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April 7th outlook for #COVID19 fatality curves:
1. The US flattening is easily seen now, but tops the chart and is headed towards 2,000/day
2. New York shows the same story compared with the other key regions and US states
ft.com/coronavirus-la…
If we're "lucky" the next 40 days for the US curve (dashed line) may look like this, with a long shoulder/plateau phase (due to wide spread, millions of confirmed cases) and very gradual descent
A couple of other comments on this regional graph
—Washington state's increased slope is quite concerning and it's a trend over ~ days
—New Jersey took a turn for the worse
(whether either is related to the "weekend" data delay effect is unclear)
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Eric Topol
@EricTopol
The route to reopen?
Testing at scale is needed, but that's not enough.
I wrote an oped on how we can use our digital infrastructure to guide us on the unchartered exit-ramp and avoid a 2nd wave rebound
washingtonpost.com/opinions/2020/… 1/x
Most are advocating some version of massive testing as the guide. But doing that for a country of 330 million people is very challenging, w/ uncertainties of the tests, the need to serially assess, and to plan for a long surveillance (e.g. 18 months) period
Full text here 2/x
Let's 1st review the tests.
For the virus, there's a problem with false negatives
For the antibody, it's a very challenging assay
And we don't know if having IgG levels confers protection from spreading, or how long it might protect 3/x
Read 10 tweets
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Eric Topol
@EricTopol
Big for #COVID19 therapy: the compassionate use results for remdesivir in 53 patients looks very encouraging, especially in very sick patients on mechanical ventilation with 18% fatality (only, expect > 50%) and overall 68% improvement nejm.org/doi/pdf/10.105… @NEJM
The previous reports of patients w/ #COVID19 who required intubation, on a ventilator, all have fatality rates >50%. That's historical controls from China, Italy, and the UK and go up to 93% fatality. We need more data for remdesivir but this really a good signal for efficacy.
Combine this clinical result with the structural biology from earlier today, pinpoint intervention (at atom level) of RdRp, the virus's replication and transcription machinery. Cool. Figure from that paper where R binds to the RNA-polymerase
Read 7 tweets
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Eric Topol
@EricTopol
The @CDCgov used to be regarded as exemplary, the model emulated by other countries. What happened w/ #COVID19?
bloomberg.com/news/articles/… by @FayCortez @jtozz @business
What I had to say about it
The UK via @ICNARC issues a detailed report every few days about their #COVID19 patients, including relevant demographics, ethnicity. UK is 20% of population of US.
What does @CDCgov make available to the US about our patients?
Blank.
Read 3 tweets

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