New paper showing strong agreement between nasal (ie self collection) and nasopharyngeal swab on rapid test. This is an important finding since, in US, rapid tests currently authorized for nasopharyngeal swabs and thus need healthcare collections

1/ medrxiv.org/content/10.110…
These types of studies are needed to identify how well rapid antigen tests may work with self collected swab - essential for wide distribution and public health screening use of these tests to help curb outbreaks.

Other notable items from this paper:

2/
One is that the rapid antigen tests in this paper (SD Biosensor) performed very well up to a Ct of about 30. This is what we have expected for these tests and is likely at this rate to capture most infections with viable virus. Great for a public health screening test

3/
Another is the rapid test specificity was very good. 99.2% and 99.6% for the two swab types (likely just noise in the data driving difference). We are starting to see more rapid tests with higher specificities - great news. Particularly when paired together for confirmation

4/
Finally an interesting piece was that the antigen test did miss a case w a slightly higher RNA concentration. But the interesting piece is that the person was at 10 days since symptom onset.

5/
This matches data we’ve seen that shows that some people will retain even higher amounts of viral RNA despite being culture negative and no evidence of live virus. Not surprising. Think of it like a lot of DNA being left at a crime scene vs what is normally a small amount.

6/
So, all in all this paper agrees with what we have expected and with other data. And the most important is the concordance between the two swab types. A crucial piece of information towards home based self testing for public health screening.

7/7
This study also shows similar findings for SD Biosensor - very good sensitivity up to about a Ct of 30. They say 100% up to a Ct of 25 but if you dig into the supplementary data it does well up to 30. Misses two at 27 but catches others at 27-30+

medrxiv.org/content/10.110…

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Michael Mina

Michael Mina Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @michaelmina_lab

29 Oct
In light of the recent article from the UK discussing antibody waning - it’s important to read additional reports that show that while the antibodies are waning, they are not disappearing. This is expected and the natural course of an immune response.

1/
After a primary infection, antibodies go sky high - along with the cells that produce them - and then after the virus clears, those cells must subside and the antibody production falls. Antibodies this wane, almost by definition, after a primary infection

2/
Importantly, the antibodies do go down and, like in the UK report may fall below the limit of detection. But like in the @SciImmunology paper above by @florian_krammer among others, when a more sensitive test is used, they often remain detectable...

3/
Read 10 tweets
27 Oct
Eli Lilly’s antibody therapy unfortunately is not working in hospitalized patients. A blow to a hopeful “remedy” that could help tip the balance between risk of infections vs risk of economic fallout

But this isn’t the last of this story.. not by far

1/

nytimes.com/live/2020/10/2…
First, there are other antibody based therapies that are being developed, are in trials and new versions in early R&D phase.

Monoclonal antibodies have a huge potential and we mustn’t let this get us down.

2/
Regeneron’s monoclonal antibody therapy for example (the drug given to the president) remains in trials for hospitalized patients. This is but one of many that will be in trials!

3/
Read 7 tweets
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/
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
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
Read 5 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

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!