If you're baking a cake, maybe one you haven't tried before, do you set the oven at a temperature, cook it for exactly xyz minutes, then turn the oven off, pull the cake out and eat it? Or do you leave the oven on while you check the cake is baked, and if it isn't leave it in?
In PCR'land we don't take our tubes out & test them, but we "set and forget" to a MAX baking time (=total number of cycles; at 40-50). We come back at the end & see the results. Virus positive samples show up *before* the run is completely finished (15-30 cycles, with some later)
In the real-world RT-PCR result below you can see a bunch of positive curves for flu (the negatives are the flat lines underneath the red threshold).
Doesn't matter what the final cycle number is (how long the oven was on), just that it allows all the ingredients to be cooked.
Leaving the cake analogy now (because it would just get confusing).

Where the curve for each sample crosses that red threshold 👆is called the "threshold cycle", or Ct.
You can see that the Cts are very different in cycle number from the final cycles (the endpoint of the PCR).
In fact, every patient sample in that real-world example👆 has a slightly different Ct, just reflecting that every person has a slightly different amount of virus in their sample (affected by lots of things); sometimes not so slight!
Some other info and a stylised PCR curve showing the endpoint (starred; what most non-users confuse with Ct when talking about cycles)

Happy to answer real questions.

Resources...
🧬
🧬
🧬virologydownunder.com/putting-pcr-in…

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More from @MackayIM

18 Sep
A short thread on blocking to maintain your own mental health from others' aggression, bullying, anger, stupidity, trolling, disingenuity and abuse (of course, you can always log off social media to get a break from its negativity)
You don't have to follow me.
You don't have to read my ramblings.
You don't have to tell me what you think.
If you don't like what I'm writing, stop reading or block me.
I promise I won't mind. I probably won't even notice.
I don't owe you my time. I'm not your punching bag or assistant. I don't have to answer or tolerate your rude, trolling, maliciously deceptive questions or debate you because you want it. I'm here at my own cost for my own reasons.
Read 7 tweets
10 Sep
The first year of COVID-19 in Australia: direct and indirect health effects

aihw.gov.au/reports/burden…
A reminder of how vaccine development has been speeding up - but scicne and medicine did especially amazingly for this pandemic. A new benchmark?
A nice reminder that while most of COVID-19 is mild and moderate, a sizable portion is not at all - from hospitals through to death.
Polio was a rare outcome from poliovirus infection - but it wasn't something anyone wanted.
Vaccines work in these severe outcomes spaces.
Read 18 tweets
7 Sep
In Australia we are talking about lifting some restrictions once 70% of the eligible population is fully vaccinated ("double-dosed"); more will lift at 80%.
It's important to be fully aware that "70% of" anything often doesn't look like this - one homogenous group all at the same level.
Here the shape might be Australia, or all people, or one jurisdiction (e.g. a State, territory, building) or an age band (e.g. 16-25 year olds).
Overall, these two groups could, as an average of both ("=all of Australia"?), be considered vaccinated to a level of 70%.
And yet one group hasn't even cracked 70% fully vaccinated.
Read 5 tweets
28 Aug
In Victoria's (Aus) Wave 2 in 2020, there was a lag to hospitalisations (blue) following the initial wave of detections (orange). A small portion of those went to ICU and some died (black line). But in the current New South Wale's Wave 2...
...the daily number of COVID-19 cases hospitalised doesn't show that lag.
Is this due to a different policy for faster admission of cases, or home hospitalisation from the outset, or something else in NSW compared to VIC?

NSW sure got the testing amped up early on (green line)
I have no idea if there's a well-known & simple reason for this.

Chime in if you know it.

Data copied from covidlive.com.au
Read 7 tweets
11 Aug
This animal reservoir thing is not a factor in SARS-CoV-2 - the animal providing the virus opportunities, is us.
RVs, RSV - they don't have animal reservoirs. *We* are their reservoirs. So it seems like this person has no understanding of endemic respiratory viruses.
Summer respiratory viruses? Um. Summer flu? Every year. Enteroviruses which are in fact also spread by a respiratory route? Did this person miss the global bounce back of RSV as the world came out of Wave 1 COVID-19 lockdowns? That's traditionally not a summer virus.
Read 6 tweets
8 Aug
What would I do? Okay. Keeping in mind I'm not in the room, not an Epi and I don't run this stuff. So a big pinch of salt.
But to answer this question for people angry at me for negatively pointing out that NSW is putting the rest of Australia at risk..
..because they started too slow (my key point, which doesn't help now, I know).
I'd reset.
I'd look at what the most stringent of the "Lockdown" rollouts from anywhere in NZ and Aus (planned or enacted) is, add anything more that can be added, ensure food and money can get to..
..those who will suffer most, and roll that out across all of NSW at once, all the same. And lots of different Comms. There is more that can be added if today's Penrith additions are a guide. So do that. Set a new benchmark. And this has to be done before any more of those..
Read 10 tweets

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