@koutterson Hi Kevin, thanks for highlighting this paper. After a first, quick read, it looks to me very similar to the earlier one in the Lancet. All patient received empirical antibiotic therapy and in it was apparently ineffective in all those who died.
@koutterson Furthermore, all deceased patients had sepsis as defined by "cytokine storm" criteria and lymphopenia as I understand it. However, the origin of the sepsis was never addressed: ie was it the result of extremely high titer virus in the blood or was it bacterial sepsis...
@koutterson ..., ie the result of a secondary bacterial infection in the bloodstream. This is what we need to know asap because if it is overwhelmingly bacterial sepsis, but depending on when & how fast it occurs, we could save many patients using correct antibiotic administration.
@koutterson And by correct antibiotic administration I am sure you know I mean administration following bacterial pathogen species identification and antibiotic susceptibility testing. The main problem is these are still mostly done by bacterial culture requiring methods the world over.
@koutterson But yet, sepsis kills fast, often within hours and the therapeutic window is tiny, ie 60-120 min maximum as I understand it. So, even PCR-based diagnotics would almost always take too long...
@koutterson Still, CARB-X now most appropriately includes a diagnostics stream. So, if I may ask, given your position, have you seen any cool POC diagnostic proposals come past your desk that could be fast tracked and then hopefully still deployed during the present pandemic?
@koutterson If not, do you know if other funding agencies have, and whether these projects could then be pushed forward instead? We desperately, desperately need them now me thinks, especially given the tragic scale this pandemic is taking.
@koutterson If we were to succeed in pushing this through in this utter emergency situation I would then hope these long, long awaited POC bacterial diagnostics would become & remain standard medical practise, first in hospitals and ultimately also, when prices came down, in community care.
@koutterson In fact, this might even become one of the most impactful silver linings of the horrifying crisis, don't you think? Along side a revolution in how we coordinate internationally to manage development other types of global common medical goods such as therapeutics and vaccines?
@koutterson To me these advances would be subservient only to a new global economic (& political?) world order, perhaps brought about by an entirely global & novel Marshall like plan still to be imagined but as I understand it already foreseen and discussed by @JeremyFarrar & @DreJoanneLiu.
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