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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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On 3/13/2020 at 7:37 AM, NoName said:

Axios Vitals on the Coronavirus Testing delay: link

and

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Data: AEI; Table: Axios Visuals

Some of the nation’s best academic laboratories wanted to begin developing their own coronavirus diagnostic tests early last month, but were blocked by federal rules about test development.

Why it matters: The U.S. is woefully behind in mass deployment of tests to detect coronavirus, determine its spread and isolate hot spots. Once given the go-ahead to develop tests under more relaxed terms, some of these labs were able to get tests up and running in a matter of days.

Even though their testing capacity is usually limited, academic labs are particularly crucial to coronavirus testing because they’re attached to hospitals. That means that providers treating patients at these hospitals can receive tests results much more quickly than those who have to send samples to commercial, state or CDC labs.

  • Part of the overall problem with testing right now isn’t just that there aren’t enough tests available, but also that there can be long delays in determining whether patients are infected or not.

“They followed the standard process, but what needed to be in vision was that this was a once in a generation pathogen — a once in a generation epidemic,” former FDA Commissioner Scott Gottlieb told me.

The approval process for the academic labs highlights the clash between bureaucracy — which is in place for a reason — and the need to move quickly in the face of an emerging pandemic.

  • “I do understand the FDA’s viewpoint, which is there’s really a need to standardize testing and make sure test results are accurate,” said Charles Chiu, associate director of the University of California at San Francisco Clinical Microbiology Laboratory. But “this is something that probably should have been discussed from the get go when we first knew about the outbreak in China.”

Yes, but: Less than a dozen academic labs are currently running tests, although others have said they’re working on developing them.

  • The FDA posted relaxed testing guidelines on Feb. 29. Major commercial labs — like LabCorp and Quest — and smaller, non-academic private labs have also gotten tests prepared for operation since the announcement, in addition to academic labs — a total of more than 30 private labs, per the FDA. 16 were testing patients as of yesterday.
  • State public health labs are also running tests, but like the CDC and commercial labs, aren’t directly connected with care sites.
  • “The spread of the virus — it basically outstripped the guidance provided by the FDA,” Chiu said.

The other side: “In the U.S., we have policies in place that strike the right balance during public health emergencies of ensuring critical independent review by the scientific and public health experts and timely test availability,” FDA Commissioner Stephen Hahn said in a speech earlier this month..

  • “The CDC test is a high-quality test, and it’s important to remember that false negatives or positives can be detrimental to making sure we are treating patients early, without delay, and also not quarantining healthy individuals.”

How it happened: Benjamin Pinsky, Medical Director of the Clinical Virology Laboratory at Stanford, told me that his lab began working on a test in early February, following the FDA guidelines at the time. After the FDA posted its more relaxed guidance, it took the lab only days to validate its test.

  • “We were waiting for the FDA to make a decision about how they would handle clinical laboratory testing,” Pinsky said. “My goal was to be prepared as soon as they were ready to allow clinical labs to start testing.”
  • Stanford got permission to begin testing on March 2 and began doing so on March 4. By the end of the day, Santa Clara County had already confirmed 14 cases, meaning that community spread was already underway.

The lab in San Francisco asked in early February if it could develop its own lab test under less extreme requirements, but the FDA said that the lab would have to instead go through the more stringent emergency use authorization process, per regulation.

  • “We were trying to submit a clinical [lab-developed test] or develop a clinical [test] for [emergency-use authorization] approval, and the issue with it was it was delayed and that was because the FDA’s requirements were quite stringent,” Chiu said. “The FDA was making it too laborious…it would take too long to actually get approval.”
  • And at that point, with the more severe requirements in place, the lab felt that it would make more sense to wait for commercial labs to develop tests rather than creating their own.
  • “I think that it would have been helpful had some of the new guidance come out earlier so that laboratories would have had more time, whereas now we’re scrambling to meet demand,” Chiu said.

And on the East Coast, Karen Carroll, director of the Division of Medical Microbiology at Johns Hopkins, said that her lab had tried to get the CDC testing kit, but was denied access.

  • “The CDC said we were not a public health laboratory and they were only making the kits available to public health” labs, Carroll said. It was eventually discovered that the kits weren’t working.
  • The lab eventually made its own test after the requirements were relaxed. It took four days.

As reported by the New York Times, the University of Washington had also wanted to develop its own test, and around mid-February, grew frustrated with the FDA’s process.

The bottom line: As of yesterday, the U.S. has the capacity to test about 22,000 people a day, although it's unclear how many people are actually being tested. South Korea — which has a significantly smaller population — is testing nearly 20,000 people a day, the BBC reports.

 

this is basically the chart that pasted weird above:

 

ES8CnLRWsAEK2JA.jpg

 

Good stuff.  That lower chart has to be bullshit, though.

You can't tell me there's zero testing capacity in the state of Texas, among several others.

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Just now, Sbbruin said:

That IS terrifying.  What is being done to increase the number of ventilators?

this isn't something that can just be ramped up - guessing the shutdowns in China really impacted the ability to do this and guessing that very few manufactures are even set up to "build" these in the States

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Heads up that German and French docs apparently are seeing an association between taking NSAIDS and having a complicated course of Covid-19.  This appears to be the case association particularly in the young people with the illness.

So maybe avoid all NSAIDS (aspirin, ibuprofen, naproxen, etc.).  Ask your prescriber first before stopping if you take it for prescribed purposes.

 

 

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7 hours ago, Hook1997 said:

My FB feed is 75% “the Democrats did this” and  “it’s just the flu”....   I grew up in a small town full of idiots so that’s most of them..   Asked a women I have chatted with from bumble that lives in Houston if she was ready to stay home for a couple weeks, I got “oh god you’re one of those”.    My lord people are fucking stupid.  She has a great rack but I’m starting to think it’s not worth it to play down to idiots to see them in person. 

On behalf of Surly, we think you're wrong.

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1 minute ago, TwiceHorn said:

Good stuff.  That lower chart has to be bullshit, though.

You can't tell me there's zero testing capacity in the state of Texas, among several others.

this was on Friday fwiw. 

from their text: AEI’s Health Policy team is actively tracking COVID-19 lab test capacity in the United States. Their comprehensive list details the number of patients per day that could be tested in academic, reference, clinical, and public health laboratories nationwide. Follow them on Twitter @COVID2019tests to stay up-to-date with the latest breaking news.

From the DSHS site: https://www.dshs.state.tx.us/coronavirus/

Quote

Texas public health labs now have the capacity to test at least 273 people per day, with more private labs coming online every day. Testing will continue to expand through both public and private labs. Private testing will far exceed what is available through the public health system.

Evidently there are about 10 state labs that can do this? here is the updated chart from about 30 min ago via their twitter (https://twitter.com/COVID2019tests

i assume it is falling into the highlighted "Public Health Labs Nationwide" row?

oKifeB4p

 

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8 minutes ago, triplehorn said:

Heads up that German and French docs apparently are seeing an association between taking NSAIDS and having a complicated course of Covid-19.  This appears to be the case association particularly in the young people with the illness.

So maybe avoid all NSAIDS (aspirin, ibuprofen, naproxen, etc.).  Ask your prescriber first before stopping if you take it for prescribed purposes.

 

 

Well shit. I started taking Alleve about 6 months ago for arthritis in my bum knee and it has changed my quality of life. Getting off of it is going to suck balls. 

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14 minutes ago, brakeman said:

My patient just told me a lot of the families in her hood have traveled to the outer banks once their kids schools closed. wow. so fucked up.  oh boy its a vacation.

This is why schools shouldn't be cancelled.  We've passed the buck onto a realm that we can't control and encouraged intercommunity spread.

Singapore is using their schools as a proxy to monitor communities for the disease.  Teachers are recording the temperatures and attendence of all their students each day.  Slight fever?  Get quarantined.

Edited by JBJ
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2 minutes ago, GreenspointTexas said:

Jesus christ impose a fucking mandatory quarantine already

 

we have the template, given to us by the rest of the world. And the ability to see into the future

 

fucking do something, govt. close everything now. All they fucking care about are numbers

No bro, y'all are in Texas, not Commiefornia.  Maybe you can just shoot Coronavirus? 

.  

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9 minutes ago, SimonBolivar said:

Man I'm worthless at work this morning. I'm nothing but a future carrier who has nearly 0 productivity.  I cant be the only one like that today, just too much stuff going on.

I convinced my wife to forgo hitting the gym ever morning (she goes at 5:30am 6 days a week)  This morning she woke me up @5 and was like "hey I'm not working out at home alone"

Nothing like hitting the weights hard before the sun comes up...   so yeah, I'm not tippy top today

Edited by Loco
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This is why schools shouldn't be cancelled.  We've passed the buck onto a realm that we can't control and encouraged intercommunity spread.
Singapore is using their schools as a proxy to monitor communities for the disease.  Teachers are recording the temperatures and attendence of all their students each day.  Slight fever?  Get quarantined.
I don't understand this. It seems like keeping kids out of school would improve the situation, even if it is imperfect.
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4 minutes ago, crimsonlonghorn said:

Well shit. I started taking Alleve about 6 months ago for arthritis in my bum knee and it has changed my quality of life. Getting off of it is going to suck balls. 

Is that article referring to people that take those as fever reducers when you get the virus and a fever?  That would be pretty bad if it gives you a fever and then the virus fucks you up even worse if you try and take something to help lower said fever.

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I convinced my wife to forgo hitting the gym ever morning (she goes at 5:30am 6 days a week)  This morning she woke me up @5 and was like "hey I not working out at home alone"
Nothing like hitting the weights hard before the sun comes up...   so yeah, I'm not tippy top today
Same. I had to use a lot of persuasion to get her to stay home. We have Peloton, treadmill, olympic weights, dumbells, pretty much everything she wants, but it was like pulling teeth to get her to stay here. It's astonishing to me that her gym is even open.
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Just now, Mikey4 said:
5 minutes ago, Loco said:
I convinced my wife to forgo hitting the gym ever morning (she goes at 5:30am 6 days a week)  This morning she woke me up @5 and was like "hey I not working out at home alone"
Nothing like hitting the weights hard before the sun comes up...   so yeah, I'm not tippy top today

Same. I had to use a lot of persuasion to get her to stay home. We have Peloton, treadmill, olympic weights, dumbells, pretty much everything she wants, but it was like pulling teeth to get her to stay here. It's astonishing to me that her gym is even open.

Was she really working out or was the gym just social hour, holding a green juice and taking selfies? 

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Just now, Mikey4 said:
6 minutes ago, Loco said:
I convinced my wife to forgo hitting the gym ever morning (she goes at 5:30am 6 days a week)  This morning she woke me up @5 and was like "hey I not working out at home alone"
Nothing like hitting the weights hard before the sun comes up...   so yeah, I'm not tippy top today

Same. I had to use a lot of persuasion to get her to stay home. We have Peloton, treadmill, olympic weights, dumbells, pretty much everything she wants, but it was like pulling teeth to get her to stay here. It's astonishing to me that her gym is even open.

Same. She was begging me to go to pilates this weekend. People just dont get it

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Just now, Js1 said:

Was she really working out or was the gym just social hour, holding a green juice and taking selfies? 

well the gym we go to is a HIIT gym.  So there isn't any standing around waiting for machines etc....  It's also ass kicking.  She goes in the morning I go in the afternoon.  (just personal preference)  We have kettlebells & dumbells/bench at home.  The one downside of HIIT is that you can't really do an effective heavy weight session (I don't really lift, bro)

I have been telling her to mix up some heavy weights/lifting...  so this seemed like a good opportunity.  My shoulders are fucking toast right now.

 

back to corona news

 

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2 hours ago, Bevo said:

I was speaking with an old friend of mine who is a PhD in Biochem and runs a biology research company (like Qiagen, Takara, Invitrogen, etc.) in Duren, Germany. This is what he had to say:

These day are very strange here in Europe cause Corona does not allow us a normal life. I think you guys are not affected that much but here in Germany from today everything except supermarkets, pharmacies, post office and banks is closed.

We built multiple teams in order to have a back up just in case somebody will be infected.

 

 

 

Let me know if there is anything you want me to ask him.

Ask him why Germans like having women shit on their chests.

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Just now, Loco said:

The official surly recommendation was a 200mg edible... posted a while back.  Reported to be a total cure....60% of the time

Have we heard from hiim lately?  That was an insane amount to take.  I did 5mg of chocolate on Saturday and I was toast so you know where my tolerance is.

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18 minutes ago, Js1 said:

No bro, y'all are in Texas, not Commiefornia.  Maybe you can just shoot Coronavirus? 

.  

 

14 minutes ago, Fozzz said:

He certainly will close them but only after so many Texans needlessly contract/die from this bug.  

I'm guessing he will decide to close the bars & restaurants after the hospitals have been over run; thus closing the barn door after the horses have died.

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22 minutes ago, NoName said:

this was on Friday fwiw. 

from their text: AEI’s Health Policy team is actively tracking COVID-19 lab test capacity in the United States. Their comprehensive list details the number of patients per day that could be tested in academic, reference, clinical, and public health laboratories nationwide. Follow them on Twitter @COVID2019tests to stay up-to-date with the latest breaking news.

From the DSHS site: https://www.dshs.state.tx.us/coronavirus/

Evidently there are about 10 state labs that can do this? here is the updated chart from about 30 min ago via their twitter (https://twitter.com/COVID2019tests

i assume it is falling into the highlighted "Public Health Labs Nationwide" row?

oKifeB4p

 

I should clarify.  Unless and until we get an "antibody test," which doesn't require much in the way of specialized lab facilities, we were stuck with PCR testing.

I am quite certain that there are facilities in Texas that can do PCR testing.  At our several fine academic and research hospitals. They may not have had the right reagents or training, but they represent capacity.

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2 minutes ago, VABuckeye said:

Have we heard from hiim lately?  That was an insane amount to take.  I did 5mg of chocolate on Saturday and I was toast so you know where my tolerance is.

Same.  My guess is he macrame'd himself into a couch.

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2 minutes ago, atomheartbevo said:

Rumors are STAAR canceled.  

It's been reported by lots of media blue check marks on Twitter. Slightly past the rumor stage but before official announcement stage.

Whoops, that's what I get for going back to the thread before looking stuff up again. Some sites have quotes from Abbott so it's essentially official.

Edited by Huckleberry
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8 minutes ago, TwiceHorn said:

I am quite certain that there are facilities in Texas that can do PCR testing.  At our several fine academic and research hospitals. They may not have had the right reagents or training, but they represent capacity.

We were supposed to open two testing “clinics” this morning. Guess what, we only have a handful of swabs or viral medium to put them in. FML.  We are a third world country.

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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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