The Key to Defeating COVID-19 Already Exists. We Need to Start Using It

[aubiefifty 16,737]

19 hours ago, augolf1716 said:

Not really they sounded bad really really bad............ j/k fiddy j/k

who told on me dammit?  lol my problem is if i put it on youtube and then on here folks will know my real name and as many folks as i have pissed off it is a worry. grins

[homersapien 11,357]

3 hours ago, Grumps said:

Are you saying that you thought I meant that we should not have spent billions on tests that don't exist?

I am saying the post in question speaks for itself as a stand-alone statement:

"Does it seem odd to spend billions for testing for a condition that has no treatment?"

It also reinforces my interpretation that you were referring to spending billions on testing, period;  even if that's not what you meant to convey.

You weren't clear from the beginning and you failed to clarify until much later than you needed to. So just own that.  After all, I am willing to accept your late clarification now, simply based on your word. 

But I am not going to take personal responsibility for misunderstanding what you meant when my misunderstanding is based on your lack of clarification at the time and up until now.

capisce?

 

[Grumps 3,704]

2 hours ago, homersapien said:

I am saying the post in question speaks for itself as a stand-alone statement:

"Does it seem odd to spend billions for testing for a condition that has no treatment?"

It also reinforces my interpretation that you were referring to spending billions on testing, period;  even if that's not what you meant to convey.

You weren't clear from the beginning and you failed to clarify until much later than you needed to. So just own that.  After all, I am willing to accept your late clarification now, simply based on your word. 

But I am not going to take personal responsibility for misunderstanding what you meant when my misunderstanding is based on your lack of clarification at the time and up until now.

capisce?

 

I completely agree that the post in question speaks for itself!

It is absolutely referring to the testing that we have spent billions on. We have done almost 53 million tests. Most of them have been RNA nasal swabs. You already agreed with me on that, I thought. There is no treatment for COVID and a positive or a negative test makes no difference if the patient is already washing hands and wearing a mask and social distancing and staying at home.

That's why it seems odd to me. If you said, "Trump is pushing worthless tests so that his cronies can get richer." I would say you might be right. If you said, "Trump wants us to do as many tests as possible because it might make him better I would also say you might be right.

I'm not trying to blame you or anyone else. I just don't like us wasting money. If you don't think the money is wasted then we can disagree. If you don't think wasting money is bad then we can disagree again.

I promise that I won't bring this up again unless it is to discuss it with Medical Guy.

[homersapien 11,357]

5 hours ago, Grumps said:

I completely agree that the post in question speaks for itself!

It is absolutely referring to the testing that we have spent billions on. We have done almost 53 million tests. Most of them have been RNA nasal swabs. You already agreed with me on that, I thought. There is no treatment for COVID and a positive or a negative test makes no difference if the patient is already washing hands and wearing a mask and social distancing and staying at home.

That's why it seems odd to me. If you said, "Trump is pushing worthless tests so that his cronies can get richer." I would say you might be right. If you said, "Trump wants us to do as many tests as possible because it might make him better I would also say you might be right.

I'm not trying to blame you or anyone else. I just don't like us wasting money. If you don't think the money is wasted then we can disagree. If you don't think wasting money is bad then we can disagree again.

I promise that I won't bring this up again unless it is to discuss it with Medical Guy.

What a weasel you've become.    I had thought better of you.

[McLoofus 35,182]

More "wasting" "billions" on testing.

Quote

The National Institutes of Health awarded $248.7 million to seven companies to accelerate the development of new coronavirus diagnostic technologies as the country grapples with rising case numbers and testing shortages. The federal research agency expects some of the companies to potentially be able to perform hundreds of thousands of tests come September.

https://www.forbes.com/sites/katiejennings/2020/07/31/the-governments-shark-tank-style-coronavirus-testing-challenge-awards-250m-to-7-companies/?utm_source=TWITTER&utm_medium=social&utm_content=3540450424&utm_campaign=sprinklrForbesTechTwitter#7a720c777160

[Grumps 3,704]

2 hours ago, McLoofus said:

More "wasting" "billions" on testing.

https://www.forbes.com/sites/katiejennings/2020/07/31/the-governments-shark-tank-style-coronavirus-testing-challenge-awards-250m-to-7-companies/?utm_source=TWITTER&utm_medium=social&utm_content=3540450424&utm_campaign=sprinklrForbesTechTwitter#7a720c777160

You are too cute! All of you medical people think that the testing that we have performed and the development of "new coronavirus diagnostic technologies" is the same thing. Thanks for educating me!

[homersapien 11,357]

1 hour ago, Grumps said:

You are too cute! All of you medical people think that the testing that we have performed and the development of "new coronavirus diagnostic technologies" is the same thing. Thanks for educating me!

Where did you get that idea, Mr. "Begging the Question"?

You are the one who said we shouldn't be spending "billions" on testing when "it does nothing to change people's behavior".  Stop with the weaseling.  It's beneath you.  Just drop it if you have nothing else to say.

[SocialCircle 570]

On 7/29/2020 at 1:06 PM, AUDub said:

As Winston Churchill once said, "...don't try to be subtle or clever. Use a piledriver."

Some anvils need to be dropped.

https://www.realclearpolitics.com/articles/2020/08/04/an_effective_covid_treatment_the_media_continues_to_besmirch_143875.html

On Friday, July 31, in a column ostensibly dealing with health care “misinformation,” Washington Post media critic Margaret Sullivan opened by lambasting “fringe doctors spouting dangerous falsehoods about hydroxychloroquine as a COVID-19 wonder cure.”

Actually, it was Sullivan who was spouting dangerous falsehoods about this drug, something the Washington Post and much of the rest of the media have been doing for months. On May 15, the Post offered a stark warning to any Americans who may have taken hope in a possible therapy for COVID-19. In the newspaper’s telling, there was nothing unambiguous about the science -- or the politics -- of hydroxychloroquine: “Drug promoted by Trump as coronavirus game-changer increasingly linked to deaths,” blared the headline. Written by three Post staff writers, the story asserted that the effectiveness of hydroxychloroquine in treating COVID-19 is scant and that the drug is inherently unsafe. This claim is nonsense.

Biased against the use of hydroxychloroquine for COVID-19 -- and the Washington Post is hardly alone -- the paper described an April 21, 2020, drug study on U.S. Veterans Affairs patients hospitalized with the illness. It found a high death rate in patients taking the drug hydroxychloroquine. But this was a flawed study with a small sample, the main flaw being that the drug was given to the sickest patients who were already dying because of their age and severe pre-existing conditions. This study was quickly debunked. It had been posted on a non-peer-reviewed medical archive that specifically warns that studies posted on its website should not be reported in the media as established information.

Yet, the Post and countless other news outlets did just the opposite, making repeated claims that hydroxychloroquine was ineffective and caused serious cardiac problems. Nowhere was there any mention of the fact that COVID-19 damages the heart during infection, sometimes causing irregular and sometimes fatal heart rhythms in patients not taking the drug.

To a media unrelentingly hostile to Donald Trump, this meant that the president could be portrayed as recklessly promoting the use of a “dangerous” drug. Ignoring the refutation of the VA study in its May 15 article, the Washington Post cited a Brazil study published on April 24 in which a COVID trial using chloroquine (a related but different drug than hydroxychloroquine) was stopped because 11 patients treated with it died. The reporters never mentioned another problem with that study: The Brazilian doctors were giving their patients lethal cumulative doses of the drug.

On and on it has gone since then, in a circle of self-reinforcing commentary. Following the news that Trump was taking the drug himself, opinion hosts on cable news channels launched continual attacks on both hydroxychloroquine and the president. “This will kill you!” Fox News Channel’s Neil Cavuto exclaimed. “The president of the United States just acknowledge that he is taking hydroxychloroquine, a drug that [was] meant really to treat malaria and lupus.”

Washington Post reporters Ariana Cha and Laurie McGinley were back again on May 22, with a new article shouting out the new supposed news: “Antimalarial drug touted by President Trump is linked to increased risk of death in coronavirus patients, study says.” The media uproar this time was based on a large study just published in the Lancet. There was just one problem. The Lancet paper was fraudulent and it was quickly retracted.

However, the damage from the biased media storm was done and it was long-lasting. Continuing patient enrollment needed for early-use clinical trials of hydroxychloroquine dried up within a week. Patients were afraid to take the drug, doctors became afraid to prescribe it, pharmacies refused to fill prescriptions, and in a rush of incompetent analysis and non-existent senior leadership, the FDA revoked its Emergency Use Authorization for the drug.

So what is the real story on hydroxychloroquine? Here, briefly, is what we know:

When the COVID-19 pandemic began, a search was made for suitable antiviral therapies to use as treatment until a vaccine could be produced. One drug, hydroxychloroquine, was found to be the most effective and safe for use against the virus. Federal funds were used for clinical trials of it, but there was no guidance from Dr. Anthony Fauci or the NIH Treatment Guidelines Panel on what role the drug would play in the national pandemic response. Fauci seemed to be unaware that there actually was a national pandemic plan for respiratory viruses.

Following a careful regimen developed by doctors in France, some knowledgeable practicing U.S. physicians began prescribing hydroxychloroquine to patients still in the early phase of COVID infection. Its effects seemed dramatic. Patients still became sick, but for the most part they avoided hospitalization. In contrast --- and in error -- the NIH-funded studies somehow became focused on giving hydroxychloroquine to late-presenting hospitalized patients. This was in spite of the fact that unlike the drug’s early use in ambulatory patients, there was no real data to support the drug’s use in more severe hospitalized patients.

By April, it was clear that roughly seven days from the time of the first onset of symptoms, a COVID-19 infection could sometimes progress into a more radical late phase of severe disease with inflammation of the blood vessels in the body and immune system over-reactions. Many patients developed blood clots in their lungs and needed mechanical ventilation. Some needed kidney dialysis. In light of this pathological carnage, no antiviral drug could be expected to show much of an effect during this severe second stage of COVID.

On April 6, 2020, an international team of medical experts published an extensive study of hydroxychloroquine in more than 130,000 patients with connective tissue disorders. They reaffirmed that hydroxychloroquine was a safe drug with no serious side effects. The drug could safely be given to pregnant women and breast-feeding mothers. Consequently, countries such as China, Turkey, South Korea, India, Morocco, Algeria, and others began to use hydroxychloroquine widely and early in their national pandemic response. Doctors overseas were safely prescribing the drug based on clinical signs and symptoms because widespread testing was not available.

However, the NIH promoted a much different strategy for the United States. The “Fauci Strategy” was to keep early infected patients quarantined at home without treatment until they developed a shortness of breath and had to be admitted to a hospital. Then they would they be given hydroxychloroquine. The Food and Drug Administration cluelessly agreed to this doctrine and it stated in its hydroxychloroquine Emergency Use Authorization (EUA) that “hospitalized patients were likely to have a greater prospect of benefit (compared to ambulatory patients with mild illness).”

In reality just the opposite was true. This was a tragic mistake by Fauci and FDA Commissioner Dr. Stephen Hahn and it was a mistake that would cost the lives of thousands of Americans in the days to come.

At the same time, accumulating data showed remarkable results if hydroxychloroquine were given to patients early, during a seven-day window from the time of first symptom onset. If given during this window, most infections did not progress into the severe, lethal second stage of the disease. Patients still got sick, but they avoided hospitalization or the later transfer to an intensive care unit. In mid-April a high-level memo was sent to the FDA alerting them to the fact that the best use for hydroxychloroquine was for its early use in still ambulatory COVID patients. These patients were quarantined at home but were not short of breath and did not yet require supplemental oxygen and hospitalization.  

Failing to understand that COVID-19 could be a two-stage disease process, the FDA ignored the memo and, as previously mentioned, it withdrew its EUA for hydroxychloroquine based on flawed studies and clinical trials that were applicable only to late-stage COVID patients.

By now, however, some countries had already implemented early, aggressive, outpatient community treatment with hydroxychloroquine and within weeks were able to minimize their COVID deaths and bring their national pandemic under some degree of control.


In countries such as Great Britain and the United States, where the “Fauci-Hahn Strategy” was followed, there was a much higher death rate and an ever-increasing number of cases. COVID patients in the U.S. would continue to be quarantined at home and left untreated until they developed shortness of breath. Then they would be admitted to the hospital and given hydroxychloroquine outside the narrow window for the drug’s maximum effectiveness.

In further contrast, countries that started out with the “Fauci-Hahn Doctrine” and then later shifted their policy towards aggressive outpatient hydroxychloroquine use, after a brief lag period also saw a stunning rapid reduction in COVID mortality and hospital admissions.

Finally, several nations that had started using an aggressive early-use outpatient policy for hydroxychloroquine, including France and Switzerland, stopped this practice when the WHO temporarily withdrew its support for the drug. Five days after the publication of the fake Lancet study and the resulting media onslaught, Swiss politicians banned hydroxychloroquine use in the country from May 27 until June 11, when it was quickly reinstated.


The consequences of suddenly stopping hydroxychloroquine can be seen by examining a graph of the Case Fatality Ratio Index (nrCFR) for Switzerland. This is derived by dividing the number of daily new COVID fatalities by the new cases resolved over a period with a seven-day moving average. Looking at the evolution curve of the CFR it can be seen that during the weeks preceding the ban on hydroxychloroquine, the nrCFR index fluctuated between 3% and 5%.

Following a lag of 13 days after stopping outpatient hydroxychloroquine use, the country’s COVID-19 deaths increased four-fold and the nrCFR index stayed elevated at the highest level it had been since early in the COVID pandemic, oscillating at over 10%-15%. Early outpatient hydroxychloroquine was restarted June 11 but the four-fold “wave of excess lethality” lasted until June 22, after which the nrCFR rapidly returned to its background value. 

Here in our country, Fauci continued to ignore the ever accumulating and remarkable early-use data on hydroxychloroquine and he became focused on a new antiviral compound named remdesivir. This was an experimental drug that had to be given intravenously every day for five days. It was never suitable for major widespread outpatient or at-home use as part of a national pandemic plan. We now know now that remdesivir has no effect on overall COVID patient mortality and it costs thousands of dollars per patient.  

Hydroxychloroquine, by contrast, costs 60 cents a tablet, it can be taken at home, it fits in with the national pandemic plan for respiratory viruses, and a course of therapy simply requires swallowing three tablets in the first 24 hours followed by one tablet every 12 hours for five days.

There are now 53 studies that show positive results of hydroxychloroquine in COVID infections. There are 14 global studies that show neutral or negative results -- and 10 of them were of patients in very late stages of COVID-19, where no antiviral drug can be expected to have much effect. Of the remaining four studies, two come from the same University of Minnesota author. The other two are from the faulty Brazil paper, which should be retracted, and the fake Lancet paper, which was.

Millions of people are taking or have taken hydroxychloroquine in nations that have managed to get their national pandemic under some degree of control. Two recent, large, early-use clinical trials have been conducted by the Henry Ford Health System and at Mount Sinai showing a 51% and 47% lower mortality, respectively, in hospitalized patients given hydroxychloroquine. A recent study from Spain published on July 29, two days before Margaret Sullivan’s strafing of “fringe doctors,” shows a 66% reduction in COVID mortality in patients taking hydroxychloroquine. No serious side effects were reported in these studies and no epidemic of heartbeat abnormalities.

This is ground-shaking news. Why is it not being widely reported? Why is the American media trying to run the U.S. pandemic response with its own misinformation?

Steven Hatfill is a veteran virologist who helped establish the Rapid Hemorrhagic Fever Response Teams for the National Medical Disaster Unit in Kenya, Africa. He is an adjunct assistant professor in two departments at the George Washington University Medical Center where he teaches mass casualty medicine. He is principle author of the prophetic book “Three Seconds Until Midnight -- Preparing for the Next Pandemic,” published by Amazon in 2019

[savorytiger 182]

https://sciencebasedmedicine.org/hydroxychloroquine-to-treat-covid-19-evidence-cant-seem-to-kill-it/

Also feel free to search for Hydroxychloroquine in 

https://www.aafp.org/journals/afp/explore/covid-19-daily-briefs.html

No idea how there are "53 studies that show positive results of hydroxychloroquine in COVID infections". Would be nice if your article actually linked one. 

[SocialCircle 570]

15 hours ago, savorytiger said:

https://sciencebasedmedicine.org/hydroxychloroquine-to-treat-covid-19-evidence-cant-seem-to-kill-it/

Also feel free to search for Hydroxychloroquine in 

https://www.aafp.org/journals/afp/explore/covid-19-daily-briefs.html

No idea how there are "53 studies that show positive results of hydroxychloroquine in COVID infections". Would be nice if your article actually linked one. 

Has this one been posted yet?  It is hard to keep up. If so, you have my apologies. 

https://hcqtrial.com/

 

 

Also, since the president of Brazil (who is 65, btw) has tested positive for the virus, he's begun the hydroxychloroquine regimen and is already responding well to the treatment. He's also pushing more to have the drug to dispense to all who need it earlier in the diagnosis, so we'll see over the next couple of weeks or so if the number of fatalities come down appreciably in Brazil. 

 

 

[savorytiger 182]

3 hours ago, SocialCircle said:

Has this one been posted yet?  It is hard to keep up. If so, you have my apologies. 

https://hcqtrial.com/

 

 

Also, since the president of Brazil (who is 65, btw) has tested positive for the virus, he's begun the hydroxychloroquine regimen and is already responding well to the treatment. He's also pushing more to have the drug to dispense to all who need it earlier in the diagnosis, so we'll see over the next couple of weeks or so if the number of fatalities come down appreciably in Brazil. 

 

 

Has not been posted, and after looking into it a bit, it seems like it's pretty much propoganda. This isn't an actual research paper, isn't actually looking to be published, nor would it pass any peer review. Just because you put the word "randomized" and "trial" in the title doesn't make it a randomized trial. The majority of their reference links at the bottom is to Twitter posts. There's no information on the authors, and if you go to their Twitter, it's 8 posts all pushing HCQ. I only took the time to look at the last one because it's looking like it's worth less and less of my time, and yeah, complete nonsense. It's a made up graph with a link to an actual study that I actually linked before which did not find a significant difference in incidents of new illness between patients given HCQ and those given the placebo. 

EDIT: forgot about the president of Brazil, but again, multiple of anecdote is not data. The majority of people given proper care for this virus get better, and just because someone too HCQ when they got it doesn't mean it's the reason they didn't die. If fatalities do fall in Brazil along with higher usage of the drug, then maybe more trials should be done. As of now though, it's looking like it doesn't even effect lung cells: https://www.nature.com/articles/s41586-020-2575-3

[SocialCircle 570]

1 hour ago, savorytiger said:

Has not been posted, and after looking into it a bit, it seems like it's pretty much propoganda. This isn't an actual research paper, isn't actually looking to be published, nor would it pass any peer review. Just because you put the word "randomized" and "trial" in the title doesn't make it a randomized trial. The majority of their reference links at the bottom is to Twitter posts. There's no information on the authors, and if you go to their Twitter, it's 8 posts all pushing HCQ. I only took the time to look at the last one because it's looking like it's worth less and less of my time, and yeah, complete nonsense. It's a made up graph with a link to an actual study that I actually linked before which did not find a significant difference in incidents of new illness between patients given HCQ and those given the placebo. 

EDIT: forgot about the president of Brazil, but again, multiple of anecdote is not data. The majority of people given proper care for this virus get better, and just because someone too HCQ when they got it doesn't mean it's the reason they didn't die. If fatalities do fall in Brazil along with higher usage of the drug, then maybe more trials should be done. As of now though, it's looking like it doesn't even effect lung cells: https://www.nature.com/articles/s41586-020-2575-3

What changed? 
 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

 

[SocialCircle 570]

1 hour ago, savorytiger said:

Has not been posted, and after looking into it a bit, it seems like it's pretty much propoganda. This isn't an actual research paper, isn't actually looking to be published, nor would it pass any peer review. Just because you put the word "randomized" and "trial" in the title doesn't make it a randomized trial. The majority of their reference links at the bottom is to Twitter posts. There's no information on the authors, and if you go to their Twitter, it's 8 posts all pushing HCQ. I only took the time to look at the last one because it's looking like it's worth less and less of my time, and yeah, complete nonsense. It's a made up graph with a link to an actual study that I actually linked before which did not find a significant difference in incidents of new illness between patients given HCQ and those given the placebo. 

EDIT: forgot about the president of Brazil, but again, multiple of anecdote is not data. The majority of people given proper care for this virus get better, and just because someone too HCQ when they got it doesn't mean it's the reason they didn't die. If fatalities do fall in Brazil along with higher usage of the drug, then maybe more trials should be done. As of now though, it's looking like it doesn't even effect lung cells: https://www.nature.com/articles/s41586-020-2575-3

We are the world 

https://c19study.com

 

[SaturdayGT 719]

27 minutes ago, SocialCircle said:

We are the world 

https://c19study.com

 

  Well, in the name of science, we spend billions of tax payers money to form ideal conclusions for the public that will disagree with this post,  and rather, promote opinions that favor a more ideal scenario for our future for all of our sakes!....nothing political...scouts honor!

[savorytiger 182]

31 minutes ago, SocialCircle said:

What changed? 
 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

 

Between that outbreak and this one? Not sure, since I'm not an immunologist. That article is one reason why research is being put into HCQ. However, the results are not being replicated: https://www.nature.com/articles/s41586-020-2558-4 

14 minutes ago, SocialCircle said:

We are the world 

https://c19study.com

 

You know that's the exact same source, right? Both CovidAnalysis? Anyway, I still went through some of them. Did not see any randomized trial that supports HCQ (the positive ones). If you do find one, feel free to share. The "Inconclusive" ones show that HCQ did not help, which I would say is negative to the assertion that HCQ is a cure. Pretty obvious that there's a bias there.

[wdefromtx 3,159]

If a doctor has success treating Covid with HCQ then they should have the latitude to keep doing so. Is it the silver bullet to stop it? No. But if it can save some lives then great. I don’t think anyone would argue with that. Should we all consider it the gold standard because Trump touted it? No. But we shouldn’t dismiss it completely because he touted it either. Bottom line is if I’m laying in a hospital bed and my doctor thinks HCQ might help me recover or keep me off a ventilator then I’ll try it. 

[SocialCircle 570]

9 hours ago, wdefromtx said:

If a doctor has success treating Covid with HCQ then they should have the latitude to keep doing so. Is it the silver bullet to stop it? No. But if it can save some lives then great. I don’t think anyone would argue with that. Should we all consider it the gold standard because Trump touted it? No. But we shouldn’t dismiss it completely because he touted it either. Bottom line is if I’m laying in a hospital bed and my doctor thinks HCQ might help me recover or keep me off a ventilator then I’ll try it. 

I mostly agree except I already have a doctor who will prescribe this regimen to me should I catch this virus and I will call them immediately should I catch it. If I were a healthcare worker seeing COVID-19 patients I would already be on the regimen. 

[SocialCircle 570]

11 hours ago, savorytiger said:

Between that outbreak and this one? Not sure, since I'm not an immunologist. That article is one reason why research is being put into HCQ. However, the results are not being replicated: https://www.nature.com/articles/s41586-020-2558-4 

You know that's the exact same source, right? Both CovidAnalysis? Anyway, I still went through some of them. Did not see any randomized trial that supports HCQ (the positive ones). If you do find one, feel free to share. The "Inconclusive" ones show that HCQ did not help, which I would say is negative to the assertion that HCQ is a cure. Pretty obvious that there's a bias there.

No what changed as it relates to the impact on lung cells? 

[wdefromtx 3,159]

1 hour ago, SocialCircle said:

I mostly agree except I already have a doctor who will prescribe this regimen to me should I catch this virus and I will call them immediately should I catch it. If I were a healthcare worker seeing COVID-19 patients I would already be on the regimen. 

And that is your choice as it should. I am just saying we need the option, but it isn't the "silver bullet" cure for everyone.

[Grumps 3,704]

https://www.harvardmagazine.com/2020/08/covid-19-test-for-public-health

Failing the Coronavirus-Testing Test

by JONATHAN SHAW

8.3.20

Michael Mina

Photograph by Sarah Storrer

 

 

“AT THE MOMENT, THE UNITED STATES has no semblance of public-health testing” for the coronavirus, says Michael Mina, an assistant professor of epidemiology at both Harvard Medical School and the Harvard T.H. Chan School of Public Health. What does Mina—an expert in viral testing protocols—mean by that?

Current tests for active infection with SARS-CoV-2 are highly sensitive—but most are given to suspected COVID-19 patients long after the infected person has stopped transmitting the virus to others. That means the results are virtually useless for public-health efforts to contain the raging pandemic. These PCR (polymerase chain reaction) tests, which amplify viral RNA to detectable levels, are used by physicians, often in hospital settings, to help guide clinical care for individual patients. In general, members of the public have not had access to such tests outside clinical settings, but even if they did, would find them too expensive for frequent use.

Furthermore, such tests detect tiny fragments of viral RNA even after the patient has recovered. Mina says that means “the vast majority of PCR positive tests we currently collect in this country are actually finding people long after they have ceased to be infectious.” In that sense, a positive result can be misleading, because the results can’t be relied on to guide the epidemiological efforts of public-health officials, which are focused on preventing transmission and controlling outbreaks: “The astounding realization is that all we’re doing with all of this testing is clogging up the testing infrastructure,” with results arriving a week or more after tests are administered, “and essentially finding people for whom we can’t even act because they are done transmitting.” In fact the testing backlog is so dire, and so “absolutely horrendously useless as a system for public-health surveillance,” that Mina believes the United States should at the very least throw away the millions and millions of samples that are waiting to be tested—and perhaps even halt the current testing regime and just start over.

“We need to change the whole script of what it means to test people,” he says. “In our country, we have always assumed that testing belongs in the clinical sphere, in the diagnostic sphere, and has to be run by laboratories or diagnosticians.  The result is that we have a system for coronavirus testing…which is flailing, with raging outbreaks occurring.” What the country needs instead are rapid tests, widely deployed, so that infectious individuals can be readily self-identified and isolated, breaking the chain of transmission.

 

 

To do that, Mina says, everyone must be tested, every couple of days, with $1, paper-based, at-home tests that are as easy to distribute and use as a pregnancy test: wake up in the morning, add saliva or nasal mucous to a tube of chemicals, wait 15 minutes, then dip a paper strip in the tube, and read the results. Such tests are feasible—a tiny company called E25Bio, and another called Sherlock Biosciences (a start-up spun out of Harvard’s Wyss Institute for Biologically Inspired Engineering and the Broad Institute in 2019) can deliver such tests—but they have not made it to the marketplace because their sensitivity is being compared to that of PCR tests.

Mina says that is beside the point. “Imagine you are a fire department,” he says, “and you want to make sure that you catch all the fires that are burning so you can put them out. You don’t want a test that’s going to detect every time somebody lights a match in their house—that would be crazy: you’d be driving everywhere and having absolutely no effect. You want a test that can detect every time somebody is walking the streets with a flame-thrower.”

 

FOR PUBLIC-HEALTH PURPOSES, speed and frequency of testing are vastly more important than sensitivity: the best test would actually be less sensitive than a PCR test. As Mina explains, when a person first becomes infected, there will be an incubation period when no test will reveal the infection, because the viral loads are so low. About “three to five days later, the PCR test will turn positive, and once that happens the virus is reproducing exponentially in a very predictable fashion.” At that point, critically, “even if a rapid test is 1,000 times less sensitive than a PCR test,” Mina says, the virus is increasing so rapidly that the test “will probably turn positive within eight to 15 or 24 hours. So the real window of time that we’re discussing here—the difference in sensitivity that makes people uncomfortable”—is so small that public-health officers would be missing very few asymptomatic people taking the test in that narrow window of time. Given that the current testing frequency in most states, using highly sensitive but expensive and delayed PCR tests, is not even once a month, he points out—“Really, it’s never.”

So even though a saliva-based paper test wouldn’t register a positive result for as long as a half or even a full day after the PCR test, it would have great value in identifying pockets of infection that might otherwise be undetected altogether. 

The strength of this system is that it would actually abrogate the need for contact tracing, says Mina. “If your goal is not to have a heavy hand over the population” (implementing onerous public-health restrictions on businesses and recreational activity), this is the way to do it, he explains, because it strips away “all of that complexity.” Most people who test positive will have done so before they become infectious, and can easily self-quarantine for the six days or so until they cease being infectious. Even if some people don’t quarantine, and the test cuts off just 90 percent of all the infections that might spread, “you’d immediately bring the population prevalence of the disease to very low numbers, to the point where all of a sudden society would start to look safe again.”

 

MINA HAS BEEN PREDICTING the advent of more widely available, cheaper tests for months. But those tests have not materialized, largely because of regulatory risk, he says: manufacturers cannot meet Food and Drug Administration (FDA) templates for test sensitivity that use PCR as the standard. The FDA—whose approval process is stringent because it is designed to test the efficacy of clinical diagnostics—has no jurisdiction over public-health testing. But at the moment, there is no alternative regulatory process for tests designed to ensure population-level wellness—such as a certification program that might be run through the Centers for Disease Control (CDC), the agency charged with safeguarding the public health.

“It is time to stop allowing diagnostic definitions to get in the way of absolutely essential public-health interventions,” says Mina, for whom explaining the distinction between the two types of test, and the different ways they can be used, has been an uphill battle. But it is one that he desperately hopes to win—and that the country needs him to win—for public-health measures to stand a chance of reining in the outbreak as schools and other institutions move toward reopening this fall.

The U.S. government has spent billions of dollars supporting attempts to develop vaccines and therapeutics. “Developing a good vaccine is very difficult to do,” he points out. “It’s a crapshoot that may or may not work. We’re putting billions more into developing therapeutics [treatments for COVID-19] which is really, really difficult.” With rapid testing, by contrast, “We have solutions, sitting in front of us right now, that are cheaper, would be much quicker to build, and much less risky to actually introduce and roll out. And the only thing standing in the way is that there just doesn't seem to be the will to bring a public-health tool to market.” 

The current cheap testing regimens were developed by just a handful of researchers, he says. “Imagine if the federal government just took over…to create an all-star team of diagnosticians centered around one of these technologies,” or even charged them with creating something brand new. “And then said, ‘We’re going to put billions of dollars into this, and it will allow us to stop the raging outbreaks that are burning in half the country right now. And we’ll do it in the next three weeks.’ That, to me, seems like a no-brainer: it takes the pressure off of needing a vaccine; it stops people from dying; it stops the virus from getting into schools and nursing homes—the moment population prevalence has been brought under control.” 

[homersapien 11,357]

  This:

“Imagine if the federal government just took over…to create an all-star team of diagnosticians centered around one of these technologies,” or even charged them with creating something brand new. “And then said, ‘We’re going to put billions of dollars into this, and it will allow us to stop the raging outbreaks that are burning in half the country right now. And we’ll do it in the next three weeks.’ That, to me, seems like a no-brainer: it takes the pressure off of needing a vaccine; it stops people from dying; it stops the virus from getting into schools and nursing homes—the moment population prevalence has been brought under control.” 

[McLoofus 35,182]

Cool. It seems like now everyone understands that more, better testing is the key.

[savorytiger 182]

4 hours ago, SocialCircle said:

No what changed as it relates to the impact on lung cells? 

I guess this isn't the easiest reading, but I'm not sure you're putting in the same effort I am. Anyway, from https://www.nature.com/articles/s41586-020-2575-3:

Quote

Chloroquine is a anti-malaria drug that is frequently employed for COVID-19 treatment since it inhibits SARS-CoV-2 spread in the kidney-derived cell line Vero^1–3. Here, we show that engineered expression of TMPRSS2, a cellular protease that activates SARS-CoV-2 for entry into lung cells⁴, renders SARS-CoV-2 infection of Vero cells insensitive to chloroquine. Moreover, we report that chloroquine does not block SARS-CoV-2 infection of the TMPRSS2-positive lung cell line Calu-3. These results indicate that chloroquine targets a pathway for viral activation that is not operative in lung cells and is unlikely to protect against SARS-CoV-2 spread in and between patients.

First line actually refers to the 2005 article you linked about how CQ inhibits COVID spead in kidney cells. Basically, nothing has changed on impact to lung cells. We're getting more information on the mechanisms how how COVID works, and these mechanisms indicate HCQ never worked on lung cells in the first place.

[savorytiger 182]

If you guys want to hear him actually talk about this stuff (along with the efficacy of batch testing):

A friend of mine pointed me at TWIV a week or so ago, and it's where I get a lot of my information from. 

[SocialCircle 570]

38 minutes ago, savorytiger said:

I guess this isn't the easiest reading, but I'm not sure you're putting in the same effort I am. Anyway, from https://www.nature.com/articles/s41586-020-2575-3:

First line actually refers to the 2005 article you linked about how CQ inhibits COVID spead in kidney cells. Basically, nothing has changed on impact to lung cells. We're getting more information on the mechanisms how how COVID works, and these mechanisms indicate HCQ never worked on lung cells in the first place.

This is why the regimen includes zinc. HCQ helps zinc get inside the infected cells to destroy the virus.