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).
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!
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
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)
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).
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…
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
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...
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.
One piece that is so cool about this method is we do NOT need a time series of case data to create a trajectory (those little bars on @nytimes website or google that we’ve all stared at for the past 9 months to see trend up vs down in cases). We can do it from a single day!
We continue to see the use of the word “accurate” but accuracy depends on the target of interest. If the goal is to detect any evidence of virus at all (i.e. RNA remnants), then PCR will be more sensitive, more specific and overall more accurate.
However if the target is to detect VIABLE and thus likely transmissible virus - then it is possible that PCR can “overcall” positive results when in fact the sample contains just RNA and no viable virus.
People may think I'm too outlandish with this tweet. I've bitten my tongue for 9 months watching this president act against all good public health policy... for what? To make a point? Politics? To seem strong? I don't know what. But it has harmed our country in massive ways
The US has failed in incredible fashion to get this virus under control. There are innumerable things we could have done better - but unfortunately I'd say few have been aided by our president. He's advocated against public health policy and downplayed the virus since day 1
It is far too easy when thinking about public health to see successes. The very nature of public health is that success is largely invisible. Reporting that no cases transmitted day after day is simply not a story. So we focus on where things go awry - its natural to do so.
This is the same issue as vaccines and preventive healthcare, and public health in general. It does not get the funding it needs because its successes go unreported and undocumented... out of sight out of mind. But it is the daily undiscussed actions of public health that matter
Ct values aren’t perfect - but nor is listening to a heart or taking an X-ray. Nevertheless, these tests have their place when considered in context - as does the Ct value of the PCR
To discard is to throw out some of the most informative data we have about one’s infection
It can help determine whether a person is early or late in their course of infection. It can tell us about he direction of an epidemic. It holds immense value. We should consider its regular use as a crucial tool in this fight against COVID. Not toss it for its imperfections.
They are saying there are sufficient tests to be used daily or weekly by many many Americans in the coming weeks, but the actual number of tests they are distributing is no where near what is needed....
Distribution of 30 million rapid tests per month may sound like a lot, but across the US, it is 1 test per person per year!
This is not near the type of rapid test volume that is needed to make a major impact...