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So far there's been lots of speculation for #COVID19 asymptomatic carrier rate
—Mild or no symptoms: 60% nature.com/articles/d4158…
—"Some degree"—Fauci wsj.com/articles/why-i…
—Mild or no symptoms: 86% science.sciencemag.org/content/early/…
We really need to know this for people w/o symptoms
1/2
To resolve this we need a random mass screen of a diverse (age, gender, ancestry, geography) group without symptoms and shouldn't this undertaken straight away?
Thoughts?
@mlipsitchn @K_G_Andersen @trvrb @florian_krammer @CT_Bergstrom @JustinWolfers @Laurie_Garrett @mtosterholm
This essay from @mlipsitch reinforces how little we know compared with testing done in Asian countries, the very high asymptomatic rate
washingtonpost.com/outlook/2020/0…
"The feckless federal response created such delays in testing that most cases here are not being confirmed, even now"
More insights on the asymptomatic story via @cmyeaton
And 30%, if that holds up, is extremely high
Add this new preprint, via @AndyBiotech

The same viral load in asymptomatic vs symptomatic people
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Eric Topol
@EricTopol
March 25 curves from @FT's @jburnmurdoch
1. The US death curve slope even continues its steep course, passing Iran and now headed towards China's
2. The US has overtaken the rest of the world for cases; the absolute total N will soon exceed China and reach 100,000 by week's end
New York's death curve has flattened slightly since yesterday, but it is the worst look of all regions
Compare today's NY death curve (above) vs. yesterday (here)
You can see the flattening today and the doubling time for deaths from nearly 1 day shifted now towards 2. So that's at least one encouraging sign for NY and the US
Read 4 tweets
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Eric Topol
@EricTopol
It's good. But I would have changed the title and expanded.
nytimes.com/2020/03/25/opi… @nytopinion #COVID19
More on this important topic @JAMA_current
jamanetwork.com/journals/jama/… by @unmc's Andre Kalil
To reiterate: No adequate evidence for chloroquines and there is real risk. We need RCTs and trials to assess
Collateral damage from false propogation of drug claims in the midst of #COVID19
buzzfeednews.com/article/tanyac… @BuzzFeed
via @DrDave01
Read 3 tweets
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Eric Topol
@EricTopol
Proof that social | physical distancing works for #COVID19 for mitigation of spread science.sciencemag.org/content/early/… @ScienceMagazine today
by @MOUGK @svscarpino and collaborators, via @hholdenthorp important evidence we've needed and need to heed
The 1918 influenza mitigation (St Louis) replicated by the 2020 #COVID19 (China)
pnas.org/content/104/18… by @mlipsitch and colleagues
Why social | physical distancing CANNOT be quickly or prematurely relaxed
Modeling for China's #COVID19 data
thelancet.com/journals/lanpu… @TheLancetPH
Fully backs up the @Science paper today on the big impact of this mitigation strategy
Read 4 tweets

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Eric
@amerix
Let us crunch Italy numbers:

Last year 2019, a total of 99,570 people died in Lombardy.

The death rate was 10.5 in 1000.

In 2020, the death rate is 10.6 in 1000.

What does this say?

Could we just be blaming the #COVIDー19 yet people die in droves daily in Italy?
In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 flu cases in Italy.

More than 68,000 deaths.

Italy showed a higher influenza attributable to excess mortality compared to other European countries especially in the elderly.

#COVIDー19
This is actually a credible study.

'The high number of fragile very old subjects living in Italy'

I choose to be stoic.

Don't panic.

#COVIDー19 is a mild respiratory infection in 80% of our population.

Don't panic!
Read 4 tweets
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Amy Maxmen
@amymaxmen
I asked leaders @CDC @WHO & @jeremyfarrar how badly coronavirus is spreading under the radar in cities around the world. Spoiler: It’s bad. Here’s how they get a handle on community transmission when many people aren’t tested & how to lessen disaster. nature.com/articles/d4158…
Epidemiologists have a few tricks for making ballpark estimates – important when true case # is unknown. Because estimate is uncertain, they look at several lines of evidence & see if results align. These models assess death tolls, genome sequences, travel routes & much more.
CDC dangerously dropped the ball w/testing but it employs incredible researchers who work overtime to investigate covert #COVID spread w/@trvb among many others. CDCs Armstrong: "Health departments will tell you this is the most complex public health emergency we have dealt with"
Read 6 tweets
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COVID19
@V2019N
WHO China joint mission #COVIDー19
COVID-19 is transmitted via droplets and fomites during close unprotected contact between an infector and infectee.

who.int/docs/default-s…
Not major drivers of transmission:
-airborne spread not been reported
(can be envisaged if certain aerosol-generating procedures are conducted in health care facilities)
-fecal shedding demonstrated from some patients, & viable virus identified in limited # case reports.
Household transmission studies underway, prelim studies ongoing in Guangdong est secondary attack rate in households ranges from 3-10%.
As COVID-19 is a newly identified pathogen, no known pre-existing immunity in humans. Everyone is assumed to be susceptible
Read 13 tweets
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Maryam Henein/ #Shadowbanned (Follows Appreciated)
@MaryamHenein
3 Arrests Inspected: Tales Of 🇨🇳China & Defection

#WuhanUSA connection
#Securitybreaches
#conspiracy
#vialsmuggling

@Jordan_Sather_
@santilli_pete
@CasparKashkin
@PatriotsSoapbox
@SGTreport
@o_rips
@Perpetualmaniac
@RedPill78F
@PrisonPlanet
@CeliaFarber
@rsbellmedia
Arrest #1: Is Charles Lieber A Fall Guy? A Strategic Scientist? A Double Agent?

Lieber, who is out on bail, is Harvard U Chair of Chemistry & Chemical Biology Dept. He is accused of lying to NIH & falsifying documents, states FBI CounterIntel Boston Squad Agent #RobertPlumb
Lieber received a cool 50K a month from China in living expenses & allegedly lied about his ties to the "Thousand Talents Plan" that reportedly welcomes treason. His expertise lies in nanoscience. Documents are sealed.

If found guilty, Lieber could face up to 5 years in prison.
Read 10 tweets
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Apothicaire Amoureux
@PotardDechaine
Je vous fais un oetit thread sur les molécules testées dans le traitement du #COVIDー19 #coronavirus et pourquoi la nouvelle de l’efficacité de la chloroquine est une connerie furieuse ET dangereuse.
Pour le moment il est utile de rappeler qu’aucun médicament n’a montré une efficacité clinique dans le traitement du #COVIDー19 et donc AUCUN médicament n’est autorisé dans cette indications. Les affabulations sur la chloroquine sont basées sur des études in vitro.
Donc, il faut attendre les résultats d’essais cliniques pour se lancer dans une telle conjecture. Si par hasard des résultats d’essais cliniques montraient l’efficacité d’une molécule ou d’une association de molécules, voici ce qui se passerait :
- l’OMS convoquerait un groupe ..
Read 17 tweets
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Natalie Exner Dean
@nataliexdean
As dozens of clinical trials are underway for #COVIDー19, a natural question is... why don’t we already have licensed treatments for other severe types of #coronavirus like #MERS and #SARS?

A thread.

nature.com/articles/d4158…
1/8 Types of therapies being considered for #COVIDー19 include antibodies and antivirals, like lopinavir (licensed for HIV) and remdesivir (developed for Ebola but shown to be ineffective in the recent PALM trial in DRC).
2/8 The challenge is that there is rarely a “homerun” with these products. They tend to have a weak/moderate effect, even when used early after symptom onset. Thus, we need randomized clinical trials to tell if they actually work.
Read 9 tweets

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