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Eric Feigl-Ding Profile picture
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23 Dec, 10 tweets, 5 min read
📍Huge blow—UK had halted plans to open rapid-turnaround #COVID19 tests across England amid concerns about the accuracy. Huge blow to UK’s £100bn “Operation Moonshot” mass-testing plan, to increase daily tests from 430k to 10mil. Poor 🇬🇧 case surging too.
theguardian.com/world/2020/dec…
2) Experts in testing and understand immunology like @michaelmina_lab think the test is good in capturing **INFECTIOUS** virus, which is key.
3) it indeed caught the critical high viral cases
4) The UK Birmingham study had serious methods problems.
5) there are MORE ACCURATE RAPID ANTIGEN tests like the Abbott PanBio test available in continental Europe. It’s cheap and relatively very accurate. See thread 🧵 below 👇
6) comparing nasal PanBio rapid antigen test vs Nasal PCR #COVID19 test:

➡️VERY good.

📌Sensitivity 98.1% (99.0% for samples with higher viral load PCR Ct<=33)

📌Specificity 99.8% (ie 0.2% false positive)

(Sensitivity is 91-94% vs deep nasopharyngeal PCR).
7) Thus, @michaelmina_lab thinks the lateral flow rapid antigen test is still indeed good for population screening.

Here is how they work.
8) For this reason, just yesterday, UK regulators also just gave the go-ahead for lateral flow devices (LFDs), which give results in 30 minutes, to be used at home by members of the public, with a few minor caveats.
dailymail.co.uk/news/article-9…
9) Notably, you can only use them to confirm you need to isolate - NOT to make decisions on whether to mix with family and friends. It should not be a passport to go party since it just focuses on active infectious status.
10) We really need rapid tests. Look how fast the epidemic is spreading in the UK recently. And especially among young people. But honestly all age groups.

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More from @DrEricDing

Eric Feigl-Ding Profile picture
25 Dec
⚠️Fecal aerosols... 9 infections in 3 families due to vertically shared toilet drainage pipes + aerosols from pipes.

To even prove it, tracer gas was released into drainage system of one unit & shown to come out of the other.

➡️Fecal airborne transmission is real. #COVID19
2) Potential scenario is infection through drainage system. U-traps typically act as water seals in each bathroom. But they can dry out if unused allowing aerosols from one unit to travel to another. Image
3) Thus is an amazingly detailed epidemiological study. They ruled out all other forms of transmission because the infected families had no other contact in their high rise. ncbi.nlm.nih.gov/pmc/articles/P… Image
Read 7 tweets
Eric Feigl-Ding Profile picture
25 Dec
2x HORRENDOUS tragedies—

—Nurse silenced by @YumaRegional hospital for speaking out about safety for security guards w/out adequate PPE

—Prison #COVID19 outbreak that has infected hundreds in Yuma, AZ prison—even killed the prison warden, and endangered prison staff & inmates.
2) The @YumaRegional hospital administration is so terrible and horrendous that key 🏥 are now resigning at high rates. Image
3) A huge wave of nurses have now resigned from @YumaRegional hospital. The security guards who weren’t given adequate PPEs also unable to speak up. Image
Read 7 tweets
Eric Feigl-Ding Profile picture
24 Dec
YOU CAN’T FIND MUTATIONS ==> IF YOU DON’T GENETIC 🧬 SEQUENCE.

Australia 🇦🇺 & New Zealand 🇳🇿 is leading the world of ~half of all viruses in their countries sequenced.

UK 🇬🇧 leads in total #SARSCoV2 samples sequenced.

USA 🇺🇸 ranks—#43 in % 🧬 sequenced. So #winning, not.🧵 Image
2) “Given the small fraction of U.S. infections that have been sequenced, the variant could already be in the United States without having been detected,” the CDC wrote on its website.
3) Remember the old saying, “No testing, no pandemic”?

📌Same goes for virus mutations. “No sequencing, no new mutated variants”

➡️We can’t be ostrich in the sand about this. To stop pandemic, we have to stay ahead of it—know when it’s changing or becoming more contagious. Image
Read 8 tweets
Eric Feigl-Ding Profile picture
24 Dec
On the brink—

📌Over 2 in 5 U.S. hospitals with intensive care units have reached occupancy levels of >=85%.

📌Contrast with early Oct, just 1 in 4 that full. #COVID19

📌The 85% occupancy’ is the threshold to trigger regional stay-at-home orders.
nytimes.com/interactive/20… Image
2) “When patients get really sick with Covid, they’re in the hospital for weeks,” said Dr. Arghavan Salles, a physician who has worked in I.C.U.s in New York and Arizona over the course of the pandemic. Image
3) “When patients get really sick with Covid, they’re in the hospital for weeks,” said Dr. @arghavan_salles, a physician who has worked in I.C.U.s in New York and Arizona over the course of the pandemic. Image
Read 5 tweets
Eric Feigl-Ding Profile picture
23 Dec
BIOLOGICAL SIGNIFICANCE B.1.1.7 🇬🇧 variant #SARSCoV2:

Read these 4 key circled sentences from @CovidGenomicsUK on why the mutations are worrisome.

Experts don’t think it will strongly affect vaccines, but some say maybe slightly.

See 🧵 for details. cogconsortium.uk/wp-content/upl…
2) This table also explains how much the variant B.1.1.7 has been seen recently. Notice how much of the total within last 28 days.
3) brand new details on the viral load.
Read 6 tweets
Eric Feigl-Ding Profile picture
23 Dec
💡New—VIRAL LOAD OF UK🇬🇧 b.1.1.7 VARIANT:

➡️New study by @OxfordViromics group indeed finds **higher viral load** for new variant w/ 501 mutation & 69-70 deletion.

📌How much higher? “Inferred viral loads were *3-fold higher* in people w/ new variant”.🧵
coronavirus-fraser-group.org/files/files/up…
2) Outside Greater London, the variant has higher viral loads. Within Greater London, the new variant does not have significantly higher viral loads. But this could be due to demographics, such as a faster variant growth rate in particular age-groups.
3) So is it higher or not? Or is it some London / non-London effect? ➡️ it’s really higher.

➡️In a multivariable model (adjusting mutually), what won was the B.1.1.7 variant’s 501Y mutation as key—**higher viral load**

❌London/other region interaction effect not significant.
Read 4 tweets

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