disinfect shoe soles before walking out of wards containing COVID-19 patients." [source]

[Foxx]

CDC PDF

[sherpa]

My daughter works as a project manager for a national printing company, and they got their largest ever single order yesterday.

Half million dollar order for masks for the NYC Police Dept.

[Hap sez: I'm confused: has the printing company retooled to make masks, or is the NYPD having something printed on the mask? @sherpa, clarify?]

Edited May 2, 2020 by Hapless Bills Fan
request clarification