I’m glad tests are becoming more available... but not like this. Not for $130!!! 10x more than cost!

I’ll say it here, #COVID19 has become commoditized. Labs are making millions of $$$ bc people are desperate. This is not how public health should work

foxbusiness.com/lifestyle/cost…
This is for a saliva based PCR test. The test actually likely costs <$10.

Add overhead for staff and the lab. Maybe - MAYBE - get to $25. But $130. This is extortion in my opinion.
#SalivaDirect on the other hand (as one example) has made a strong concerted (and so far successful) effort to drop prices and raise awareness that these exorbitant prices need not exist

Not surprising - they are not-for-profit and doing what’s right

@awyllie13 @NathanGrubaugh
Many non-profit labs are taking high road. Using their physical set ups / skilled staff to do what’s right for people. Charging near cost (within reason) to do their part and help. Many are using SalivaDirect or similar assays as a good option - Ie for ease of EUA. This can work.
Also - to be clear - this isn’t the only lab. Many are charging similar rates. These high rates are due essentially solely to CMS agreed upon reimbursement rates. It’s part of the medical complex (that I’m a part of) that gauges customers - particularly those w out insurance.

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More from @michaelmina_lab

25 Oct
This is incredibly sad and bad news for the US.

In only 3 days, the 14-day average change in #COVID19 HOSPITALIZATIONS has skyrocketed from 7% to 15%!

This means hospitalizations are not simply increasing but accelerating upwards at a fast pace.

1/ Image
For the 14 day average change to >double in only 3 days means that the actual current change is much more than 15% (to pull a 14-day change that far up in only 3 days means the past three days have seen remarkably large increases).

2/
This is not some fear tactic. This is peoples lives. This is the proper functioning of our healthcare system (already stretched to the brim at baseline).

We are only at the beginning of this “spike” and it could continue accelerating up for months!

3/
Read 6 tweets
24 Oct
#COVID19 Cases at all time high.
#COVID19 Hospitalizations up 40% in last month

Deaths lag cases! Herd Immunity = deaths

Step 1) Stop Virus
Step 2) Open Up

Step 2 will NOT cause Step 1 without 100,000’s more deaths.
Step 1 WILL allow Step 2 to happen safely.

Solutions exist!
We don’t have a vaccine. Rx won’t bail us out

We must stop spread.
Economic/human fallout too costly for total shutdown

We must think creatively and can’t let perfection paralyze us

Simply, we must know who’s infectious and remove them

Frequent rapid tests can enable this
**Natural Herd Immunity that is **
Read 4 tweets
22 Oct
This happened faster than I expected, and I’ve been anticipating major upswings. We’re unfortunately just at the beginning

Going into fall w 60k cases/d means winter may well dwarf the spring and summer peaks

It’s up to us to change the course. But won’t w/out proper leadership
I’m referring to the fact that we are right back to our summertime peak. So early into this long winter.
This makes me mad as hell and really really sad. Not just for the ppl who will die (1000/d right now) but for the stores that will close, the families that will lose jobs, the health effects due to COVID and as important as anything else, the mental health effects that will occur
Read 5 tweets
21 Oct
Severe #COVID19 resulting from Original Antigenic Sin??

May be a contributor. Makes sense

Superb paper evaluating cross-reactivity between donor B cells targeting SARS-CoV-2 and other seasonal Coronas.

This figure (2) is really depicts it well...

1/

medrxiv.org/content/10.110…
This figure depicts one persons different B cells (x axis) across 3 different weeks in time, and how they react to SARS2 spike (y axis - broad categories) and how the secreted antibodies from those B cells reacts with other seasonal coronaviruses (y axis - smaller categories)

2/
What is remarkable is the change over time from day 9 to day 16 in the binding of antibodies to the seasonal coronavirus OC43 by B cells elicited by exposure to the SARS-CoV-2 Spike ectodomain (S ecto).

3/
Read 11 tweets
16 Oct
NEW! research shows rapid antigen tests can work in a real world setting - with asymptomatic and symptomatic people. The rapid "paper-strip" antigen test called the BinaxNOW detected >90% of people with high viral loads who are likely to be infectious
nytimes.com/2020/10/15/hea…

1/
I've written about the BinaxNOW from @abbottnews before and why these types of tests can be 'game changers' for our ability to combat this virus


2/
As expected... the BinaxNOW did NOT detect all PCR positive people... only ~60%

BUT DID detect >90% of those with high/contagious virus load. THESE ARE THE PPL THAT MATTER most when trying to cut off transmission chains.

3/
Read 20 tweets
14 Oct
Rapid test data!

@MarionKoopmans and team evaluate rapid “paper-strip” Ag tests against likely contagious virus samples

Here @AbbottNews PanBio and SD Biosensor rapid tests perform very well to detect infectious virus

But, not all tests are equal

medrxiv.org/content/10.110…
1/ Image
The authors evaluated a number of different tests against PCR positive and culture positive specimens. (Culture positive is generally appreciated as representing likely transmissible virus).

They find a large disparity across different tests...

2/
Against culturable virus, they find that the Abbott PanBio Test and the SD Biosensor (Neither available in the US right now) perform very well. An additional 3 tests were evaluated 2, also looked quoted good but the rapigen performed quite poorly.

3/
Read 4 tweets

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